Vegan Burgers – Healthy & Yum Yum? Forget it!

If you count yourself among the one in three vegans choosing a plant-based diet for health reasons 1 , then think again before following the thronging crowds to pig out (if that’s not speciesist) on the growing range of vegan fast foods – particularly yummy burgers that try so hard to imitate those traditionally made from meat.

The article

A reader sent me an article, entitled “Vegan burgers can contain more saturated fat than TWO McDonald’s Big Macs” 2 , which basically expanded on what’s clear from the article’s title.

Saturated fat – what’s the problem?

Consuming even moderate quantities of saturated fat has been proven 3 4 5  to be a really dumb option – if, that is, you want to be healthy. Naturally, if you don’t care about your health and the length of your useful life, then eating foods with saturated fat – especially if they’re also accompanied by lots of sugar, oil, salt and cholesterol – will certainly titillate your taste buds, while, of course,  simultaneously totalling your ticker.

And it’s not just your heart that cringes when it sees those burgers or fatty patties approaching the hallowed doors of your intestinal tract. The following are just some of the conditions with strong links to saturated fat consumption 6 :

Oh, and I nearly forgot, also MS (Multiple Sclerosis), covered in detail in a previous blog 7 .

Surely vegan burgers can’t be that bad…they’re vegan!

This is the list of burgers mentioned in the article:

You’ll notice Marstons’ Moving Mountain’s B12 and Aldi’s  The Meat Free Butcher: Juicy Quarter Pounder vegan burgers each contain more saturated fat than a McDonald’s Big Mac, and the vegan All Bar One Beyond Burger has more than a standard McDonald’s hamburger. Only Iceland’s vegan No Bull Burger drops below the saturated fat content of McDonald’s meaty offerings.

What’s the recommended daily allowance of saturated fat?

The answer to this depends on whether you want to eat the recommended amount for normal people who end up having all the normal diseases. If so, then the UK government health recommendations 8 are that the average man aged 19-64 years should eat no more than 30 g of saturated fat a day, while the average woman aged 19-64 years should eat no more than 20 g of saturated fat a day. Less for people younger or older than this. Meanwhile, the US FDA recommendations9 are that less than 20 g per day should be eaten, based on a 2,000 calorie diet – higher or lower depending on calorie requirements.

However, if you want the hard truth about tolerable limits of saturated fat (or trans fats or cholesterol) the answer is that anything above zero is not tolerable. “The Institute of Medicine did not set upper limits for trans fat, saturated fat, and cholesterol because any intake level above zero increased bad cholesterol (LDL cholesterol).” 5 10

What’s the saturated fat in vegan burgers?

Usually it’s coconut oil – one of the few plant-derived foods that is not recommended at all as part of a WFPB diet. A previous blog 11 , entitled “Coconut Oil is ‘Pure Poison’ says Harvard Professor” dealt with this Frankenfood 12 in more detail.

Pause for a giggle

At the start of this Mirror online article about the dangers of processed vegan foods, it was rather ironic that the video-advert included was for another super-unhealthy ultra-processed food:

They just can’t stop themselves, can they?

Final thoughts

It’s no surprise that these ultra-processed 13 14 vegan burgers, and similar vegan fast foods, are modified in order to appeal to our vulnerable taste buds, in just the way that similar meat-based products are; but the fleeting buzz from all that fatty nonsense is always closely followed by a nasty sting. And whether you consciously feel it or not, the cells, tissues and organs within your body certainly do. You just have to look at some of the mass of research on dietary saturated fats, using brachial artery flow‐mediated dilation tests 15 16 17 18 19 20 21 22 , to see how much immediate damage is caused by consuming these foods.

Since coconut oil is 100% fat with 87% being saturated fat, my best advice to you is, if you come across a product that contains it, avoid it like the plague.

It gets repeated time and time again on this website, but the only way you can be absolutely certain you’re avoiding all these dietary pitfalls and food industry tricks is to eat the optimal diet for human health and longevity: a non-SOS WFPB diet.

Fancy a quick quiz?

Vegan Burgers

(All answers are contained in the article.)


How many people are reported to choose a vegan diet mainly for health reasons? 


Vegan burgers are always a healthier option than meat-based burgers. True/False?


Which is the major lipid (fat or oil) used in processed vegan burgers?

4. What percentage of coconut oil is saturated fat?
5. What is the US Institute of Medicine's recommendation regarding daily intake of saturated fat?


  1. Vegan Society: Why Go Vegan? []
  2. The Mirror: “Vegan burgers can contain more saturated fat than TWO McDonald’s Big Macs.”  13th February 2019. []
  3. Ann Nutr Metab. 2017 Apr; 70(1): 26–33. Saturated Fat Consumption and Risk of Coronary Heart Disease and Ischemic Stroke: A Science Update. Joyce A. Nettleton, Ingeborg A. Brouwer, Johanna M. Geleijnse, and Gerard Hornstrad. []
  4. PLoS One. 2017; 12(11): e0186672. Health effects of saturated and trans-fatty acid intake in children and adolescents: Systematic review and meta-analysis. Lisa Te Morenga, Jason M. Montez, C. Mary Schooling, []
  5. Trumbo PR, Shimakawa T. Tolerable upper intake levels for trans fat, saturated fat, and cholesterol. Nutr Rev. 2011 May;69(5):270-8. doi: 10.1111/j.1753-4887.2011.00389.x. [] []
  6. Nutritionfacts: Saturated Fat. []
  7. Multiple Sclerosis & Saturated Fat []
  8. NHS Eat Well: How to eat less saturated fat. []
  9. US FDA: Saturated Fat. []
  10. Trans Fat, Saturated Fat, & Cholesterol: Tolerable Upper Intake of Zero. Michael Greger M.D. FACLM December 23rd, 2011 Volume 6. []
  11. Coconut Oil is ‘Pure Poison’ says Harvard Professor []
  12. Dr Fuhrman: Frankenfoods []
  13. Ultra-Processed Food & Cancer []
  14. All Ultra-Processed Foods Linked to Increased Cancer Links []
  15. Blood viscosity/tissue oxygenation & plant-based diets []
  16. Plotnick G. D., Corretti M. C., and Vogel R. A.. 1997. Effect of antioxidant vitamins on the transient impairment of endothelium—dependent brachial artery vasoactivity following a single high‐fat meal. JAMA 278:1682–1686. []
  17. Vogel R. A., Corretti M. C., and Plotnick G. D.. 1997. Effect of a single high‐fat meal on endothelial function in healthy subjects. Am. J. Cardiol. 79:350–354. []
  18. Bae J.‐H., Bassenge E., Kim K.‐B., Kim Y.‐N., Kim K.‐S., Lee H.‐J., et al. 2001. Postprandial hypertriglyceridemia impairs endothelial function by enhanced oxidant stress. Atherosclerosis 155:517–523. []
  19. Tsai W.‐C., Li Y.‐H., Lin C.‐C., Chao T.‐H., and Chen J.‐H.. 2004. Effects of oxidative stress on endothelial function after a high‐fat meal. Clin. Sci. 106:315–319. []
  20. Padilla J., Harris R. A., Fly A. D., Rink L. D., and Wallace J. P.. 2006. The effect of acute exercise on endothelial function following a high‐fat meal. Eur. J. Appl. Physiol. 98:256–262. []
  21. Tucker W. J., Sawyer B. J., Jarrett C. L., Bhammar D. M., Ryder J. R., Angadi S. S., et al. 2018. High‐intensity interval exercise attenuates, but does not eliminate, endothelial dysfunction after a fast‐food meal. Am. J. Physiol. Heart Circ. Physiol. 314:H188–H194. []
  22. Physiol Rep. 2018 Sep; 6(18): e13867. Fast‐food meal reduces peripheral artery endothelial function but not cerebral vascular hypercapnic reactivity in healthy young men. Jordan C. Patik, Wesley J. Tucker, Bryon M. Curtis, Michael D. Nelson, Aida Nasirian, Suwon Park, Robert M. Brothers. []

All Ultra-Processed Foods Linked to Increased Cancer Links

A major 2018 prospective study 1 , involving 104,980 French participants, shows a shocking link between ultra-processed foods and cancer. And don’t think that this term ‘ultra-processed’ refers to foods that most of us are unlikely to eat – unless you eat an exclusively non-SOS WFPB diet, most people in our societies are most likely to be eating these foods on a regular basis.

At the risk of repeating  myself…

Whilst the press is treating this research as having just been released2 , a previous blog3 looked at this research when it was first published in February 2018 (maybe it takes this length of time for the mainstream media to catch up with such research findings). In any case, because the information is so important, it seems worthwhile reiterating some points, as well as processing some food definitions .

The Study

The BMJ study, entitled “Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort study“, looked for associations between ultra-processed food intake and risk of overall, breast, prostate, and colorectal cancer. To do this, they followed a large number of individuals for over 8 years, getting a wide range of data from them and analysing the results to see if there was a convincing link between consumption of so-called ‘ultra-processed foods’ and various forms of cancer.

Study Results

And, yes, they did. They concluded:

In this large prospective study, a 10% increase in the proportion of ultra-processed foods in the diet was associated with a significant increase of greater than 10% in risks of overall and breast cancer.

Pretty clear confirmation of a relationship although, of course, in any observational study, no matter how long and far-reaching, there’s always a question of whether a causal relationship exists between the two variables.

Irrespective of Dietary Habits

The relationship between 10% increase in ultra-processed food consumption and over 10% increased risk of developing various forms of cancer did not vary with diet. This means that, regardless of whether you’re a vegan, vegetarian, omnivore, or have a higher or lower ratio of particular macronutrients (carbs, fat or protein) in your diet, the risk remained statistically the same: anyone, no matter how healthy your diet, eating these ultra-processed foods appears to have their risk of cancer increased by the same percentage.

 The 4 Definitions of Processed

In the study, they define 4 groups of foods, as outlined by the NOVA Group 4 .

  1. a. Unprocessed or b. minimally-processed foods
  2. Processed culinary ingredients
  3. Processed foods
  4. Ultra-processed food and drink products

I’m going to explain the above 4 classifications in a fair bit of detail. I think this important since most of us are going to get confused by what differences exist between these groups. Indeed, most of only use two terms, “unprocessed” and “processed”, and even this is mostly done without being absolutely certain what we’re really talking about.

Group 1. Unprocessed or minimally processed foods

a. Unprocessed (or natural) foods are edible parts of plants (seeds, fruits, leaves, stems, roots) or of animals (muscle, offal, eggs, milk), and also fungi, algae and water, after separation from nature.

b. Minimally processed foods are natural foods altered by processes such as:

  • removal of inedible or unwanted parts
  • drying
  • crushing
  • grinding
  • fractioning 5
  • filtering
  • roasting
  • boiling
  • pasteurisation
  • refrigeration
  • freezing
  • placing in containers
  • vacuum-packaging
  • nonalcoholic fermentation

None of these processes adds substances such as salt, sugar, oils or fats to the original food.

The main purpose of the processes used in the production of group 1a. foods is to extend the life of unprocessed foods, allowing their storage for longer use, such as chilling, freezing, drying, and pasteurising.

Other purposes include facilitating or diversifying food preparation, such as:

  • removal of inedible parts
  • fractioning vegetables
  • crushing or grinding seeds
  • roasting coffee beans or tea leaves
  • fermentation of milk to make yoghurt

Foods included in Group 1:

  • fresh, squeezed, chilled, frozen, or dried fruits and leafy and root vegetables
  • grains such as brown, parboiled or white rice, corn cob or kernel, wheat berry or grain
  • legumes such as beans of all types, lentils, chickpeas
  • starchy roots and tubers such as potatoes and cassava, in bulk or packaged
  • fungi such as fresh or dried mushrooms
  • meat, poultry, fish and seafood, whole or in the form of steaks, fillets and other cuts, or chilled or frozen
  • eggs
  • milk, pasteurised or powdered
  • fresh or pasteurised fruit or vegetable juices without added sugar, sweeteners or flavours
  • grits, flakes or flour made from corn, wheat, oats, or cassava
  • pasta, couscous and polenta made with flours, flakes or grits and water
  • tree and ground nuts and other oil seeds without added salt or sugar
  • spices such as pepper, cloves and cinnamon
  • herbs such as thyme and mint, fresh or dried
  • plain yoghurt with no added sugar or artificial sweeteners added
  • tea, coffee, drinking water

Group 1 also includes foods made up from two or more items in this group:

  • dried mixed fruits
  • granola made from cereals, nuts and dried fruits with no added sugar, honey or oil
  • foods with vitamins and minerals added generally to replace nutrients lost during processing, such as wheat or corn flour fortified with iron or folic acid

Group 1 items may infrequently contain additives used to preserve the properties of the original food:

  • vacuum-packed vegetables with added anti-oxidants
  • ultra-pasteurised milk with added stabilisers.

Group 2 – Processed culinary ingredients

These are substances obtained directly from group 1 foods or from nature by processes such as:

  • pressing
  • refining
  • grinding
  • milling
  • spray drying

Purpose of processing –  to produce products that can be used in both home and restaurant kitchens to prepare, season and cook group 1 foods and to make with them varied and enjoyable hand-made dishes, soups and broths, breads, preserves, salads, drinks, desserts and other culinary preparations.

Group 2 items are rarely consumed in the absence of group 1 foods, for instance:

  • salt mined or from seawater
  • sugar and molasses obtained from cane or beet
  • honey extracted from combs
  • syrup from maple trees
  • vegetable oils crushed from olives or seeds
  • butter and lard obtained from milk and pork
  • starches extracted from corn and other plants

Products consisting of two group 2 items remain in this group, such as:

  • salted butter
  • group 2 items with added vitamins or minerals (e.g. iodised salt)
  • vinegar made by acetic fermentation of wine
  • some alcoholic drinks (see group 4)

Group 2 items may contain additives used to preserve the product’s original properties, such as:

  • vegetable oils with added anti-oxidants
  • cooking salt with added anti-humectants 6
  • vinegar with added preservatives that prevent microorganism proliferation

Group 3. – Processed foods

These are relatively simple products made by adding sugar, oil, salt or other group 2 substances to group 1 foods. Most processed foods have two or three ingredients.

Processes include various preservation or cooking methods, and, in the case of breads and cheese, non-alcoholic fermentation.

Main purpose of processed food manufacture is to increase durability of group 1 foods, or to modify or enhance their sensory qualities.

Typical examples of group 3 processed foods include:

  • canned or bottled vegetables
  • canned or bottled fruits and legumes
  • salted or sugared nuts and seeds
  • salted, cured, or smoked meats [including fish]
  • canned fish
  • fruits in syrup
  • cheeses
  • unpackaged freshly-made breads

Processed foods may contain additives used to preserve their original properties or to resist microbial contamination. For instance:

  • fruits in syrup with added anti-oxidants
  • dried salted meats with added preservatives
  • alcoholic drinks produced by fermentation of group 1 foods (such as beer, cider and wine)

Group 4. – Ultra-processed food and drink products

These are industrial formulations typically with five or more and usually many ingredients, including those also used in group 3 processed foods, such as:

  • sugar
  • oils
  • fats
  • salt
  • anti-oxidants
  • stabilisers
  • preservatives

Ingredients only found in group 4 ultra-processed products include:

  • substances not commonly used in culinary preparations
  • additives whose purpose is to imitate sensory qualities of group 1 foods
  • additives whose purpose is to imitate culinary preparations of group 1 foods
  • additives used to disguise undesirable sensory qualities of the final product

Group 1 foods are a small proportion of or are even absent from group 4 ultra-processed products.

Substances only found in ultra-processed products include:

  • some directly extracted from foods, for instance:
    • casein
    • lactose
    • whey
    • gluten
  • some derived from further processing of food constituents, for instance:
    • hydrogenated oils 7
    • hydrolysed proteins 8
    • soy protein isolate 9
    • maltodextrin 10
    • invert sugar 11
    • high fructose corn syrup 12

Classes of additive only found in ultra-processed products include:

  • dyes and other colours
  • colour stabilisers
  • flavours
  • flavour enhancers
  • non-sugar sweeteners
  • processing aids, such as:
    • carbonating agents
    • firming agents
    • bulking agents
    • anti-bulking agents
    • defoaming agents
    • anti-caking agents
    • glazing agents
    • emulsifiers 13
    • sequestrants 14
    • humectants

Several industrial processes with no domestic equivalents are used in the manufacture of group 4 ultra-processed products, such as  extrusion 15moulding and pre-processing for frying.

The main purpose of industrial ultra-processing is to create products that are ready to eat, to drink or to heat. Unfortunately, these will probably replace both unprocessed or minimally processed foods in the diet – the latter being naturally ready to consume, such as fruits and nuts, milk and water, and freshly prepared drinks, dishes, desserts and meals.

Common attributes of group 4 ultra-processed products are:

  • hyper-palatability
  • sophisticated and attractive packaging
  • multi-media and other aggressive marketing to children and adolescents
  • health claims
  • high profitability
  • branding/ownership by transnational corporations

Examples of typical group 4 ultra-processed products include:

  • carbonated drinks
  • sweet or savoury packaged snacks [including crisps – potato chips in the US]
  • ice-cream
  • chocolate
  • candies (confectionery)
  • mass-produced packaged breads and buns
  • margarines and spreads
  • cookies (biscuits)
  • pastries
  • cakes and cake mixes
  • breakfast ‘cereals’
  • ‘cereal’ and ‘energy’ bars
  • ‘energy’ drinks
  • milk drinks
  • ‘fruit’ yogurts
  • ‘fruit’ drinks
  • cocoa drinks
  • meat and chicken extracts
  • ‘instant’ sauces
  • infant formulas
  • follow-on milks
  • other baby products
  • ‘health’ and ‘slimming’ products, such as:
    • powdered meal substitutes
    • ‘fortified’ meal substitutes
  • many ready to heat products, including:
  • pre-prepared pies
  • pasta dishes
  • pizza dishes
  • poultry ‘nuggets’
  • fish ‘nuggets’ or ‘sticks’
  • sausages
  • burgers
  • hot dogs
  • other reconstituted meat products
  • powdered and packaged ‘instant’ soups
  • ‘instant’ noodles
  • powdered and ‘instant’ desserts

Group 4 foods also include any products made solely of group 1 or group 3 foods which also contain cosmetic or sensory intensifying additives, such as:

  • plain yoghurt with added artificial sweeteners
  • breads with added emulsifiers

Group 4 also includes any alcoholic drinks which are identified as foods which are produced by fermentation of group 1 foods followed by distillation of the resulting alcohol, such as:

  • whisky
  • gin
  • rum
  • vodka

Everything but group 4’s okay, then?

Short answer? No.

Adding single additives like salt 16 , sugar 17 , and oils 18 have detrimental effects on health. All animal foods are associated with serious health issues 19 , compared with plant foods 20 . Cured/smoked fish, in particular, though it’s in group 3, has been shown to be carcinogenic 21 .

It’s also worth noting that this is a survey from the country historically known to be the centre of culinary excellence – noted for its supposedly health Mediterranean diet 18 . It would be no surprise, then, that populations in other Western countries – particularly the UK and USA 22 – have considerably more consumption of ultra-processed foods.

All clear now?

If you’ve got all the food types, food combinations and preparation methods nice and sorted in your head, then you’re cleverer than most of us. Whilst some elements have been made clear by this research, there remains some lack of clarity about which items out of groups 1 to 3 might still cause adverse effects.

Perhaps, the only sure way to know that the foods you are eating offer optimal protection against developing cancer is to eat a non-SOS WFPB diet.  Foods on the plate that look remarkably similar to how they looked when they were first harvested.

Podcast by the authors

You may be interested in listing to a short podcast 23 , where two of the authors of the above study are interviewed by a representative from the BMJ (British Medical Journal):

Final thoughts

It would surprise me greatly if many people reading this could say with hand on heart that they never eat any of the above group 4 foods. They have become such a mainstay of our modern Western diets that they go largely unnoticed and accepted without question.

Are the scientists helping?

Have you ever heard anyone talking about ‘ultra-processed’ foods before? Of course not – we conventionally refer to group 4 foods as simply ‘processed foods’.

Whether the likes of McDonald’s Egg McMuffin or Walker’s Prawn-Flavoured Crisps will ever be referred to as ‘ultra-processed’ foods by the general population is, I think, unlikely. So, once again, there’ll be an unfortunate disconnect between the technical terms used in scientific reports and the terminology used ‘on the street’.

However, the study makes one thing certain: If you want to maintain optimal health and longevity, you’re not going to get it by eating the processed foods that most people eat, most days.

With a greater than 10% increase of an early (probably painful and humiliating) death from every 10% increase in the percentage of processed (group 4) foods we can’t resist stuffing into our mouths – what’s the difference between eating this junk or smoking a few cigarettes a day?

Finally, you may like to have a go at the quiz below.

Ultra-Processed Foods

(All answers are contained in the article.)


How many people are reported to choose a vegan diet mainly for health reasons? 


Vegan burgers are always a healthier option than meat-based burgers. True/False?


Which is the major lipid (fat or oil) used in processed vegan burgers?

4. What percentage of coconut oil is saturated fat?
5. What is the US Institute of Medicine's recommendation regarding daily intake of saturated fat?


  1. BMJ. 2018 Feb 14;360:k322. doi: 10.1136/bmj.k322. Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort. Fiolet T, Srour B, Sellem L, Kesse-Guyot E, Allès B, Méjean C, Deschasaux M, Fassier P, Latino-Martel P, Beslay M, Hercberg S, Lavalette C, Monteiro CA, Julia C, Touvier M. []
  2. Daily Telegraph 13th February 2019: How to identify ‘ultra-processed’ foods – the grub that’s linked to death []
  3. Ultra-Processed Food & Cancer []
  4. NOVA Group: Food classification. Public health
    NOVA. The star shines bright. []
  5. “Fractioning” foods or, simply, “fractionation” is a separation process in which a certain quantity of a mixture (gas, solid, liquid, enzymes, suspension, or isotope) is divided during a phase transition, into a number of smaller quantities in which the composition varies according to a gradient. []
  6. An anti-humectant (or anti-humidity) product is a moisture blocker which aims to resist potential moisture intrusion. []
  7. Hydrogenated oils are oils treated with hydrogen. It is a chemical reaction between molecular hydrogen and another compound or element, usually in the presence of a catalyst such as nickel, palladium or platinum. The process is commonly employed to reduce or saturate organic compounds.
  8. interesterified oils  ((Interesterified oils or fat is a type of oil where the fatty acids have been moved from one triglyceride molecule to another. This is generally done to modify the melting point, slow rancidification and create an oil more suitable for deep frying or making margarine with good taste and low saturated fat content. []
  9. Hydrolysed protein is a protein that has been at least partially hydrolysed or broken down into its component amino acids. While many means of achieving this exist, two of the most common methods are prolonged boiling in a strong acid or strong base (alkaline), or using an enzyme such as pancreatic protease to simulate the naturally occurring hydrolytic process, where hydrogen and oxygen molecules in water are separated using electricity. []
  10. Soy protein isolate is produced through a process called hexane extraction. The fats are separated from the soybean in a hexane bath. Hexane is a gasoline byproduct  and the USDA classifies it as a neurotoxin which they do not allow to be used in food defined as organic. Once the fats are removed from the soybean, it’s then soaked in an ethanol or an acidic bath to remove carbohydrates and any lingering flavour. []
  11. Maltodextrin is a polysaccharide that is used as a food additive. It is produced from starch by partial hydrolysis and is usually found as a white hygroscopic spray-dried powder. Maltodextrin is easily digestible, being absorbed as rapidly as glucose and might be either moderately sweet or almost flavourless. []
  12. Inverted sugar (also called inverted sugar syrup) is a mixture of two simple sugars – glucose and fructose. It’s made by heating sucrose with water. Sweeter than table sugar, the foods containing it can retain moisture and, thus, crystallise less easily. Bakers, who call it ‘invert syrup’, may use it more than other sweeteners. []
  13. Dangerous stuff: BMC Nephrol. 2018 Nov 8;19(1):315. doi: 10.1186/s12882-018-1105-0. Fructose increases risk for kidney stones: potential role in metabolic syndrome and heat stress. Johnson RJ, Perez-Pozo SE, Lillo JL, Grases F, Schold JD, Kuwabara M, Sato Y, Hernando AA, Garcia G, Jensen T8, Rivard C, Sanchez-Lozada LG, Roncal C, Lanaspa MA. []
  14. Dietary emulsifiers impact the mouse gut microbiota promoting colitis and metabolic syndrome. Benoit Chassaing, Omry Koren, Julia K. Goodrich, Angela C. Poole, Shanthi Srinivasan, Ruth E. Ley & Andrew T. Gewirtz. Nature volume 519, pages 92–96 05 March 2015. []
  15. A sequestrant is a food additive which improves the quality and stability of foods. A sequestrant forms chelate complexes with polyvalent metal ions, especially copper, iron and nickel, which can prevent the oxidation of the fats in the food. Sequestrants are a type of preservative. []
  16. Extrusion is is a process by which a set of mixed ingredients are forced through an opening in a perforated plate or die with a design specific to the food, and is then cut to a specified size by blades. []
  17. Don’t Be Fooled – Salt Can Kill You []
  18. Three Reasons Why Sugar May Make Us Ill []
  19. Olive Oil Injures Endothelial Cells [] []
  20. Animal Foods Are The Smoking Gun []
  21. Nutrients in Plant and Animal Foods []
  22. Food Processing & Preserving Causes Cancer []
  23. UK eats almost four times more packaged food than fresh. The Guardian. []
  24. BMJ talk medicine: “We don’t really know the impact of these products on our health”: Ultraprocessed food & cancer risk []

Seven Dates a Day Keeps Colon Cancer Away?

Surely dates taste far too nice to be good for us! Isn’t there a catch? Well, it appears research is pretty clear about whether or not eating seven dates a day is a healthy option. We’ll look specifically at whether such a sweet addition to the daily diet helps to protect against colon cancer. In addition, some other surprising potential benefits will also come under scrutiny.

Antioxidant content of sweeteners

Compared with other sweeteners, date sugar (a powder made simply from powdered dried dates) has the most antioxidants, as shown in the following chart 1 :

Other health claims for dates

One study 2 makes pretty wide claims about the benefits of dates for a whole range of diseases – although the research was based largely on experiments with rats:

Although there needs to be more research regarding several of the above claims before drawing final conclusions, there are at least two of the benefits mentioned for which there’s support from some compelling studies – namely, aiding relaxation during labour and delivery 3 4 5 6 7 and possessing an anti-tumour effect . Dr Greger has a couple of videos on the former (i.e. dates and pregnancy) 8 9 , if you’re interested. However, our main focus here is on the anti-tumour (anti-cancer) effects, particularly with regard to the colon.

Dates & the colon

Although this sounds like some 70’s Punk Band, dates seem to be seriously beneficial for the colon.

In several earlier blogs 10 11 12 13 , we looked at health issues related to the bacteria in our guts (variously referred to as ‘gut flora‘, ‘gut microbiome‘ or ‘gut microbiota‘ – technically, ‘microbiota’ refers to the microbes found in a specific environment, while ‘microbiome’ is the whole collection of microbial genomes in that environment.  In any case, the billions of bacteria living inside us seem to have astonishingly diverse and far-reaching influences on every aspect of human health – from psoriasis and MS to depression and fibromyalgia.

Central to the ability of the microbiota to do their best work for us, is the type of foods we consume – with prebiotics, such as fibre and polyphenols (a type of antioxidant phytonutrient), being really important to get the best out of these little chaps (and chapesses?). And, weirdly inappropriate gender allusion aside, it just so happens that dates contain lots of these prebiotics.

Dates in vitro 

Research 14 has shown the ability of dates (at least, in these in vitro tests), not only to increase the amount of ‘good’ bacteria, but also to kill off colon cancer cells. The researchers concluded: “…consumption of date fruits may enhance colon health by increasing beneficial bacterial growth and inhibiting the proliferation of colon cancer cells. This is an early suggestion that date intake by humans may aid in the maintenance of bowel health and even the reduction of colorectal cancer development.”

Dates in vivo

Of course, the latter were in vitro and not in vivo tests – that is, in a petri dish rather than in a dishy Peter (or Polly, for that matter). However, a subsequent randomised, controlled, cross-over, intervention study 15 , which looked for similar effects in actual human beings, found that consumption of seven dates for three weeks:

1. Significantly increases bowel movements and stool frequency

The additional fibre will play a big part here. Having regular (and easy!) bowel movements is, of course, a strong sign of good bowel health – helping to prevent constipation, diverticulosis (which can develop into diverticulitis), hiatal hernias, heartburn, GERD, etc. When eating a high fibre diet, two or three healthy bowel movements each day are quite normal. With enough fibre in the stool, you should be able to sit in any position and have a comfortable bowel movement 16 .

In terms of long-term ‘uncomfortable’ or infrequent bowel movements and the development of colon cancer, one study concludes: “Constipation was associated with a moderately increased risk of colorectal cancer.” 17 , while another study concludes: “Patients with chronic constipation are associated with significantly higher prevalence and incidence of colorectal cancer and benign colorectal neoplasm than matched chronic constipation‐free patients. These risks increase with the severity of chronic constipation.” 18 .

Now, there is some debate about whether there’s a causal link between chronic constipation and colon cancer (also referred to as colorectal cancer or CRC, which covers the rectum as well as the colon).  But why take the chance?

2. Significantly reduces stool ammonia concentration

So what? Isn’t ammonia an alkaline? And previous blogs 19 20 have encouraged us to eat a more alkaline diet, even suggesting we use a litmus paper test to ensure we produce alkaline urine. So why wouldn’t it be a good thing to have alkaline poo?

Well, in overly simplistic terms, alkaline urine is good and alkaline poo is bad.

Back in 1981, a study 21 stated: “Considerable evidence suggests that the carcinogens or co-carcinogens responsible for the development of colorectal cancer are either bacterially degraded bile acids or cholesterol. It is proposed that a high colonic pH promotes co-carcinogen formation from these substances…

This potentially carcinogenic process is inhibited once the pH of stools drops below a pH of 6.5 – around the alkalinity of milk. The same study largely blames alkaline poo on a lack of vegetables in the diet, and recommends dietary changes that increase fibre content (i.e. eat more veggies), which gut bacteria will then break down to short-chain fatty acids (SCFA’s) and thereby help to neutralise the problem.

Following this, a 1982 population study 22 confirmed the above hypothesis, showing that those with a faecal pH of 8 or above (around the pH of eggs, by the way) were at particular risk of developing colon cancer.

A 2013 study 23 found that African Americans were 50-times more at risk of colon cancer then Native Africans, concluding: “Our results support the hypothesis that colon cancer risk is influenced by the balance between microbial production of health-promoting metabolites such as butyrate and potentially carcinogenic metabolites such as secondary bile acids.

The importance of dietary fibre for the production of butyrate (and other SCFA’s such as propionate and acetate) was shown in previous blogs 24 25 , as was the importance of the metabolism of bile acids 26 in relation to alcohol-consumption.

The researchers continued: “In summary, our study supports the hypothesis that colon cancer risk is determined by the interaction between diet and gut microbiota 27 28 and that the higher risk in African Americans could be attributed to their chronically lower consumption of [soluble] fiber and resistant starch [insoluble fibre] and their higher consumption of dietary fat.” Furthermore, “The higher consumption of animal protein is one possible explanation for higher stool pH values in subjects on an omnivorous diet, as proteolytic putrefaction bacteria are able to increase stool pH by producing alkaline metabolites [such as ammonia].” 29

In one of his videos, “Testing Your Diet with Pee & Purple Cabbage” 30 , Dr Greger provides a clear explanation of why it is that we should be looking for purple poo and blue pee, when using his ‘red cabbage water down the loo’ technique!

3. Significant reduction in faecal genotoxicity

What this means is that eating those seven dates for just three weeks resulted in significantly less DNA-damage. This is really important, being that the inside protective walls of the colon are made up of DNA.

A 2015 study 31 looked in more detail at the the relationship between date-consumption and cancers. They did in vitro testing of whether or not dates (and they used a rather wide-range of different varieties) were able to kill off various cancer cells from common cancers, including:

  • stomach cancer
  • prostate cancers
  • colon cancer
  • breast cancer, and
  • lung cancer

They concluded: “…extracts from all 29 varieties of date fruits showed that it contained components than can act as reducing agents and free radical scavengers in cellular reactions in vivo…” It’s a well-accepted fact that free radicals are known to cause DNA-damage 32 , and that DNA-damage, in turn, is the major cause of cancer 33 .

“…Similarly, the inhibition of COX enzymes [enzymes responsible for prostanoid-formation] indicated that the extracts contain compounds that can inhibit the production of inflammation causing hormones such as prostaglandins and thromboxanes by preventing the formation of prostaglandin endoperoxide which then leads to the production of inflammatory intermediates…” We’ve seen before 34 how inflammation is responsible for considerable damage within the body – often leading to cancer-formation, and how plant-based diets are anti-inflammatory, while animal-based diets are pro-inflammatory.

…These results further support the health-benefits of date fruits over and above its nutritional value. The bioassay results also suggest that most varieties of date fruits studied provide similar levels of health benefits.

This may once again suggests just how interlinked everything is within our bodies, and provides additional support for a wholistic (that deals with the whole body) rather than a reductionist (one that deals with each cell, tissue, organ, or disease as relatively separate and unrelated entities) approach to human nutrition and general health. 35 We’re still relatively ignorant, not only about the true complexity and inter-relatedness of the nutrients we consume, but even about the sum total of nutrients that have not even been identified or named yet.

Naturally, the latter is an in vitro study, and more in vivo research is needed to establish any causal relationship between date-consumption and cancer-prevention/treatment. What was especially interesting in the latter results was that the positive effects were not just on the cancer cells normally coming into direct physical contact with the contents of our gastrointestinal tracts (that is, stomach and colon), but that cancer cells from other organs (prostate, breast and lung) were also killed by the date extract.

Final thoughts

In terms of constipation-avoidance, dates will, of course, only play a small part in alleviating or preventing this unpleasant and potentially dangerous condition. Eating a WFPB diet – including the seven daily dates – will ensure that you’re doing the best for the smooth-running within the plumbing “down there”, as my mother used to say…

Avoiding high levels of saturated fat and animal protein, while filling up on the fibre-rich plant foods, appears to be the way to ensure that what comes out of our bottoms falls on the right side of the pH scale. This is borne out by research 36 37  on plant-based diets and how their gut microbiome was populated by more health-beneficial bacteria species, such as Bifidobacterium and Lactobacillus, when compared with the typical omnivore Western diets. And such ‘good’ bacteria are responsible for releasing organic products such as lactic acid and acetic acid, which decrease pH value. So, once again, it’s the plant foods, including dates, of course, that keep it all above board down below.

If just seven dates a day for three weeks can reduce both free radicals and inflammation, what’s to be lost in making them a daily staple? I simply chop up seven dates and add them to my daily fruity-muesli breakfast – making sure there are no stones accidentally left lurking within, of course.

Finally, you may be interested in having a go at the little quiz below, covering aspects of this blog.

Seven Dates a Day

(All answers are contained in the article.)


How many people are reported to choose a vegan diet mainly for health reasons? 


Vegan burgers are always a healthier option than meat-based burgers. True/False?


Which is the major lipid (fat or oil) used in processed vegan burgers?

4. What percentage of coconut oil is saturated fat?
5. What is the US Institute of Medicine's recommendation regarding daily intake of saturated fat?


  1. Manickavasagan A. “Dates as Potential Substitute for Added Sugar in Food.” Dates: Production, Processing, Food, and Medicinal Values. CRC Press, Boca Raton, FL. 2012;317-321. []
  2. Rahmani AH, Aly SM, Ali H, Babiker AY, Srikar S, Khan AA. Therapeutic effects of date fruits (Phoenix dactylifera) in the prevention of diseases via modulation of anti-inflammatory, anti-oxidant and anti-tumour activity. Int J Clin Exp Med. 2014;7(3):483-91. []
  3. Al-Kuran O, Al-Mehaisen L, Bawadi H, Beitawi S, Amarin Z. The effect of late pregnancy consumption of date fruit on labour and delivery. J Obstet Gynaecol. 2011;31(1):29-31. []
  4. Kordi M, Meybodi FA, Tara F, Nemati M, Shakeri MT. The Effect of Late Pregnancy Consumption of Date Fruit on Cervical Ripening in Nulliparous Women. JMRH. 2014;2:150-156. []
  5. Khadem N, Sharaphy A, Latifnejad R, Hammod N, Ibrahimzadeh S. Comparing the Efficacy of Dates and Oxytocin in the Management of Postpartum Hemorrhage. Shiraz E Med J. 2007;8(2):64-71. []
  6. Razali N, Mohd Nahwari SH, Sulaiman S, Hassan J. Date fruit consumption at term: Effect on length of gestation, labour and delivery. J Obstet Gynaecol. 2017;37(5):595-600. []
  7. Kordi M, Salek Nasiri N, Safarian M, Esmaili H, Shadjuo K. The Effect of Oral Honey- Date Syrup Intake during Labor on Labor Progress of Nulliparous Women. Iranian J Obstetr, Gynecol Infert. 2010;13(2):23-30. []
  8. Best Food for Late Pregnancy. Published on Oct 15, 2018 []
  9. Best Food for Labor & Delivery. Michael Greger M.D. FACLM October 17th, 2018 Volume 44 []
  10. Fibromyalgia, Probiotics & Gut Microbiota []
  11. Two Types of Gut Bacteria: Plant Eaters’ & Meat Eaters’ []
  12. Obstructive Sleep Apnea (OSA) & Gut Microbiota []
  13. Gut Microbiota & Depression []
  14. Eid N, Enani S, Walton G, et al. The impact of date palm fruits and their component polyphenols, on gut microbial ecology, bacterial metabolites and colon cancer cell proliferation. J Nutr Sci. 2014;3:e46. []
  15. Eid N, Osmanova H, Natchez C, et al. Impact of palm date consumption on microbiota growth and large intestinal health: a randomised, controlled, cross-over, human intervention study. Br J Nutr. 2015;114(8):1226-36. []
  16. Bowel Movements. Nutritionfacts topic summary contributed by Charlie. []
  17. Asian Pac J Cancer Prev. 2011;12(8):2025-30. Constipation and colorectal cancer risk: the Fukuoka Colorectal Cancer Study. Tashiro N1, Budhathoki S, Ohnaka K, Toyomura K, Kono S, Ueki T, Tanaka M, Kakeji Y, Maehara Y, Okamura T, Ikejiri K, Futami K, Maekawa T, Yasunami Y, Takenaka K, Ichimiya H, Terasaka R. []
  18. Risk of developing colorectal cancer and benign colorectal neoplasm in patients with chronic constipation. A. Guérin R. Mody B. Fok K. L. Lasch Z. Zhou E. Q. Wu W. Zhou N. J. Talley. First published: 15 May 2014. []
  19. Alkaline Diet – So What?! []
  20. Psoriasis & Eczema Cured by Alkaline Diet? Caution: Some Graphic Images []
  21. J R Thornton. High colonic pH promotes colorectal cancer. Lancet. 1981 May 16;1(8229):1081-3. []
  22. S L Malhotra. Faecal urobilinogen levels and pH of stools in population groups with different incidence of cancer of the colon, and their possible role in its aetiology. J R Soc Med. 1982 Sep;75(9):709-14. []
  23. J Ou, F Carbonero, E G Zoetendal, J P Delany, M Wang, K Newton, H R Gaskins, S J O’Keefe. Diet, microbiota, and microbial metabolites in colon cancer risk in rural Africans and African Americans. Am J Clin Nutr. 2013 Jul;98(1):111-20. []
  24. Butyrate – Why Dietary Fibre is So Important []
  25. Oat Bran & UC []
  26. All alcohol in your drinks is ethanol []
  27. Dethlefsen L, Eckburg PB, Bik EM, Relman DA. Assembly of the human intestinal microbiota. Trends Ecol Evol 2006;21:517–23. []
  28. O’Keefe SJD. Nutrition and colonic health: the critical role of the microbiota. Curr Opin Gastroenterol 2008;24:51–8. []
  29. Stool pH & Colon Cancer. Michael Greger M.D. FACLM February 23rd, 2015 Volume 23. []
  30. Testing Your Diet with Pee & Purple Cabbage []
  31. Zhang CR, Aldosari SA, Vidyasagar PSPV, Shukla P, Nair MG. Health-benefits of date fruits produced in Saudi Arabia based on in vitro antioxidant, anti-inflammatory and human tumor cell proliferation inhibitory assays. Journal of the Saudi Society of Agricultural Sciences. 2017;16(3):287-293. []
  32. Free Radic Biol Med. 2002 Jun 1;32(11):1102-15. Free radical-induced damage to DNA: mechanisms and measurement. Dizdaroglu M1, Jaruga P, Birincioglu M, Rodriguez H. []
  33. ICR: DNA damage and cancer. []
  34. Where’s the beef? Look for the inflammation. []
  35. Wholism vs Reductionism – Not Just a War of Words []
  36. J Zimmer, B Lange, JS Frick, H Sauer, K Zimmermann, et al. A vegan or vegetarian diet substantially alters the human colonic faecal microbiota. Eur J Clin Nutr. 2012 Jan;66(1):53-60. []
  37. J Maukonen, M Saarela. Human gut microbiota: does diet matter? Proc Nutr Soc. 2015 Feb;74(1):23-36. []

What Happens When You Eat a Bowl of Kellogg’s Frosties?

Further to recent blogs on breakfasts 1 and the ‘bliss point’ in processed foods 2 , I thought it would be interesting to take a more detailed look inside the body, just to see what actually happens when a highly processed sugary product, specifically Kellogg’s Frosties, meets the inside of a human body – touching on associated issues, ranging from insulin resistance and cellular respiration to diabesity and non-alcoholic fatty liver disease.

Grrreat for whom?

It’s quite true that such breakfast cereals are great for the manufacturer’s profit and loss account, but what’s their true cost in terms of human health?

In order to understand what happens to those sweet, crunchy morsels once they get into our bodies, we’ll need to delve into a bit of nutritional science. So here goes…

Frosties – ingredients & nutritional information

As you will see from the footnote below 3 , a 100 g of Frosties contains 87 g processed carbohydrates, 37 g of which is pure sugar (specifically, sucrose – a disaccharide consisting of one glucose and one fructose molecule). The carbohydrates are processed to remove nearly three quarters of the fibre contained in the original whole corn (also called maize) – 2 g/100 from 7-8 g/100 g in whole corn. This gives Frosties a glycaemic index (GI) of 51 compared to 100 for pure glucose 4 . To its credit, Frosties is at least fortified with several vitamins and doesn’t contain any palm oil.

From mouth to bloodstream

As soon as Frosties enter the mouth, the carbohydrate-digesting enzyme amylase produced in saliva starts to break down the sucrose into its two monosaccharides, glucose and fructose, and the lump of food in the mouth is then referred to as a ‘bolus’.

From the mouth, the bolus passes to the stomach, during which time it magically changes its name to ‘chyme’ – a pulpy acidic fluid consisting of gastric juices and partly-digested food.

From the stomach, the chyme passes into the first part of the small intestine, the duodenum.

A signal then passes to the pancreas for it to release pancreatic amylase along a duct and into the duodenum.

At this point, a number of enzymes have pretty much completed the digestion of the sugars and any starches, producing the end product of the monosaccharide, glucose.

The resulting glucose within the mixed contents of the intestine (the ‘lumen’) then passes through the wonderfully complex epithelial membrane and into the bloodstream through an absorption process called ‘active transport’.

Here comes the insulin – hopefully…

Once the glucose levels rise in the bloodstream, the beta cells of the islets of Langerhans within the pancreas detect this increase and release the hormone, insulin – in healthy individuals, that is.

The situation is different for those with type 1 diabetes (T1D), where the pancreas does not produce insulin (or only very small quantities).

For those with type 2 diabetes (T2D), the situation is not the same, since plenty of insulin may be released from the pancreas but, for reasons covered below, fails to do its job properly.

If blood glucose levels are too low, another hormone called glucagon is released into the bloodstream, this time from the alpha cells in the islets of Langerhans within the pancreas.

Glucagon’s function is to instruct the release of some glucose which has been stored as glycogen in the liver and muscle cells (a process called glycogenolysis).

This is just one of the wonderful examples of homeostasis – a continual balancing act occurring within our bodies every second of every day. Put simply:

  • when blood glucose levels rise above a certain level, the pancreas produces more insulin
  • when blood glucose levels fall below a certain level, insulin production stops and glucagon production starts

From blood to cell

In our scenario, the sugar in the Frosties has been converted into glucose and has ended up in the bloodstream. Insulin’s main job now is to get that glucose into the body’s cells. If it does so successfully – and this is the big IF when it comes to those with T2D – the glucose is oxidised in the cells (that is, the glucose combines chemically with oxygen) and becomes a source of energy. This intracellular energy-production process is known as ‘cellular respiration’.

Cellular respiration (also known as internal respiration) is a complex process, involving three metabolic pathways: glycolysis, the citric acid (Krebs) cycle, and oxidative phosphorylation; but the important result is that the glucose from our Frosties is converted into energy. This energy is in the form of ATP (adenosine triphosphate), known as the “molecular (or energy) currency” of intracellular energy transfer. This only takes place within cells,  mostly within the mitochondria (the ‘energy factories’) but also, to a lesser degree, within the cytoplasm of the cell. The product is the energy our bodies require for every function.

If there’s any excess glucose which is not required immediately, it will get stored as glycogen in the liver or skeletal muscles for future use (a process rather confusingly called glycogenesis – the reverse process to glycogenolysis).

If you’re interested in a little more detail on the process of carbohydrate metabolism not covered above, see the note 5 below.

Now comes the spike

If glycogen reserves in the liver are saturated, the excess glucose gets converted into fat for long-term storage in the adipose (fat) tissues – beneath the skin (subcutaneous fat), around internal organs (visceral fat) and in bone marrow (yellow bone marrow).

Because Frosties contain highly refined carbs, rather than the complex starchy carbs found in whole plants, the glucose is released very rapidly. Basically, the more processed the carbs, the quicker they end up as glucose in the bloodstream. Thus, the Frosties are likely to cause what is called an initial ‘insulin spike‘.

In the long term:

  • insulin spikes can cause serious and irreversible damage to organs, nerves, and blood vessels
  • there’s likely to be an excess of glucose produced as a result of eating such foods as Frosties – unless you’re running fast on a treadmill when you’re eating! This means that regular consumption may lead to increased body fat and all the health problems associated with that

In the short term:

  • the sudden hit of these simple carbs (the ‘sugar rush‘) is likely to upset the delicate balance in the blood sugar level and is known to cause some fluctuations in energy levels and mood over the following hours – which could leave the person irritable and tired as the ‘sugar crash‘ arrives and glucose levels settle back to normal
  • it’s also likely that the person will feel hungry again very soon, since they didn’t get enough of the other nutrients to sustain energy, like protein and fibre
  • while eating the Frosties, the person’s brain would have responded to the sugar by creating a surge of the “feel-good” brain chemicals dopamine and serotonin. This also happens with certain drugs, such as cocaine. In a similar way to a drug, the body craves more after the initial high. This is one of the reasons that it is very much easier to overeat simple carbs, while complex starchy carbs don’t have the same effect

When the spikes have burst the insulin bubble

Prediabetes 6 – arguably a disease in itself – usually takes a number of years to develop into full-blown T2D, where muscle and other cells stop responding to insulin. Known as insulin resistance, this condition causes blood sugar and insulin levels to stay high long after eating. The excessive demands made on the insulin-making cells can eventually wear them out so much that insulin production can eventually cease. 7

Insulin resistance & diabetes

Before pinning down what insulin resistance is, we probably need to be clear on just what diabetes is.

As far back as a 1927 study 8 , a clear link between diabetes and fat consumption was demonstrated. In this study, young, healthy people were split into two groups: half were put on a fat-rich diet, and the other half were put on a carb-rich diet. Within just two days, glucose intolerance rose alarmingly in the fat-rich group, with twice as much blood sugar as the carb-rich group. The same principle revealed in this study has been duplicated and confirmed ever since, namely:

  • as fat in the diet rises, blood sugar spikes rise

Why is this? As it happens, it took around seven decades before the answer could be provided and, thus, form the basis of the current understanding of the cause of T2D. In basic terms, fat in the cells blocks insulin from being able to usher glucose into the cells to be used as energy. As a result of this, the sugar stays in the bloodstream, eventually filling available organs and muscle cells with fat, and reaping havoc on the body as a whole.

Every vampire needs an invitation

“Prepare ye the way for the Lord”!

I think it was Dr Greger who drew the comparison between blood sugar (glucose) and vampires. Just as a vampire requires an invitation before entering private homes, glucose needs an invitation before it can enter our cells. Within our bodies, that invitation comes in the form of insulin.

When a cell requires additional energy, it binds to one of the insulin molecules passing by in the bloodstream and that molecule binds to a specific insulin receptor on the surface of the cell membrane. Once there, the insulin acts like a key, opening up a ‘gap’ in the cell membrane – through the release of a number of enzymes – so that glucose, also circulating in the bloodstream, can enter the cell. It’s important to understand that there’s no other way that glucose can enter the cell than through this insulin receptor.

Glucose (C6H12O6) is a large molecule with 6 carbon atoms. As such. it’s too big to get into the cell through simple diffusion. This is why it needs its own John the Baptist (insulin) to ‘prepare the way for the load‘. The term used for this is ‘facilitated diffusion‘ (also known as ‘facilitated transport’) and it happens down a concentration gradient – that is, it will only happen when there’s more glucose outside the particular cell than there is inside it. If the cell has sufficient glucose inside already, it will close up the insulin receptor and no more glucose will get inside, until more is required.

This form of glucose transport within our muscles is responsible for clearing around 85% of the glucose from our blood.

By the way, all of this is something a simplification of the whole process, of course. In actual fact, even the insulin receptor (one of many different types of cell receptors) has multiple additional roles in physiological processes within us.

The diagram below 9  gives a brief overview of this complexity (sometimes referred to as pleiotropy – where one gene affects other seemingly unrelated traits).

Insulin through its receptor affects multiple physiological processes in the organism (left) by increasing (green arrows) or decreasing (red arrows) various intracellular metabolic pathways (right).

Time to call the locksmith

All well and good, but if the pancreas doesn’t produce insulin (as in T1D) then our muscle cells don’t get any energy, no matter how much glucose is floating around in the bloodstream, because there’s no key (insulin) to open the lock (insulin receptor in the cell membrane). This is why sufferers of T1D have to have insulin injections (the locksmith), otherwise blood sugar levels would simply rise and rise and eventually result in death. A person with T1D will have to monitor their blood sugar levels very carefully if they’re in the habit of eating bowls of Frosties – a habit which would not be recommended by any medical expert.

When the fat hits the fan

But what about T2D, where there’s still plenty of insulin being released into the bloodstream from the pancreas – at least, until later stages of untreated/unreversed 10 diabetes? If our muscle cells are so full of intramyocellular lipids (fat stored as a result of less-than-ideal dietary habits, where sugary foods like Frosties and high-saturated fat products have been eaten over extended periods of time), the key won’t be able to open the lock – again, no matter how much insulin and glucose might be available. The result is similar to T1D: blood sugar levels can rise and rise11

Dr Greger explains this process in more detail in his video, “What Causes Insulin Resistance?” 12 .


The link between obesity and diabetes (so strong now that the term ‘diabesity’ 13 has been coined) can be explained by realising that the fat spilling into the bloodstream from fat cells in obese individuals can get lodged in the very muscle cells we’ve been talking about. This then leads to insulin resistance and the onset of T2D.

So, although Frosties contain very little fat (only 0.6%), if the person eating them is already obese, the blood glucose quickly resulting from their consumption will end up in the bloodstream and find that the muscle cells are already fully or partially blocked by the intracellular fat 14 . Some of the glucose will be stored as further fat deposits, while some will continue to circulate in the bloodstream.

Non-alcoholic fatty liver disease

In T2D, the pancreas has been pumping out more and more insulin in an effort to overcome the fat induced insulin resistance in muscle cells. Over time, these high blood insulin levels can lead to accumulation of fat in the liver – non-alcoholic fatty liver disease (NAPFD).

Before the final diagnosis of T2D, the liver will certainly be protesting, without its owner ever hearing its silent screams. But eventually, this fat build up in the liver will make it, too, resistant to insulin in the same way as it does with the muscles.

Breakfast & the liver

Between meals, a normal liver will constantly be turning its stores of glycogen into glucose, which it then pumps into the blood to keep the brain alive; and when we do eat breakfast, after a night without dietary intake, the insulin released from the meal should turn off liver glucose production. However, if there’s too much fat in the liver, it fails to respond to that breakfast signal.

The twin vicious cycles of diabetes 15

Cycle #1

The fatty liver continues pumping out glucose all day long, on top of whatever we’re eating. The pancreas responds to the high level of blood sugar by releasing more insulin, causing the liver to get fatter and fatter. Meanwhile, fatty muscles (i.e. muscle cells that have been stuffed with surplus fat), within the context of eating too many calories, leads to the fatty liver getting even fattier.

And this all starts before diabetes is even diagnosed. This is why it’s a mistake to under-estimate the danger of being prediabetic.

Cycle #2

Fatty liver can be fatal and, because our bodies do all they possibly can to keep us alive (in spite of the relentless pressure we may impose on them), the liver tries to offload the fat by dumping it back into the bloodstream in the form of VLDL (very low density lipoprotein). This then finds its way into the beta (or so-called eyelet) cells of the pancreas, making it into a fatty pancreas – thereby destroying the ability of the pancreas to produce insulin. Blood sugar levels go up and up, leading to hyperglycemia – damaging the vessels supplying blood to vital organs, increasing the risk of heart disease, stroke, kidney disease, vision loss and irreversible nerve damage, gangrene, amputations and, of course, death.

Thus, by looking at these two cycles, it’s possible to see how T2D diabetes develops and to understand how it is a condition of excess fat inside our organs.

Final thoughts

Just eating the odd bowl of Frosties isn’t, of course, going to lead to diabesity; but if we tell ourselves that eating such foods “isn’t really all that bad” (they are, after all, fortified with added vitamins and minerals!), then we’re also likely to justify eating a whole load of other processed foods. And it’s the combination of these fatty, sugary, salty, processed foods being eaten over extended periods of time that ends up causing serious diet-related diseases.

Another important aspect is that every time we choose such unhealthy foods, we establish habits and addictions that can keep us locked in to vicious cycles – starting with those silent screams within, but ending up with very apparent indications of harm that’s already been done.

I think I’ll give Mr Kellogg’s offerings a miss.

You may want to have a go at the brief quiz below…

Quick Quiz - Diabetes

(All answers are contained in the article.)


How many people are reported to choose a vegan diet mainly for health reasons? 


Vegan burgers are always a healthier option than meat-based burgers. True/False?


Which is the major lipid (fat or oil) used in processed vegan burgers?

4. What percentage of coconut oil is saturated fat?


  1. Breakfast Confusion []
  2. Bliss Points, Pleasure Traps & Wholefood Plant-Based Diets []
  3.  Source: Waitrose. []
  4. GI of Frosties. []
  5. A little more information on carbohydrate metabolism: Not all cells in the body are the same in relation to their requirements for glucose and only glucose. Erythrocytes (red blood cells) and neurones (brain cells) can use only glucose for fuel. This means that the maintenance of blood glucose levels is vital to ensure the provision of a constant energy source to these cells.

    Most other cells can also use other sources of fuel (amino acids, fatty acids, glycerol and occasionally nucleic acid) in a process called gluconeogenesis.

    So, while some glucose is transported to the liver (to satisfy its own significant energy requirements), and some will be oxidised in other cells around the body, a certain level of glucose has to remain in the circulating blood to maintain the normal blood glucose of about 3.5– 8 mmol/ L (63– 144 mg/ 100 ml). If there is excess glucose above blood level requirements, insulin will convert it to the insoluble polysaccharide, glycogen, in the liver and in skeletal muscles.

    Glycogen is the main storage form of glucose in animal cells. In humans, most glycogen is found in the liver (10% of the liver mass), with muscles only containing a relatively low amount (1% of the muscle mass), and small amounts of glycogen also being stored in some glial cells in the brain.

    Inside cells, glycogen-formation is a means of storing carbohydrate without upsetting osmotic equilibrium. However, before it can be used to maintain blood levels or provide ATP, it has to be broken down again into its constituent glucose units.

    Liver glycogen stores constitute a store of glucose used for liver activity and to maintain the blood glucose level.

    Muscle glycogen stores provide glucose requirements of muscle activity.

    Glucagon isn’t the only hormone associated with the breakdown of glycogen to glucose, adrenaline (epinephrine) and thyroxine are are also involved. Naturally, if there is an excess of carbohydrate, above that required to maintain blood glucose level and glycogen stores in the tissues, it will be converted to fat and stored in the fat depots around the body.

    This is just a glimpse at the complex world of carb metabolism, and doesn’t even touch on the metabolism of the other two macronutrients, protein and fat. If you want to delve deeper into this subject, I can recommend the following introductory book: Ross & Wilson Anatomy and Physiology in Health and Illness. 2018 edn. Anne Waugh BSc(Hons) MSc CertEd SRN RNT PFHEA (Author), Allison Grant BSc PhD FHEA. []

  6. Dr Michael Greger Podcast – start at 6:30 mins – The Latest on Children’s Health. []
  7. Hocking S, Samocha-Bonet D, Milner K-L, Greenfield JR, Chisholm DJ. Adiposity and insulin resistance in humans: the role of the different tissue and cellular lipid depots. Endocr Rev. 2013 August; 34(4): 463-500. []
  9. Endotext: The Insulin Receptor and Its Signal Transduction Network
    Pierre De Meyts, MD, PhD, F.A.C.E. []
  10. Diet Reverses Type 2 Diabetes – How Long Have We Known This? []
  11. Roden M. How free fatty acids inhibit glucose utilization in human skeletal muscle. News Physiol Sci. 2004; 19: 92-96. []
  12. What Causes Insulin Resistance by Michael Greger M.D. FACLM January 6th, 2017 Volume 33. []
  13. Diabesity Hardcover – 1 Oct 2004 by Francine R., MD Kaufman []
  14. Estadella D, da Penha Oller do Nasciment CM, Oyama LM, Ribeiro EB, et al. Lipotoxicity: effects of dietary saturated and transfatty acids. Mediators Inflamm. 2013: 137579. doi: 10.1155/2013/137579. Epub 2013 Jan 31. []
  15. Diabetes as a Disease of Fat Toxicity. Michael Greger M.D. FACLM April 8th, 2015 Volume 24 []

Bliss Points, Pleasure Traps & Wholefood Plant-Based Diets

After looking at the confusion, not just about the best type of breakfast, but about whether breakfast was a good idea in the first place 1 , a recent newspaper article, “Beware the ‘bliss point’ – the sinister reason why you can’t put down your favourite snacks” 2 raised some pertinent points.

Linked to this topic are two books I would strongly recommend: “Salt, Sugar, Fat: How the Food Giants Hooked Us” by Michael Moss 3 , and “The Pleasure Trap: Mastering the Hidden Force That Undermines Health and Happiness” by Doug Lisle & Alan Goldhamer 4 .

Bliss point & pleasure trap – What’s the problem?

The bliss point is something that food manufacturers employ expert scientists to find so that you become addicted to their foods. Too blunt a way of putting it? Okay, maybe the above-mentioned newspaper article will put a little more flavoursome flesh on the bones.

You may already be aware that we in the UK eat more processed food than any other European nation – around 50.7% of our diet on average, and this figure only appears to be going in one direction – upwards 5 . With the growing interest in vegan foods, many of which are highly processed in an attempt to mimic animal foods like burgers and sausages, even those choosing a plant-based diet may not be able to avoid the bliss point and thus getting caught in the pleasure trap, unless they scrutinise the ingredients lists.

But what’s the bliss point got to do with this? Michael Moss, author of the above-mentioned “Salt, Sugar, Fat: How the Food Giants Hooked Us” says:

The bliss point is an industry reference to the perfect amount of sugar in products that will get us to not just like those products, but to want more and more…It’s a specific reference to sugar, although it’s been used more broadly to refer to the incredible allure that processed foods have.”

So, when we casually joke that we can’t resist certain foods (from biscuits and ice-cream to crisps and cheesy/meaty ready-meals), the truth is closer than we think – brilliant scientific minds are employed specifically to ensure that our brains make it virtually impossible for us to resist the temptation to eat more than we probably know is good for us.

Salt, fat and sugar

When salt, fat (whether in solid form like lard and butter or liquid like sunflower or olive oil) and sugar are combined, your brain doesn’t stand a chance against the pleasure signals your tongue will send it.

In nature, these three are rarely – if ever – found together in any natural food. Yet, our animal brains have been programmed over millions of years of evolution to fill up on fatty and sugary foods whenever we were lucky enough to find them. This would normally occur seasonally – picking fruits in summer and autumn, or coming across a beehive full of energy-rich, sweet honey.

But nowadays, we’re surrounded by these “Frankenfoods” 6 , which ‘pull us back in’. And these Big Food guys and gals are pretty cute – so that, even when you’ve selected what you think is the healthy low-fat, non-gluten, organic, locally-sourced and sustainable ready meal, they’ll already have ensured that whatever addictive element was reduced in quantity, was replaced by an increase in another equally-addictive element.

We’ve been processed just like the food!

There’s no doubt that most of us consider that we are doing our best to eat more health-consciously; but it’s really an uphill battle when you’re fighting against Big Food and their hunger for making huge profits from cheap ingredients – apparently with little regard for the devastating health implications for the unwitting consumer, while virtue-signalling the food’s health benefits. All efforts to change the “profit over health” bias within major food manufacturing, even by leading-lights such as Hugh Fearnley-Whittingstall, appear to produce little more than token gestures from the likes of Kellogg’s and Nestlé 7 8 .

 Voting with your feet

This is all well and good if you know which direction to go. However, even when we watch documentaries or read articles that reveal these industry techniques, aimed at making us addicted to their products, we still unconsciously reach out for that bag of crisps or the chocolate Hobnobs. With this onslaught of industry influence, no matter how healthily we try to eat, few of us are likely to discover the route to a truly healthy, life-long plant-based diet, free of all the pleasure traps and bliss points – at least, when the only information we receive comes via clever media trickery.

So are plant-based foods tasteless?

It could be argued that anything which compels you to consume something, even though you implicitly know that it’s bad for you, is an addiction with certain negative health connotations. People don’t smoke tobacco, inject heroin or drink excess amounts of alcohol without being aware both that it’s bad for them and that they find it really difficult to stop. There appears to be little difference between these forms of addiction and processed food.

We humans are masters of cognitive dissonance 9 .

With unadulterated plant foods, your body will not allow you to reach a point of no return – where you are so addicted that you consume more of something than your body knows is good for you. When you eat a food that your body recognises as food, with all the natural combination of fibre, water, macro- and micro-nutrients, there’s a perfect alignment between the amount your stomach contains and the amount your brain thinks has been consumed. A previous blog 1 showed that this alignment does not exist when it comes to highly calorific, salty/sugary/fatty processed foods.

As for whether or not plant-foods lack flavour, our taste buds (and brain) become accustomed to the natural flavours of natural foods. An imperceptible shift occurs in both our expectations of what food will provide and in the satisfaction we derive from it. After only a short period of time (often only a number of days) of being freed-up from the overpowering saltiness, fattiness and sweetness of processed foods, our taste buds normalise and the true flavours emerge.

It’s true that a memory of previously-eaten foods will remain somewhere in the recesses of the brain, much like an ex-smoker will always have some part of his or her brain that’s still drawn to the memories of social or psychological aspects of the addiction – but, the memories are invariably selective in nature. When one has the occasional yearning for a blow-out meal of fish and chips or a Double Whopper Meal, it’s so easy – I know – to remember how wonderful they tasted – even causing us to physically salivate, much like Pavlov’s dogs 10  – but, of course, without immediately recalling how stuffed and ill we may have felt immediately afterwards, and how we promised not to eat such food ever again.

Cravings – a thing of the past?

It can come as quite a surprise when you find that eating a WFPB begins to free you up from food cravings. When you’re hungry, you eat. Plants, being rich in nutrients and low in calories 11 , fill you up more than foods high in calories and low in nutrients.

The whole is greater than the sum of its parts

One important point to recognise is that you wouldn’t be able to consume as much of a given food if salt, sugar or fat were added individually without the others. It’s the combination of these three that’s able to fool your brain.

Would you let a stranger give your child a cigarette?

Moss, says: “There’s nothing more important than the bliss point to understand how we became so overly dependent on processed foods.” Dr Joel Fuhrman’s excellent book, “Fast Food Genocide: How Processed Food Is Killing Us and What We Can Do About It” 12 , provides such a clear analysis of this situation that I’m obliged to quote a fair chunk below:

Consuming fast food is legal and socially acceptable. But these foods, rich in added sweeteners, salt, oils, and artificial flavoring (called “highly palatable foods” by scientists) have addictive properties. Eating a little makes you want more. Overeating and substance-drug abuse share important common characteristics, including tolerance (needing greater amounts over time to reach the same ‘high”), unsuccessful efforts to cut back on consumption, and use of the substance despite negative consequences. 13 

Sugar-izing all foods to reach the “bliss point” that maximises pleasure (and purchases), leads to a gradual deadening of the taste buds. Over time, this has two negative consequences: first, you crave more and more sugar; and second, the level of sweetness in natural foods (such as berries and carrots) no longer has any appeal. Children raised on fast food meals, soda, and frequent junk food treats do not like fruits and vegetables. Why? Because they can hardly taste these foods. Their taste buds have been shut down by excess salt and sugar and simply can’t register the nuances of flavors in real food.

Fast food prevents you from tasting the naturally delicious flavors of fruits and vegetables; therefore, the very foods that provide the body with the necessary nutrients to thrive and live a long, healthy life are made less desirable by human-made processed foods designed to cultivate addictive consumption. 

Feeding sweetened soda, doughnuts, cake, and junk food to children is practically the same as handing them a shot of whiskey or lighting up a cigarette for them. There is just a small degree of difference between one addictive, dangerous substance and another. The same brain centers are stimulated by cocaine, narcotics, and super-sweetened foods. It is debatable which is more deadly, as so many people eat super-sweetened foods multiple times a day every day.” 14

Where did the bliss come from?

The term ‘bliss point’ was first coined by the market researcher and psychophysicist Howard Moskowitz around the 1970’s. Since that time, he worked with Big Food to optimise junk foods as wide-ranging as soft drinks, soups, salad dressings and pasta sauces.

Mr Kellogg, way back in the 19th century, started the taste for processed breakfast cereals, which have become further contaminated with loads of sugar, artificial sweeteners, colourings and flavourings over the past decades. But it was in the 1970’s and 1980’s that “extraordinary science to perfect our taste reaction” really took off, according to Michael Moss, with the food scientists engineering such terms as “moreishness,” “craveability”, “snackability”, “mouthfeel”, “flavour burst”, etc. No coincidence, then, that this heralded the start of the massive rise in obesity levels and other non-communicable diseases 15 16 .

Intentional or not?

Do the food manufacturers do all this on purpose in order to make us ill? I’ll let you decide that – although you may have to research Big Food’s links to Big Pharma to get a full picture!

However, it’s hard to consider it an accident when if you look at the amount of sugar, fat and salt they pile into every processed food – from ready meals to crisps, and from loaves of bread to children’s yogurts – especially when there is a mountain of scientific studies showing the devastating impact such foods have on human health.

The Telegraph article mentions a really cute technique that food scientists call “vanishing caloric density“, specifically in relation to the supposedly light snack, “Cheesy Puffs“:

The human body…is pretty good at detecting calories. After all, they were once our primary concern. But clever brains at food corporations can get around that. Cheese puffs are a highly fatty, salty (and often sugary) snack. But when they melt in the mouth, our brain thinks the calories disappear along with the puff. Clever.”

Discussing the book, “The Pleasure Trap“, the TrueNorth Newsletter says: “people who are chronically overweight, miserable, or junk food junkies aren’t that way because they’re lazy, undisciplined, or stuck with bad genes. They reveal that they are victims of a primal dilemma that harkens back to our prehistoric past called The Pleasure Trap..” 17

The innate incentives from our ancient ancestors, which they call The Motivational Triad consists of three elements:

  1. the pursuit of pleasure
  2. the avoidance of pain, and
  3. the conservation of energy

The newsletter continues: “Unfortunately, in present day America’s convenience-centric, excess-oriented culture where fast food, recreational drugs, and sedentary shopping have become the norm, these basic instincts that once successfully insured the survival and reproduction of man many millennia ago, no longer serve us well. In fact, it’s our unknowing enslavement to this internal, biological force embedded in the collective memory of our species that is undermining our health and happiness today.”

Final thoughts

So what’s the main benefit of switching to a WFPB diet?

The answer to this question could probably be summed up in just one word:


Freedom from the pleasure trap and freedom from enslavement by that boring cycle of bliss point-chasing and bliss point-regretting.

And it doesn’t stop there. This enlightened self-interest will also play a part in :

  • Mental and physical health  – your body and mind will ‘thank you’ for choosing arguably the most nutritious and healthy diet 18
  • Environmental & animal welfare – your dietary choices will help to produce immediate and remarkable positive benefits for the environment and the protection of other animal species on our planet 19


  1. Breakfast Confusion [] []
  2. Telegraph 6th February 2019: “Beware the ‘bliss point’ – the sinister reason why you can’t put down your favourite snacks” []
  3. “Salt, Sugar, Fat: How the Food Giants Hooked Us” by Michael Moss. []
  4. “The Pleasure Trap: Mastering the Hidden Force That Undermines Health and Happiness” by Doug Lisle & Alan Goldhamer. []
  5. Public Health Nutr. 2018 Jan;21(1):18-26. doi: 10.1017/S1368980017001379. Epub 2017 Jul 17. Household availability of ultra-processed foods and obesity in nineteen European countries. Monteiro CA, Moubarac JC, Levy RB, Canella DS, Louzada MLDC, Cannon G. []
  6. Dr Joel Fuhrman: Frankenfoods. []
  7. BBC’s Britain’s Fat Fight with Hugh Fearnley-Whittingstall: The Battle Continues. []
  8. Evening Standard: Take heed of Hugh’s Fearnley-Whittingstall noble fight to stop the obesity crisis – or we’ll all be stuffed []
  9. Definition of cognitive dissonance []
  10. Pavlov’s Dogs & Classical Conditioning. []
  11. Nutrients in Plant and Animal Foods []
  12. Fast Food Genocide: How Processed Food Is Killing Us and What We Can Do About It []
  13. Nutrients. 2014 Sep; 6(9): 3653–3671. Food Addiction in the Light of DSM-5. Adrian Meule, Ashley N. Gearhardt. []
  14. Fast Food Genocide: How Processed Food Is Killing Us and What We Can Do About It. 2017 First Edition.Page 22. []
  15. The Real Contribution of Added Sugars and Fats to Obesity. Adam Drewnowski
    Epidemiologic Reviews, Volume 29, Issue 1, 1 January 2007, Pages 160–171, []
  16. Am J Clin Nutr. 2007 Oct;86(4):899-906. Potential role of sugar (fructose) in the epidemic of hypertension, obesity and the metabolic syndrome, diabetes, kidney disease, and cardiovascular disease. Johnson RJ, Segal MS, Sautin Y, Nakagawa T, Feig DI, Kang DH, Gersch MS, Benner S, Sánchez-Lozada LG. []
  17. Truenorth Health Newsletter November 2003: THE PLEASURE TRAP. []
  18. The Blue Zones: Lessons for Living Longer From the People Who’ve Lived the Longest by Dan Buettner. []
  19. The EAT-Lancet Commission on Food, Planet, Health []

Are Nitrates & Nitrites Bad For Us?

You may have come across warnings about consuming foods high in nitrates and/or nitrites, with respect to both animal- and plant-based foods. But what does the science say? Whilst previous blogs have touched on this subject – specifically in relation to chewing vs juicing 1 and whether athletic performance is affected by nitrate consumption 2 –  here, the subject of dietary nitrates and nitrites is covered in more depth, to provide some clarity on which foods are to be avoided and which are to be embraced.

Nitric Oxide – The Good Stuff

Really, this is all about a vital molecule called nitric oxide (with the chemical formula NO). In any list of the most important compounds within the human body, NO is right up there.

It’s so important because it gets involved in pretty much every single organ system within the body and has a central role as a major and powerful vasodilator. This means that it makes blood vessels wider – of immense importance in allowing the blood to flow without the heart having to strain.

There are a wide range of common diseases associated with insufficient NO, including:

  • diabetes 3
  • atherosclerosis 4
  • cardiovascular disease 5
  • stroke 6
  • peripheral artery disease 7
  • hyperlipidemia/hypercholesterolemia 8
  • hypertension 9
  • Alzheimer’s 10
  • dementia 11
  • depression 12
  • psoriasis 13
  • gout 14
  • erectile dysfunction 15
  • obstructive sleep apnea 16 17

The list goes on and on…really, it’s hard to over-estimate the importance of NO for human health.

But what have nitrates and nitrites got to do with nitric oxide?

Nitrates, Nitrites & Nitric Oxide

The above diagram 18  basically indicates that the body converts dietary nitrates to nitrites and then to NO (as well as to ammonia) 19 . During this process, an enzyme connected to the non-essential amino acid L-arginine (also just known as arginine) is required in order to produce NO from the nitrites. L-arginine is called ‘non-essential’ (or, more specifically, a ‘conditionally indispensable amino acid’) because, although it can be derived from foods, the body can also produce a certain amount of it. 20

L-arginine is found in many protein-containing foods, both animal- and plant-based 21 .

  • Some animal foods high in L-arginine:
    • turkey breast
    • chicken
    • pork loin
    • beef
  • Some plant foods high in L-arginine:
    • leafy green vegetables 22
    • nuts & seeds (pumpkin seeds, sesame seeds, walnuts, almonds, pine nuts)
    • legumes (soybeans, chickpeas, peanuts)
    • seaweed
    • peanuts
    • spinach

A problem with L-Arginine

Increasing age, smoking, high cholesterol, inflammation, dietary deficiencies and other factors can negatively affect the functioning of the enzyme required for this conversion of L-arginine to NO. And the problem of insufficient L-arginine is not solved by taking L-arginine supplements – indeed, L-arginine supplements have been shown, not only to be ineffective and even cause less NO to be produced 23 , but such supplements have led to increased mortality when given to patients who have had heart attacks 24 . In fact, not only that, it’s been shown to cause cardiovascular risk in perfectly healthy men, as well 25 .

So what do we need to do to ensure that we have optimal NO levels?

First – A Bit of NO History

In 1987, Bob Furchgott 26 was the first to propose that NO was the EDRF (endothelium-derived relaxing factor) – i.e. that NO was the stuff responsible for the observed dilation of blood vessels, as well as a range of other vital physiological processes. Thus, NO is a relative newcomer to pharmacology. However, its impact was so significant that Bob Furchgott and his two collaborators, Louis J Ignarro and Ferid Murad, received the Nobel Prize in Physiology for its discovery.

Since then, hundreds of thousands of papers have been published with reference to NO –  both in respect of NO as the endothelium-derived relaxing factor, as well as the role of L-arginine in NO synthesis.

During the time since 1987, the significance of the L-arginine:NO pathway has increased considerably – in relation to both the importance and the range of physiological roles this pathway plays. Roles which include:

  • maintenance of vascular tone
  • neurotransmitter function regulation in both the central and peripheral nervous systems
  • mediation of cellular defence
  • interaction within mitochondrial systems to:
    • regulate cell respiration, and
    • augment generation of reactive oxygen species, thereby
      • triggering mechanisms of cell survival or death 27

Nitrates, Nitrites & Cancer

During this time, and until fairly recently, there was a particular concern about a potential increase in cancer risk from dietary nitrates and nitrites. This concern was accompanied by (and perhaps, to some extent, based on) the mistaken belief that the enzyme responsible for synthesising L-arginine within the body was the only pathway to produce NO in humans.

However, it’s been shown that when we ingest dietary nitrate, bacteria in the oral saliva convert it to nitrite. This nitrite is then swallowed and gets further converted into NO within the stomach, blood vessels and tissues 28 29 .

Mouthwashes, Antibiotics, Spitting & NO

We’ve looked previously 30 at the important role played by the bacteria in our mouths (the oral microbiome), and how it differs between meat- and plant-eaters. It’s important to stress that these oral bacteria are absolutely essential for the production of NO from our foods. Indeed, they are vital for this process, since humans can’t convert dietary nitrate to nitrite – it’s the bacteria living in our mouths that do the conversion.

So, predictably enough, it’s been shown 31 32 that, if you kill these oral bacteria by using an antibacterial mouthwash or taking antibiotics, the production of NO from dietary nitrate can stop completely. Additionally, if you spit a lot, you can deplete the bacterial concentration in your mouth, and this has a significant effect on nitrate conversion 29 .

Antacids & NO

Stomach acid also provides another important step in the production of NO from dietary nitrate 33 . Therefore, reducing the concentration of stomach acid by taking certain medication, including antacids and acid-reducing medications (such as Losec 34 ) can also decrease NO production and, thus, diminish its protective benefits 28 .

Quantity Matters

Today, dietary nitrate is understood as a highly significant precursor to NO in a dose-dependent manner 35 . So, the more nitrate consumed, the more NO becomes available in the body. There are, of course, upper limits, but these are only when nitrates are consumed in very large quantities, and this is unlikely (if even possible) from eating a WFPB diet – unless you’re unwise enough to take supplements.

Plant Nitrates vs Animal Nitrites

Plants are the primary source of dietary nitrates, while processed/cured meats are the primary sources of dietary nitrites (used as preservatives). It will comes as no surprise that the latter have a different impact on human health than the former.

Ingesting nitrates in plants increases NO and provides protective and healing benefits for a wide range of diseases characterised by insufficient NO (see the above list).

Ingesting nitrites in processed and cured meats (bacon, frankfurters, etc) can cause the nitrites to react with the amino acids, fat and haem iron already present within the meat, resulting in the formation of harmful substances before the meat is even cooked or eaten 36 37 .

A previous blog 38 went into more detail on how meat preservation methods have led to such foods being classified as Group 1 carcinogens, along with tobacco and asbestos.

When nitrites are consumed in animal foods, they can form nitrosamines 39 40 – one of the carcinogenic agents also present in cigarette smoke. Nitrosamines in processed meats (smoked, canned and preserved), as well as in grilled meats, are formed from nitrites in the absence of phytonutrients and antioxidants found in plant foods. “Just a few hot dogs may contain the carcinogenic nitrosamine load of a pack of cigarettes. In fact, just the smell of frying bacon even contains nitrosamines.” 41  Indeed, whenever you consume a diet high in animal foods (whether it’s processed meats or organically-produced eggs or dairy), you’re consuming nitrites in the absence of the phytochemicals and antioxidants that only plants contain.

Athletic Performance, NO & ATP

A previous blog, which looked at the effects of NO on athletes 2 , emphasised how important NO is for optimal athletic performance and recovery. Basically, dietary nitrate in plant foods increases the diameter of blood vessels, thereby increasing the volume of blood moved around the body with each heartbeat. This increases oxygen production to the muscles and thus increases muscle strength.

Another aspect of the relationship of NO to physical activity is ATP (adenosine triphosphate) . ATP is produced when the food we’ve eaten is metabolised in the presence of oxygen 42 . ATP is within every cell of our bodies and produces the energy we need to survive and function. The more oxygen within our red blood cells, the more ATP can be produced and, thereby, the more energy we can have available to us. However, it’s not just a matter of being an athlete with bigger lungs that facilitates this; recent research has shown 43  that dietary nitrate can actually decrease the amount of oxygen you need in order to produce sufficient ATP – that is, more work can be performed using the same amount of oxygen inhaled. Dietary intake of nitrates appears to be particularly effective for short-term, high-intensity rather than long-term, less intensive exercise.

Dietary Nitrate & Mitochondria

Furthermore, it appears 44  that dietary nitrate also improves the efficiency of our mitochondria (the energy-producing powerhouses within every human cell). Thus, increased nitrate consumption can have significance for athletes, people who live at high altitudes (where oxygen levels are lower in the air), and people with certain oxygen-limited diseases (e.g. lung disease or sleep disorders) .

Research has shown 45 particular benefits of nitrate consumption for those individuals who have lower fitness levels and/or impairments related to their muscles, heart and/or lungs, for instance in cases of non-ischaemic, dilated cardiomyopathy 46 , COPD 47heart failure 48 , and peripheral artery disease 49 .

Blood Pressure & NO

There are few conditions that cause more chronic illness and early deaths than hypertension. And the increase in the number of people affected is clearly associated with the increase in prevalence of the Western diet – richer in animal foods and processed junk than any time in human history.

And it’s all connected to the function of NO. Since two of NO’s major functions are to maintain the health of the single layer of delicate endothelial cells lining our blood vessels, and to ensure that our blood vessels dilate effectively, any reduction in production of NO is bound to result in damage to the integrity and flexibility of the vessels.

It’s a matter of simple equations:

  • increased plant foods + (decreased animal/processed foods) = increased dietary nitrates
  • increased dietary nitrates = increased nitrite production in the body
  • increased nitrite production in the body  = increased NO
  • increased NO = decreased blood pressure
  • decreased NO = increased blood pressure

Even in early studies with young, healthy individuals, it’s been shown 50 51 that dietary nitrate-consumption decreases their blood pressure. More recent research also demonstrates 52 53 54  how it can also decrease blood pressure in those more at-risk populations who already have high blood pressure. One study 55 concluded: “an additional strategy, based on intake of nitrate-rich vegetables, may prove to be both cost-effective, affordable and favourable for a public health approach to hypertension.” Another study 56 showed how chronic OSA (obstructive sleep apnea) could be effectively treated by reducing blood pressure as a result of simply eating more dietary nitrates in plant-based foods. And research is starting to suggest 57  that brain disorders such as dementia, Alzheimer’s disease, etc may be helped by dietary nitrates helping to increase blood flow to the brain.

It took some time for scientists to be convinced that eating your veggies could really increase NO when other conventional therapies had continually failed to do so. But now, the sheer weight of research data supports this view – as one editor of an eminent journal stated 58 back in 2008: “Mother was right: eat your vegetables and do not spit!

Long-Term vs Short-Term

As with most aspects of nutrition, doing the right thing for longer is more effective than doing it for shorter periods of time. This is no different with vegetable-consumption and NO production. It appears that the longer you eat a plant-based diet, the more beneficial the effects on your health. It makes sense, therefore, that transitioning to a life-long WFPB diet, rather than merely opting for a short period of relief from animal proteins (for instance, during Veganuary) and processed junk, is the way to enjoy maximum life-long benefits.

How Safe Is Dietary Nitrate?

Ingesting nitrates when they are inside vegetables is extremely safe, being that they are combined with fibre, antioxidants and phytochemicals. Having said this, infants under the age of three months should not be given dietary nitrates – that is, not fed vegetables 59 . This shouldn’t even be an issue since, as we saw in a highly-detailed previous blog on Vegan Pregnancy & Parenting 60 , all babies of this age should only be receiving breast milk or, if that is not available, appropriate formula milk.

Also, for those taking particular medications (including blood-thinning drugs like Warfarin), the high levels of vitamin K (phylloquinone) in green vegetables can be a potential issue, since vitamin K’s blood-clotting action can reduce the required actions of the prescribed drug. As Dr Greger says 61 : “In fact dark green leafies are so packed with vitamin K that if you’re on the drug coumadin (warfarin), a drug that works by poisoning vitamin K metabolism, you have to closely work with your physician to titrate the dose to your greens intake so as to not undermine the drug’s effectiveness!

How To Increase Nitrate Intake

Although there is some variation in levels (depending on plant type and the quality of the soil used for growing), it’s important to understand that all whole plant foods contain nitrates. Whilst around 85% of nitrates will come from the plants you eat, around 15% is actually contained in the water you drink 62 .

Green, Leafy Veg

Research indicates 63 64  that green, leafy veg have the highest levels of nitrates:

  • rocket (arugula in the US)
  • cabbage
  • lettuce
  • chard
  • beetroot and rhubarb have moderate amounts
  • carrots and other veg contain lesser amounts

USA & European Nitrate Consumption

Surveys of dietary habits in the US and Europe show 65 52 low levels of daily nitrate intake (~0.5-3 mmol/day), which is consistent with the low levels of vegetable consumption. All diets which tend to contain more vegetables (such as Japanese diets, the DASH diet, vegetarian and vegan diets), all show 66 a higher amount of nitrate intake (~20 mmol/day) than standard Western diets.

Regular & Sufficient Nitrates

The positive effects of dietary nitrate don’t last for ever. The peak effectiveness appears to be 29 at around three hours after consumption. There’s still some benefit after this point, but after 24 hours the effect of the nitrate is virtually nil. Thus, the ideal diet would consist of nitrate-rich foods being consumed at least a couple of times each day.

In terms of nitrate quantity, one study suggests 67 that 8.4-16.8 mmol/day produces the greatest improvement in NO utilisation (and, hence, in exercise performance), while 4.2 mmol/day produces little or no effect and anything above 16.8 mmol/day appears to achieve no additional benefits. The suggestion is that maximum benefit is achieved with ~10 mmol/day – quite manageable by eating a moderate amount of varied plant foods (green leafy veg, beetroot, rhubarb, etc). Exercise is also reported to increase NO production.

Final thoughts

Whatever you may have heard to the contrary, the consistent scientific consensus is that green, leafy veg are one of the healthiest foods on the planet for humans, and many authorities maintain 68 69 29 that the NO-producing nitrates in those veg accounts for a lot of these health benefits. 70

Finally, how better to finish than a short video by Dr Michael Greger?


  1. Greens: Chewing vs Juicing []
  2. Which Athlete Ate the Most Nitrates… [] []
  3. Diabetes. 2010 Sep; 59(9): 2152–2159. Nitric Oxide Synthesis Is Reduced in Subjects With Type 2 Diabetes and Nephropathy. Paolo Tessari, Diego Cecchet, Alessandra Cosma, Monica Vettore, Anna Coracina, Renato Millioni, Elisabetta Iori, Lucia Puricelli, Angelo Avogaro, and Monica Vedovato. []
  4. Nitric Oxide. 2006 Dec;15(4):265-79. Epub 2006 Apr 15. Nitric oxide and atherosclerosis: an update. Napoli C, de Nigris F, Williams-Ignarro S, Pignalosa O, Sica V, Ignarro LJ. []
  5. Mol Aspects Med. 2005 Feb-Apr;26(1-2):33-65. Epub 2005 Jan 24. The role of nitric oxide in cardiovascular diseases. Naseem KM. []
  6. Med Gas Res. 2017 Jul-Sep; 7(3): 194–203. The role of nitric oxide in stroke. Zhou-qing Chen, Ru-tao Mou, Dong-xia Feng, Zhong Wang, M.D., and Gang Chen, M.D., Ph.D. []
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  20. More on L-arginine and NO synthesis: Another amino acid, L-citrulline, found in watermelons and also produced in the body, is an endogenous precursor for L-arginine. The family of enzymes involved in L-arginine synthesis – the NO synthases (NOSs, EC – catalyse the oxidation of L-arginine (Arg) to NO and l-citrulline, with NADPH and O2 serving as cosubstrates  (Alderton, R. K., Cooper, C. E. & Knowles, R. G. (2001) Nitric oxide synthases: structure, function and inhibition. Biochem. J. 357(pt. 3):593–615.). The NOSs first hydroxylate a terminal guanidino nitrogen of Arg to generate N-hydroxy-l-arginine (NOHA) as an enzyme-bound intermediate. NOHA is then oxidized further by the enzyme to generate NO plus l-citrulline. []
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  67. Wylie LJ, Mohr M, Krustrup P, Jackman SR, Ermιdis G, Kelly J, Black MI, Bailey SJ, Vanhatalo A, Jones AM. Dietary nitrate supplementation improves team sport-specific intense intermittent exercise performance. Eur J Appl Physiol. 2013 Jul;113(7):1673-84. doi: 10.1007/s00421-013-2589-8. Epub 2013 Feb 1. []
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  70. Special thanks to Conor Kerley PhD, writing on behalf of CNS, for his article “Nitric Oxide & Dietary Nitrate: Another Reason to Eat Your Vegetables”, December 13, 2017. []

The Healing Power of Plants

Previous blogs have mentioned the H.O.P.E. Project 1 , particularly the two films, H.O.P.E. What You Eat Matters 2017/2018 2 3 . In this brief blog, I just want to draw your attention to a recent story which demonstrates the power of plants and exercise to fight disease – in this case, neurofibromatosis, a cancer where the tumours grow in the nervous system.

In the first episode of their new short film series, ‘Plant Power Stories’, the producers of H.O.P.E. look at individuals from many different backgrounds, all of whom have one thing in common: their lives have completely transformed by adopting a plant-based lifestyle.

D Anthony Evans -The Film

The following short film is the first part of Plant Power Stories, featuring the inspirational story of an American man called D Anthony Evans.

D’s Story

As a child, at age 6, D was diagnosed with neurofibromatosis, a rare genetically inherited disorder where tumours grow on nerve tissue. Often benign, they can become malignant, resulting in an aggressive form of cancer.

Since his diagnosis he has undergone 11 surgeries (including nine 9-hour surgeries) to remove 385 tumours.

In 2012, D was diagnosed with this aggressive form of cancer and was given six months to live.

The Power of Plants & Exercise

Now, over 5 years later, he’s not just surviving – he’s positively thriving. Anyone looking at D’s outward appearance would never guess that he’d suffered from a life-threatening cancer which was predicted to claim his life.

He attributes his survival to his lifestyle change – eating a completely plant-based diet, intensive physical exercise, and a positive mental attitude.

He’s now helping others as an inspirational speaker, author, strength coach and at-risk youth mentor, serving as an Ambassador Constituent Team Lead for the American Cancer Society.

‘Plant Power Stories’

This series of films (more to come in the future) aims to inform and inspire people about the power of a healthy, plant-based diet and conscious lifestyle.

The Aims of H.O.P.E.

The Project: H.O.P.E. stands for Healing Of Planet Earth, and the central aim of ‘H.O.P.E. The Project’ is to create mass awareness of the vital importance of a whole food, plant-based lifestyle.

Final thoughts

These are the sort of inspirational stories that can give hope to so many people who might be suffering from diseases they think are untreatable – struggling to find a way through their pain and suffering, without even being aware that simple lifestyle changes are able to pack a punch which is often more powerful than that provided by pharmaceuticals and surgical interventions.

Our bodies want to heal themselves. Our bodies can heal themselves. But they need to be provided with the right nutrients (and protected from the wrong nutrients) in order to do so.


  1. The H.O.P.E. Project []
  2. I H.O.P.E. You Watch & Share This Film []
  3. Videos []

Arthritis & Plant-Based Foods

I know from personal experience within my family that arthritis can be an excruciatingly painful disease which imposes significant limits on the quality of one’s life. At first inspection, it seems too good to be true that making simple dietary and lifestyle changes could significantly improve the symptoms of arthritis; but delving into the research (and eating the diet myself) has shown that it’s possible, not only to reduce arthritic pain, but to remove the major symptoms completely, allowing the body to heal itself where it can.

What is Arthritis?

It’s really a group of diseases causing swollen and painful joints.

Osteoarthritis (OA) is usually a gradual degeneration of joint cartilage and underlying bone which is most common from middle age onward – indeed, OA is “the most frequent cause of physical disability among older adults” in the world 1 . It results in stiffness and pain, especially in the hip, knee, and thumb joints. It’s commonly thought that OA is merely unavoidable wear and tear, but this is not the case. In fact, it’s an active joint disease with a prominent inflammatory component.

Rheumatoid arthritis (RA) is where the body itself attacks the joints in a much more aggressive manner. As a chronic progressive disease, the inflammation it causes in the joints can result in painful deformity and immobility, especially in the fingers, wrists, feet, and ankles.

Genes & Arthritis

There are genetic predispositions within families, making it more or less likely that a person may develop RA. However, just because there’s a genetic predisposition, it does not necessarily mean that those genes have to be triggered and, hence, dictate the course of events in a person’s life.

Inflammation & Arthritis

We’ve already looked 2 at how the foods we eat can significantly affect the inflammation within our bodies. There is strong evidence that dietary changes can help to prevent the development of arthritis and, if it has already developed, to reduce inflammation and, thereby, potentially to eliminate the pain and stiffness altogether. Basically, get rid of the foods that spark the inflammatory responses within the joints, and you get rid of the inflammation.

A survey of more than 1,000 arthritis patients revealed that red meat, sugar, fat, salt, caffeine, and nightshade plants (e.g., tomatoes, eggplant) most commonly worsen the condition. Research also shows that dairy protein may make symptoms worse.” 3

Research on Diet & Osteoarthritis

A 2012 study 4 considered that dietary changes along with increased physical exercise represents the best first-line option in preventing and treating OA: “Healthy living can be exploited to reduce inflammation, oxidative stress, and related pain and disability and improve patients’ overall health. This approach aligns with evidence-based best practice and holds the promise of eliminating or reducing chronic low-grade inflammation, attenuating disease progression, reducing weight, maximizing health by minimizing a patient’s risk or manifestations of other lifestyle-related conditions hallmarked by chronic low-grade inflammation, and reducing the need for medications and surgery. This approach provides an informed cost effective basis for prevention, potential reversal, and management of signs and symptoms of chronic osteoarthritis.”


A 2015 study 5 considered whether people with OA could benefit from dietary changes. They found that those eating a WFPB diet were able to report a significant decrease in their OA pain – and this was in just 2 weeks. At the end of the six-week study, they also reported more energy and better physical functioning, too. The study concluded: “…results suggest that a whole-foods, plant-based diet significantly improves self-assessed measures of functional status among osteoarthritis patients.

Osteoarthritis & Obesity

We’ve already looked at the powerful evidence 6 7 8 showing that the best, safest and most sustainable diet to prevent and treat obesity consists of moving away from all animal and processed food and replacing them with whole plant foods. But what about the relationship between OA and obesity?

A 2018 study 9 considered the evidence for a strong link between obesity and OA. It concluded: “With excess adiposity appearing to underlie the metabolic factors now recognized as being integral to OA, particularly of the hand and knee 10 11 , dietary modification to achieve weight reduction where appropriate, together with increased physical activity, are the strongest evidence-based recommendations.

Obesity is a significant risk factor for developing OA. And it’s not just a matter of obesity putting more pressure on the joints. Within the joints, fatty tissue represents a potent source of pro-inflammatory chemicals that actively increase cartilage breakdown. When you lose weight, there are fewer of these chemicals and the symptoms of OA improve. It’s not rocket science to realise that the modern Western diet is going to supply the body with ample amounts of these pro-inflammatory chemicals which, in turn, will build up and put increased stress on joints.

Which Foods Fight Osteoarthritis?

Whilst I would always suggest that it’s best to focus on eating a varied and balanced plant diet, rather than merely focusing on the latest individual ‘miracle’ foods that regularly hit the media, there are some specific plant foods that research has indicated are particularly good for preventing and treating OA, including:

  • turmeric curcumin 12
  • ginger 13
  • sesame seeds 14
  • rose hips 15
  • soy protein 16
  • coriander/cilantro 17
  • acai berries 18
  • sulforaphane in broccoli/cabbage leaves 19

A 2012 study 20 looked at some of the mechanisms  (particularly the molecular antiosteoarthritic mechanisms) involved in how OA may be prevented and treated by the polyphenols in common plant foods, including:

  • turmeric curcumin
  • epigallocatechin gallate 21 and green tea extract
  • resveratrol 22
  • nobiletin 23 and citrus fruits
  • pomegranate
  • genistein 24 and soy protein


Research on Diet & Rheumatoid Arthritis

It’s been known for some time that diet can have a notable affect on RA.

A 2000 study 25 looked at whether following a raw vegan diet rich in antioxidants and fibre could decrease joint stiffness and pain in patients with RA. The study stated: “In conclusion the rheumatoid patients subjectively benefited from the vegan diet rich in antioxidants, lactobacilli and fibre, and this was also seen in objective measures.”

A 2001 study 26  found a gluten-free, vegan diet was of significant benefit in improving the signs and symptoms of RA, with the authors concluding: “…this benefit may be related to a reduction in immunoreactivity to food antigens eliminated by the change in diet.

A 2001 systematic review 27 concluded that fasting followed by a vegetarian or vegan diet might be useful in the treatment of RA: “The pooling of these studies showed a statistically and clinically significant beneficial long-term effect. Thus, available evidence suggests that fasting followed by vegetarian diets might be useful in the treatment of RA.

A 2002 study 28 looked at the how a very low-fat vegan diet would affect individuals with moderate-to-severe RA. It only took 4 weeks on the diet to see significant improvements in the following:

  • morning stiffness
  • RA pain
  • joint tenderness, and
  • joint swelling

Which Foods Fight Rheumatoid Arthritis?

Whatever helps to prevent/treat OA would, you’d imagine, also help with RA. Again, picking out specific plants or phytochemicals is not the ideal approach, compared with simply eating a balanced and varied WFPB diet; but, as mentioned above, there are some specific foods which it’s worth pointing out have been shown as potentially helpful in preventing/treating RA, including:

  • turmeric 29 30
  • rosehip 31
  • coriander/cilantro 32
  • sour cherries & pomegranates 33
  • ginger 34
  • green tea 35
  • parsley 36

Of course, an astonishingly wide range of inflammatory-fighting polyphenols are in all fruit and vegetables, and so any balanced WFPB diet will help to inhibit platelet activity which is associated with inflammation.

What Mechanisms Are Involved?

Things are changing in our view of arthritis. The question of just how central inflammation and immune responses are in the causation and prolongation of both OA and RA is an unfolding journey of discovery. It would appear to me as though the research is heading towards concluding that the role of immune responses and inflammation – and, hence, the primary role of diet in preventing both of these bodily reactions – is a lot more important in the pathogenesis of arthritis in general.

For instance, one study 37 comments: “Osteoarthritis (OA) has traditionally been classified as a noninflammatory arthritis; however, the dichotomy between inflammatory and degenerative arthritis is becoming less clear with the recognition of a plethora of ongoing immune processes within the OA joint and synovium.

Naturally, if the joint defences (the cartilage) are chronically damaged, any excessive exercise or trauma to that joint will exacerbate joint damage; however, studies are revealing that it’s the food we eat, to some not-insignificant extent, that causes cartilage damage (or fails to protect the cartilage in the first place).

One study 38 looked at the role of WFPB diets in the treatment of OA, describing OA as: “...a group of mechanical abnormalities involving the degradation of articular cartilage and subchondral bone in the joints….A variety of causes including hereditary, developmental, metabolic, and mechanical etiologies may initiate the process of cartilage loss. As cartilage thins, bony surfaces become less well-protected and bone may be exposed or damaged. Regional muscles may experience atrophy and ligaments become more lax as a result of decreased movement secondary to pain.”

The same study concludes: “The present and earlier studies provide further evidence for the beneficial effects of WFPB diets in many patients with OA. We hope that the results from the current study will encourage an increased appreciation and clinical evaluation of dietary variables and that WFPB diet therapies are recommended as an adjunct to standard medical management of this debilitating chronic disease.”

In a podcast entitled “Healthy Joints” 39 , Dr Greger reinforces this by analysing how a plant-based diet protects our joints against arthritis. The common feature throughout, is the association between joint damage (be it via cartilage breakdown/loss of bone density or via autoimmune responses) and the consumption of animal foods.

In one of his short videos entitled “Preventing Arthritis40 , Dr Greger draws a clear link between the pathogenesis of arthritis and the consumption of animal foods: “...eating meat—even a tiny amount—may dramatically increase our risk of developing degenerative arthritis. Even eating meat less than once a week may trigger arthritis. My patients will say things to me like, they only smoke x number of cigarettes, and my response is always that any amount of smoking is too much.”

Plenty of other research supports this view of the link between consuming animal foods and developing arthritis, with one study 41 concluding: “Greater meat consumption is associated with a higher prevalence of degenerative arthritis and soft tissue disorders in both male and female subjects of this population…

Dr Greger on Arthritis & Animal Foods

Dr Greger mentions 42  one particular case: “…a case report of a woman eating eggs, dairy, and meat with joint inflammation so bad she was on chemo and steroids—until she stopped ingesting animal products, and her symptoms disappeared when she just ate plant proteins. She could turn on and off her disease like a light switch. It even says how she ate meat the night before her doctor’s appointment, just to show the doctor that she really did have bad arthritis…

When susceptible people put all these foreign animal proteins in their body, one of two things may happen. When we nibble on the cartilage at the end of a chicken’s leg, our immune system may react to these foreign cartilage proteins by producing anti-cartilage antibodies that may get confused, and start attacking our own cartilage. That’s what they mean by meat-induced joint attack. The other possibility is that even if there are no cross-reactivity confusions, the immune complexes formed by the meat proteins and our antibodies may migrate into our joints and trigger inflammation that way.

Animal Fats & Arthritis

Dr Neil Barnard posits 43 the possibility that animal fats may have a causal relationship with arthritis: “Plant-based diets are often lower in fat and contain different kinds of fat than diets with animal products. For example, many whole plant foods have an optimal ratio of omega-6 to omega-3 fats. Healthful weight loss from eating a vegan diet is also anti-inflammatory, further helping cool irritated joints.

Dr Barnard goes on to provide two food lists – one that’s thought to help and the other that’s thought to exacerbate the symptoms of arthritis. He suggests that you eat an abundance of foods on the former list and avoid all foods on the latter list. Any foods that do not appear on either list, he suggests can be eaten freely. He also suggests that sufferers monitor if there are any foods that clearly trigger symptoms. These should be removed from the diet to see if their removal improves symptoms.

Foods That Help Alleviate Arthritis Symptoms

These ‘pain-safe foods’ virtually never contribute to arthritis, headaches, or other painful conditions:

  • brown rice
  • cooked green vegetables
  • cooked orange vegetables
  • cooked yellow vegetables
  • cooked or dried non-citrus fruits
Common Trigger Foods To Be Avoided
  • animals foods (this means all fish, meat, eggs and dairy)
  • alcoholic beverages (especially red wine)
  • monosodium glutamate (MSG)
  • aspartame (NutraSweet)
Foods Reported As Potential Trigger Foods In Some Sufferers
  • caffeinated drinks (coffee, tea, and colas)
  • nitrites [Shown to be responsible in animal foods, but research 44 45 46    does not appear to support this in plant-foods.]
  • chocolate [Research 47 48  seems to suggest this does not apply to plain unsweetened cocoa – it’s the usual sweetened dairy chocolate that’s the problem.]
  • citrus Fruits [Some recent research 49 questions whether this is indeed the case, since there may be a protective aspect of citrus fruits for those with arthritis, particularly RA.]
  • wheat [There’s uncertainty here about whether it’s the processed wheat in white bread and pastries that’s the issue. I suspect that wholegrains do not present the same potential to trigger arthritis symptoms, since other research 50 includes them in the anti-inflammatory diet suggested for arthritis sufferers.]
  • nuts and peanuts [Alternative research 51 suggests that nuts and seeds are beneficial for arthritis sufferers.]
  • tomatoes [Arthritis Research UK state 52 that they know of no research proving a link between tomatoes and arthritis. I guess this also relates to other nightshade veg.]
  • onions [Other research 53  considers alliums (including onions, garlic and leeks) to be protective against arthritis.]
  • corn [I’ve found no research that supports the notion that whole corn (either fresh on a cob or dried whole) has negative effects on arthritis. Once again, I suggest it’s when the corn is eaten as an isolated oil or within fast-food snacks that problems arise.]
  • apples [This is an odd one, since research 54 55 indicates that apples are excellent for both reducing inflammation and providing a rich supply of easily-absorbed vitamin C and other phytonutrients.]
  • bananas [Comments by Arthritis Research UK 56 exemplify the confusion over bananas and arthritis by saying that there’s anecdotal evidence both for and against bananas for relieving arthritis symptoms. As far as I can see, there’s no solid research evidence either way.]

My suspicion with some of the above ‘triggers’ is that they have become anecdotally associated with increasing arthritic symptoms rather than because there is any convincing research evidence.

Of course, this is not to claim that these foods cannot trigger arthritis symptoms in some people, but this appears to be the typical situation where people focus on one particular ‘bad boy’ food rather than their whole diet – often in the hope that, thereby, they won’t have to radicalise their diet and remove favourite food (meat, fast-food, snacks, confectionery, processed foods) to which they are virtually addicted and which they can’t imagine living without. More of this below in relation to wholism vs reductionism.

Joint Damage in Athletes

We looked previously 57 58 59 in some detail at how a plant-based diet protects athletes against joint and muscle damage, as well as being effective in helping to heal the body more quickly from exercise-related injury.  Thus, it would make sense that making the right choice between a diet consisting of pro-inflammatory animal-foods or of anti-inflammatory plant-foods may be a primary factor in the pathogenesis and development of both OA and RA. This is made more probable when we take into account how plant-foods are shown 60 to provide such strong support for the body’s immune system, for instance through producing the ideal microbiome in our guts.

Gout – A Form of Arthritis

In a previous blog specifically on gout 61 , we looked in great detail at how the consumption of animal-foods is perhaps the major cause of this excruciating condition; conversely, we saw that transitioning to a wholefood plant-based diet (as well as making other lifestyle changes, such as cutting out alcohol) prevents and treats gout more effectively than current medications – and without all the associated side-effects of the latter.

Wholism vs Reductionism

Once again, it’s possible to pan out on this whole topic and conjecture that a more wholistic approach to disease prevention and treatment – one that would deal with the vast range of seemingly interlinked conditions, such as obesity, diabetes, heart-disease, hypertension, immune disease and inflammatory diseases – is the way to kill more than one disease with just one diet.

As discussed in a previous blog 62 , modern medicine appears to have fallen into a reductionist trap, where drug companies (and thereby medical practitioners) are on a constant race to find one specific drug to treat – what they think is – one specific disease. An alternative paradigm is that all medical conditions are linked in complex ways within our bodies and, since we are what we eat, the thing that most dramatically and directly affects this complex of bodily conditions is the food we put in our mouths.

Final Thoughts

Six of One or Half a Dozen of the Other

So, to some extent, the most important general questions might not be whether arthritis is caused by animal protein-induced autoimmune attack in the joints or by the animal proteins/fats themselves attacking the joints; rather, perhaps we should be stepping back and looking at the elephant in the room – the animal foods themselves. This is particularly the case when animal foods are eaten to excess in highly processed form, as is the norm within the Western diet.

Maybe Confusion is a Good Thing Sometimes

If the above has left you with a degree of confusion about which specific foods are good or bad for the prevention/treatment of different forms of arthritis, then maybe that’s not as bad a thing as it might at first appear.

After all, we only understand a small fraction of the incredibly complex interactions of the tens of thousands of nutrients in foods – and this is apart from our relative ignorance of the precise ways in which these interactions affect the tissues, organs, processes and trillions of interrelated cells within our bodies. In the above-mentioned blog, Wholism vs Reductionism 62 , this was well-demonstrated by looking at just one diagrammatic representation of the partial metabolic processes involved in one single cell:

Don’t even try to read this, let alone understand it.

As Professor T Colin Campbell adds 63 :

The fact that each nutrient passes through such a maze of reaction pathways suggests that each nutrient also is likely to participate in multiple health and disease outcomes. The one nutrient/one disease relationship implied by reductionism, although widely popular, is simply incorrect. Every nutrient-like chemical that enters this complex system of reactions creates a rippling effect that may extend far into the pool of metabolism. And with every bite of food we eat, there are tens and probably hundreds of thousands of food chemicals entering this metabolism pool more or less simultaneously.

So, we’re faced with the same choice in terms of arthritis as we are with all the non-communicable diet-related diseases which are growing at terrifying rates within our populations: do we wait until the media, health authorities, politicians and food manufacturers/retailers own up to the reality of plant-based diets being the optimal choice for humans, or do we take our own health in our hands and choose the WFPB dietary route for ourselves today?


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  30. J Med Food. 2016 Aug;19(8). Efficacy of Turmeric Extracts and Curcumin for Alleviating the Symptoms of Joint Arthritis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Daily JW, Yang M, Park S. []
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Say Cheese?

You may not have noticed that there’s a section in which is full of really fascinating and informative podcasts. Why not have a scroll through them?

They’re great for listening to while you’re doing other things – cooking wonderful plant-based meals, for instance…

I’ve just added another podcast released by the gorgeous Dr Greger, entitled “Say Cheese?

In this 13 minute long animated rant against the almost unbelievable tricks of major food industries, he explains how they can produce spurious studies to support the nutritional value of…you guessed it… their own products.

For instance, he explains how the US National Dairy Council were able to produce a shocking study which claims they have demonstrated that cheese causes less inflammation than a vegan alternative. But how did they manage such a trick? Click on the link below to find out.

Breakfast Confusion

An article in the Telegraph 1 makes the choice clear about whether or not breakfast is the most important meal of the day – well, as clear as mud

The study

The article reports on a recent BMJ study 2 which demonstrates that the accepted ‘truth’ about the primary importance of breakfast is not quite as true as we’ve been told.

Specifically, the study (a systematic review and meta-analysis) reviewed 13 previous breakfast studies and found that those who eat breakfast consume significantly more calories (an average of around 249 kcal a day) than those who skip the meal – and then end up weighing more.

A little more on this study below, but first: why have we been told that breakfast is so important?

Confused? Just you wait…

Breakfast is BAD

For decades, health experts have warned us not to miss breakfast if we want to lose/maintain a healthy weight, since we’ll just end up snacking more later in the day.

Breakfast is GOOD

But the newspaper points out that previous studies suggested eating breakfast “fires up the metabolism and can help dieters stop overeating later in the day.

Breakfast is BAD

Then the newspaper points out that the BMJ suggests otherwise, since it “…found those who skip breakfast do not compensate by eating more later in the day.

Breakfast is GOOD

The NHS advice goes like this: “Some people skip breakfast because they think it will help them lose weight. In fact, research shows that people who regularly eat breakfast are less likely to be overweight.” 3 .

Breakfast is GBOAODD

Then the Telegraph tries to clarify the situation for us by stating that “researchers also found no significant difference in metabolic rates between breakfast eaters and skippers – suggesting there is no evidence that eating breakfast may help with weight loss due to “efficient” burning of calories earlier in the day.

Study Conclusion

Surely this meta-analysis will clear up the situation for us…mmm.

The researchers’ conclusion includes the following decisive statement: “Caution is needed when recommending breakfast for weight loss in adults, as it could have the opposite effect.”

A Bit of History

So, if there’s so little clarity on whether or not we should have breakfast, why has there been such a widespread belief passed down to us that breakfast is the most important meal of the day?

Breakfast Cereal As A Passion Killer

As far back as 1895, John Harvey Kellogg created Kellogg’s Corn Flakes and advertised it as a health food which, as part of a bland diet, would not only counter ill-health, but would minimise sexual arousal. Since then, Kellogg’s have advertised how healthy their cereals are, irrespective of a lack of positive evidence and a fair amount of evidence to the contrary 4 – especially nowadays, with the shocking amounts of added sugar in most breakfast cereals which the manufacturers still want to make us think are a healthy option.

The Classic Bacon Breakfast

The bacon industry were having a bit of a recession during the 1920’s in the United States; so they used the services of public relations supremo Edward Bernays (a nephew of Sigmund Freud).

Did they get him to publicise some wonderful new research that showed the healthful benefits of a good bacon-based morning fry up? Not quite! Rather, they got him to persuade around 5,000 US doctors to sign a statement that supported the importance of starting the day with a big breakfast.

This message was spread across the country as though it was solid fact, although it was based on an utter lack of any supporting scientific evidence.

If General Foods Say It, It Must Be true

In 1944, General Foods (makers of breakfast cereals) came up  with the phrase “breakfast is the most important meal of the day”.

During the GF campaign, radio advertisements announced “Nutrition experts say breakfast is the most important meal of the day.”

Reminds me of doctors who used to claim that their favourite brand of cigarettes were actually good for you – and it was probably just a coincidence that they were getting sponsored (and given free boxes of ciggies) by the cigarette companies.

Kings, Princes & Paupers

In 1954, nutritionist Adelle Davis came up with the phrase: “Eat breakfast like a king, lunch like a prince, and dinner like a pauper.” Whilst there was no solid evidence for or against the validity of this bold claim, it didn’t stop the phrase from becoming de rigueur until the present day.

Eggsaggerating The Importance of Breakfast

Tim Spector, professor of genetic epidemiology at King’s College London, thinks that most of us alive today have been indoctrinated from childhood by campaigns like “go to work on an egg”.

But who could possibly benefit from such advice if it doesn’t have any proven nutritional validity? Fay Weldon came up with the classic slogan “Go to work on an egg” in 1957 at the request of the UK’s Egg Marketing Board, reinforced in the 1960’s by TV adverts with the comedian Tony Hancock.

It’s Just a Matter of Numbers

Public Health England had a 2018 campaign on healthy eating 5 . In this campaign they urged us to follow a simple rule of thumb:

  • breakfast – 400 calories
  • lunch – 600 calories
  • dinner – 600 calories

Great! Sorted! Oh, but maybe they haven’t heard that calorie counting has been shown as a non-starter for sustained and healthy weight loss/maintenance 6 … And perhaps it would be useful to point out that 400 calories of doughnuts is not quite the same as 400 calories of unprocessed fruit and veg.

News – What News?

Oh and by the way, the Daily Telegraph and other media outlets made such a big fuss about this story, in spite of a short sentence in the cited study which goes something like this: “All of the included trials were at high or unclear risk of bias in at least one domain and had only short term follow-ups…. As the quality of the included studies was mostly low, the findings should be interpreted with caution.

This is a fact that the Telegraph article didn’t mention. This begs the question whether this study was even newsworthy. The only effect it probably had on the general public was to sow confusion with an eye-catching headline.

Final thoughts

It’s important to to note that the BMJ study (undertaken by researchers from Monash University in Melbourne, Australia) were looking at 13 randomised controlled trials related to breakfast and weight in high income countries, including the UK. This is probably key to the confusion.

The breakfasts eaten in these ‘high income countries’ are likely to be the type of breakfasts that cause the confusion – bacon and eggs, breads and pastries, porridge and cow’s milk, breakfast cereals from the likes of Kellogg’s and Nestlé, etc.

If optimally healthy WFPB breakfasts 7  were eaten, I suspect the results would be somewhat different. Not that it would give a clear indication of whether it was better to eat or not to eat breakfast, since it may well be that very little change would be detected in the weight of the WFPB eaters.

Why not?

In my experience, and it’s just that so far, eating a WFPB diet (whether or not it regularly includes breakfast) results in the body reaching its optimal healthy weight and, if you eat when your body ‘tells’ you, then it doesn’t seem to matter when or what you eat – so long as the foods come from wholefood plants without any added salt, oil or sugar.

And, finally, I’m not against breakfasts; in fact, I eat a huge breakfast of berries, seeds, nuts, fruit, and whole grains. It’s just that this is another case of the media (and hence the unsuspecting reader/viewer) focusing on minutiae at the cost of the wider picture.

It’s the food! The type of food, not whether you’re dieting this way or that, eating the right amount of calories, tucking into or skipping your breakfasts: it’s whether the food you put into your mouth is the type that offers optimal human health and longevity, or if it enslaves your taste buds, poisons and bloats your body, and does so without you ever seriously questioning the motives of those who peddle their cheap junk, and without these companies giving a damn about whether your health is seriously and irrevocably compromised – so long as they make their profits.



  1. Daily Telegraph 31 January 2019: Breakfast may not be the most important meal of the day, after all. []
  2. Effect of breakfast on weight and energy intake: systematic review and meta-analysis of randomised controlled trials. BMJ 2019; 364 doi: []
  3. NHS: Eight Tips For Healthy Eating. []
  4. Guardian 23 November 2010: Drop that spoon! The truth about breakfast cereals []
  5. Public Health England: 2018 Healthy Eating Campaign []
  6. The Case Against Counting Calories []
  7. WFPB Breakfast Recipes. []