How Not to Die

Seeking answers, the pioneering researcher Dr. Dean Ornish teamed up with Dr. Elizabeth Blackburn, who was awarded the 2009 Nobel Prize in Medicine for her discovery of telomerase. In a study funded in part by the U.S. Department of Defense, they found that three months of whole-food, plant-based nutrition and other healthy changes could significantly boost telomerase activity, the only intervention ever shown to do so.69 The study was published in one of the most prestigious medical journals in the world. The accompanying editorial concluded that this landmark study “should encourage people to adopt a healthy lifestyle in order to avoid or combat cancer and age-related diseases.”70

So were Dr. Ornish and Dr. Blackburn able to successfully slow down aging with a healthy diet and lifestyle? A five-year follow-up study was recently published in which the lengths of the study subjects’ telomeres were measured. In the control group (the group of participants who did not change their lifestyles), their telomeres predictably shrank with age. But for the healthy-living group, not only did their telomeres shrink less, they grew. Five years later, their telomeres were even longer on average than when they started, suggesting a healthy lifestyle can boost telomerase enzyme activity and reverse cellular aging.71

We’ve known about the dramatic power of dietary changes for decades. For example, there was a paper entitled “Angina and Vegan Diet” published in the American Heart Journal back in 1977. Vegan diets are exclusively plant based, avoiding meat, dairy, and eggs. Doctors described cases like that of Mr. F. W. (initials are often used to protect patient confidentiality), a sixty-five-year-old man with angina so severe he had to stop every nine or ten steps. He couldn’t even make it to the mailbox. He was started on a vegan diet, and his pain improved within days. Within months, he was reportedly climbing mountains with no pain at all.48 Not ready to start eating healthier? Well,

To test the power of dietary interventions to prevent DNA damage, scientists often study chronic smokers. Researchers rounded up a group of longtime smokers and asked them to consume twenty-five times more broccoli than the average American—in other words, a single stalk a day. Compared to broccoli-avoiding smokers, the broccoli-eating smokers suffered 41 percent fewer DNA mutations in their bloodstream over ten days. Is that just because the broccoli boosted the activity of the detoxifying enzymes in their livers, which helped clear carcinogens before they even made it to the smokers’ cells? No, even when DNA was extracted from the subjects’ bodies and exposed to a known DNA-damaging chemical, the genetic material from the broccoli eaters showed significantly less damage, suggesting that eating vegetables like broccoli may make you more resilient at a subcellular level.7

Certain compounds in broccoli may have the potential to suppress this metastatic spread. In a 2010 study, scientists laid down a layer of human lung cancer cells in a petri dish and cleared a swath down the middle. Within twenty-four hours, the cancer cells had crept back together, and within thirty hours, the gap had closed completely. But when the scientists dripped some cruciferous-vegetable compounds onto the cancer cells, the cancer creep was stunted.9 Whether or not eating broccoli will help prolong survival in cancer patients has yet to be tested in clinical trials, but the nice thing about healthy dietary interventions is that since they have no downsides, they can be added

Certain compounds in broccoli may have the potential to suppress this metastatic spread. In a 2010 study, scientists laid down a layer of human lung cancer cells in a petri dish and cleared a swath down the middle. Within twenty-four hours, the cancer cells had crept back together, and within thirty hours, the gap had closed completely. But when the scientists dripped some cruciferous-vegetable compounds onto the cancer cells, the cancer creep was stunted.9 Whether or not eating broccoli will help prolong survival in cancer patients has yet to be tested in clinical trials, but the nice thing about healthy dietary interventions is that since they have no downsides, they can be added

Certain compounds in broccoli may have the potential to suppress this metastatic spread. In a 2010 study, scientists laid down a layer of human lung cancer cells in a petri dish and cleared a swath down the middle. Within twenty-four hours, the cancer cells had crept back together, and within thirty hours, the gap had closed completely. But when the scientists dripped some cruciferous-vegetable compounds onto the cancer cells, the cancer creep was stunted.9 Whether or not eating broccoli will help prolong survival in cancer patients has yet to be tested in clinical trials, but the nice thing about healthy dietary interventions is that since they have no downsides, they can be added to whatever other treatments one chooses.

So how does curcumin affect this process? It appears to have the ability to reprogram the self-destruct mechanism back into cancer cells. All cells contain so-called death receptors that trigger the self-destruction sequence, but cancer cells can disable their own death receptors. Curcumin, however, appears able to reactivate them.17 Curcumin can also kill cancer cells directly by activating “execution enzymes” called caspases inside cancer cells that destroy them from within by chopping up their proteins.18 Unlike most chemotherapy drugs, against which cancer cells can develop resistance over time, curcumin affects several mechanisms of cell death simultaneously, making it potentially harder for cancer cells to avoid destruction.19

When fat is heated to frying temperatures, whether it be animal fat, such as lard, or plant fat, such as vegetable oil, toxic volatile chemicals with mutagenic properties (those able to cause genetic mutations) are released into the air.22 This happens even before the “smoke point” temperature is reached.23 If you do fry at home, good ventilation in the kitchen may reduce lung cancer risk.24 Cancer risk may also depend on what’s being fried. A study of women in China found that smokers who stir-fried meat every day had nearly three times the odds of lung cancer compared to smokers who stir-fried foods other than meat on a daily basis.25 This is thought to be because of a group of carcinogens called heterocyclic amines that are formed when muscle tissue is subjected to high temperatures. (We’ll talk more about these in chapter 11.) The

plane—sometimes all by myself! She was the perfect—and perfectly doting—grandmother.

What are some of the truly potassium-rich foods? The healthiest common whole-food sources are probably greens, beans, and sweet potatoes.

The positive effects of citrus fruits on blood flow don’t require a machine to measure them. In one study, scientists recruited women who suffered from sensitivity to cold weather due to poor blood flow—women with chronically cold hands, feet, and toes—and placed them in a highly air-conditioned room. The women in the experimental group drank a solution containing actual citrus phytonutrients, while another (control) group drank a placebo (an artificially flavored orange drink). The placebo drinkers got colder and colder. Because of decreased blood flow, the temperature of their fingertips dropped nearly 9 degrees Fahrenheit during the course of the study. The fingertips of the women who drank real citrus, meanwhile, cooled less than half as fast, because their blood flow remained steadier.

They tested dozens of brands of beer to see which has the most antioxidants. (Santa Claus beer from Eggenberg, Austria, tied for first place.)46 Sadly, beer represents Americans’ fourth-largest source of dietary antioxidants.47 You can check out the list to see where your favorite foods and beverages

They tested dozens of brands of beer to see which has the most antioxidants. (Santa Claus beer from Eggenberg, Austria, tied for first place.)46 Sadly, beer represents Americans’ fourth-largest source of dietary antioxidants.47 You can check out the list to see where your favorite foods and beverages rank at this link: http://bit.ly/antioxidantfoods.

They tested dozens of brands of beer to see which has the most antioxidants. (Santa Claus beer from Eggenberg, Austria, tied for first place.)46 Sadly, beer represents Americans’ fourth-largest source of dietary antioxidants.47 You can check out the list to see where your favorite foods and beverages rank at this link: http://bit.ly/antioxidantfoods.

What does the ApoE gene do? It makes the protein that’s the principal cholesterol carrier in the brain.100 The E4 variant may lead to an abnormal accumulation of cholesterol within brain cells, which could trigger Alzheimer’s pathology.101 This mechanism may explain the so-called Nigerian paradox. The highest frequency of the ApoE4 variant occurs in Nigerians,102 who surprisingly also have some of the lowest rates of Alzheimer’s.103 Wait a second. The population with the highest rate of the “Alzheimer’s gene” has one of the lowest rates of Alzheimer’s disease? This contradiction may be explained by Nigerians’ extremely low blood-cholesterol levels, thanks to a diet low in animal fat104 and consisting mainly of grains and vegetables.105 So, it seems, diet can trump genetics.

Ideally, you should sanitize your hands after every bathroom visit and handshake, before all food preparation, and before touching your eyes, nose, or mouth after coming in contact with public surfaces. The latest recommendations from the World Health Organization favor the use of alcohol-based sanitizing rubs or gels over hand washing for routine disinfection of your hands throughout the day. (Products containing between 60 and 80 percent alcohol were found to be more effective than soap in every scientific study available for review.) The only time hand washing is preferable is when they are dirty or visibly contaminated with bodily fluids. For routine decontamination—that is, for all other times—alcohol-based products are the preferred method for hand sanitation.19

Here’s a simple recipe for a whole-food version of a tasty cranberry beverage, what I call my Pink Juice: 1 handful fresh or frozen cranberries 2 cups water 8 teaspoons erythritol (a naturally derived low-calorie sweetener; read more about erythritol and other sweeteners in part 2) Place all the ingredients in a blender and blend at high speed. Pour over ice and serve.

complications of chronic liver inflammation? It is now the third-leading cause of cancer-related death, an upsurge driven largely by increases in hepatitis C infections

The news is good. A 2013 review of the best studies to date found that people who drank the most coffee had half the risk of liver cancer compared to those who drank the least.84 A subsequent study found the consumption of four or more cups of coffee a day was associated with 92 percent lower risk among smokers dying from chronic liver disease.85 Of course, quitting smoking would have helped as well; smoking may multiply by as much as tenfold the odds of those with hepatitis C dying from liver cancer.86 Similarly, heavy alcohol drinkers who consume more than four cups of coffee per day appear to reduce their risk of liver inflammation—but not by nearly as much as people who cut down on alcohol.87

The researchers found three specific dietary components associated with this sign of declining kidney function: animal protein, animal fat, and cholesterol. Each of these is found in only one place: animal products. The researchers found no association between kidney function decline and the intake of protein or fat from plant sources.9

It’s easy to avoid added phosphorus in processed foods—just don’t buy anything containing ingredients with the word “phosphate” in their names, including pyrophosphate and sodium triphosphate.87 With meat, it’s more difficult to determine the phosphate content, as producers aren’t required to disclose injected additives.

The release of IGF-1 appears to be triggered by the consumption of animal protein.90 This may explain why you can so dramatically bolster the cancer-fighting power of your bloodstream within weeks of eating a plant-based diet. Remember the experiments in which dripping the blood from people eating healthy diets onto cancer cells wiped more of them out? Well, if you add back to the cancer cells the amount of IGF-1 that left the plant eaters’ systems, guess what happens? The diet-and-exercise effect disappears. The cancer cell growth comes surging back. This is how we suspect plant-based eating boosts our blood defenses: By reducing animal protein intake, we reduce our levels of IGF-1.91

How plant focused does a diet have to be to lower IGF-1 levels? Animal protein stimulates IGF-1 production whether it’s the muscle proteins in meat, the egg-white protein in eggs, or the milk proteins in dairy. Vegetarians who include eggs and dairy in their diets don’t seem to achieve a significant reduction in IGF-1. Only men93 and women94 who limit their intake of all animal proteins appear able to significantly drop their levels of the cancer-promoting hormone and raise their levels of the protective binding proteins.

If part of this protection arises from the aspirin phytonutrients, which plants in particular are packed with the stuff? While salicylic acid is ubiquitously present in fruits and vegetables, herbs and spices contain the highest concentrations.74 Chili powder, paprika, and turmeric are rich in the compound, but cumin has the most per serving. Indeed, just one teaspoon of ground cumin may be about the equivalent of a baby aspirin. This may help explain why India, with its spice-rich diets, has among the lowest worldwide rates of colorectal cancer75—the cancer that appears most sensitive to the effects of aspirin.76

But why would your family doctor or internist push the procedure if they’re not the ones doing it? Many doctors who refer their patients to gastroenterologists receive what are essentially financial kickbacks. The U.S. Government Accountability Office (GAO) reported on this practice of so-called self-referrals, a scheme where providers refer patients to entities in which they have a financial interest. The GAO estimated that doctors make nearly a million more referrals every year than they would have if they were not personally profiting.102

This is one of the most important concepts in all of nutrition. Yes, there is calcium in cheese, protein in pork, and iron in beef, but what about all the baggage that comes along with these nutrients—the dose of dairy hormones, the lard, the saturated fat? As much as Burger King proclaims you can “Have It Your Way,” you can’t go up to the counter and ask for a burger, hold the saturated fat and cholesterol. Food is, indeed, a package deal. Dairy is the number-one source of calcium in the United States, but it’s also the number-one source of saturated fat. What kind of “baggage” do you get along with the calcium in green, leafy vegetables? Fiber, folate, iron, and antioxidants—some of the very nutrients lacking in milk. By getting most of your nutrition from whole plant foods, you get a bonus instead of baggage. When the National Pork Board promotes ham as an “excellent source of protein,”12 I can’t help but think of the famous quote from a McDonald’s senior vice president for marketing who, under oath in a court of law, described Coca-Cola as nutritious because it is “providing water.”13

When the Guidelines tell you to eat less added sugar, calories, cholesterol, saturated fat, sodium, and trans fat, that’s code for eat less junk food, less meat, less dairy, fewer eggs, and fewer processed foods. But they can’t actually say that. When they did in the past, all heck broke loose. For example, when a USDA employee newsletter even suggested trying a meat-free lunch once a week as part of Johns Hopkins University’s School of Public Health “Meatless Mondays” initiative,17 the resulting political firestorm from the meat industry led the USDA to retract the advice just hours later.18 “As a result of these conflicts [of interest],” concluded an analysis in the Food and Drug Law Journal, “the Guidelines sometimes favor the interests of the food and drug industries over the public’s interest in accurate and impartial dietary advice.”19 This reminds me of the landmark report on trans fat from the National Academy of Sciences’ Institute of Medicine, one of our most prestigious institutions.20 They concluded that no amount of trans fat is safe “because any incremental increase in trans fatty acid intake increases C[oronary] H[eart] D[isease] risk.”21 Since trans fats are found naturally in meat and dairy products,22 this placed them in a quandary: “Because trans fats are unavoidable in ordinary, nonvegan diets, consuming 0 percent of energy would require significant changes in patterns of dietary intake.”23 So if trans fats are found in meat and dairy and the only safe intake of trans fats is zero, that means the Institute of Medicine went on to encourage everyone to start eating a plant-based diet, right? No, they did not. The director of Harvard’s Cardiovascular Epidemiology Program famously explained why: “We can’t tell people to stop eating all meat and all dairy products,” he said. “Well, we could tell people to become vegetarians,” he added. “If we were truly basing this only on science, we would, but it is a bit extreme.”24 We certainly wouldn’t want scientists to base anything on science!

I remember a man once telling me that he could never “go plant based” because he could never give up his grandma’s chicken soup. Huh? Then don’t! After I asked him to say hello to his bubby for me, I told him that enjoying her soup shouldn’t keep him from making healthier choices the rest of the time. The problem with all-or-nothing thinking is that it keeps people from even taking the first steps. The thought of never having pepperoni pizza again somehow turns into an excuse to keep ordering it every week. Why not scale down to once a month or reserve it for special occasions? We cannot let the “perfect” be the enemy of the good.

Today, Google whole-food, plant-based recipes, and a million hits pop up. If you’re feeling overwhelmed, good places to start include: • ForksOverKnives.com: This site of the wildly popular documentary and book of the same name offers hundreds of recipes. • StraightUpFood.com: Cooking instructor Cathy Fisher shares more than one hundred recipes on this site. • HappyHealthyLongLife.com: This site’s tagline reads: “A [Cleveland Clinic] medical librarian’s adventures in evidence-based living.” She used the e word—I think I’m in love!

If you crave more structure and social support, the Physicians Committee for Responsible Medicine (PCRM), a nonprofit nutrition research and policy advocacy organization in Washington, D.C., has a fantastic three-week kick-start program for plant-based eating. Check it out at 21DayKickstart.org. This free online nutrition program starts the first of every month and offers a full meal plan, recipes, tips, resources, a restaurant guide, and a community forum. As of this writing, it’s offered in four languages. Hundreds of thousands of people have already benefited from it, so feel free to give it a try.

original source material? Early on in my practice, I decided that I didn’t want to rely on anyone else’s interpretation for what could ultimately be life-or-death decisions for my patients. I had the access, the resources, and the background to interpret the science on my own. When I initially began my annual reviews of the nutrition literature, it was really just to make myself a better doctor. But when I discovered such a treasure trove of information, I knew I couldn’t keep it to myself. My hope is to disseminate it in a way that removes me as much as possible from the equation. I don’t want to present the trademarked Dr. Greger Diet; I want to present the best-available-evidence diet. That’s why I show the original papers, charts, graphs, and quotes with links to all the primary sources in my NutritionFacts.org videos. I try to keep my own interpretation to a minimum—though admittedly, I sometimes can’t help myself!

Miso is another fermented whole soy food. This thick paste is commonly mixed with hot water to make a delicious soup that’s a staple in Japanese cuisine. If you want to give it a try, I suggest white miso, which has a mellower flavor than red miso. Making miso soup can be as easy as mixing one tablespoon of miso with two cups of hot water and whatever vegetables you prefer. That’s it! Because miso may contain probiotic bacteria,19 it’s probably best not to actually cook the miso, lest the good bugs be wiped out. When I prepare it, I boil dried mushrooms, a pinch of arame seaweed, a few sun-dried tomatoes, and greens in a pot and ladle off about a quarter cup of hot broth into a large bowl, add the miso, and mash it with a fork until only a thin paste remains. I then pour the rest of the soup into the bowl and stir to combine it with the miso. And, because I’m a bit of a hot-sauce freak, I add some Sriracha for a little kick. My new favorite addition is freshly toasted sesame seeds. I pour out a layer of raw, hulled sesame seeds, put them in the toaster oven until they just start to turn golden, and then throw them sizzling into the soup. Makes the whole kitchen smell heavenly.

Lentils are already one of the most nutrient-dense legumes. But when sprouted, their antioxidant power doubles (and even quintuples for chickpeas).37 Lentils can be easily sprouted into one of the healthiest possible snacks. I was amazed when I first tried making them. What start out looking like hard little pebbles transform into tender morsels in just a couple of days. Why add protein powder to your smoothies when you can add sprouted lentils? In a sprouting jar, or simply a mason jar covered with cheesecloth secured with a rubber band, soak lentils overnight in water, drain, and then rinse and drain twice daily for another couple of days. Sprouting to me is like gardening on steroids—I can create fresh produce in three days right on my kitchen counter.

Any leguminous dessert options? Three words: black-bean brownies. I don’t have a recipe of my own, but if you poke around online, you’ll find many good ones, including the one Dr. Joel Fuhrman shared on The Dr. Oz Show, which uses almond butter as the green-light source of fat and dates as the green-light source of sugar.44

Guess which have more antioxidants—red onions or white onions? You don’t need to look up the answer. You can see the difference with your own eyes. (Indeed, red onions have 76 percent more antioxidant capacity than white, with yellow onions in between.3) So, given the choice, why buy another white onion ever again? Red cabbage may contain eight times more antioxidants than green cabbage,4 which is why you’ll never find a green cabbage in my house. Pop quiz: Which wipes out more free radicals—pink grapefruit or regular grapefruit? Granny Smith or Red Delicious? Iceberg lettuce or romaine? Red grapes or green? Yellow corn or white corn? See, you don’t need me to go to the grocery store with you. You can make all these calls yourself.

Shop for the reddest of strawberries, the blackest of blackberries, the most scarlet tomato, the darkest green broccoli you can find. The colors are the antiaging, anticancer antioxidants.

Studies show that if you drink a glass of water with three tablespoons of sugar (similar to what would be in a can of soda), you’ll have a big spike in your blood sugar levels within the first hour. That causes your body to release so much insulin to mop up the excess sugar that you actually overshoot and become hypoglycemic by the second hour, meaning that your blood sugar drops even lower than it would if you were fasting. Your body detects this low blood sugar, thinks you might be in some sort of famine situation, and responds by dumping fat into your bloodstream as an energy source to keep you alive.13 This excess fat in the blood can then go on to cause further problems. (See chapter 6.) But what if you eat a cup of blended berries in addition to the sugar? The berries, of course, have sugars of their own—an additional tablespoon’s worth—so the blood sugar spike should be even worse, right? Actually, no. Study participants who ate berries with their cup of sugar water showed no additional blood sugar spike and no hypoglycemic dip afterward; their blood sugar levels merely went up and down, and there was no surge of fat into the blood.14 Consuming sugar in fruit form is not only harmless but actually helpful. Eating berries can blunt the insulin spike from high-glycemic foods like white bread, for example.15 This may be because the fiber in fruit has a gelling effect in your stomach and small intestine that slows the release of sugars16 or because of certain phytonutrients in fruit that appear to block the absorption of sugar through the gut wall and into your bloodstream.17 So eating fructose the way nature intended carries benefits rather than risks.

Cherries can reduce the level of inflammation among healthy people too (as measured by a drop in C-reactive protein levels),32 so I was excited to find a green-light source available year-round—a canned product with only two ingredients: cherries and water. I drain off the liquid (which then goes into my hibiscus punch recipe here) and mix the cherries in a bowl of cooked oatmeal along with cocoa powder and pumpkin seeds. If you sweeten it with date sugar or erythritol (see here), it’s like eating chocolate-covered cherries for breakfast.

Cooking without oil is surprisingly easy. To keep foods from sticking, you can sauté in wine, sherry, broth, vinegar, or just plain water. For baking, I’ve successfully used green-light ingredients such as mashed bananas or avocado, soaked prunes, and even canned pumpkin to substitute for oil to provide a similar moistness.

Cooking without oil is surprisingly easy. To keep foods from sticking, you can sauté in wine, sherry, broth, vinegar, or just plain water. For baking, I’ve successfully used green-light ingredients such as mashed bananas or avocado, soaked prunes, and even canned pumpkin to substitute for oil to provide a similar moistness.

I think of oil as the table sugar of the fat kingdom. Similar to the way manufacturers take healthy foods like beets and throw out all their nutrition to make sugar, they take wholesome corn and scorch-earth it down to corn oil. Like sugar, corn oil calories may be worse than just empty. In chapter 1, I touched on the impairment of artery function that can occur within hours of eating red-light fare like fast food and cheesecake. The same detrimental effect happens after the consumption of olive oil8 and other oils9 (but not after eating green-light sources of fat like nuts).10 Even extra-virgin olive oil may impair your arteries’ ability to relax and dilate normally.11 So, like any yellow-light food, its use should be curtailed.

This made me determined to make my own. I bought an inexpensive dehydrator from eBay, and I’m so glad I did. Fruit is about 90 percent water, so imagine intensifying the flavor of a fresh, ripe mango tenfold. Mind-blowing! Mangos can be a messy pain to peel, but once that’s done, I slice them about a centimeter thick and sprinkle them with chia seeds before putting them in the dehydrator. If I’m taking them on a plane or a hike, I’ll dry them completely. Otherwise, I only wait until just the outside is dry. The outer layer, encrusted with chia, gets a crispy texture while the core remains moist and ready to burst. It’s the kind of thing I can’t eat while watching a movie or reading a book. It tastes so good I just have to stop, close my eyes, and savor it. I also like drying thin apple slices. I either sprinkle them with cinnamon or rub them with freshly grated ginger. They can be just dried until chewy or completely dehydrated into crunchy apple chips. Eating a dozen dried apple rings a day may drop LDL cholesterol levels 16 percent within three months and 24 percent within six months.17 If you buy

This made me determined to make my own. I bought an inexpensive dehydrator from eBay, and I’m so glad I did. Fruit is about 90 percent water, so imagine intensifying the flavor of a fresh, ripe mango tenfold. Mind-blowing! Mangos can be a messy pain to peel, but once that’s done, I slice them about a centimeter thick and sprinkle them with chia seeds before putting them in the dehydrator. If I’m taking them on a plane or a hike, I’ll dry them completely. Otherwise, I only wait until just the outside is dry. The outer layer, encrusted with chia, gets a crispy texture while the core remains moist and ready to burst. It’s the kind of thing I can’t eat while watching a movie or reading a book. It tastes so good I just have to stop, close my eyes, and savor it. I also like drying thin apple slices. I either sprinkle them with cinnamon or rub them with freshly grated ginger. They can be just dried until chewy or completely dehydrated into crunchy apple chips. Eating a dozen dried apple rings a day may drop LDL cholesterol levels 16 percent within three months and 24 percent within six months.17

This made me determined to make my own. I bought an inexpensive dehydrator from eBay, and I’m so glad I did. Fruit is about 90 percent water, so imagine intensifying the flavor of a fresh, ripe mango tenfold. Mind-blowing! Mangos can be a messy pain to peel, but once that’s done, I slice them about a centimeter thick and sprinkle them with chia seeds before putting them in the dehydrator. If I’m taking them on a plane or a hike, I’ll dry them completely. Otherwise, I only wait until just the outside is dry. The outer layer, encrusted with chia, gets a crispy texture while the core remains moist and ready to burst. It’s the kind of thing I can’t eat while watching a movie or reading a book. It tastes so good I just have to stop, close my eyes, and savor it. I also like drying thin apple slices. I either sprinkle them with cinnamon or rub them with freshly grated ginger. They can be just dried until chewy or completely dehydrated into crunchy apple chips. Eating a dozen dried apple rings a day may drop LDL cholesterol levels 16 percent within three months and 24 percent within six months.17

The formation of sulforaphane in cruciferous vegetables is like a chemical flare reaction. It requires the mixing of a precursor compound with an enzyme called myrosinase, which is inactivated by cooking8 (though microwaved broccoli appears to retain some cancer-fighting capacity). This may explain why we see dramatic suppression of test-tube cancer-cell growth by raw broccoli, cauliflower, and brussels sprouts, but hardly any reaction when they’re cooked.9 But who wants to eat raw brussels sprouts? Not me. Thankfully, there are ways to get the benefits of raw vegetables in cooked form.

Biting into broccoli is like snapping that chemical flare. When raw broccoli (or any other cruciferous vegetable) is chopped or chewed, the sulforaphane precursor mixes with the myrosinase enzyme and sulforaphane is created as the vegetable sits on the cutting board or lies in your upper stomach waiting to be digested.10 Though the enzyme is destroyed by cooking, both the precursor and the final product are resistant to heat. So here’s the trick: Use what I call the “Hack and Hold” technique (maybe I should call it Whack and Wait?). If you chop the broccoli (or brussels sprouts, kale, collards, cauliflower, or any other cruciferous vegetable) and then wait forty minutes, you can cook it as much as you want. At that point, the sulforaphane has already been made, so the enzyme is no longer needed to achieve maximum benefit. It’s already done its job. (You can also buy bags of fresh greens and other crucifers that are prechopped or shredded, which can presumably be cooked immediately.)

Given this understanding, can you see how most people prepare broccoli soup incorrectly? Typically, they first cook the broccoli and then blend it. But, when you blend it, you’re merely mixing the precursor with an enzyme that’s been inactivated by cooking. Do it in the opposite order: First blend your veggies and then wait forty minutes before cooking them. This way, you can maximize sulforaphane production. What about frozen broccoli and other crucifers? Commercially produced frozen broccoli lacks the ability to form sulforaphane because the vegetables are blanched (flash-cooked) before they’re frozen for the very purpose of deactivating enzymes.11 This process prolongs shelf life, but when you take the veggies out of your freezer, the enzyme is inert. At that point, it doesn’t matter how much you chop or how long you wait—no sulforaphane is going to be made. This may be why fresh kale has been shown to suppress cancer cell growth in vitro up to ten times better than frozen kale.12

The frozen crucifer is still packed with the precursor, though—remember, it’s heat resistant. You could make lots of sulforaphane from it by adding back some enzyme.13 But where can you get myrosinase? Scientists buy theirs from chemical companies, but you can just walk into any grocery store. Mustard greens are also cruciferous vegetables. They grow from mustard seeds, which you can buy ground up in the spice aisle as mustard powder. If you sprinkled some mustard powder on frozen broccoli that’s been cooked, would it start churning out sulforaphane? Yes! Boiling broccoli prevents the formation of any significant levels of sulforaphane due to inactivation of the enzyme. However, the addition of powdered mustard seeds to cooked broccoli significantly increases sulforaphane formation.14 Then it’s almost as good as eating it raw! So, if you don’t have forty minutes to spare between chopping and cooking, or if you’re using frozen greens, just sprinkle the crucifers with some mustard powder before you eat them, and you’ll be all set. Daikon radishes, regular radishes, horseradish, and wasabi are all cruciferous vegetables and may have the same effect. All it appears to take is a pinch to revitalize sulforaphane production.15 You can also add a small amount of fresh greens to your cooked greens. So when I add shreds of purple cabbage to my finished dishes, it not only adds a beautiful garnish with a delightful crunch, it’s filled with the sulforaphane-producing enzyme.

Roasting Cruciferous Vegetables As much as I love mashed cauliflower, roasted cauliflower (or broccoli, for that matter) is my favorite. Roasting brings out a nutty, caramelized flavor. I slice raw cauliflower into “steaks,” roast at 400°F for about a half hour, and then smother it in a lemon-tahini sauce. Sometimes I go minimalist and just sprinkle on lemon juice, zest, capers, and garlic. (This chapter is making me hungry!)

After chopping and discarding the waste, red cabbage averages 45 cents a cup.19 But broccoli sprouts—if you make them yourself—may be even cheaper. Broccoli sprout seeds can be purchased online or at natural foods stores for about twenty dollars a pound, but that makes about seventy-five cups of sprouts. In terms of sulforaphane content, that may be around three hundred cups of mature broccoli. So DIY broccoli sprouts provide a green-light sulforaphane source for about a nickel a day. Sprouting broccoli sprouts is as easy as sprouting lentils. Start with a mason jar with a sprouting (screen) lid. Add a tablespoon of seeds, let them soak overnight in water, drain in the morning, and then after that, just quickly rinse and drain twice a day. Most people wait for about five days, until the seeds fully sprout (taking on the look of alfalfa sprouts), but new science suggests sulforaphane content peaks at forty-eight hours after the seeds are initially drained.20 This makes them even quicker and easier to grow and eat. When I’m not traveling, I usually have a few jars in rotation. It can be the middle of winter, and I’m growing my own salad on my kitchen counter! Every day, you can get cups of fresh produce for your family without ever having to go to the store.

Patent publication number EP 1069819 B1. Method for selective increase of the anticarcinogenic glucosinolates in brassica species. http://www.google.com/patents/EP1069819B1?cl=en. July 24, 2002. Accessed April 13, 2015.

Q10.17 CoQ10, also known as ubiquinol, is an antioxidant. When ubiquinol extinguishes a free radical, it is oxidized to ubiquinone. To act as an effective antioxidant again, the body must regenerate ubiquinol from ubiquinone. Think of it like an electrical fuse: Ubiquinol can only be used once before having to be reset. That’s where sunlight and chlorophyll may come in. Researchers exposed some ubiquinone and dietary chlorophyll metabolites to the kind of light that reaches your bloodstream … and poof! CoQ10 was reborn. However, without the chlorophyll, or without the light, nothing happened. All along, we’ve been thinking that the main benefit of sunlight was only the formation of vitamin D and that the main benefit of greens was the antioxidants they contain. But now we suspect the combination of the two may actually help the body create and maintain its own internal stock of antioxidants.

The sweetness trick is why green smoothies can be so delicious (if not a little odd looking). Smoothies can be a great way to introduce greens into children’s diets. The basic triad is a liquid, ripe fruit, and fresh greens. I’d start with a two-to-one ratio of fruits to greens to start with before tipping heavier toward greens on the scale. So, for example, one cup of water, a frozen banana, a cup of frozen berries, and a cup of packed baby spinach would be a classic green smoothie 101. I like to add fresh mint leaves as well for a boost of flavor (and even more greens). Fresh herbs can be expensive at the store, but mint can grow like a weed in your yard or in a pot on your windowsill. Eating greens for breakfast can be as delicious as mint chocolate oatmeal—cooked oatmeal, chopped mint leaves, cocoa powder, and a healthy sweetener (see here). When you’re thinking about ways to pair your greens with something you already love to make the greens more palatable, consider mixing them with a green-light source of fat: nuts, seeds, nut or seed butters, or avocados. Many of the nutrients greens are famous for are fat soluble, including beta-carotene, lutein, vitamin K, and zeaxanthin. So pairing your greens with a green-light source of fat may not only make them taste better but will maximize nutrient absorption. This can mean enjoying a creamy tahini-based dressing on your salad, putting walnuts in your pesto, or sprinkling some toasted sesame seeds on your sautéed kale. The jump in nutrient absorption is no small effect. When researchers tried feeding people a healthy salad of spinach, romaine, carrots, and tomatoes along with a source of fat, there was an impressive spike in carotenoid phytonutrients in their bloodstream over the next eight hours. With a fat-free dressing, carotenoid absorption flatlined down to negligible amounts; it was as if they’d never eaten the salad at all.23 Similarly, adding some avocado to your salsa may triple the amount of fat-soluble nutrients that make it into your bloodstream (in this case, the lycopene in the tomatoes).24 It doesn’t take much. Just three grams of fat in an entire hot meal may be sufficient to boost absorption.25 That’s just a single walnut or a spoonful of avocado or shredded coconut. Snack on a few pistachios after a meal, and you’re all set. The greens and the source of fat just have to end up in your stomach at the same time. Another way

You can also find prepackaged pouches of Indian food online or at Indian or natural foods markets. Again, I’d use them as sauces rather than eat them as a meal in themselves. My favorite is spinach dal—that way, I’m eating greens in a greens sauce! That’s like the kale-pesto principle: Use one green (basil) to make the other green (kale) taste better.

Salad Days Having a big salad every day is a great way to burn through the Daily Dozen. To a base of mesclun greens and arugula, I add tomato, red bell pepper, beans, and barberries, along with toasted nuts if I’m using a fat-free dressing. My current favorite dressing recipe is a Caesar spin-off shared by Dr. Michael Klaper from the TrueNorth Health Center: 2 tablespoons almond meal 3 cloves crushed garlic 3 tablespoons dijon mustard 3 tablespoons nutritional yeast flakes 2 tablespoons white miso 3 tablespoons lemon juice 1/3 cup water Blend and enjoy! (If you have a high-speed blender, you could probably use whole almonds instead of meal.)

Sweet potatoes are one of my favorite snacks. During harsh Boston winters while I was in medical school, I would take two freshly microwaved sweet potatoes and pop them in my coat pockets as natural hand warmers. When they cooled down, my hand warmers became instant healthy snacks! It’s actually better to boil them, though, to best preserve their nutritional content.33 Regardless of your cooking method, be sure to keep on the skin. The peel of the sweet potato has nearly ten times the antioxidant power as the inner flesh (on a per-weight basis), giving them an antioxidant capacity approaching that of blueberries.34 Sweet potatoes themselves

Sweet potatoes are one of my favorite snacks. During harsh Boston winters while I was in medical school, I would take two freshly microwaved sweet potatoes and pop them in my coat pockets as natural hand warmers. When they cooled down, my hand warmers became instant healthy snacks! It’s actually better to boil them, though, to best preserve their nutritional content.33 Regardless of your cooking method, be sure to keep on the skin. The peel of the sweet potato has nearly ten times the antioxidant power as the inner flesh (on a per-weight basis), giving them an antioxidant capacity approaching that of blueberries.34 Sweet potatoes themselves can be considered a superfood.35 They are ranked as one of the healthiest foods on the planet36 and one day, perhaps, even off the planet—NASA has chosen them for future space missions.37 In fact, they’re among the healthiest and cheapest, with one of the highest nutrient-rich food scores per dollar.38 When picking out varieties at the supermarket, remember that a sweet potato’s nutritional content is tied directly to the intensity of its color. The more yellow or orange its flesh, the healthier it may be.39 Sweet potatoes are healthier than plain potatoes, but if you’re going to choose the latter, seek out those with blue or purple flesh. The consumption of one boiled purple potato a day for six weeks was found to significantly decrease inflammation, something neither white nor yellow potatoes were able to accomplish.40 The same was found for oxidation, but much faster. Within hours of consumption, purple potatoes increased the antioxidant capacity of study subjects’ bloodstream, whereas white potato starch appeared to actually have a pro-oxidant effect.41 Blue potatoes may have ten times more antioxidant power than regular white ones.42 The most exciting purple potato study to date had people with hypertension eat six to eight microwaved small purple potatoes a day, and they were able to significantly bring down their blood pressure levels within a month.43 Purple sweet potatoes may offer the best of both worlds.44 I was so excited to discover them that I bought them as holiday gifts for my family one year—stocking stuffers they could stuff themselves with!

As the above salad example illustrates, garlic, onions, leeks, and other vegetables in the allium family appear to have special properties. Wait a second, though. Like chemotherapy, maybe garlic isn’t just toxic to cancer cells but toxic to all cells? That wouldn’t be good. Researchers also wondered about this, so they decided to compare the effects of garlic and other vegetables on the growth of both cancer cells and normal cells. The same garlic dose that blocked nearly 80 percent of cancer cell proliferation appeared to have no effect whatsoever against normal cells, and similar results were found for the other allium and cruciferous vegetables. In other words, vegetables are selective; they destroy cancer cells but leave normal cells alone.

Is it better to eat your vegetables raw or cooked? If you’re thinking raw, you’re right. But if you guessed cooked, you’re also right.66 Confused? Well, a number of nutrients, like vitamin C, are partially destroyed by cooking. For example, steamed broccoli may have about 10 percent less vitamin C than raw broccoli.67 If, however, you prefer cooked broccoli enough to eat seven florets of steamed rather than six florets of raw, then you just more than made up the difference. Other nutrients, however, actually become more absorbable after cooking. For example, you end up with more than six times the vitamin A in your bloodstream from cooked carrots compared to raw ones.68 A study of long-term raw foodists found surprisingly low blood levels of the red antioxidant pigment lycopene.69 It’s not what you eat but what you absorb, and cooked tomatoes appear able to better boost your lycopene levels.70 Steaming may also improve the bile acid–binding capacity of vegetables,71 which may help lower breast cancer risk.72

whole plant foods. Some cooking methods, though, are preferable to others. Deep-fried foods, whether of plant origin (like french fries) or from animals (like fried chicken), have been associated with higher cancer risk.73 Deep-frying leads to the production of dangerous heterocyclic amines in meat (as detailed in chapter 11) and to acrylamide in deep-fried plant foods. The excess lifetime cancer risk attributable to the consumption of french fries in young children, for example, may be as high as one or two in ten thousand—meaning about one in ten thousand boys and girls eating french fries may develop cancer that would have otherwise not occurred had they not eaten french fries. The researchers urge deep-fryer cooking times and temperatures be set as low as possible “while still maintaining a tasty quality.”74 (They wouldn’t want to reduce cancer so much that the deep-fried foods wouldn’t be as tasty!) Blanching potatoes first can reduce acrylamide formation, but potato chip companies argue that this might have a negative impact on the “nutritional properties of the fried product,” because it would leach away some of the vitamin C.75 But if you’re relying on potato chips to get your vitamin C, acrylamide is probably the least of your worries.

Thankfully, there is a solution that is both cheap and effective: salt water. A 10 percent saltwater rinse has been found to work as well as full-strength vinegar.86 To make your own pesticide-reducing bath, add one part salt to nine parts water. Just make sure to rinse off all the salt before eating.

use a half teaspoon each of smoked paprika, garlic powder, and onion powder, but you should play around until you find a (salt-free) spice profile you prefer. When cut into thirty-two pieces,

all green-light ingredients. Honestly, it’s pretty easy to make your own flax crackers. Mix two cups of ground flaxseeds with a cup of water, add whatever herbs and spices you want, and then spread the dough thinly on a parchment- or silicone-lined baking sheet. Score the dough into thirty-two crackers and bake at 400°F for about twenty minutes. To flavor mine, I use a half teaspoon each of smoked paprika, garlic powder, and onion powder, but you should play around until you find a (salt-free) spice profile you prefer. When cut into thirty-two pieces, each cracker meets your Daily Dozen serving requirement.

I also use my trusty discount dehydrator to make raw flax crackers. All you do is mix a cup of whole flaxseeds with a cup of water along with flavorful ingredients like sun-dried tomatoes and basil. After it firms for about an hour and gets a jelly-like consistency, I spread it out thinly and dehydrate away. Give it a try! Dip your flax crackers in hummus or another bean dip for double check marks. Since you’re using whole flaxseeds, though, make sure to chew thoroughly for maximum benefit.

Flaxseeds have a wonderful binding quality that makes them a great ingredient for thick, milkshake-like smoothies. Toss a tablespoon of ground flax into a blender with some frozen berries, unsweetened soy milk, and half a ripe banana or mango or a few dates for sweetness, and you have a delicious drink containing both classes of protective phytoestrogens—lignans in flax and isoflavones in soy. (See chapter 11.) Blend in some cocoa powder for a chocolate milkshake that could help improve your chances of both preventing and surviving breast and prostate cancers.

This same binding quality makes flaxseeds a green-light thickener to replace cornstarch. I use flax to make my favorite quickie stir-fry sauce. I start with some bok choy and fresh mushrooms. The water clinging to the bok choy after it’s rinsed, along with the liquid that gets released from the mushrooms while cooking, is enough to flash-steam the veggies in a hot pan without any added oil. Once the bok choy is tender-crisp, I add a cup of water mixed with a tablespoon each of tahini, ground flaxseeds, and Asian black-bean garlic sauce, a fermented yellow-light condiment you can find in a jar at most large grocery stores. Once the sauce thickens, it’s ready for some fresh ground pepper (and hot sauce, if you’ve got that spicy tooth like I do) and … voilà! You can even use ground flaxseeds to replace eggs in baking. For each egg in the recipe, whisk one tablespoon of ground flaxseeds with three tablespoons of water until the mixture becomes gooey. Unlike chicken eggs, “flax eggs” are not only cholesterol-free but they’re also packed with soluble fiber to bring your cholesterol down11 instead of up.

This same binding quality makes flaxseeds a green-light thickener to replace cornstarch. I use flax to make my favorite quickie stir-fry sauce. I start with some bok choy and fresh mushrooms. The water clinging to the bok choy after it’s rinsed, along with the liquid that gets released from the mushrooms while cooking, is enough to flash-steam the veggies in a hot pan without any added oil. Once the bok choy is tender-crisp, I add a cup of water mixed with a tablespoon each of tahini, ground flaxseeds, and Asian black-bean garlic sauce, a fermented yellow-light condiment you can find in a jar at most large grocery stores. Once the sauce thickens, it’s ready for some fresh ground pepper (and hot sauce, if you’ve got that spicy tooth like I do) and … voilà! You can even use ground flaxseeds to replace eggs in baking. For each egg in the recipe, whisk one tablespoon of ground flaxseeds with three tablespoons of water until the mixture becomes gooey. Unlike chicken eggs, “flax eggs” are not only cholesterol-free but they’re also packed with soluble fiber to bring your cholesterol down11 instead of up.

sprigs of cilantro daily for two months reduced inflammation

This may actually be an advantage, though, because cilantro is healthy stuff. Mother Nature has been described as the most comprehensive pharmacy of all time, and cilantro is one of her oldest herbal prescriptions.46 About twenty sprigs of cilantro daily for two months reduced inflammation levels in arthritis sufferers and cut uric-acid levels in half, suggesting that lots of cilantro may be useful for people suffering from gout.47

Ginger Many successful natural treatments start like this: Some doctor learns that a plant has been used in some ancient medical tradition and figures, “Why not try it in my practice?” Ginger has been used for centuries for headaches, and so a group of Danish physicians advised one of their migraine patients to give it a go. At the first sign of a migraine coming on, the patient mixed a quarter teaspoon of powdered ginger in some water and drank it. Within thirty minutes, the migraine disappeared. And it worked every time for her, with no apparent side effects.55

Eventually, a double-blind, randomized, controlled clinical trial was performed comparing the efficacy of ginger for the treatment of migraine headaches to sumatriptan (Imitrex), one of the top-selling, billion-dollar drugs in the world. Just one-eighth of a teaspoon of powdered ginger worked just as well and just as fast as the drug (and costs less than a penny). Most migraine sufferers started with moderate or severe pain, but after taking the drug or the ginger, ended up in mild pain or were entirely pain-free. The same proportion of migraine sufferers reported satisfaction with the results either way.

You can buy amla online or at any Indian spice store. Ayurvedic herbal supplements are typically something you’d want to stay away from, as they have been found to be heavily contaminated with heavy metals,90 some of which are actually added intentionally.91 But none of the samples of powdered amla tested so far has been found to be contaminated. You can find whole Indian gooseberries in the frozen section of Indian grocery stores, but frankly, I find them inedible—astringent, sour, bitter, and fibrous all at the same time. The powder isn’t much tastier, but it can be disguised in something with a strong flavor, like a smoothie. Alternatively, you could pack amla into capsules like the turmeric. Whenever I’m out on the road on a speaking tour, I try to take daily capsules of turmeric and amla until I can get back home and wrest back control over my diet.

Too much nutmeg can also be a problem. A paper entitled “Christmas Gingerbread … and Christmas Cheer: Review of the Potential Role of Mood Elevating Amphetamine-like Compounds…” suggested that certain natural constituents of spices like nutmeg may form amphetamine compounds within the body sufficient “to elevate the mood and to help provide some added

Christmas cheer” during the holiday season.102 This hypothetical risk was raised as far back as the 1960s in the New England Journal of Medicine in an article called “Nutmeg Intoxication.”103 The paper pondered whether the age-old custom of adding nutmeg to eggnog arose from the “psychopharmacological effect” described in cases of nutmeg intoxication. Such cases evidently go back to the 1500s, when nutmeg was used as an abortifacient to induce a miscarriage.104 In the 1960s, the spice was used as a psychotropic drug.105 During that decade, mental health professionals concluded that while nutmeg “is much cheaper for use and probably less dangerous than the habit-forming heroin, it must be stated that it

There are two main types of cinnamon: Ceylon cinnamon and cassia cinnamon (also known as Chinese cinnamon). In the United States, anything simply labeled “cinnamon” is probably cassia, since it’s cheaper. This is unfortunate, because cassia contains a compound called coumarin, which may be toxic to the liver at high doses. Unless it’s specifically labeled Ceylon cinnamon, a quarter teaspoon of cinnamon even a few times a week may be too much for small children, and a daily teaspoon would exceed the tolerable upper safety limit for adults.111 Can’t you just switch to Ceylon cinnamon and get the benefits without the risks? Without the risks, yes, but we’re no longer so sure about the benefits.

Dr. Greger’s Eight Check-Mark Pesto 2 cups fresh basil leaves ¼ cup freshly toasted walnuts 2 cloves fresh garlic ¼ of a peeled lemon ¼ teaspoon lemon zest ¼ inch of fresh turmeric root (or ¼ teaspoon turmeric powder) ¼ cup pinto beans ¼ cup water or liquid from bean can 1 tablespoon white miso Pepper to taste Combine all ingredients in a food processor. Blend until smooth. Scoop onto a cup and a half of cooked whole-grain pasta.

The Five-to-One Rule If you buy packaged grain products, anything labeled on the front with words like “multigrain,” “stone-ground,” “100% wheat,” “cracked wheat,” “seven-grain,” or “bran” is usually not a whole-grain product. They’re trying to distract you from the fact that they’re using refined grains. Here, color may not help. Ingredients like “raisin juice concentrate” are used to darken white bread to make it look healthier. Even if the first word in the ingredients list is “whole,” the rest of the ingredients could be junk. I suggest using the Five-to-One Rule. When buying healthier, whole-grain products, look at the Nutrition Facts label on the package and see if the ratio of grams of carbohydrates to grams of dietary fiber is five or less (see figure 7). For example, let’s see if 100 percent whole-wheat Wonder Bread passes the test: Per serving, the package lists 30 grams of carbohydrates and 3 grams of fiber. Thirty divided by 3 is 10. Well, 10 is more than 5, so the 100 percent whole-wheat Wonder Bread goes back on the shelf even though, technically, it’s a whole-grain product. Compare that to Ezekiel bread, a sprouted-grain bread based on a biblical verse. It has 15 grams of carbohydrates and 3 grams of fiber, and, just like that, passes the test. So do Ezekiel english muffins, which taste great with fruit-only jam and nut butter. Though the science on the potential benefits of sprouted grains is still in its infancy, available data look promising.

I already discussed the role green tea may play in breast cancer prevention in chapter 11. Drinking tea may protect against gynecological malignancies, such as ovarian cancer59 and endometrial cancer,60 as well as lower your cholesterol,61 blood pressure,62 blood sugar,63 and body fat.64 It may protect the brain from both cognitive decline65 and stroke.66 Tea consumption is also associated with decreased risk of diabetes,67 tooth loss,68 and up to half the risk of dying from pneumonia.69 Those who suffer from seasonal allergies may also benefit from drinking tea. Randomized trials have shown that drinking about three cups of Japanese Benifuuki green tea per day starting six70 to ten71 weeks before pollen season significantly reduces allergy symptoms. That’s nothing to sneeze at!

How about stevia? During the 1990s, research out of Japan found that steviosides, the “active” ingredient in stevia, appeared harmless. But in the guts of rats, intestinal bacteria transformed steviosides into a toxic substance called steviol, which can cause a big spike in mutagenic DNA damage in vitro.88 Unfortunately, it turns out that humans have the same bacterial activity in their guts.89 It’s the dose that makes the poison, though. The World Health Organization considers up to 1.8 mg of stevia compounds per pound of body weight to be a safe amount. Given the American sweet tooth, though, if we sweetened everything with stevia, you could exceed that safety limit. But just drinking up to two stevia-sweetened beverages a day should be considered harmless.

How about stevia? During the 1990s, research out of Japan found that steviosides, the “active” ingredient in stevia, appeared harmless. But in the guts of rats, intestinal bacteria transformed steviosides into a toxic substance called steviol, which can cause a big spike in mutagenic DNA damage in vitro.88 Unfortunately, it turns out that humans have the same bacterial activity in their guts.89 It’s the dose that makes the poison, though. The World Health Organization considers up to 1.8 mg of stevia compounds per pound of body weight to be a safe amount. Given the American sweet tooth, though, if we sweetened everything with stevia, you could exceed that safety limit. But just drinking up to two stevia-sweetened beverages a day should be considered harmless.90 The sugar alcohols sorbitol and xylitol are harmless in themselves, but they aren’t absorbed by the body and end up in the colon, where they can draw in fluid and cause diarrhea. This is why they’re only used commercially in small quantities, such as in mints or chewing gum, as opposed to beverages. A related compound, however, erythritol, is absorbed and may have the harmlessness of xylitol without the laxative effect. Erythritol is found naturally in pears and grapes, but industrially, yeast is used to produce it. Erythritol doesn’t cause cavities,91 and it hasn’t been implicated in fibromyalgia,92 preterm birth,93 headaches,94 hypertension,95 brain disorders,96 or platelet disorders97 like other low-calorie sweeteners. Moreover, erythritol may actually have some antioxidant properties.98 As with any highly processed product, though, its utility should be confined to increasing your consumption of green-light foods. So, for example, if the only way for you to eat half a grapefruit is to sprinkle some sugar on it, then it’s probably better to eat a sugared grapefruit than no grapefruit at all—though sprinkling it with erythritol would be even better. With this logic in mind, I use erythritol to increase my consumption of cranberries (remember my Pink Juice recipe in chapter 8?), cocoa powder (see here), and hibiscus tea.

99 And the winner is … hibiscus tea! I documented its potent antihypertensive effects in chapter 7. I’ve always had “normal” blood pressure by U.S. standards, but I wanted to shoot for optimal, so hibiscus became a daily staple for me. Give this recipe a try: To eight cups of water, add a handful of bulk dried hibiscus or four bags of tea in which hibiscus is the first ingredient. Then add the juice of one lemon and three tablespoons of erythritol, and leave it in your fridge to cold-brew overnight. In the morning, strain out the hibiscus or take out the tea bags, shake well, and drink throughout the day. That’s something I try to do every day I’m home. For extra credit, add green foam: Pour a cup of the tea into a blender with a bunch of fresh mint leaves, blend on high, and enjoy. You end up with dark-green leafies blended into what may be the highest antioxidant beverage in the world, and it tastes like fruit punch. Your kids will love it! As with any sour food or beverage, make sure to rinse your mouth with water after consumption to prevent the natural acids from dissolving your enamel.100 Do not brush your teeth within an hour after eating or drinking something sour, as your enamel may be in a softened state and be further damaged by brushing.101 If you sip continuously throughout the day, I suggest using a straw to bypass your teeth.102