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1-Page PDF Summary of How Not to Die

Picture the end of your life. Do you want to die from heart disease? Cancer? Diabetes?

In How Not to Die, Michael Greger argues that a plant-based, whole-food diet has been scientifically shown to reduce the most common diseases leading to death. He then gives his recommendation for 'The Daily Dozen' foods to eat to maximize health benefits.

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Why does plant-based diet improve health? Humans evolved over millions of years eating primarily vegetables, so many of our biological responses to food were wired to prehistoric diets.

Today’s modern environment is unnatural, in the sense that we haven’t evolved to handle the new types of food available to us, as well as the quantity available.

  • Processed foods now contain much more fat, sodium, and caloric density than we evolved eating. Our normal biological processes haven't adapted to surviving on modern diets.
  • Modern foods are so nutrient dense that they amplify the dopamine reward circuit. After eating ice cream, ordinary mangos are nowhere near as enjoyable. By eating whole foods, you can reset this sensitivity.

Regulation of food is often strongly influenced by industry. Just like how the tobacco industry fought to show smoking didn't cause cancer, there is a strong agriculture lobby promoting meat and processed foods.

Why Plants Help and Meat Hurts

Meat itself seems negatively correlated with health and mortality, even controlling for vegetable intake. In other words, if group 1 eats vegetables, and group 2 eats the same amount of vegetables but adds meat, group 2 shows higher mortality and risk of disease.

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In these research studies, are vegetarians healthier simply because they tend to be skinnier? No—in population studies, plant-based diets show lower mortality even controlling for BMI, wealth, and other confounding factors.

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In research studies, eating health supplements doesn’t have as positive an effect as whole foods. This might be because whole foods contain many other benefits, such as fiber and other micronutrients. Supplement extracts also introduce risk of contaminants and toxicity.

Even More Reasons to Eat Vegetables and Fruit

Think of your diet everyday as a bank account of 2000 calories you can spend everyday. Eating one 800 calorie hamburger displaces eating 7 sweet potatoes or 26 cups of broccoli. Which one would benefit your body more?

Some might shy away from a plant-based diet because it seems expensive. This is partly true—on a calories-per-dollar basis, junk food and fat are the cheapest. But on a nutrients-per-dollar basis, vegetables offer 6x more nutrition compared to processed food.

  • Meat costs 3x more than vegetables but deliver 16x less nutrition. Thus, meat is 48x more expensive on a nutrient basis than vegetables.

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Diet by Traffic Light

Eating a plant-based diet doesn’t have to be complicated. Michael Greger suggests thinking of food as a traffic light system:

Green Foods: Unprocessed plant foods

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  • Unprocessed means nothing bad is added, and nothing good is taken away.
  • Sometimes, processing actually makes food healthier. Tomato juice may be healthier than whole fruit because the nutrient lycopene is more available. Similarly, cocoa powder is processed to remove saturated fat.
  • You can eat unlimited amounts of green foods.

Yellow Foods: Processed plant foods, Unprocessed animal foods

  • Processed means something bad is added, or something good is taken away.
  • For example, almond milk is worse than eating pure almonds.
  • Ideally you’d replace yellow foods with their corresponding green foods, which are more nutritious.

Red Foods: Ultra-processed plant foods, Processed animal foods

  • Eat red foods sparingly. In driving, you might run a red light once in a while, but you don’t make a habit of it. The same is true of red foods.
  • It’s OK to eat these in small amounts, if they help you eat more green foods (such as bacon bits or hot sauce with vegetables).

Dr. Greger’s Daily Dozen

As a simple checklist for what to eat everyday, Dr. Greger recommends these 12 components. Each box represents one serving.

  • Beans: 3 Servings [ ] [ ] [ ]
  • Berries: 1 Serving [ ]
  • Other Fruits: 3 Servings [ ] [ ] [ ]
  • Cruciferous Vegetables: 1 Serving [ ]
  • Greens: 2 Servings [ ] [ ]
  • Other Vegetables: 2 Servings [ ] [ ]
  • Flaxseeds: 1 Serving [ ]
  • Nuts: 1 Serving [ ]
  • Spices: 1 Serving [ ]
  • Whole Grains: 3 Servings [ ] [ ] [ ]
  • Beverages: 5 Servings [ ] [ ] [ ] [ ] [ ]
  • Exercise: 1 Serving [ ]

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These 12 recommendations form “Dr. Greger’s Daily Dozen.”

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