The quest for a healthier and longer life often leads us to explore various dietary approaches. Dr. Michael Greger's "How Not to Die" presents a compelling case for leveraging plant-based foods to prevent and reverse disease. This article delves into the core principles of Dr. Greger's approach, particularly his "Daily Dozen" concept, and provides a detailed roadmap for incorporating these principles into your daily life.
Introduction: The Power of Plant-Based Nutrition
Dr. Greger, a physician and internationally recognized speaker, advocates for a diet centered around whole plant foods. His book, "How Not to Die: Discover the Foods Scientifically Proven to Prevent and Reverse Disease," is a comprehensive guide to understanding the profound impact of nutrition on health. He is the Chief Science Officer for NutritionFacts.org, which provides free lifesaving information to “those hungry for evidence-based nutrition”. The core idea is that many of today’s leading causes of death are not caused by drug deficiencies.
The Daily Dozen: A Checklist for Optimal Health
To make the vast amount of information in his book practical, Dr. Greger introduced "The Daily Dozen"-a checklist of twelve food groups, each with recommended serving sizes, that should ideally be consumed daily. The Daily Dozen App can be downloaded to see the full list and get a virtual checklist. This checklist serves as a reminder to make a conscious choice about food. While aiming for perfection is admirable, the goal is to consciously choose whole plant foods when meal planning and selecting snacks, and how those meals will fit into the Daily Dozen recommendation.
Understanding the Components
Here's a breakdown of the Daily Dozen food groups and their serving recommendations:
- Beans: This category includes legumes like beans, split peas, chickpeas, and lentils. Aim for three servings a day. A serving is defined as a quarter-cup of hummus or bean dip; a half-cup of cooked beans, split peas, lentils, tofu, or tempeh; or a full cup of fresh peas or sprouted lentils.
- Berries: Enjoy a half-cup of fresh or frozen berries, or a quarter-cup of dried berries, daily.
- Other Fruits: Consume three servings of other fruits daily. A serving is a medium-sized fruit, a cup of cut-up fruit, or a quarter-cup of dried fruit.
- Cruciferous Vegetables: Include at least one serving of cruciferous vegetables like broccoli, cabbage, collards, and kale each day (typically a half-cup).
- Greens: Aim for at least two additional servings of greens a day, cruciferous or otherwise.
- Flaxseeds: Incorporate one tablespoon of ground flax seeds into your daily diet. Flax may average a hundred times more lignans than other foods.
- Nuts and Seeds: Consume a quarter-cup of nuts, or two tablespoons of nut or seed butters, including peanut butter, daily. For nut allergies, simply eat seeds such as pumpkin, sesame, chia seeds, etc.
- Spices: Add spices like turmeric to your meals.
- Whole Grains: Enjoy three servings of whole grains daily. If you're allergic to wheat, you can still check off your grain boxes with gluten-free grains such as quinoa, oat groats, millet, etc.
- Beverages: Drink five glasses (twelve ounces each) of water daily, in addition to the water you get naturally from the foods in your diet.
- Exercise: Engage in one daily “serving” of exercise, which can be split up over the day. I recommend ninety minutes of moderate-intensity activity each day, such as brisk (four miles per hour) walking or, forty minutes of vigorous activity (such as jogging or active sports) each day.
Practical Tips for Incorporating the Daily Dozen
It may all sound like a lot of boxes to check, but it’s easy to knock off a bunch at a time. One simple peanut butter/banana sandwich, and you just checked off four boxes. Or imagine sitting down to a big salad. Two cups of spinach, a handful of arugula, a handful of walnuts, a half-cup of chickpeas, a half-cup of red bell pepper, and a small tomato. You just knocked out seven boxes in one dish. Sprinkle on your flax, add a handful of goji berries, and enjoy it with a glass of water and fruit for dessert, and you just wiped out nearly half your daily check boxes in a single meal!
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- Start small: If you are new to eating a lot of beans (or grains, greens, etc!), you may need to start with smaller amounts and slowly increase the quantity in order to give your microbiome a chance to adjust.
- Get creative: Get creative: for example, add some beans to your morning oatmeal. If you load it up with berries, flax seeds, and nuts, you won't even notice the beans.
- Visualize your plate: Looking over the checklist, you’ll see there are three servings each of beans, fruits, and whole grains, and about twice as many vegetables in total than any other component. So, glancing at my plate, I can imagine one quarter of it filled with grains, one quarter with legumes, and a half of the plate filled with vegetables, along with maybe a side salad, and fruit for dessert.
Beyond the Daily Dozen: Additional Considerations for Optimal Health
While the Daily Dozen provides a solid foundation for a healthy diet, Dr. Greger's "How Not to Die" and "How Not to Diet" delve into other crucial aspects of nutrition and lifestyle.
The Importance of Whole Foods
In my book, How Not to Die, I suggest we try to center our diets around whole plant foods. But, some plants are healthier than others. For example, you can apparently live extended periods eating practically nothing but white potatoes. That would, by definition, be a whole-food, plant-based diet-but not a very healthy one. The more I’ve researched over the years, the more I’ve come to realize that healthy foods are not necessarily interchangeable. Some foods and food groups have special nutrients not found in abundance elsewhere. For example, sulforaphane, the amazing liver-enzyme detox-boosting compound, is derived nearly exclusively from cruciferous vegetables. It’s the same with flax seeds and the anticancer lignan compounds. And mushrooms aren’t even plants at all; they belong to an entirely different biological classification, and may contain nutrients (like ergothioneine) not made anywhere in the plant kingdom.
Weight Loss Strategies
Dr. Greger’s How Not to Diet shines a much-needed spotlight on myths and truths related to diets and weight loss and covers 17 characteristics of diets that will help people lose body fat. He highlights that humans evolved for millions of years in an environment of scarcity. Our environment has changed to an abundance of available food, but our built-in bodily mechanisms for surviving periods of undernourishment have not. The gist to losing weight effectively is to eat foods that will make you feel full physically and eat foods that work with your built-in chemical signaling system to either “eat” or “stop eating”.
The Twenty-One Tweaks
Building on the research discussion in Section 4 about enhancements, Dr. Greger boils down these recommendation to 21 easy-to-follow diet tweaks. His tweaks are meant as a complement to the Daily Dozen list, his previously published checklist of foods he encourages people to fit into their daily eating habits.
- Preload with water
- Preload with ‘negative calorie’ foods
- Enjoy undistracted meals
- Follow the 20-minute rule
- Incorporate vinegar
- Cumin
- Black cumin
- Garlic powder
- Ground ginger and cayenne pepper
- Nutritional yeast
- Green tea
- Stay hydrated
- De-flour your diet
- Front-load your calories
- Time-restrict your eating
- Optimise exercise timing
- Complete your implementation intentions
- Weigh yourself twice a day
- Fast after 7pm
- Get sufficient sleep
- Experiment with mild Trendelenburg
Addressing Common Concerns and Misconceptions
- Protein: Most Americans (including vegetarians and vegans) are getting about 70 percent more protein than they need every day. The estimated average requirement is a paltry 42 grams a day, but the recommended daily allowance (to account for variation among individuals) comes out to be about 51 grams.
- Sustainability: The book outlines the numerous research studies and meta-analyses that have shown that a plant-based approach to weight loss and long-term maintenance is significantly more effective than low-carb diets, including the ketogenic diet. He notes that “lifelong weight control requires lifelong lifestyle changes” and discusses at length the superiority of a plant-based diet for maintenance.
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