Importance of Gut Bacteria

Neurologist Speaks Out About the Importance of Gut Health for Prevention and Treatment of “Incurable” Neurological Disorders

May 17, 2015

The quality, quantity, and composition of the bacteria in your gut have enormous influence on your brain. Dr. David Perlmutter explores this phenomenon in great detail in his new book, Brain Maker: The Power of Gut Microbes to Heal and Protect Your Brain-for Life.

Dr. Perlmutter is a board-certified neurologist and a fellow of the American College of Nutrition (ACN). He also has a clinic in Naples, Florida, and he’s been very active in publishing his findings in peer-reviewed medical journals.

His previous book, Grain Brain, topped the New York Times bestseller list for 54 weeks. In my view, Dr. Perlmutter is probably the leading natural medicine neurologist in the US.

Certainly, most neurologists fail to consider how lifestyle impacts the neurological disorders they diagnose and treat every day, and prevention is an area of utmost importance as we still do not have effective treatments for many of the most common brain disorders.

“We’re now recognizing from research at our most well-respected institutions from around the globe that the gut bacteria are wielding this very powerful sword of Damocles,” he says.

They determine whether we’re going to have a healthy brain or not, whether our brain is going to function well or not, and whether our brain is going to become diseased or not. Who knew that we’d be referring back to the gut?”

Microbiome Research Shreds Notion of Reductionism

It turns out that this notion of reductionism—where your body is reduced to its individual parts—is completely nonsensical and grossly flawed. As explained by Dr. Perlmutter, every system in your body interrelates in a way that ultimately causes the manifestation of either health or disease.

In a previous interview, Dr. Perlmutter discussed specific dietary factors that influence your brain health, but one of the primary mechanisms of action that explains how a healthy diet “works” is that it upregulates, modifies, and improves the quality of your gut microbiome.

“These hundred trillion bacteria that live within your gut are so intimately involved in your brain at a number of levels. They manufacture neurochemicals, for example. Things like dopamine and serotonin. 

They manufacture important vitamins that are important to keep your brain healthy. They also maintain the integrity of the lining of your gut,” he explains.

The latter is important because when your gut lining becomes compromised, you end up with permeability or leakiness of the gut. This increases inflammation, which is a cornerstone of virtually all brain disorders, from Alzheimer’s and multiple sclerosis (MS), to Parkinson’s and autism.

“We’ve got to really deal with it on a preventive basis,” Dr. Perlmutter says.“[We must] understand what in our Western culture, especially from a dietary perspective, is threatening the health of our commensals. 

We call these bacteria ‘commensals’ because they share the table with us. We eat together with the bacteria. Basically, they eat what we eat. Our food choices have a dramatic effect on the health viability and even the diversity of those gut bacteria.” 

Research Shows Swapping Gut Bacteria Can Reverse Type 2 Diabetes and Other Diseases

A researcher in Amsterdam, Dr. Max Nieuwdorp, has published a number of studies looking at changes in the microbiome that are characteristic of type 2 diabetes.

In one trial, he was able to reverse type 2 diabetes in all of the 250 study participants by doing fecal transplantations on them. Remarkable as it may sound, by changing the makeup of the gut bacteria, the diabetes was resolved.

Dr. Perlmutter has embraced this new information full force, and has even helped develop a peer-reviewed scientific journal, Medicus, that focuses on this kind of research. They’re also holding an annual conference to which the leading microbiome researchers in the world are invited.

In his view, and in mine, the understanding and practical adjustment and modification of the microbiome is an important part of the future of medicine. Fifteen years ago, we thought that the Human Genome Project (HGP) would allow modern medicine to leapfrog into new gene-based therapies that would solve all our ills.

That didn’t happen, as HGP discovered that genetics are only responsible for only about 10 percent of human disease,1 the rest—90 percent—are induced by environmental factors. Now we’re coming to realize that your microbiome is actually a driver of genetic expression, turning genes on and off depending on which microbes are present.

“The gut microbiome is 99 percent of the DNA in your body, and it is highly responsive and changeable based upon lifestyle choices, most importantly our food choices,” Dr. Perlmutter says.

“There’s this beautiful dance that happens between the gut bacteria and your own DNA. The gut bacteria actually influenced the expression of our 23,000 genes. Think about that. The bugs that live within us are changing our genome expression moment to moment. 

Our genome has not changed over thousands of years. But now, suddenly, because we’re changing our gut bacteria, we are changing the signals that are going to our own DNA; coding now for increasing things like free radicals, oxidative stress, and inflammation. That is a powerful player in terms of so many disease processes… 

Being a brain specialist dealing with brain disorders, my whole career I’ve been stymied by not having really powerful tools to implement to bring about changes in individuals who have these issues. Now we’re beginning to get those tools, and they are in the gut. Who knew? 

In neurology school, we didn’t study the makeup of the gut bacteria and how that would ever influence the brain, and yet, this is leading-edge science. 

This is what our most well-respected researchers and peer-reviewed journals are talking about: not only are the gut bacteria fundamentally involved in brain health, but you can change the gut bacteria by interventions – taking probiotics and choosing to eat foods that are rich in prebiotics and to enhance the growth of good bacteria – and even more aggressive therapies [such as fecal transplants]“

Nourish Your Microbiome, and It Will Nourish You

Two key strategies to nourish and protect your microbiome are to limit your consumption of antibiotics to when they’re absolutely necessary, and be judicious in terms of the foods you eat. Ideally, opt for whole, raw organic, non-genetically modified (GM) foods, along with traditionally fermented and cultured foods. Good examples include fermented vegetables of all kinds, including sauerkraut and kimchi, kombucha (a fermented drink), and fiber-rich prebiotic foods like jicama (Mexican yam), Jerusalem artichoke, garlic, and dandelion greens.

Avoiding confined animal feeding operation (CAFO) meats is also important, as the animals raised in these factory farms are raised on antibiotics, which changes their microbiome as well. This routine practice also promotes antibiotic-resistant bacteria that now threaten the lives of tens of thousands of Americans each year. Pesticides have also been shown to alter gut bacteria and foster drug-resist bacteria in the soil and food, so organically-grown and raised foods are really your best bet.

“These are all very relevant lifestyle choices that we can make to enhance the health and the diversity of the gut bacteria. That’s going to give us a lifelong advantage in terms of being resistant to the very diseases that we dread the most,”Dr. Perlmutter says.

“The true definition of symbiosis: we’re supporting their health and they are supporting our health. We do that by the foods that we eat. They are, as I said, commensals. We’re sharing this meal. We treat them right by eating fermented foods that are rich in probiotic bacteria and prebiotic foods that contain prebiotic types of fiber like inulin and fructooligosaccharides (FOS). 

These are nutrients that enhance the growth of good bacteria with multitudes of studies indicating things like weight loss, a better control of blood sugar, and reduction of inflammation… One study came out just last month showing how children with allergic rhinitis and breathing issues have improvements by just giving them fiber to enhance the growth of healthy bacteria.” 

The Link Between the Microbiome and Autoimmune Disease

Inflammation is a hallmark of autoimmune diseases such as MS, Lou Gehrig’s disease, Crohn’s, and inflammatory bowel disease, just to name a few. As explained by Dr. Perlmutter, many of the factors that affect permeability of the blood-brain barrier are similar to those that affect the gut, which is why leaky gut can lead to neurological diseases as easily as it can manifest as some other form of autoimmune disorder.

The permeability of your gut lining can be measured by looking at a chemical called lipopolysaccharide (LPS), which is the covering over certain groups of bacteria in your gut. When you have higher levels of antibodies against LPS in the bloodstream, it’s a marker of leaky gut.

LPS is also in and of itself a powerful instigator of the inflammatory cascade. Higher levels of LPS in the blood dramatically increase inflammation throughout your body, including your brain. Alzheimer’s and Lou Gehrig’s disease, for example, are both correlated with dramatically elevated levels of LPS.

“In Brain Maker I present pretty aggressive treatments for maintaining and restoring gut health using a variety of techniques – from using probiotic enemas to even going as far as having people get fecal transplantation. And do we see success? We sure do,” Dr. Perlmutter says.

“I have a case history in Brain Maker of a young man with MS who couldn’t walk without two canes and who underwent a series of fecal transplantations in Europe, and came back and walks without any assistance whatsoever. His videotape is linked to the book and is on our site. I use the video of this man walking when I do lectures to physicians. They look at this with their jaws hanging, because again, for you and me, this was never even a consideration in medical school… 

If you did pay any attention to the gut you’d become a gastroenterologist, otherwise there’d be no interest in looking at it. But it turns out that it’s relevant whether you’re a gastroenterologist, a neurologist, a psychiatrist, a joint specialist, a skin specialist, or even a cancer specialist. We’ve got to pay attention to nurturing these bacteria if we’re going to keep people healthy.” 

Seven Essential Keys to Rehabilitate Your Gut, from Birth to Death

In his book, Dr. Perlmutter delves into seven essential keys for rehabilitating your gut, starting at birth.

1. Vaginal birth Do everything you can to avoid a Caesarian section. When you elect to deliver a child via Caesarian section – and there are times when it needs to be done to save the life of the mother or the baby—understand that by and large, you’re tripling the risk for attention-deficit hyperactivity disorder (ADHD) and doubling the risk for autism in your child. You’re also dramatically increasing the risk that your child will struggle with obesity, type 1 diabetes, and allergies. These are all inflammatory issues that are dramatically increased in children born via Caesarian section.

Dr. Perlmutter describes a simple and elegant technique developed by researchers at Yale University, whereby an organic gauze sponge is placed in the birth canal before the mother who is going to have a C-section is given the IV antibiotics. The sponge is then removed, the antibiotics are given, and as soon as the baby is born, the sponge is placed over the baby’s face, inoculating the child with its mother’s bacteria. This could be a good adjunct anytime a Caesarian is required. Unfortunately, at present it’s unlikely you’d be able to get your doctor to do it.

2. Breastfeeding Aside from providing the most appropriate nutrients, breast feeding also affects your child’s microbiome via bacterial transfer from skin contact.
3. Antibiotics When you change your microbiome, certain groups of bacteria tend to be favored, such as the Firmicutes group. When present in excess, Firmicutes increase your risk of obesity. Animal research shows that when you change the animals’ microbiome using antibiotics, they gain weight. We also give antibiotics to cattle to make them fatter, faster. The same thing occurs in your body, which is why avoiding unnecessary antibiotics is so important.

Disinfectant products like antibacterial soaps and hand gels also fall into this category and should be avoided as much as possible.

4. Refined sugar and processed fructose Sugar and high-fructose corn syrup (HFCS) preferentially increases the growth of pathogenic disease-causing bacteria, fungi, and yeast, so limiting the amount of refined and processed sugars in your diet is a key dietary principle for gut health.

According to Dr. Perlmutter, fructose in particular promotes gut dysbiosis, and there’s also a good correlation between fructose consumption and the levels of LPS, the inflammatory marker that shows your gut is leaking.

Fructose is also far more aggressive in terms of causing glycation of protein than other sugars, meaning high levels of sugar in your blood that bind to proteins. This too is correlated with leaky gut, and may explain why fructose consumption is related to increased gut permeability, and inflammatory diseases like obesity.

5. Genetically engineered foods and pesticides Avoid genetically engineered foods. As noted by Dr. Perlmutter: “Yes, there is a clear and present danger in the notion of genetically modifying the food that we share with our gut bacteria. The gut bacteria are expecting the type of food that they have been provided for a couple of million years. 

Suddenly, we’re introducing foods that are genetically unlike anything the human microbiome has ever seen. The research that allows the Food and Drug Administration (FDA) to allow genetically modified food has not even considered looking at the effects of GMOs on the human microbiome.” 

Glyphosate, which is liberally used on genetically engineered Roundup Ready crops, and many non-organic non-GMO crops as well, has also been found to alter the human microbiome, so genetically engineered foods deliver a double assault on your gut bacteria every time you eat it.

“We’re poisoning the food that we eat. If that’s not bad enough, that’s the food we’re feeding our microbiome, which are going to determine whether we live or die,” Dr. Perlmutter says. “It’s a bit of a worry.”

6. Probiotic foods Focus on eating probiotic foods, such as fermented vegetables, sauerkraut, kimchi, kefir, and kombucha (a fermented drink). A broad-spectrum probiotic supplements may also be advisable—especially if you have to take a course of antibiotics.
7. Prebiotic fiber Consume plenty of prebiotic fiber. Not all fibers are prebiotic, so not any old fiber will do the job here. Whole foods are the best. Examples include dandelion greens, which can be lightly sautéd, Mexican yam or jicama that can be chopped up raw and put in your salad.

Onions and leeks are also excellent choices. These kinds of foods will allow your gut bacteria to flourish, which is the key to health, disease resistance, and longevity.

Optimal Health and Disease Prevention Begins in Your Gut

By making new choices, following the recommendations outlined above—which are not excessively complex by any means—you can rehabilitate your gut bacteria so that they will do “the heavy lifting” of preventing disease and promoting the healthy function of your body and mind.

To learn more, I highly recommend picking up a copy of Dr. Perlmutter’s NY Times bestselling book, Brain Maker: The Power of Gut Microbes to Heal and Protect Your Brain-for LifeIn it you will also find plenty of references from well-respected medical journals that you can use to make more empowered choices.

Brain Maker



Are You a Nutritarian?

Dr. Fuhrman coined the word, Nutritarian to describe his recommended diet which concentrates on eating the most micronutrient rich foods.

What is Dr. Fuhrman’s Nutritarian Diet?

Simply put, a Nutritarian diet is a way of eating which bases food choices on maximizing the micronutrients per calorie. A Nutritarian diet is designed with food that has powerful disease-protecting and therapeutic effects and delivers a broad array of micronutrients via a wide spectrum of food choices. It is not sufficient to merely avoid fats, consume foods with a low glycemic index, lower the intake of animal products, or eat a diet of mostly raw foods. A truly healthful Nutritarian diet must be micronutrient rich and the micronutrient richness must be adjusted to meet individual needs. The foods with the highest micronutrient per calorie scores are green vegetables, colorful vegetables, and fresh fruits. For optimal health and to combat disease, it is necessary to consume enough of these foods that deliver the highest concentration of nutrients.

A Nutritarian diet is guided by nutritional quality.

Dr. Fuhrman’s Prescription for Improving and Maintaining Great Health

  • Dr. Fuhrman’s food pyramid is based on his principles of the health equation Health = Nutrients / Calories (H=N/C).
  • At least 90% of the daily diet should be comprised of whole plant foods that naturally contain health-promoting phytochemicals.*
  • The pyramid promotes foods that are richest in micronutrients and benefit health and longevity.

*The other 10 percent may include minimally processed foods such as tortillas, coarsely-ground or sprouted whole grain breads or cereals, tofu, tempeh and a limited amount of animal products, preferably not more than 5 percent of total caloric intake. Though the ANDI (Aggregate Nutrient Density Index) is not the only thing that excellent nutrition needs to consider, attention should be given to consuming a variety of high ANDI scoring plant foods, to maximize immune function and lifespan. Dr. Fuhrman specifically recommends that people consume greens, beans, onions, mushrooms, berries, seeds and tomatoes on a regular basis to maximize immune function and protection against cancer.

The quality of a diet can be based on three simple criteria:

  1. Levels of micronutrients (vitamins, minerals, phytochemicals) per calorie
  2. Amounts of macronutrients (fat, carbohydrate, protein) to meet individual needs, without excessive calories that may lead to weight gain or health compromise
  3. Avoidance of potentially toxic substances (such as trans fats) and limited amounts of other potentially harmful substances (such as sodium)

Dr. Fuhrman created The Health Equation: H=N/C or Health = Nutrients/Calories (first published in 1999 in his work, The Health Equation and later described in more detail in his book, Eat To Live) to define how the quality of calories impacts health.

This equation means your future health can be predicted by the micronutrient per calorie density of your diet. Micronutrient per calorie density is important in devising and recommending menu plans and dietary suggestions that are the most effective for tackling weight loss and for preventing and reversing disease.

Assuring superior nutrition means meeting an individual’s unique nutritional needs to profound therapeutic effects for preventing, treating and reversing disease. Dietary micronutrient quality must be increased accordingly to utilize dietary recommendations therapeutically for disease reversal or to protect high-risk individuals.

Though micronutrient density is critically important, it is not the only factor that determines health. For example Vitamin D levels, B12, and proper omega-3 intake are important for optimal long-term health as well as avoidance of sodium and other toxic excesses. These concerns are not addressed in the H = N/C equation. However, if the focus is consuming more micronutrient-rich natural foods then the other important nutritional benefits automatically will follow, such as lower sodium, reduced calories, high fiber and volume, a low glycemic index, and a high satiety and phytochemical index to name a few.

Eating low nutrient foods fuels overeating behavior and toxic hunger.

Last, but not least, Dr. Fuhrman’s unique contribution to the science of nutritional care, disease reversal and weight loss is his explanation of the physiology behind hunger and food cravings.

It is important to recognize that low nutrient eating (and toxic eating) leads to increased cellular toxicity with undesirable levels of free radicals and advanced glycation end products (AGE’s), lipofuscin, lipid A2E and other toxins that contribute to the development of chronic disease. His findings are that these toxic substances lead to addictive withdrawal symptoms (toxic hunger) which result in the desire to eat more frequently and overeat. Low nutrient eating, therefore, establishes a mechanism that leads to food addictions and food cravings that can’t be ignored. This is the reason why calorie counting diets fail. Without addressing dietary quality, excess food cravings are almost impossible to ignore.

Fortunately the drive to over-consume calories is blunted by high micronutrient, high food antioxidant, consumption and the symptoms that people thought were hypoglycemia or even hunger, simply disappear after following his dietary recommendations. Not only do people lose the symptoms of fatigue, headaches, irritability and stomach cramping, but they get back in touch with true hunger felt in the throat, which simply makes eating more pleasurable and directs them to a more appropriate amount of calories for their body’s biological needs.


Nutritarian Checklist

Download a printable PDF version
of the Nutritarian Checklist to help you
keep on track every day.

In a portion controlled (calorie counting) diet it is likely that the body will not get adequate fiber or micronutrients. The body will have a compounded sensation of hunger and cravings which for most is simply overwhelming. It invariably results in people either being unable to lose weight or unable to keep the weight off and eventually gaining it back. The biochemistry and physiology behind food cravings are more thoroughly explained in Dr. Fuhrman’s books and lectures, but without a thorough understanding of these principles weight loss attempts are typically doomed to fail. 

Are you striving to adopt a Nutritarian diet to extend lifespan and reverse and prevent disease?
Here are 5 basic rules that may help you:

  1. Consume a large green salad every day, and put some raw onion and shredded cruciferous veggies on top.
  2. Eat at least a 1/2 cup of beans or lentils each day, in a soup, stew, or top of a salad or in another dish.
  3. Eat at least 3 fresh fruits a day, especially berries, pomegranate, cherries, plums, and oranges.
  4. Eat at least 1 ounce of raw seeds and nuts daily, utilizing some chia seeds, flax seeds and walnuts.
  5. Consume a double-sized serving of steamed greens daily, and utilize mushrooms and onions in your dishes.

Which of These Food Myths are you Following?

Top 5 Misconceptions About Food: A Doctor’s Daily Experience

As a primary care doctor, I spend my days taking care of patients with diabetes, high blood pressure, high cholesterol, heart disease, and obesity. I also see “healthy” patients whose eating habits are starting them on the road to a future filled with doctor’s appointments and hospital visits.

I enjoy reminding my patients that their fork can be more powerful than my prescription pad when it comes to preventing and reversing chronic diseases. This conversation usually uncovers some common misconceptions about food and nutrition. Here are five myths that I hear almost every day, among patients and colleagues alike:

1. “I need to eat more protein.”

Many people don’t realize that the average American consumes more than twice the Recommended Dietary Allowance (RDA) of protein, most of it from animal products.1,2 Unfortunately, animal-based proteins have been shown to promote faster growth, not only of normal cells but of cancer cells, and have been linked to a variety of cancers as well as heart disease, diabetes, Alzheimer’s disease, and kidney stones.3,4

Plant foods contain plenty of protein, and a whole-foods, plant-based diet actually provides exactly what’s recommended in terms of protein requirements – about 8-10% of total daily calories from protein.  This happens naturally when people eat a diet of diverse, whole plant foods – there is no need to count grams of protein!  And unlike animal proteins, plant proteins from whole foods are not associated with cancer or other chronic diseases.  In fact, these foods actually prevent many of the diseases we see today!

2. “I need to drink milk to have strong bones.”

Many people equate dairy with calcium, strong bones, and the prevention of osteoporosis (low bone density). Generations of advertising slogans have perpetuated this idea. However, dairy isn’t the answer here. Studies show that dairy products may actually increase the risk of fractures related to osteoporosis!5-7

The biological purpose of cow’s milk is to support the rapid growth of a calf. Humans have no nutritional or medical need to consume the milk of cows or any other nonhuman species. Cow’s milk has significant levels of female hormones, and usually contains antibiotics, pesticides, saturated fat, and cholesterol — substances that definitely do NOT do a body good! Dairy has been specifically linked with prostate, ovarian, and uterine cancer, as well as heart disease and early death.7-13

The best sources of calcium come from the earth, in foods such as kale, broccoli, bok choy, and Brussels sprouts. As a bonus, these vegetables are high in vitamin K, which is also important for strong bones. Beans may be an especially good source of calcium, because they are also high in phytates, antioxidant compounds that may enhance mineral absorption14 (despite common perception to the contrary) and thus protect bone density.15 Many brands of soy milk, almond milk, orange juice, and tofu are fortified with calcium and vitamin D, just as cow’s milk is artificially fortified with these nutrients. However, there is no need to specifically target calcium sources in the diet; a diverse, whole-foods, plant-based diet will provide all of the calcium you need.

3. “Chicken, turkey, fish, and eggs are healthy sources of protein.”

Chicken, turkey, fish, and eggs contain significant amounts of cholesterol and saturated fat, in many cases as much as beef,16 so they are not “heart healthy” foods. Plant-based sources of protein contain zero cholesterol and far less saturated fat. Chicken and turkey usually contain antibiotics, pesticides, and fecal contaminants, and have been associated with salmonella, staph, and other infectious disease outbreaks. Chicken, fish, and eggs have been associated with an increased risk of diabetes.17-25Almost all fish contain mercury, which can cause neurologic and cognitive problems; many also contain polychlorinated biphenyls (PCBs), a toxin associated with cancer.16And a recent study showed that eggs cause intestinal bacteria to make a substance called TMAO, which can trigger heart attacks and other cardiovascular events.26

Whole plant foods supply plenty of protein, and they don’t come packaged with cholesterol or high levels of saturated fat. Instead, their protein is bundled with fiber and many necessary nutrients! Great plant-based sources of protein include lentils, chickpeas, black beans, kidney beans, soybeans, and quinoa. Green vegetables such as spinach, collards, broccoli, and peas are also quite high in protein per calorie. But remember, it’s not necessary to seek out plant foods high in protein, since a varied whole-food, plant-based diet will naturally provide enough protein, without special effort.27

4. “I can’t eat carbs.”

Many people are mistakenly led to believe they should avoid carbohydrates, particularly for weight management and diabetes control. Instead, they focus on proteins — especially animal proteins — and fats. Sadly, this approach actually increases the risk of chronic disease and death,28-32 and it deprives people of the numerous nutrients found in carbohydrate-containing foods.

It is true, however, that not all carbohydrates are created equal. Refined, highly processed carbohydrates can raise triglycerides, promote weight gain, and drive up blood sugar. On the other hand, starches that come from whole grains bring fiber, essential fatty acids, B vitamins, zinc, and protein into our diets and provide an excellent source of energy. Beans, legumes, starchy vegetables, and fruits are other healthy carbohydrate sources. Balancing these foods with non-starchy vegetables is an optimal way to eat for weight loss, diabetes control, and reversal of heart disease.

5. “Healthy food is too expensive.”

You don’t need to shop at a gourmet health food store to find nutritious foods. Actually, some of the healthiest foods are the least expensive, and they are readily available at most grocery stores and many local farmers’ markets. Beans, lentils, brown rice, and frozen vegetables are usually inexpensive, especially when bought dried and in bulk. (Organic fruits and vegetables can cost more, but eating nonorganic plant-based foods is still more nutritious than eating meat, chicken, fish, eggs, and dairy, organic or otherwise.)

Even when processed foods and animal products are sold cheaply, they are expensive in terms of the cost to your health. What you may save now, you could end up spending later in pharmacy co-payments and medical bills!


1 Institute of Medicine. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington, DC: National Academies Press; 2002.
2 Rizzo NS, Jaceldo-Siegl K, Sabate J et al. Nutrient profiles of vegetarian and nonvegetarian dietary patterns. J Acad Nutr Diet 2013; 113(12):1610-9.
3Campbell TC, Campbell TM. The China Study: Startling Implications for Diet, Weight Loss, and Long-Term Health. Dallas: BenBella Books; 2006.
4 Barnard NB, Weissinger R, Jaster BJ, et al. Nutrition Guide for Clinicians, First Edition. Washington, DC: Physicians Committee for Responsible Medicine; 2007.
5 U.S. Department of Health and Human Services. Bone Health and Osteoporosis: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General; 2004.
6 Feskanich D, Willett WC, Colditz GA. Calcium, vitamin D, milk consumption, and hip fractures: a prospective study among postmenopausal women. Am J Clin Nutr 2003; 77:504-11.
7 Michaëlsson K, Wolk A, Langenskiöld S, et al. Milk intake and risk of mortality and fractures in women and men: cohort studies. British Medical Journal2014;349:g6015.
8 Qin LQ, Xu JY, Wang PY, et al. Milk consumption is a risk factor for prostate cancer: Meta-analysis of case-control studies. Nutr Cancer 2004; 48(1):22-7.
9 Qin LQ, Xu JY, Wang, PY, et al. Milk consumption is a risk factor for prostate cancer in Western countries: Evidence from cohort studies. Asia Pac J Clin Nutr 2007; 16(3):467-76.
10 Chan JM, Stampfer MJ, Ma J, et al. Dairy products, calcium, and prostate cancer risk in the Physicians’ Health Study. Presentation, American Association for Cancer Research, San Francisco, April 2000.
11 Chan JM, Stampfer MJ, Giovannucci E, et al. Plasma insulin-like growth factor-I and prostate cancer risk: a prospective study. Science 1998; 279:563-565.
12 Genkinger JM, Hunter DJ, Spiegelman D, et al. Dairy products and ovarian cancer: a pooled analysis of 12 cohort studies. Cancer Epidemiol Biomarkers Prev 2006; 15:364–72.
13 . Ganmaa D, Sato A. The possible role of female sex hormones in milk from pregnant cows in the development of breast, ovarian, and corpus uteri cancers. Med Hypotheses 2005; 65:1028–37.
15 López-González AA, Grases F, Monroy N, et al. Protective effect of myo-inositol hexaphosphate (phytate) on bone mass loss in postmenopausal women. Eur J Nutr 2013; 52(2):717-26.
16 Simon, D. Meatonomics. San Francisco, Conari Press, 2013.
17Li Y, Zhou C, Zhou X, et al. Egg consumption and risk of cardiovascular diseases and diabetes: a meta-analysis. Atherosclerosis 2013; 229(2):524-30.
18 Djoussé L, Gaziano JM, Buring JE, et al. Egg consumption and risk of type 2 diabetes in men and women. Diabetes Care 2009; 32(2):295-300.
19 Radzevičienė L1, Ostrauskas R. Egg consumption and the risk of type 2 diabetes mellitus: a case-control study. Public Health Nutr 2012; 15(8):1437-41.
20 Tonstad S, Butler T, Yan R, et al. Type of vegetarian diet, body weight, and prevalence of type 2 diabetes. Diabetes Care 2009; 32(5):791–6.
21 Chiu TH, Huang H, Chiu Y. Taiwanese vegetarians and omnivores: dietary composition, prevalence of diabetes and impaired fasting glucose. PLoS One 2014; 9(2):e88547.
22 van Nielen M, Feskens EJ, Mensink M. Dietary protein intake and incidence of type 2 diabetes in Europe: the EPIC-InterAct Case-Cohort Study. Diabetes Care 2014; 37(7):1854-62.
23 van Woudenbergh GJ, van Ballegooijen AJ, Kuijsten A, et al. Eating fish and risk of type 2 diabetes: a population-based, prospective follow-up study. Diabetes Care 2009; 32:2021–6.
24 Kaushik M, Mozaffarian D, Spiegelman D, et al. Long-chain omega-3 fatty acids, fish intake, and the risk of type 2 diabetes mellitus. Am J Clin Nutr 2009; 90:613–20.
25 Djoussé L, Gaziano JM, Buring JE, et al. Dietary omega-3 fatty acids and fish consumption and risk of type 2 diabetes. Am J Clin Nutr 2011; 93:143–50.
26 Tang WH, Wang Z, Levison BS. Intestinal microbial metabolism of phosphatidylcholine and cardiovascular risk. N Engl J Med 2013; 368(17):1575-84.
27 Young VR, Pellett PL. Plant proteins in relation to human protein and amino acid nutrition. Am J Clin Nutr 1994; 59 (suppl):1203S-1212S.
28 Larsson SC, Orsini N. Red meat and processed meat consumption and all-cause mortality: a meta-analysis. Am J Epidemiol 2014; 179(3):282-9.
29 Lagiou P, Sandin S, Lof M, et al. Low carbohydrate-high protein diet and incidence of cardiovascular diseases in Swedish women: prospective cohort study. British Medical Journal 2012; 344:e4026.
30 Fung TT, van Dam RM, Hankinson SE, et al. Low-carbohydrate diets and all-cause and cause-specific mortality: two cohort studies. Ann Intern Med 2010; 153(5):289-98.
31 Noto H, Goto A, Tsujimoto T, et al. Low-carbohydrate diets and all-cause mortality: a systematic review and meta-analysis of observational studies. PloS One 2013; 8(1):e55030.
32 de Koning L, Fung TT, Liao X, et al. Low-carbohydrate diet scores and risk of type 2 diabetes in men. Am J Clin Nutr 2011; 93(4):844-50.

Guide for Making Green Drinks

How many of you have tried green drinks?
I am always experimenting with new veggies but Today I made one of my best with kale, spinach, celery, cucumber, lemon and 1/2 golden delicious apple and lots of ice to beat the 90+ degree days we are having here in Philly.  It was perfection!!!!  These drinks really make you feel amazing, which is why I continue to drink them into my 37th week of pregnancy.
Here is a great guide on making tasty green drinks (that you will actually enjoy) from The Rawfoodfamily:

Our Most Favorite Green Juice Recipe For You

I would like to share our most favorite green juice with you today.  I believe green juices are the most valuable food you can give yourself.  They are so full of nutrients, minerals, vitamins, enzymes – really everything you need to feel alive!  I am so very passionate about this.  We have been making this juice for over 10 years with very little variation.
We have certain ingredients that we always use every time.  One of those is celery, we love to have the freshest celery.  You will know it is fresh when you try and bend it and  it has a strong fiber and doesn’t snap.  The wilder and more nutrition rich celery tends to be small.  The large bunches you get in the supermarket are not necessarily the best.
The second vegetable is cucumber.  It helps to liquefy the juice and makes it easier to drink and not as intense in taste.  We always have dark leafy greens – we alternate between spinach, kale and different wild herbs.  It depends on where we are in the world and what is readily available.  It is very important to have lots of veggies, it is not a fruit juice but a veggie juice.  We do usually add some kind of fruit to make it a little sweeter.

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We will add carrots which help make it sweeter.  We also add apples or pineapples to add a little sweetness.  We have been adding fennel lately because we love it. Sometimes we replace the fennel with red beets.  It is not important which of these ingredients you choose but more what combination you really like best.  You can vary it up depending on what is available to you and what you prefer that day.  You will soon discover your most favorite green juice recipe!
As long as you have celery, cucumber, a dark leafy green and something that is a little sweeter, you are all set.  You will need a juicer and you are ready to juice!
 Green juices are possibly the best way to get many of the most valuable nutrients your body needs in a delicious way.  Everyone should try and drink a green juice every day, you will notice right away how fantastic you feel!