How Not to Die by Michael Greger MD: Food list

How Not to Die: Discover the Foods Scientifically Proven to Prevent and Reverse Disease (2015) is a whole-food, plant-based, fairly low-fat diet.

• Eat unprocessed plant foods – beans/legumes, berries, other fruits, cruciferous vegetables, greens, other veggies, flaxseeds, nuts, turmeric, whole grains.
• Minimize processed plant foods and unprocessed animal foods.
• Avoid ultra-processed plant foods and processed animal foods.

See below on this page for a description of the food recommendations in the diet. General guidelines  |  Portions/servings  |  What to eat / Green-light foods  |  Foods to minimize / Yellow-light foods  |  Foods to avoid / Red-light foods. There’s a lot more in the book.

Use this page as a cheat sheet alongside the book. Send this page to friends, family, and anyone else who you want to understand what you’re eating on this diet.

Get a copy of How Not to Die for why this diet is relevant for different health conditions (heart disease, lung disease, brain diseases, digestive cancers, infections, diabetes, high blood pressure, liver diseases, blood cancers, kidney disease, breast cancer, suicidal depression, prostate cancer, Parkinson’s disease, doctor errors); guidance on how exercise can improve your health; tips on how to incorporate all the recommended foods (note there are no actual recipes in the book); how to persuade people to eat their veggies; exercise recommendations; supplement recommendations; and references (which take up 1/3 of the book).

The reasoning behind How Not to Die

Telomeres, found at the top of each chromosome, have been thought of as your life “fuse”: They can start shortening as soon as you’re born, and when they’re gone, you’re gone. The book claims that 3 months of whole-food, plant-based nutrition and other healthy changes could significantly boost telomerase activity, the only intervention ever shown to do so. Weight loss through calorie restriction and an even more vigorous exercise program failed to improve telomere length, so it appears that the active ingredient is the quality, not quantity, of the food eaten. Also, the book claims that a more plant-based diet may help prevent, treat, or reverse every single one of our fifteen leading causes of death.

How Not to Die diet plan – what to eat and foods to avoid

General guidelines  |  Portions/servings  |  What to eat / Green-light foods  |  Foods to minimize / Yellow-light foods  |  Foods to avoid / Red-light foods

General guidelines

• Know your own psychology
  • If you tend to have an “addictive” personality, or if you are the kind of person who takes things to extremes— for instance, you either don’t drink at all or you drink in excess— it’s probably best for you to try to stick with the program
  • You might find it easy to go cold-turkey, or have a 3-step method, starting with dinner – (1) think of three meals you already enjoy that are plant based, like pasta and marinara sauce that could be easily tweaked to whole-grain pasta with some added veggies; (2) think of three meals you already eat that could be adapted to become a green-light meal, like switching from beef chili to five-bean chili; (3) discover new healthy options, 3 new whole-foods plant-based recipes to eat. Then rotate these 9 meals and add lunch and breakfast options
• Remove junk food from your house
• Note that your taste will change as you move to a new diet
• Eat a variety of different plant foods, to get a full range of beneficial substances
• Foods that Dr. Greger mentions multiple times in the book:
  • Broccoli, kale, legumes, berries, flaxseeds, cardamom, saffron, turmeric, green tea

Portions / servings

• Every day, eat:
  • 3 servings of beans/legumes
  • 1 serving of berries
  • 3 servings of other fruits
  • 1 serving of cruciferous vegetables
  • 2 servings of greens
  • 2 servings of other vegetables
  • 1 serving of flaxseeds
  • 1 serving of nuts
  • 1 serving of spices
  • 3 servings of whole grains
  • 5 servings of beverages
  • 1 exercise
• For serving sizes, see “foods to eat” section below
• Plate proportions: ¼ grains, ¼ legumes, ½ vegetables, along with maybe a side salad and fruit for dessert
• If you’re still hungry, the book doesn’t give clear guidelines about what to do – it encourages you to eat unlimited greens (prescription in Greens chapter), and talks about people losing weight after eating large amounts of legumes (Diabetes chapter) or fruit (“What About All the Sugar in Fruit?” section in the Berries chapter), but isn’t clear about whether you should focus on specific foods to add or just increase all foods proportionally
• Try to combine foods to meet these goals, e.g. a peanut butter and banana sandwich. When sitting down to a meal, ask yourself what you could add to it – e.g. greens, beans, flax seeds
• If you eat poorly one day, just try to eat better the next day
• Buy the most colorful foods you can find – purple rather than white eggplant, the reddest of strawberries, the blackest of blackberries, the most scarlet tomato, the darkest green broccoli you can find

Foods to eat in How Not to Die – green-light foods – unprocessed plant foods

• Beans/legumes
  • Recommended: 3 servings per day
  • Serving size: ¼ cup of hummus or bean dip; ½ cup of cooked beans, split peas, lentils, tofu, or tempeh; 1 cup of fresh peas or sprouted lentils. Note that peanuts are listed under nuts instead of beans, and green beans are listed under vegetables.
  • Beans, including black beans, butter beans, cannellini beans, chickpeas, great northern beans, kidney beans, navy beans, pinto beans, small red beans
  • Canned beans are okay, just get no-salt-added varieties if you can
  • Chickpeas / garbanzo beans, black-eyed peas, split peas (yellow or green)
  • Lentils (beluga, french, and red varieties)
  • Soybeans; edamame, miso, tofu, tempeh
  • Sprouted beans
  • English peas / garden peas
  • Hummus, bean paste
• Fruits
  • Berries
    • Recommended: 1 serving per day
    • Serving size ½ cup fresh or frozen, ¼ cup dried
    • Defined in this book as small edible fruits
    • Açai berries, barberries, bilberries, blackberries, black currants, blueberries, cherries (sweet or tart), cranberries, goji berries, concord grapes, kumquats, mulberries, raspberries (black or red), strawberries
    • Dried berries inc. raisins
  • Other fruits
    • Recommended: 3 servings per day
    • Serving size is a medium-sized fruit, 1 cup of cut-up fruit, or ¼ cup dried fruit
    • Apples (including the peel), dried apricots, avocados, bananas, cantaloupe melon, clementines, dates, dried figs, grapefruit, other grapes apart from concord grapes (preferably with seeds), honeydew melon, kiwifruit, lemons, limes, lychees, mangos, nectarines, oranges, papayas, passion fruit, peaches, pears, pineapple, plums (especially black plums), pluots, pomegranates, prunes, rhubarb, tangerines, watermelon
  • If you buy dried fruit, look for no sugar added and unsulfured
  • Inform your physician if you eat grapefruit, as it can interact with more than half of commonly prescribed drugs
• Vegetables
  • Eat a mixture of raw and cooked vegetables. Some veggies are best raw (e.g. bell peppers); some benefit from cooking (e.g. carrots, celery, and green beans); some are hardly affected (artichokes, beets, onions)
  • Best cooking methods so you don’t lose antioxidants are griddling and microwaving. Boiling and pressure cooking lose the most antioxidants. Baking and frying are in between, but deep-frying could have other negative effects
  • Buy organic when you can
  • At least half your plate should be filled with vegetables
  • Cruciferous vegetables
    • Recommended: 1 serving per day
    • Serving size is ½ cup chopped; ¼ cup brussels or broccoli sprouts; 1 tablespoon horseradish
    • Arugula, bok choy, broccoli, brussels sprouts, cabbage, cauliflower, collard greens, horseradish, kale (black, green, and red), kohlrabi, mustard greens, radishes, red cabbage, rutabaga, turnip greens, wasabi, watercress
    • “Hack and hold” – chop the cruciferous vegetable, wait 40 minutes, then you can cook it as much as you want without destroying beneficial compounds
    • Note that frozen cruciferous vegetables are blanched, so they don’t contain all the beneficial compounds – to compensate, add some mustard powder, horseradish, or raw cruciferous veggies
  • Green leafy vegetables
    • Recommended: 2 servings per day
    • Serving size 1 cup raw, ½ cup for cooked
    • Arugula, beet greens, collard greens, kale (black, green, and red), mesclun greens (assorted young salad greens), mustard greens, oak leaf lettuce, sorrel, spinach, swiss chard, turnip greens
    • If you are taking warfarin/Coumadin, talk with your physician before you increase your greens intake
  • Other vegetables
    • Recommended: 2 servings per day
    • Serving size ½ cup raw or cooked nonleafy vegetables, ½ cup vegetable juice, ¼ cup dried mushrooms
    • Acorn squash, artichokes, asparagus, beets, bell peppers, carrots, celery, corn, cucumber, eggplant, endive, fennel, garlic, green beans, green onion, leeks, mushrooms (button, oyster, portobello, shiitake), okra, onions, purple potatoes, peppers, pumpkin, radicchio, red onions, scallions, sea vegetables (arame, dulse, nori), snap peas, squash (delicate, summer squash, spaghetti squash), sweet potatoes/yams, tomatoes, zucchini
  • Nuts and seeds
    • Flaxseeds
      • Recommended: 1 serving per day
      • Serving size: 1 tablespoon
      • Golden or brown
      • Grind them well with a blender or coffee or spice grinder, or buy them preground or “milled” – ground flaxseed should last at least 4 months at room temperature
    • Nuts or other seeds
      • Recommended: 1 serving per day
      • Serving size: ¼ cup of nuts or seeds, or 2 tablespoons of nut or seed butters
      • Almonds, Brazil nuts (at least 4 a month), cashews, hazelnuts/filberts, macadamia nuts, peanuts, pecans, pistachios, walnuts
      • Note that chestnuts and coconuts don’t nutritionally count as nuts)
      • Almond butter, peanut butter
      • Chia seeds, hemp seeds, pumpkin seeds, sesame seeds, sunflower seeds
    • Spices and herbs:
      • Recommended: 1 serving per day
      • Serving size: ¼ teaspoon a day of the spice turmeric, plus any other salt-free herbs and spices you enjoy
      • If you suffer from gallstones, turmeric may trigger pain. Too much turmeric may increase the risk of certain kidney stones
      • When pregnant, limit ginger to 20 grams per day (about 4 teaspoons of freshly grated ginger)
      • Spices – e.g. allspice, amla (Indian gooseberry), cardamom, chili powder, cinnamon (Ceylon cinnamon is preferable to cassia), cloves, coriander, cumin, curry powder, fenugreek, ginger, horseradish, lemongrass, mustard powder, nutmeg, paprika, pepper, saffron, turmeric, vanilla
      • Limit poppy seeds and nutmeg
      • Spice mixes (make sure they’re salt-free) e.g. pumpkin pie spice, curry powder, chili powder, Chinese five-spice powder, a savory Indian spice blend called garam masala, an Ethiopian blend called berbere, Italian seasoning, poultry seasoning, and a Middle Eastern blend called za’atar.
      • Herbs – e.g. basil, bay leaves, cilantro, dill, garlic, marjoram, mint, oregano, parsley, rosemary, sage, thyme
    • Whole grains
      • Recommended: 3 servings per day
      • Serving size: ½ cup of hot cereal (e.g. oatmeal, cooked grain such as rice or quinoa, cooked pasta, corn kernels); 1 cup of ready-to-eat/cold cereal; ½ a bagel or english muffin; 3 cups of popped popcorn
      • Barley, corn / popcorn, oatmeal, brown rice, rye, whole wheat, wild rice
      • Pseudo-grains – e.g. amaranth, buckwheat, millet, quinoa, teff
      • Products made with whole grains – e.g. pasta, bread
      • Intact whole grains are better than whole grains that have been processed, e.g. whole grain pasta or bread
      • For the 98% of people who don’t have wheat issues, there is no evidence to suggest that following a gluten-free diet has any benefits
      • Use the Five-to-One Rule for whole grain foods. When buying 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 5 or less (e.g. 30 grams of carbohydrates and 3 grams of fiber, 30/3 = 10, which is more than 5, so should be avoided)
    • Beverages
      • Recommended: 5 servings per day
      • Serving size 1 glass / 12 ounces; have 5 glasses a day in addition to the water you get naturally from the foods in your diet
      • Water
      • Green and white teas, e.g. green tea, jasmine tea, matcha tea, white tea
      • Black tea, e.g. tea, chai tea, earl grey tea, oolong tea
      • Herbal tea, e.g. chamomile tea, hibiscus tea (not more than a quart a day), lemon balm tea, peppermint tea, rooibos tea
      • Hot chocolate (no milk)
      • Coffee – moderate daily ingestion of unsweetened coffee may be helpful against liver damage, depression, and Parkinson’s disease. Be careful if you have GERD or glaucoma. However, green tea is preferable to coffee as a healthy beverage
      • Unless you have a condition like heart or kidney failure or your physician otherwise advises you to restrict your fluid intake, the author recommends you drink five glasses of tap water a day (not bottled water, which may have chemical and microbial contamination); that water can be flavored with fruit, tea leaves, or herbs
    • Sweeteners
      • Blackstrap molasses and date sugar
      • Stevia – up to 2 stevia-sweetened beverages a day
      • Erythritol – if you need a sweetener in order to eat a healthy food, e.g. cranberry juice. Don’t use it as an excuse to eat junk food
    • Condiments and pantry
      • Mustard, nutritional yeast, vinegar
      • Liquid smoke is okay, it doesn’t contain most of the smoke cancer compounds (unlike smoked fatty foods)

Foods to minimize with How Not to Die – yellow-light foods – processed plant foods, unprocessed animal foods

After the very prescriptive guidelines on what to eat, the guidelines on minimizing food are sketchy at best.

Dr. Greger spends much of the book telling you how eggs, chicken, meat, fish, and dairy can harm your health, but doesn’t say what level of those foods wouldn’t be harmful. However, the best-defined guideline in the book for “yellow-light” foods is to minimize processed plant foods and unprocessed animal foods.

He says in the Part 1 introduction, “In this book, I don’t advocate for a vegetarian diet or a vegan diet. I advocate for an evidence-based diet, and the best available balance of science suggests that the more whole plant foods we eat, the better— both to reap their nutritional benefits and to displace less healthful options.”

He says in the Part 2 introduction, “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.”  “ Why not scale down to once a month or reserve it for special occasions?”

In “How I Define Processed” in the Part 2 introduction, he says “The limited role I see for yellow-light foods in a healthy diet is to promote the consumption of green-light foods.”

So, it appears that these foods, if you want to eat them, should be for special occasions only or in very limited amounts for daily use if the only way you’d eat the green-light-foods is to add some of the yellow-light food.

• Processed plant foods
  • Not entirely clear what this means; see “How I Define Processed” in the Part 2 introduction for some limited guidance
  • Examples may include natural caloric sweeteners, processed meat substitutes such as veggie burgers, cocoa powder, milk substitutes such as almond milk
  • Unclear whether non-whole-grains such as white pasta should be included here
• Unprocessed animal foods
  • Meat (unprocessed) – e.g. beef, pork
  • Poultry (unprocessed) – e.g. chicken, turkey
  • Fish and shellfish (unprocessed) – e.g. cod, salmon, tuna, fish oil
  • Eggs
  • Milk (unprocessed or minimally processed) – e.g. milk, cheese, cream cheese, cream, yogurt
• Salt – don’t add salt at the table, or when you cook; avoid processed foods
• White potatoes
• Olives
  • Minimize because they’re salty
  • Olive oil – freshly squeezed olive juice already has less nutrition than the whole fruit, but then olive oil producers also thrown away the olive wastewater, which contains the water-soluble nutrients. As a result, you end up getting just a small fraction of the nutrition of the whole fruit by the time extra-virgin olive oil is bottled
• Sweeteners
  • Natural caloric sweeteners such as honey, less processed cane sugars, and maple, agave, and brown rice syrups don’t appear to have much to offer nutritionally
  • Sorbitol and xylitol

Foods to avoid with How Not to Die – red-light foods – ultra-processed plant foods, processed animal foods

Again, it’s not entirely clear what’s included here – the items below are taken mostly from part 1 of the book where the author says to avoid specific foods. There aren’t clear guidelines about the difference between processed plant foods and ultra-processed plant foods.

• Vegetables
  • Alfalfa sprouts – these are often linked to salmonella outbreaks
• Processed animal foods
  • Grilled / stir-fried / broiled / barbecued meats and fish
  • Cured meats – e.g. bacon, bologna, ham, hot dogs, sausage, salami
• Fats
  • Refined olive oil and other vegetable oils e.g. corn oil
  • Trans fats – found in processed foods and naturally in meat and dairy
  • Saturated fat – found mainly in animal products and junk foods; also in cocoa butter, coconut oil, and palm kernel oil
  • Dietary cholesterol (less important to lower LDL cholesterol levels) – found exclusively in animal-derived foods, especially eggs
  • Fried foods in general – fried meat foods are worse than fried plant foods but both have varying degrees of DNA mutations
  • If you fry at home, good ventilation (or grilling outside) may reduce lung cancer risk from toxic volatile chemicals with mutagenic properties
• Processed foods
  • Sodas and sugary drinks
  • Ultra-processed plant foods, e.g. most breakfast cereals, chips, pastries
  • Salty processed foods
  • Foods containing partially hydrogenated vegetable oil / shortening
  • Foods with artificial additives
• Sweeteners
  • Sugar
  • Artificial sweeteners
• Alcohol
  • One or two drinks lower the risk of heart disease for people living unhealthy lifestyles, but not for people with even the bare minimum of healthy behavior – the underlying ingredients are better eaten in their non-distilled form

Health benefits claimed in How Not to Die

The diet in this book claims to reduce the risks for: acid reflux / GERD, Alzheimer’s disease, anal fissure, angina, asthma, atherosclerotic plaque, Barrett’s esophagus, blood infections, brain diseases, cancer (brain cancer, breast cancer, colon cancer, colorectal cancer, esophageal cancer, kidney cancer, leukemia, liver cancer, lung cancer, lymphoma, myeloma, non-Hodgkin’s lymphoma (HNL), pancreatic cancer, prostate cancer, skin cancer), chronic obstructive pulmonary disease (COPD), cirrhosis, claudication, clinical depression, constipation, coronary heart disease, depressions, diabetes, prediabetes, diabetic neuropathy, heart disease, hemorrhoids, hepatitis E (HEV), hiatal hernia, high blood pressure, high blood sugar, high cholesterol, insulin resistance, kidney disease, kidney stones, liver disease, lung cancer, lung diseases, nonalcoholic fatty liver disease (NAFLD), overweight/obesity, Parkinson’s disease, respiratory infections, stroke, suicidal depression, varicose veins

As always, this is not intended to be a replacement for professional medical diagnosis or treatment for a medical condition. Consult your doctor before starting a new diet. This page describes what the authors of the diet recommend – Chewfo is describing the diet only, not endorsing it.

Get a copy of How Not to Die for why this diet is relevant for different health conditions; guidance on how exercise can improve your health; tips on how to incorporate all the recommended foods; how to persuade people to eat their veggies; exercise recommendations; and supplement recommendations.

The author’s website is http://nutritionfacts.org. He’s on Facebook at https://www.facebook.com/NutritionFacts.org; Twitter at https://twitter.com/nutrition_facts; Google+ at https://plus.google.com/+NutritionfactsOrgMD; and YouTube at https://www.youtube.com/user/NutritionFactsOrg.

The book mentions a free app – it appears it’s the “Dr Greger’s Daily Dozen” app available on Google Play for Android and iTunes for iOS.

How has this diet helped you? Please add a comment or question below.