Chris Castig Co-founder of Adjunct Prof at Columbia University Business School.

How Not To Die by Dr. Michael Greger | Summary and Quotes

14 min read

How Not To Die Summary

In How Not to Die, Dr. Michael Greger, founder of the wonderful nutrition site, examines the top causes of premature death in America: from heart disease, to high blood pressure, and cancer. In the book he illustrates how good nutrition can improve your health more than any diet, or pill.


Hello and welcome to On Books. This week, I want to inspire you to read How Not to Die by Michael Greger M.D.

This is one of my favorite books from the past year, I have read I think over 20 or 25 nutrition and health books over the past few years. I’ve been really deep and interested in the subject and I’ve done some live speaking and events on nutrition. I’m very passionate about this subject. Of all the books I’ve read on nutrition, I feel like this one is really just the one to read. 

A few things to come, jumping into this, I want to talk about why this book? Who is Michael Greger? Why is he writing it? At the end I want to give you two takeaways from the book where I’m going to read a little bit. Two takeaways that after reading the book caused me to change something in my day every single day, in my habits every single day. I’m going to bring those to you as well.

At the front of this episode, you heard Dr. Greger talking about his site I want to just tell you a little bit about why I think he’s doing a wonderful job with his site and how it relates to the book. The site, basically, I’m just going to read from the about page here because it sums it up. He says,

Whenever there’s a new drug or surgical procedure, you can be assured that your doctor will probably hear about it because there’ll be a corporate budget driving its promotion. But, what about advances in the field of nutrition? The reason we don’t see ads on TV for broccoli is the same reason groundbreaking research on the power of foods and eating patterns to affect our health and longevity gets lost and buried in medical literature. There’s no profit motive. It may not make anyone money, but would it profit our lives?

Dr. Greger says,

But, what if it could profit our lives? 

I’m sharing with you the site because the site NutritionFacts, the amount of time over the years that he’s put reading through different journal studies and working with this research team, this nonprofit team put this together. Dr. Greger has put together thousands of videos at this point that are all free.

How Not to Die is the aggregate of the best of those videos. It’s a gem! I’m going to play an excerpt from one video in particular that I think has some really beneficial takeaways that you could get away.

Dr. Michael Greger:

When I used to teach medical students at Tufts, I gave a lecture about this amazing new therapeutic called “iloccorB. I talked about all the new signs, all of the things you can do, excellent safety profile and just as they were all scrambling to buy stock in the company and prescribing to their patients, I did the big reveal, apologizing for my dyslexia. I had gotten it backwards, all this time I had been talking broccoli. Sulforaphane, is thought to be the active ingredient in broccoli, which may protect our brain, protect our eyesight, protect us from free radicals, induce our detoxification enzymes, help prevent cancer as well as help treat it. For example, I’ve talked about how Sulforaphane can target breast cancer stem cells.

Then I talked about how the formation of this compound is like a chemical flare reaction requiring the mixing of a precursor compound with an enzyme and broccoli, which is destroyed by cooking. This may explain why we get dramatic suppression of cancer cell growth from raw broccoli, cauliflower, Brussels sprouts, but hardly anything from boiled microwave or steamed except from microwave broccoli that actually retained some cancer fighting abilities.

Chris: What you can’t see (as I’m reading) is that in the video, as he’s talking, Dr. Greger is highlighting the various reports. In real time, he is citing himself by using different medical journal reports. You have to watch it for yourself as he’s talking!

Everything he is saying is backed up by reports. He’s not just kind of preaching from some philosophy or some things that he heard or just speaking off cuff, everything is very well documented and cited and that’s really profound. I’m going to move a little bit further through the video now just to give you one of the big takeaways.

Chris: If you’re following along, he’s saying that Sulforaphane has this really potential healing property in broccoli, that’s very healthy for you. One of those situations where the problems is that when we cook broccoli, what happens? We cook it and it loses the Sulforaphane, right? It loses that potential. He gives this method called “Hack and Hold.”

I’m going to play it for you now, which is a way that you can still cook your broccoli and not lose all the nutrition that comes along with it.

Dr. Michael G:

That’s why I described the hack and hold technique. If you chopped the broccoli, Brussels sprouts or kale, collards, cauliflower. First, and then wait 40 minutes, then you can call cook them all you want, the Sulforaphane is already made, the enzyme has already done its job, so you don’t need it anymore. When most people make broccoli soup, for example, they’re doing it wrong! Most people cook the broccoli first, then blend it, but now we know what should be done in the exact opposite, blend it first, wait, then cook it.

Chris: Now, in How Not to Die he’s taking the best of all that research, the best of all his videos and the stories, and all that kind of stuff. He’s putting it into more or less just this big magazine, this encyclopedia that you can read through and find what you’re looking for.

How is the book arranged?

Where do you start with a big book like this? Well, the book is divided into two parts, the first part is the why? The second part is the how? He writes,

This book is divided into two parts. The why and the how. Part one, the why, to eat healthy section?

Dr. Greger explores the role of food in prevention, treatment and reversal of the 15 leading causes of death in the United States. I’m going to pause there. As he’s saying, the first half of the book is then subdivided into the top 15 ways basically that Americans die, which is interesting in, and of itself. Do you know the top number one reason that Americans die? The number one disease?

Most people think it’s cancer. But it’s heart disease. Heart disease is number one.

Then the list goes down from there, we have heart disease, lung disease, brain disease, goes, digestive cancers, infections, and diabetes. 

Chris: I’m going to read the chapter titles, How Not to Die from Heart Disease Page 17, How Not to Die from Lung Disease, Page 30, How Not to Die from Brain Disease, and it just goes down there, the top 15. Within that, he looks at how you know based on all of this research, like I said, he looks at the role that diet plays in preventing these diseases. I’m going to read from the introduction at the beginning of the book, he writes,

There may be no such thing as dying from old age until recently, advanced age had been considered to be a disease itself. But, people don’t die as a consequence of maturing, they die from disease most commonly heart attacks. Most deaths in the United States are preventable and they’re related to what we eat. Our diet is the number one cause of premature death and the number one cause of disability. Surely, diet must also be the number one thing taught in medical school. Right? Sadly, it’s not. According, to the most recent national survey, only a quarter of medical schools offer a single course in nutrition down from 37%, 30 years ago.

I’ll repeat what he said because this is crazy, but if you’re a doctor, you don’t have to take that many nutrition courses, actually, maybe only one. Yet a lot of us go to our doctor and ask them for nutrition advice, “Hey doctor, what should I eat? Should I eat this? Should I eat this?” But, doctors are not necessarily trained in nutrition.

This is something I’ve read about a lot and a few other books such as The China Study and a variety of other books that people have argued that doctors should have more nutrition training.

Dr. Greger goes on,

While most of the public evidently considers doctors to be very credible sources of nutritional information. Six out of seven graduating doctors surveyed, physicians were inadequately trained to counsel patients about their diets. Exactly that, one study found that people of the street sometimes knew more about the basic nutrition than their doctor’s, concluding physicians should be more knowledgeable about nutrition than their patients, but these results suggest that this is not necessarily true.

I really like the way that the first half of this book is broken down, how he’s broken it down to the 15 diseases that Americans most die from because I don’t know, I think of life is a game in some ways, whereas like you want, I want to have good health, and I want to live as long as I can, but I want to live those years without prescriptions and drugs or all the side effects of all that. You want to just live healthy and personally then I just want to not live anymore. Right? I want to live in good health as long as I can, more or less. It makes sense, logically if I was playing this game, so to speak, that to know the top 15 things that are going to come up and potentially destroy me, so to speak, that I could become educated, trained, strong and take care of those because if you were thinking of this as a pie graph, that’s a big chunk of the pie graph of things against you.

What Dr. Greger does is for each of the 15 diseases he offers why, why certain foods, why or why not, they may contribute to this disease. I’m just going to look at the first one, the number one, which is heart disease, How Not to Die from Heart Disease.

I’m going to read a little bit and just give you some of his thinking on this. Dr. Greger starts writing,

Imagine if terrorists created a bio agent that spread mercilessly claiming the lives of nearly 400,000 Americans every year. That is the equivalent of one person every 83 seconds, every hour around the clock, year after year. The pandemic would be front page news, all day, every day with Marshall the army and march our finest medical minds into a room to figure out how to find a cure for this bio terror plague.

In short, we’d stop at nothing until the terrorists were stopped. Fortunately, we’re not actually losing hundreds of thousands of people each year to preventable threat. Are we? Actually, yes we are. This particular biological weapon may not be given, may not be a germ released by terrorists, but it kills more Americans annually than have all past wars combined. It can be stopped not in a laboratory, but right in our grocery stores, kitchens and dining rooms. As far as weapons go, we don’t need vaccines or antibiotics, a simple fork will do.

What’s going on here? If this epidemic is presence on such a massive scale, yet so preventable, why aren’t we doing more about it? The killer I’m talking about is coronary heart disease and it’s affecting nearly everyone raised on the standard American diet.

Our top killer, America’s number one killer is a different kind of terrorists, fatty deposits in the walls of your arteries caused by I’m going to not say this right, but as arteriosclerosis plague, maybe that’s how you say it. For most Americans raised on conventional diet. Plague accumulates inside the coronary arteries, the blood vessels that crown the heart hence the coronary and supply it with oxygen rich blood. The buildup of plaque known as arteriosclerosis from the Greek word athere, gruel and sclerosis, hardening is the hardening of the arteries by pockets of cholesterol, rich gunk that builds up within the inner linings of blood vessels.

I want to move ahead a little bit here because he goes on telling the story and he looks at, there’s a page here is fish oil, just snake oil is talking about how fish oil may relate to heart disease, talks about Lipitor a little bit and moving on.

There’s a part here called Heart Disease is Reversible, where he looks at research from Dean Ornish, Caldwell Esselstyn, and Nathan Pritikin. Nathan Pritikin is one of the doctors that helped cure his grandmother: I’ll tell you the story, but basically, his grandmother was sentenced to die at 65 from heart disease. It was like, “There’s nothing we can do.” Then Nathan Pritikin came in. He took her off of her pharmaceutical drugs. He changed her nutrition to a plant-based diet. And thus she went on to live, I think for at least like another into her ’80s at least.

I’ll read a little bit more and then leave it to you. Dr. Michael Greger writes about heart disease, he says,

Originally researchers blamed the animal fat or animal protein, but attention has recently shifted to bacterial toxins known as Endotoxins. Certain foods such as meats appear to harbor bacteria that can trigger inflammation dead or alive even when the food is fully cooked. Endotoxins are not destroyed by cooking temperatures, stomach acids, or digestive enzymes. After a meal of animal products, these Endotoxins may end up in your intestines. They are then, ‘I’m sorry.’ They are then thought to be ferried by saturated fats across the gut wall into your bloodstream where they can trigger the inflammatory reaction in your arteries.

One of the main points here, the building on Ornish’s Study is that Dr. Ornish reported 91% reduction in angio attacks within just a few weeks in patients place on a plant based diet, both with or without exercise. This is talking about the role that meat has in basically causing or exacerbating heart disease, and the reversibility of it, which is I’ll just repeat that here, 91% reduction in attacks was in just a few weeks of removing meat and eating healthy plants as a substitute.

I’m going to move to the second half of the book and it’s going to be short. As you can tell from me reading the first half of the book, it’s a little bit in depth that parts, there’s some science, there’s storytelling and it breaks down. Like I said, there’s 15 diseases, one, two, three, four, five, all the way to 15. That’s all the why, right? The second half of the book is a little bit more of like a how to guide and maybe I guess if you trusted enough you came to this book, you just wanted to know how do I just start living healthier? If you just were like, “I’m with your doctor, I’ve seen your videos, I’ve read the introduction, I’m with you.” 

Then you could probably just get to the second half and just gobble up some of these tips that he has in here.

I’m going to share with you two, that are just frameworks that I use now for informing my own health. I think, one thing that’s important to point out as well, when we look at different diets, there’re so many different diets out there, right? There’s like paleo, there’s Atkins, I don’t know there’s vegan, plant based, there’s always different dIetary that you can do. I think, the question that’s worth asking is what are you trying to optimize for is important? Because, I do believe that there are certain. Again, I should say that I’m not a doctor, take these for what you’re worth, do your own research, don’t just follow me.

I’m not a doctor at all. I believe I will say based on what I’ve read, that there are certain diets that will optimize you gaining muscle. There are certain diets that will optimize you for losing weight. Right? If those are your goals, you may lose weight on the Atkins diet, you may gain muscle doing Crossfit and eating paleo.

My goal in this game, so to speak, is good health. I want to live a healthy life and I want my mind to be functioning at high level of cognitive ability. I want to have friends and family and treat them well and be alert for that and live right, good health, all that stuff that comes to good health. There’s going to be trade offs when you decide what you’re optimizing for. If you’re optimizing for losing weight, you may slightly be giving up some of your good health and they don’t talk about that. I think, that’s a pretty profound realization, right? Is that, okay, yeah, you may be losing the weight, but what are you giving up? The trade offs are rarely talked about.

In this book, the main optimization is good health. How not to die! You may disagree with some of this and say, “Well, paleo says I need to eat, so-and-so lean chicken protein, X amount of days so that I can gain body mass.” Okay, that may also be true, right? But this is about health.

Within that context, Dr. Greger gives his recommendations for living a healthy life and not dying. He gives what he calls Dr. Greger’s Daily Dozen. Dr. Greger’s daily dozen, it’s 12 different types of food that you should have and the amount of servings that you should have of them every day.

Right now I’m just going to read down the list of 12 that you should have every single day and if you would like when you get the book, each of the chapters at the end, more or less goes through these 12 foods and why you should have them or how they can affect you or how you can use them to your benefit more or less. They’ll talk about things like the effects of hibiscus tea or green tea versus white tea, coffee, like all this is just in the beverage category. There’s 12 different types of food that you should have every single day and the list goes. Barry’s beans, other fruits, cruciferous vegetables which are like broccoli, Swiss chard, there’s a few other things, greens, other vegetables, flaxseed, nuts, spices, whole grains, beverages and exercise.

Dr. Greger Daily Dozen

Like I said, each one of the chapters goes through why? A little bit about the science, how often to have it. If you’re this type of person and you may want to have more or less of this, all that kind of stuff. There’s not recipes like actual, there’s a whole another book about recipes if you want that, but it’s more or less just broken down by each of the foods, broccoli, hibiscus tea, and the health benefits of each one. Which is, like I said, it’s that kind of encyclopedic read where you can come to it when you have questions and thumb through and get your answers.

I’m going to read from the exercise portion here, this is one of them. Dr. Greger says,

You need to do exercise every day” that’s my number two takeaway.

My number one takeaway was just having this list and reading through the benefits. I have begun to incorporate flaxseed into my diet every day as well as spices. I make a drink of turmeric and cinnamon, I’ll put together, it takes a second. You put it together, but after reading the benefits of and how easy this is to get this nutrition every day, just made some quick changes in my life that I’ve really felt good about, that’s the nutrition part. 

One of them here —  exercise —  I also found really interesting because I thought that I exercised. All right, I thought that I exercised enough three times, four times a week. I thought that that was pretty good, but I love, I love this part here where the question is how much should you exercise? This is looking, like I said, a research and so he writes and you might not want to hear this if you don’t like to exercise. He says,

The current official physical activity guidelines recommend adults get at least 150 minutes a week of moderate aerobic exercise, which comes out to a little more than 20 minutes a day. That’s actually down for previous recommendations from The Surgeon General, The CDC, and The American College of Sports Medicine, which recommend 30 minutes a day, at least 30 minutes a day. The exercise authority seemed to have fallen into the same trap as the nutrition authorities recommending what they think might be achievable rather than simply informing you what the science says and letting you make the decision for yourself.

I think that, that’s a pretty profound way for us to end here because that’s what this book is doing. I really believe that he’s bringing us the science in its raw form saying, this is what the science is about food, about disease, about exercise. There’s a lot of other books out there which you can read about the politics of food, about how, I don’t know how to go into it, but the food triangle, the politics of the fact that the people who put meat and eggs and dairy on the food pyramid are lobbyists from those organizations, and there just happens to not be a broccoli lobbying group for reasons we could go into, but so because of money more or less. This is really interesting, I think that’s what this book really is doing and I love that. He says, 

They should be just showing you the science and letting you make up your mind.

I think that, that’s what this book is doing.

In case, you didn’t get the takeaway, his serving size here for exercise is 40 minutes of vigorous activity every day. That’s what you should be doing. What is vigorous activity? Something like basketball, bicycling, tennis, scuba diving, swimming laps, jogging, hockey, football. I don’t know, there’s a whole list here or 90 minutes a day of moderate activity. That would be, I don’t know what he has here, dancing, dodge ball, yoga yard work, etc, etc. There’s a whole list, you could read through it when you get the book.

Yeah, 40 minutes a day, and so I don’t know, as soon as I read that and I read this chapter, it sounds crazy, but I got in the habit of doing about 40 minutes. Let’s say 35, almost 40 minutes of exercise every single day and it’s just become a habit since the past year of reading this book. I’ve just pushed myself every day to get out there and yeah, I’ve been feeling really good and it’s when we can talk about habit, the way you make habits in a different time. But, once I just decided I was going to do it every day, it became a lot easier. As crazy as that might sound for some people out there who don’t like to exercise perhaps.

How Not to Die was really inspirational to me. I have it, I keep it by my bedside. It’s something as I explore new foods, as I hear about new diets, it’s always there. It’s such a really well researched. Yeah, it’s such a well put together book and there’s so much in here that I want to share with you.

I’m going to leave it to you now to check out How Not to Die, please pick it up and check it out. As well as Michael Greger’s site, where he has a lot of free videos and education on there without any advertisements, totally non-profit up there for you to enjoy public service announcement basically that he put together to share his decades of research with the world. 

Buy How Not to Die, by Dr. Michael Greger on Amazon



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Chris Castig Co-founder of Adjunct Prof at Columbia University Business School.