Ep. 42: Michael Greger, MD, FACLM – Avoiding Osteoarthritis and Other Complications

Depending on who you listen to, almost any food can either heal you or make you worse.

Food and nutrition might be the most confusing topic of all. There’s so much different information available that it’s very easy to just throw your arms up in the air and go, “I give up. I really don’t know who to believe.” I understand this because sometimes it seems impossible to figure out the facts with so many conflicting views and so much conflicting research on the topic of nutrition.

But for millions of people worldwide, Dr. Michael Greger does just that with his Nutrition Facts website where he presents the newest research and addresses controversies in a light-hearted, easy to understand way, but always supported with solid data.

He’s also a New York Times best-selling author, an internationally recognized speaker on nutrition, food safety, and public health issues.

In this interview, you’ll discover:

  • How to prevent or heal osteoarthitis with the help of specific foods.
  • How to prevent blood clots after surgery or when you’re bedridden.
  • About the most common supplement that doctors prescribe – but can actually be harmful.
  • Which three foods to include for best healing.

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Show notes & links

The show notes are written in chronological order.

  • Dr. Michael Greger’s website: https://nutritionfacts.org/
  • Dr. Michael Greger’s books:
  • Dr. Greger’s Daily Dozen was developed based upon the best available balance of evidence. Rather than being a meal plan or diet in itself, it is simply a checklist to inspire you to include some of the healthiest foods in your diet.
  • PubMed® | Largest medical library in the world. It comprises more than 35 million citations for biomedical literature from MEDLINE, life science journals, and online books.
  • The Global Burden of Disease study offers a powerful resource to understand the changing health challenges facing people across the world in the 21st century.
  • Dai, Z., Niu, J., Zhang, Y., Jacques, P., & Felson, D. T. (2017). Dietary intake of fibre and risk of knee osteoarthritis in two US prospective cohorts. Annals of the rheumatic diseases76(8), 1411–1419. [read it here]
  • Khadem Haghighian, M., Alipoor, B., Malek Mahdavi, A., Eftekhar Sadat, B., Asghari Jafarabadi, M., & Moghaddam, A. (2015). Effects of sesame seed supplementation on inflammatory factors and oxidative stress biomarkers in patients with knee osteoarthritis. Acta medica Iranica53(4), 207–213. [read it here]
  • Matthews, V. L., Knutsen, S. F., Beeson, W. L., & Fraser, G. E. (2011). Soy milk and dairy consumption is independently associated with ultrasound attenuation of the heel bone among postmenopausal women: the Adventist Health Study-2. Nutrition research (New York, N.Y.), 31(10), 766–775. [read it here]
  • Zhang, Y. F., Kang, H. B., Li, B. L., & Zhang, R. M. (2012). Positive effects of soy isoflavone food on survival of breast cancer patients in China. Asian Pacific journal of cancer prevention : APJCP, 13(2), 479–482. [read it here]
  • Messina, M. J., & Loprinzi, C. L. (2001). Soy for breast cancer survivors: a critical review of the literature. The Journal of nutrition, 131(11 Suppl), 3095S–108S. [read it here]
  • Murray, S., Lake, B. G., Gray, S., Edwards, A. J., Springall, C., Bowey, E. A., Williamson, G., Boobis, A. R., & Gooderham, N. J. (2001). Effect of cruciferous vegetable consumption on heterocyclic aromatic amine metabolism in man. Carcinogenesis22(9), 1413–1420. [read it here]

00:00 – excerpt from the episode
00:54 – intro (listen to discover a little more about your host. Martin will tell you a new lesser-known fact about Dr. Maya)

Dr. Maya Novak:
Food and nutrition might be the most confusing topic of all. There’s so much different information available that it’s very easy to just throw your arms up in the air and go, “I give up. I really don’t know who to believe.” I understand this because sometimes it seems impossible to figure out the facts. If you like short and easy to absorb information then you’ll appreciate the work of Dr. Michael Greger. I did an interview with him back in 2019 and we talked about osteoarthritis, how to prevent blood clots after surgery, and which common supplements might be actually harmful. Enjoy.

Dr. Maya Novak:
In this interview, I’m joined by Dr. Michael Greger who is a physician, New York Times best-selling author, and internationally recognized speaker on nutrition, food safety, and public health issues. He is the driving force behind nutritionfacts.org, a website with more than 2000 health topics freely available and with new videos and articles uploaded every day. His lighthearted approach, combined with incredible knowledge, is what changes people’s lives every single day. In 2017, Dr. Greger was honored with the ACLM Lifestyle Magazine Trailblazer Award, and his latest book How Not To Die became an instant New York Times best-seller. Without further ado, Dr. Greger – one of my heroes – thank you for joining me.

Dr. Michael Greger:
I’m so happy to be here. I’m so excited you’re doing this Summit.

Dr. Maya Novak:
Thank you so much. So, for those who don’t know you, the first question that I would love to explore with you is why nutrition? Why not any other field of medicine?

Dr. Michael Greger:
Well, according to the Global Burden of Disease Study, which is the largest study on disease risk factors in history, funded by the Bill and Melinda Gates Foundation, the number one cause of death in the United States is the American diet. In fact, the number one cause of death globally, around the world, is what we eat. So as a physician, that’s what I care about most, so that’s why I focus on nutrition. The good news is we have tremendous power over our health destiny and longevity. The vast majority of premature death and disability is preventable with a plant-based diet and other healthy lifestyle behaviors.

Dr. Maya Novak:
I’m so extremely excited about our conversation because you have an incredible wealth of knowledge, and there are many things that people can find on nutritionfacts.org. However, I do have a few specific questions. The first one is about osteoarthritis. After accidents, after fractures especially, many people hear that over the years there is a big possibility of developing osteoarthritis and that there is nothing that they can actually do about that. What are your thoughts about this?

Dr. Michael Greger:
Well, if you go nutritionfacts.org and type in osteoarthritis a whole bunch of videos will come up talking about foods, not only associated with prevention but also treatment and randomized control studies. So just osteoarthritis – fiber consumption is associated with lower risk of getting it in the first place and in terms of treatment. Turmeric, ginger powder, ground ginger, rosehips – which is the fruit of the rose bush, and sesame seeds, I believe, are the same. So a quarter of a cup of sesame seeds a day was shown to offer dramatic improvement in osteoarthritis symptoms. So there’s things we can do about it, we just have to take care of ourselves, and our bodies will take care of us back.

Dr. Maya Novak:
So is – the foods that you mentioned – so turmeric and sesame seeds – do these work both for prevention and also treatment? Or can we do something more in regards of prevention when we are talking about food choices?

Dr. Michael Greger:
Well, I mean if you think about it, any food powerful enough to actually treat the condition, one would presume it would help prevent it. Now, that’s not always the case, but if a food is able to – or a dietary pattern, is able to reverse heart disease, well you assume the same dietary pattern would prevent heart disease because you’re reversing it every single day. But those specific foods, with the exception of fiber – which is associated with prevention, those foods were only used in a treatment setting to actually make osteoarthritis better. But you figure if they’re so powerful to actually make it better once it’s already flared up, then presumably it would help to stop it in the first place, but we just don’t have that data.

Dr. Maya Novak:
Yes. So, there is a huge jungle out there and you are aware of this when it comes to diet. We have the keto craze, and paleo craze, and plant-based, and vegan, and everything. So if we are talking about a specific diet, is there any specific diet that is the best for healing? Or is it better to say are there any foods that we need to avoid when we are healing, when we are recovering from injuries?

Dr. Michael Greger:
Well, I mean for recovering from injuries it’s all about anti-inflammatory foods and foods that reduce inflammation and oxidative stress. So that means anti-inflammatory foods and foods that are packed with antioxidants. Basically, that’s synonymous with saying whole plant foods. So it’s the more whole plant foods you can fit in your diet, the better. That’s fruits, vegetables, and legumes – which is your beans, split peas, chickpeas and lentils, whole grains, nuts and seeds, herbs and spices – basically real food that grows out of the ground. These are our healthiest choices for recovery.

Dr. Maya Novak:
Is it necessary to be 100% when it comes to diet? So, for example, 100% plant-based?

Dr. Michael Greger:
Oh, I never said anything completely plant-based. I said the more of these whole foods that you can get into your diet, the better. So you can eat a steak and broccoli. Is it better to eat broccoli and broccoli? Yes. But it’s better to eat steak and broccoli than it is to eat just steak without broccoli. I mean, in fact, there’s actually studies showing what happens when you give people broccoli and grilled meat. It actually reduces and helps your body detoxify the carcinogens – these so-called polycyclic aromatic hydrocarbons in grilled meat, barbecued meat – and it lasts a week. So you can eat a big broccoli. You can eat a lot of broccoli now, and at next weekend’s barbecue, you can actually help your body. You can boost your detoxifying liver enzymes so much that you can detoxify those carcinogens faster even a week earlier. That’s how powerful some of these foods are. Of course, it would be better if you put some Portobello mushrooms on that grill instead, sure, but it’s not all or nothing. It’s not black and white. Any movement we can make towards including more healthy foods in our diet the better.

Dr. Maya Novak:
People that are tuning in, that are listening, are coming from all around the world. So it also really depends, if we’re talking about surgeries, after a surgery the protocol may vary. So some doctors in some countries, they go with blood thinners, some don’t. Then, of course, there is the big topic of blood clots after the surgery, and especially if someone is in a cast for a few weeks. Is there anything that we can do in regards to that? Also, are blood clots a sign that something is happening in the body and that we have to pay attention to that?

Dr. Michael Greger:
Yeah, well what it’s a sign of is stasis – circulatory stasis – the lack of blood flow. You’re in a cast. You’re bedridden. Basically, your calf muscles act like pumps. We have a pump called the heart that pushes blood out, but how does blood get back to the heart? We don’t have little hearts throughout our body. What we have are our muscles. Our veins actually go through our muscles and have little valves, one-way valves. So when our muscles contract, it pushes the blood up back towards the heart, so our calf muscles are pumping as we walk, for example. They are constantly pumping our blood back to the heart and the heart’s reciprocating. But, if we’re sedentary, and this is if we’re sitting all day, in an airplane, for example, not moving around at all. Or, being bedridden after an injury, the blood just sits. It stagnates in our lower limbs and can form a clot. If you bled into a bowl it wouldn’t just sit there as liquid, it would coagulate into a clot. Now, if you kept stirring it, it might not but you’re not going to stir it when it’s sitting in your veins stagnating. So that’s there’s a variety of things surgeons do. Some of them like squeezy things, if you’ve ever visited someone after surgery, they have these kind of cuffs that go around people’s ankles and actually periodically squeeze their ankles all day long. That’s what they’re concerned about. They’re concerned about a clot forming, and then pieces that are caught breaking off and getting stuck in the lungs, which can sometimes have a fatal outcome. Or they give people blood thinners, right. They inject them with Heparin, or they give them oral blood thinners like Coumadin, to so thin your blood that even if there is stasis, even if you aren’t moving around, then your blood should be too thin to clot. Now, the natural approaches would be to eat a lot of aspirin rich foods. Aspirin is usually taken from willow tree bark, but it’s actually found widely throughout the kingdom. So if you take blood from someone who eats a healthy diet, like a vegetarian, for example, they have aspirin levels in their blood that can be as high as people that don’t eat any plants, but actually take a baby aspirin every day. That’s how thin you can make your blood just from eating healthy because there’s aspirin found throughout the plant kingdom. Some foods have more than others, and I have videos on this. So, for example, garlic. There’s recommendations you should stop garlic consumption a week before surgery. Why? Because they’re afraid it’s going to make your blood so thin that when they slice into you it’s going to be difficult for them to stop the bleeding, right. So foods can have important effects. On the flip side, foods can actually counteract the benefits one might get from a blood thinning drug like Coumadin (Warfarin), which basically thins your blood by blocking Vitamin K, which your body uses to clot your blood. So if all of a sudden you start eating lots of Vitamin K, which is found in dark green leafy vegetables, they actually counteract the effects of the blood and wipe out the effects of the blood as if you never took at all, and then you can put yourself at risk for clots as well. This is not to say avoid dark green leafy vegetables, it’s just your doctor has to titrate the level of that drug to your regular green leafy consumption.

Dr. Maya Novak:
So if I understand you correctly, for example, no garlic before the surgery, but after surgery definitely something, or if you are in a cast definitely add something to your diet?

Dr. Michael Greger:
Well, I would talk to your surgeon, talk to your physician about it. Because maybe, for example, they want your blood to be thin, for whatever reason because of the kind of surgery they did. But there certainly are foods that can thin your blood. So you can go to your surgeon do you mind if I start eating garlic? Do you mind if I – you know – and see what they say.

Dr. Maya Novak:
Is this something to talk with, for example, a registered dietician or do doctors have this knowledge about foods?

Dr. Michael Greger:
Good doctors do and if your doctor’s not a good one, get a new one!

Dr. Maya Novak:
Okay. In regards to the blood supply and what you talked about, I do have a very specific question about avascular necrosis. I fractured and dislocated my talus bone and one of the things that I also heard is that the talus bone can die off because of the blood supply. So avascular necrosis doesn’t just occur in ankles, but people experience this also in hips and so on. So in regards to the blood supply, or helping your body in the best way that you can, is there something in regards to nutrition that we can do to help with prevention perhaps? Or even if something is already going on, that we can help our body to heal?

Dr. Michael Greger:
I’m looking right now – so anytime you have any question about diet or any other medical related question, you can go to pubmed.gov for the largest medical library in the world and you can search through their database. So I just popped in avascular necrosis and the diet, and it looks like there’s a lot of studies done on laboratory animal models. Rabbits, I’m seeing mice, rats, but I’m not seeing anything having to do with diet and human - preventing or treating human avascular necrosis. Oh, well don’t get scurvy – that’s one thing. So eat Vitamin C rich foods. So that’s, of course, your tropical fruit and citrus, broccoli, bell peppers. But you need very little Vitamin C to prevent scurvy. But that looks like the only thing in the medical literature in humans.

Dr. Maya Novak:
So right now, we don’t have data that would tell us anything in regard to that.

Dr. Michael Greger:
Right. I mean you should eat a healthy diet, period, because that will support healing. But there’s nothing specifically about avascular necrosis and diet that I’m aware of – at least in the English language medical literature.

Dr. Maya Novak:
Okay. So what would you say to someone who is injured? What would be your number one advice?

Dr. Michael Greger:
Well, prevent re-injury, obviously and take care of yourself. I mean so it’s the same kind of advice – get enough sleep, eat healthily, etc., but it’s just that much more important when your body is trying to recover from an injury, from any kind of injury. So it’s just your body needs everything that it normally needed just for day to day function, plus it needs extra resources. So it’s just that much more important to do everything right – to not smoke. These are not just preventing disease, but giving or letting your body not have to divert its resources to heal all the damage in your lungs from every puff on your cigarette. Instead, take all those resources and target it towards healing whatever injury you might have.

Dr. Maya Novak:
Perfect. Can we touch on the topic of protein? Because this is something that people are very concerned about, and especially after an injury or after an accident, to add more protein. Can you talk about good protein versus bad protein, if there is such a thing as this?

Dr. Michael Greger:
Yeah, so we’re already eating – I mean a typical person is eating more protein than they need in the first place. So even if there are higher injury needs for tissue repair, which there are, they’re more than covered by the typical buffer – with the exception of burn victims. So a burn patient can have extraordinarily high protein requirements - that’s something that you’d work with a dietician over. But in terms of – regardless of how much you need, what’s the best source? The best source is plant foods, particularly legumes, beans, split peas, chickpeas, and lentils – the kind of protein plant superstars. That’s because food is a packaged deal, right. So yes, there is protein in pork and iron in beef and calcium in dairy. But there’s baggage that comes along with those nutrients – saturated fat and cholesterol and all those things that we don’t want. Whereas the “baggage” that comes along with protein in plant foods, like in a kidney bean or something, it’s all the good stuff and the fiber and the folate and the antioxidants and potassium - all these things that you’d be missing out on. So because food is a packaged deal, where are you going to get your protein from? You get it in the healthiest package possible and that’s beans, split peas, chickpeas and lentils and also whole grains, nuts and seeds have protein. Everything has protein, but those are the real concentrated sources.

Dr. Maya Novak:
You mentioned beans. Am I right, if I remember correctly, that beans are also really helpful in regards to bone health and also healing?

Dr. Michael Greger:
Bone health and healing? Well, I mean beans are wonderful for everything, for baseline health. But specifically for bone – well certainly soy, so soybeans. I mean take – these were older women, randomized to drink soy milk or dairy milk, for example, and the women drinking the regular cow’s milk continued to lose bone mass, whereas those that instead switched to soy milk actually gained – they not only stopped losing bone mass, but they actually gained mass – bone marrow density. But whether it’s because they weren’t drinking milk or because they were eating beans – we assume it’s from the soy, the benefits of soy. But yeah, you can actually decrease fracture rates in women with soy food consumption. The healthiest sources of soy are not something like soymilk because it’s a relatively processed food, but edamame, like those little green immature soybeans in a pod, or miso, tempeh, these whole soy foods would be your best bet for bone health.

Dr. Maya Novak:
Can you talk a bit more about soy? Because I know that many people are afraid of it. Soy is the devil that you shouldn’t be eating. They’re afraid of it. Can you talk a bit about this?

Dr. Michael Greger:
Yeah, this is a manufactured controversy. I mean if you look at the medical literature you don’t see this kind of craziness. But people hear soy, they know it has these phytoestrogens, these isoflavones, estrogen – it’s kind of scary sounding because there’s estrogen receptors that are causes of breast cancer, for example. But people don’t realize that the phytoestrogens are what’s called SERMS or selective estrogen receptor modulators – meaning they have pro-estrogenic effects in some tissues and anti-estrogenic effects in the others. For example, bone strengthening – that’s an estrogenic effect. Preventing hot flashes in menopausal women – that’s a pro-estrogenic effect. But in other tissues soy has an anti-estrogenic effect, like on the breasts. So breast cancer survivors, thousands of them have been followed over time, and those that eat soy live significantly longer and have a lower risk of the cancer coming back. So that’s an anti-estrogenic effect. There have been five studies done so far on human breast cancer survivors and every single one showed the same thing. So it’s actually kind of the best of both worlds eating soy. I mean you don’t have to have soy, all the legumes are good, but that’s an excellent choice.

Dr. Maya Novak:
When it comes to bone fractures many people start taking calcium supplements. Are calcium supplements very beneficial, or is it better if we get calcium from foods?

Dr. Michael Greger:
Calcium supplements are neither effective nor are they even safe. So those that take calcium supplements suffer a higher risk of cardiovascular events because these unnatural surges of calcium in the bloodstream have caused arterial problems. I have videos on calcium supplements, on their safety, and their efficacy – and they don’t prevent or reduce hip fracture risk. You need to get calcium from somewhere, it’s a vital mineral. But the best source, again, is – because it’s all about a packaged deal – you get it from plants. So low oxalate dark green leafy vegetables – that’s all greens except for spinach, Swiss chard, and beet greens. All the other greens like kale and collards are packed with readily absorbable – in fact about twice as absorbable as calcium milk. So we should be eating greens every day - which is one of the reasons they made it onto my daily dozen list of foods I encourage people to fit into their daily routine.

Dr. Maya Novak:
Can you talk a bit about your daily dozen? What this is and how it benefits people?

Dr. Michael Greger:
Yeah, so I have a free app on iPhone and Android called Dr. Greger’s Daily Dozen and basically it’s just all the foods – the healthiest of health foods. So berries are the healthiest fruits, greens the healthiest vegetables, a tablespoon of ground flaxseed, a quarter teaspoon of turmeric, the best beverages, the best sweeteners, how much exercise to get every day. Just in hopes of inspiring people to include some of these healthy choices in their day-to-day lives. You can check them off, play kind of game out of it and it’s just a reminder to, by the end of the day, see how many you can fit into your day.

Dr. Maya Novak:
But it’s not to make someone stress out because they cannot fill everything?

Dr. Michael Greger:
It is aspirational, all right! The more the better.

Dr. Maya Novak:
Okay. Because as a recovered perfectionist, when I found out about your app and I started using it sometimes, it was a bit hard. Like oh, but I should have a thing there.

Dr. Michael Greger:
Well, then eat it!

Dr. Maya Novak:
Yes, absolutely!

Dr. Michael Greger:
Or just do better the next day, right.

Dr. Maya Novak:
True, true. Dr. Greger, people who listening are being so inspired by your words, but there are also those who are losing hope about their recovery, about their healing. What would you say to someone who is losing hope about their healing?

Dr. Michael Greger:
I’d have them think back to earlier in their life. Everybody’s had some kind of injury whether it’s a broken bone or even whacking your shin on something. It hurts and it feels like – if you break or toe or something, it feels like it’s never going to get better. Then all of a sudden one day you’re like oh yeah, my toe used to hurt. Like it plagued you day after day, and then you completely forgot about it because it went away on its own. That’s what your body does. Your body heals. It just has this remarkable ability. The human body is a self-healing machine so all we can do is basically just stand back. Get out of the way and let our body’s natural healing processes bring us back towards health. We just have to support it along the way. It just knows what to do, and comes right back to where it should be, if possible. So we’ve just got to kind of – it’s the patience. It’s having the patience to just let your body do its thing. All we can do is stand back and support it and realize that even some of these really catastrophic injuries, months later or years later, people can be completely transformed. Then in retrospect, they can think back, oh I remember how depressed and I thought this would never get better, and look at me now. Well, you can look forward to that future self and realize yes, it may take time, but you should use this time to think about all the great things you’re going to do for yourself now that you’re not going to take health for granted again, right? It’s a great lesson, a life lesson. The moment before the injury, remember that time. Maybe you were having a bad day. In retrospect, you were having a fantastic day. You could still walk, you could still see, you could still whatever. However bad off you are now, oh my god, it could be so much worse, and there are people having so much worse, and we should just thank our lucky stars for how much function we have and the fact that human body functions at all is a miracle. Just kind of have some perspective and patience.

Dr. Maya Novak:
Dr. Greger, if you would have to choose only three foods that are amazing for healing, what would you choose and why?

Dr. Michael Greger:
Well, you’d want to go anti-inflammatory. So there’s a dietary inflammatory index, which ranks foods based on their pro-inflammatory or anti-inflammatory effects. So the most anti-inflammatory food on the entire index is turmeric – turmeric root. You can actually buy the root. If you go to an Asian market you can actually buy these little – they look like kind of ginger fingers that are bright fluorescent day-glow orange inside. You can grate it, or chop it, or blend it into things. So for inflammation, it would be turmeric root. You don’t have to use fresh, but I just think it tastes better than dried. What are two others? One, well, it would be something with lots of antioxidants – polyphenol antioxidants. So a deeply colored berry whether it’s a wild blueberry or black raspberry, blackberry, yeah. Okay, so we’ve got two down. Berries, turmeric, oh what’s a good third. So then blood flow, so something with nitrates. Arugula has the highest nitrates – so any dark green leafy vegetables or beets or beetroot would have lots of nitrates that help improve blood flow and oxygen metabolism. So arugula, blackberries, and turmeric.

Dr. Maya Novak:
Great advice, I love it. I do have one last question that is a bit more of a fun one, and out of the box. If you were stuck on a desert island with an injury and you could bring only one thing with you that could help you heal amazingly well, what would that be?

Dr. Michael Greger:
One thing with me on a desert island – water, otherwise I’m going to be dead in like a day!

Dr. Maya Novak:
What if water is there?

Dr. Michael Greger:
Well, oh they’ve got water, all right. It’s not a very deserty island if it’s got water, but okay. What’s the one thing you need – you need a cellphone with service so you can call Medivac, that’s what you need!

Dr. Maya Novak:
Perfect. Dr. Greger, I so enjoyed this conversation. Where can people find more about you?

Dr. Michael Greger:
So you can go to nutritionfacts.org and download the free app Dr. Greger’s Daily Dozen, sign up for a free newsletter. I’m eager to help people help themselves and their families.

Dr. Maya Novak:
Thank you so much for being here and for all the work that you do.

Dr. Michael Greger:
Happy to help out, good luck everybody!

Dr. Maya Novak:
Thank you for tuning into today’s episode with Dr. Michael Greger. If you haven’t done it yet, subscribe to the podcast Mindful Injury Recovery Talks on whatever platform you’re using to tune in. Of course, also remember to share this episode with your loved ones and help them out. To access show notes, links, and transcript, of today’s talk go to mayanovak.com/podcast. To learn more about The Mindful Injury Recovery Method visit my website mayanovak.com and find my book Heal Beyond Expectations on Amazon. Until next time – keep evolving, blooming, and healing.

Love and gratitude xx
Dr. Maya

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