How Not to Die Summary

Discover the Foods Scientifically Proven to Prevent and Reverse Disease

By Michael Greger
11-minute read

What age would you like to live to, and would you like to know how to lead a healthier and longer life?

How Not to Die uses practical cutting-edge nutritional science, to show us that a plant-based diet is scientifically proven to prevent, and even reverse disease. The book is divided into two parts that deal with the theoretical science behind lifestyle and diseases, and practical ways to live a healthier and longer life.

Dr. Michael Greger is an internationally-recognized physician and founder of, and he shows how a plant-based diet can lead to a long and healthy life. According to Dr. Greger, most deaths in the United States are preventable, and are related to our diets. He has spent countless hours reviewing credible scientific journals, that bring us cutting-edge information on plant-based nutrition. And, How Not to Die sums up complex science, in a digestible way, so that we can all take responsibility for our health.

We'll briefly look at the main ideas in How Not To Die. Part One of the book delves into the top causes of death in America, including heart disease, various cancers, diabetes, and high blood pressure. It also explains how nutrition and lifestyle can help us to heal without drugs and invasive surgeries. Part Two provides a checklist of foods that we should consume daily. These foods are called, Dr. Greger's Daily Dozen. Here you'll get some practical ideas such as upping your intake of blueberries to boost immunity and aid post-workout recovery. Or, drinking hibiscus tea as a way to help with high blood pressure and hypertension.

Greger's Own Story

The journey through the book parallels what happened in Dr. Greger's own life. Greger's grandmother made a miraculous recovery, after being diagnosed with end-stage heart disease. The family contacted Dr. Nathan Pritikin - an inventor, engineer, nutritionist, and longevity researcher. Under his guidance, Greger's grandmother adopted a plant-based lifestyle, and within three weeks, she was out of her wheelchair and walking 10 miles a day. She lived for a further thirty-one years. This sparked Greger's decision to pursue a medical career, focusing on how diet is a leading factor in health.

Dr. Greger's belief, that following a plant-based lifestyle can reverse coronary heart disease, was further confirmed by Dr. Dean Ornish's landmark 1998 publication, the Reversal of Coronary Heart Disease. However, despite this groundbreaking study, the practice of medicine hasn't really changed, and heart disease remains the leading cause of death for men and women in the USA. The question that haunted Greger during his medical training was, 'if the cure to the number one killer could get lost down the rabbit hole, what else might be buried in the medical literature?' He made it his life's mission to find this out.

Should We Pay So Much Attention to Nutrition?

Quite simply, yes we should.

However, Greger argues that there's a disconnect between, science, medicine, and public policy. You'd think that nutrition would be the number one thing taught in medical school, and the first thing your doctor asks you about during consultations. But this isn't the case. He argues that education about nutrition and its role in disease prevention and longevity is deficient at a tertiary level. In 2001, a bill was introduced in the California State Legislature, that would require physicians to receive twelve hours of nutritional training, over four years. However, the California Medical Association opposed it. The California Medical Board, requires all doctors to receive twelve hours of instruction in pain management and end-of-life care, but apparently has less interest in using nutrition to stop people from getting sick.

There's an even more significant disconnect when it comes to science and public policy. Greger uses the example of smoking in the 1950s. There was convincing evidence that linked smoking to lung cancer, but because smoking was considered the social norm, this evidence was largely ignored. With reassurance from medical associations that smoking in moderation was fine, on average, Americans were smoking half a pack a day. It took over a decade, and seven thousand studies, before the American Medical Association came out against smoking. Greger says that today the same disconnect between evidence and policy applies, regarding the dairy, meat, and processed food industry. And, until this disconnect stops, we're the ones who need to take responsibility for our health.

Diet Can Be More Effective Than Medication

According to the Global Burden of Disease Study, published in 2010, the number one cause of death and disability in the USA, is related to diet. Prescribed medications typically target symptoms, but diets treat the cause of disease.

Our health is being hammered by the standard American diet (which, unsurprisingly, is abbreviated to SAD). The S.A.D consists mainly of meat, sugar, salt, eggs, dairy, and processed foods, and is high in calories but very low in nutritional value. Studies show that people who have diets rich in these food groups, are at higher risk of heart disease, diabetes, and other chronic ailments. Furthermore, excessive animal fats and processed meats, result in high cholesterol and elevated heart disease risk. However, merely restricting the amount of animal-based processed food we eat, isn't going to do much good. Dr. Greger says you're still beating yourself up - just with a smaller hammer. Why beat yourself up at all?

The healthiest diets minimize, dairy, meat, eggs, and processed foods, and maximize fruit, beans, vegetables, whole grains, nuts, and seeds. We could describe the latter as, real food that grows out of the ground. Dr. Greger gives us actionable advice on plant-based food, that can prevent the top causes of death in the USA, with a chapter dedicated to each ailment.

The goal is to eat a whole-food plant-based diet. But, as with all things, not all plant foods are created equal, and there are certain plants with unique medicinal properties. Dr. Greger's Daily Dozen checklist contains foods, that we should aim to eat on a daily basis. Fruits, leafy greens, vegetables, beans, whole grains, nuts, seeds, herbs, spices, and beverages, along with an extra serving of exercise are included.

Fruits, and the Importance of Berries

We've all been told to eat an apple a day, but we should actually try to eat three fruit servings a day. Fruits, particularly berries, are rich in antioxidants, which limit cellular damage and reduces inflammation. One study showed that over a six-week period, a cup and a half of blueberries per day, doubled natural killer counts in athletes, after intense exercise. Natural killer cells are critical to the immune response because they fight off tumors, and virally infected cells. Berries also help with brain function. Women who ate one serving of blueberries, and two servings of strawberries per week, had slower cognitive decline rates. And, if you're worried about the sugar, don't be. The science shows that if you eat whole fruits, as opposed to juicing them, then the fiber, as well as the antioxidants and phytonutrients, cancel out the fructose by lowering absorption rates.

Eat Five Servings of Leafy Greens and Vegetables Every Day

Eating a wide variety of vegetables every day, will improve your overall health. Leafy greens such as kale, spinach, arugula, and chard, are particularly important and should be eaten twice a day, because they contain the most nutrition per calorie than any other food on earth. Cruciferous vegetables, such as broccoli, cabbage, or cauliflower, should be eaten once a day, and carrots, beetroots, and mushrooms are also recommended.

A 2010 study involving longtime smokers, revealed the superpowers of broccoli. Participants who were fed twenty-five times more broccoli per day than that of the average American, showed astonishing results. When tested after the tenth day, this group's blood contained just over 40% fewer DNA mutations, than that of smokers who didn't eat broccoli. And, it's important to note that taking supplements doesn't have the same nutritional value, and they're often very expensive. So, Dr. Greger's advice is to load up on broccoli sprouts, because they're an inexpensive and effective power food.

Eat More Beans

Eating three servings of beans is easier than you may think. Just a quarter of a cup of hummus counts as a single serving, as does ½ a cup of cooked beans. If you don't have time to boil beans, canned beans and lentils are just as healthy. Just be sure to rinse them first, as brine can contain a lot of salt.

Whole Grains, Nuts, and Seeds

Try to eat three servings of brown rice, whole-wheat pasta, millet, oats, quinoa, and yes, popcorn, per day. The more colorful a grain, the higher its antioxidant content. Be careful of packaging, and remember, that grain products labeled 'multi-grain' or 'stone-ground' are not whole grains. When grains are processed into flour, they digest more rapidly, and their glycemic index increases.

Dr. Greger says that just by eating a quarter cup of nuts every day, you can increase your lifespan by two years. Phytates found in nuts and seeds, detoxify excess iron in the body, inhibit free radical production, and increase bone density. Walnuts are the most nutritious of all nuts, and pistachios can even serve as a substitute for Viagra! Studies have found that three to four handfuls of these tasty nuts, can increase blood flow to the male genitalia, decreasing erectile dysfunction. There are many interesting ways to incorporate nuts and seeds into your diet, to maximize your daily intake.

Herbs and Spices Don't Just Make Food Taste Better

Herbs and spices also improve your health and wellbeing.

Did you know, that just by adding a teaspoon of oregano to your food, you can up your antioxidants by 150 units? Turmeric is another wonder ingredient and contains curcumin, which reduces lung disease, brain disease, cancers, rheumatoid arthritis, osteoarthritis, and ulcerative colitis. If you consume an eighth of a teaspoon of turmeric every day, you'll reduce free radical damage and DNA breakage by 50% in extracted blood cells.

Drink More Water

We all know that staying hydrated is essential, but even so, most of us aren't drinking enough water. Dr. Greger recommends 10-15 cups of water per day for men, and 8-11 for women. But, there are other beverages that have health benefits too. For example, coffee seems to benefit the liver and the brain, and tea has a broad range of medicinal effects.

Get Moving

While healthy eating is essential to a longer and healthier life, exercise should also form part of any lifestyle. The daily recommendation is 90 minutes of moderate exercise such as brisk walking, or 40 minutes of intense exercise such as running, active sports, and weight training.

In Conclusion

Dr. Greger's advice for living a longer and healthier life, may seem like a rigorous list of boxes that need ticking, but you needn't feel boxed. Transitioning to a plant-based diet doesn't have to be complicated, or make you feel deprived. There are three ways that can make the process easier. These are, adapt, add, and experiment. So, try 'adding' health to your meals. For example, add an extra side of greens to your meal. Adapt, by swapping the beef in your chili with beans, or by replacing your ordinary spaghetti with a wholegrain version. View this transition as an experiment rather than a complete lifestyle change. And finally, listen to your body and let it tell you what it likes.

So why not begin by committing to a plant-based diet for three weeks, and see what happens?

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