V. Dr. Greger’s Twenty-One Tweaks
Too Much Food, Not Enough Calories
In How Not to Die, I compiled the healthiest of the Green Light foods into my Daily Dozen checklist of foods I encourage people to try to fit into their daily routines. I made it into a free app, Dr. Greger’s Daily Dozen, available for iPhone and Android, so anyone and everyone can try to check off all the boxes every day and track their progress over time.
As the feedback poured in from people giving the app a try, two themes of complaints arose. The first was that it was just too much food. There was no way they could eat all that food in one day. In response, I explained that the Daily Dozen was aspirational, something to shoot for, just a tool to inspire people to include some of the healthiest of healthy foods into their daily diets. The vast volume of food I prescribed was on purpose. I was hoping that by telling people to eat so much healthy stuff, it would naturally crowd out some of the less-healthy stuff. After checking off all twenty-four servings in the Daily Dozen, there’s only so much room left for a pepperoni pizza.
Ironically, the second major complaint we got is that it doesn’t have enough calories. I had to explain that the Daily Dozen just represented the minimum I encourage people to eat, not the maximum, and that, certainly, training athletes requiring thousands more calories would have to eat much more. This all got me thinking, though. Too much food but too few calories? Sounds like the perfect weight-loss diet!
The Daily Dozen is by definition all Green Light foods, all whole plant foods, so that right there bakes in all seventeen of the ideal weight-loss diet ingredients listed here. What about the calorie count? A systematic review of successful weight-loss strategies concluded that given the metabolic slowing and increased appetite that accompanies weight loss, to achieve significant weight loss, calorie counts may need to drop as low as 1,200 calories a day for women and 1,500 calories a day for men.4983 I set up a spreadsheet and tried a bunch of common foods in each of the categories, and what do you know: The Daily Dozen averages about 1,200 calories, with the higher-calorie food choices nailing 1,500 calories.
The Daily Dozen Diet
There are a number of tweaks necessary to optimize the Daily Dozen for weight loss. A typical breakfast of Green Light foods that would check off a few of the Daily Dozen boxes would be a big bowl of oatmeal sweetened with raisins. Based on what we learned in the Low in Calorie Density, High in Water-Rich Foods, Eating Rate, and Wall Off Your Calories sections, we could optimize that meal for weight loss by making the oatmeal from steel-cut or whole groats rather than rolled or instant, cooking it thick, and switching the dried fruit for fresh, for example, swapping in strawberries for the raisins. If we did want to use dried, as we learned in the Amping AMPK and Inflammation Quenchers sections, barberries or gojis might be a better choice.
Similarly, when choosing vegetables, we can steer toward above-ground veggies highest on the water scale. Bell peppers have that nicotine edge I described in Amping AMPK, and uncooked vegetables in general offer more orosensory stimulation. If you want to go underground, based on what we learned about glycemic load, sweet potatoes would be preferable to white. We certainly want to mix it up, though, to take advantage of our built-in striving for variety, and since vegetables represent the healthiest class of foods with the fewest calories, we should aim to eat them earlier in the meal.
In the Appetite Suppression section, we learned yet another reason to include ground flaxseeds in our daily diets. Nuts are a great complement to greens to boost the absorption of fat-soluble nutrients, but they ideally should be eaten raw and whole or coarsely chopped rather than blended into butters. Miss the taste of peanut butter? A sprinkle of any one of the myriad powdered peanut butters on the market can help satisfy that craving. This is not to say something like almond butter or tahini is unhealthy by any stretch, but for weight-loss acceleration, structurally intact nuts and seeds would be better.
My free Dr. Greger’s Daily Dozen app has become so popular that I decided to completely revamp it with new features for this book, so I’ve incorporated all these tweaks to the Daily Dozen to optimize it for weight control. You just have to switch over to the weight-loss setting. Now, you can not only track your progress, graphing your momentum day to day and month to month to see how well you’re nailing each of the Daily Dozen, but since so many seemed to really appreciate having a list of reminders to check off throughout the day, I decided to add an entirely new checklist to capture the weight-loss boosters I documented in part IV. With this new, expanded version of the app, you can toggle over to weight-loss mode and make a game out of how many of the new fat-busting boosters you can squeeze in every day, along with your Daily Dozen checkboxes.
Boxes of Tricks
Some of the weight-loss boosters are automatically taken care of with the Daily Dozen. For example, fat-blocking thylakoids and calcium are covered with my recommendation to eat lots of low-oxalate greens. But for the others, I’ve developed my Twenty-One Tweaks, practical takeaways from the boosters collected into one simple list on the next page.
You may have noticed that not all the strategies I covered in part IV are included in the list. Some only apply to certain individuals. For example, asking people to get into the NEAT habit of using steppers, fidget bars, or bouncing their knees during prolonged sitting may only apply to those with desk jobs. Other accelerants may be too risky for general consumption. For example, while the 25:5 modified fasting shows promise, you probably shouldn’t drop below a thousand calories a day for more than twenty-four hours without medical supervision.4984 Finally, there are options that show theoretical promise but haven’t been sufficiently vetted in clinical trials, such as pistachios for circadian synchronization or mixing peppermint oil into hand lotion to facilitate BAT activation.
So here’s the list of strategies that made the cut—broadly applicable, relatively safe, and evidence-based. See how many of these easily actionable tweaks you can incorporate into your daily routine.
At Each Meal
Preload with Water
Time your metabolism-boosting two cups of cool or cold unflavored water before each meal to also take advantage of its preload benefits.
Preload with “Negative Calorie” Foods
As the first course, start each meal with an apple or a Green Light soup or salad containing fewer than one hundred calories per cup.
Incorporate Vinegar (2 tsp with each meal)
Never drink vinegar straight. Instead, flavor meals or dress a side salad with any of the sweet and savory vinegars out there. If you want to drink it, make sure to mix it in a glass of water and, afterward, be sure to rinse your mouth out with water to protect your tooth enamel.
Enjoy Undistracted Meals
Don’t eat while watching TV or playing on your phone. Give yourself a check for each meal you’re able to eat without distraction.
Follow the Twenty-Minute Rule
Whether through increasing viscosity or the number of chews, or decreasing bite size and eating rate, dozens of studies have demonstrated that no matter how we boost the amount of time food is in our mouths, it can result in lower caloric intake. So extend meal duration to at least twenty minutes to allow your natural satiety signals to take full effect. How? By choosing foods that take longer to eat and eating them in a way that prolongs the time they stay in your mouth. Think bulkier, harder, chewier foods in smaller, well-chewed bites.
Every Day
Take Your Daily Doses
Black Cumin (Nigella sativa) (¼ tsp)
As noted in the Appetite Suppression section, a systematic review and meta-analysis of randomized, controlled weight-loss trials found that about a quarter teaspoon of black cumin powder every day appears to reduce body mass index within a span of a couple of months. Note that black cumin is different from regular cumin, for which the dosing is different. (See below.)
Garlic Powder (¼ tsp)
Randomized, double-blind, placebo-controlled studies have found that as little as a daily quarter teaspoon of garlic powder can reduce body fat at a cost of perhaps two cents a day.
Ground Ginger (1 tsp) or Cayenne Pepper (½ tsp)
Randomized controlled trials have found that ¼ teaspoon to 1½ teaspoons a day of ground ginger significantly decreased body weight for just pennies a day. It can be as easy as stirring the ground spice into a cup of hot water. Note: Ginger may work better in the morning than evening. Chai tea is a tasty way to combine the green tea and ginger tweaks into a single beverage.
Alternately, for BAT activation, you can add one raw jalapeño pepper or a half teaspoon of red pepper powder (or, presumably, crushed red pepper flakes) into your daily diet. To help beat the heat, you can very thinly slice or finely chop the jalapeño to reduce its bite to little prickles, or mix the red pepper into soup or the whole-food vegetable smoothie I featured in one of my cooking videos on NutritionFacts.org.4985
Nutritional Yeast (2 tsp)
Two teaspoons of baker’s, brewer’s, or nutritional yeast contains roughly the amount of beta 1,3/1,6 glucans found in randomized, double-blind, placebo-controlled clinical trials to facilitate weight loss.
Cumin (Cuminum cyminum) (½ tsp with lunch and dinner)
Overweight women randomized to add a half teaspoon of cumin to their lunches and dinners beat out the control group by four more pounds and an extra inch off their waists. There is also evidence to support the use of the spice saffron, but a pinch a day would cost a dollar, whereas a teaspoon of cumin costs less than ten cents.
Green Tea (3 cups)
Drink three cups a day between meals (waiting at least an hour after a meal so as to not interfere with iron absorption). During meals, drink water, black coffee, or hibiscus tea mixed 6:1 with lemon verbena, but never exceed three cups of fluid an hour (important given my water preloading advice).
Take advantage of the reinforcing effect of caffeine by drinking your green tea along with something healthy you wish you liked more, but don’t consume large amounts of caffeine within six hours of bedtime. Taking your tea without sweetener is best, but if you typically sweeten your tea with honey or sugar, try yacon syrup instead.
Stay Hydrated
Check this box if your urine never appeared darker than a pale yellow all day. Note that if you’re eating riboflavin-fortified foods (such as nutritional yeast), then base this instead on getting nine cups of unsweetened beverages a day for women (which would be taken care of by the green tea and water preloading recommendations) or thirteen cups a day for men. If you have heart or kidney issues, don’t increase fluid intake at all without first talking with your physician. Remember, diet soda may be calorie-free, but it’s not consequence-free, as we learned in the Low in Added Sugar section.
Deflour Your Diet
Check this box every day your whole grain servings are in the form of intact grains. The powdering of even 100 percent whole grains robs our microbiomes of the starch that would otherwise be ferried down to our colons encapsulated in unbroken cell walls.
Front-Load Your Calories
There are metabolic benefits to distributing more calories to earlier in the day, so make breakfast (ideally) or lunch your largest meal of the day in true king/prince/pauper style.
Time-Restrict Your Eating
Confine eating to a daily window of time of your choosing under twelve hours in length that you can stick to consistently, seven days a week. Given the circadian benefits of reducing evening food intake, the window should end before 7:00 p.m.
Optimize Exercise Timing
The Daily Dozen’s recommendation for optimum exercise duration for longevity is ninety minutes of moderately intense activity a day, which is also the optimum exercise duration for weight loss. Anytime is good, and the more the better, but there may be an advantage to exercising in a fasted state, at least six hours after your last meal. Typically, this would mean before breakfast, but if you timed it right, you could exercise midday before a late lunch or, if lunch is eaten early enough, before dinner. This is the timing for nondiabetics.
Diabetics and prediabetics should instead start exercising thirty minutes after the start of a meal and ideally go for at least an hour to completely straddle the blood sugar peak. If you had to choose a single meal to exercise after, it would be dinner, due to the circadian rhythm of blood sugar control that wanes throughout the day. Ideally, though, breakfast would be the largest meal of the day, and you’d exercise after that—or, even better, after every meal.
Weigh Yourself Twice a Day
Regular self-weighing is considered crucial for long-term weight control, but there is insufficient evidence to support a specific frequency of weighing. My recommendation is based on the one study that found that twice daily—upon waking and right before bed—appeared superior to once a day (about six versus two pounds of weight loss over twelve weeks).
Complete Your Implementation Intentions
Every two months, create three new implementation intentions—“if X, then Y” plans to perform a particular behavior in a specific context—and check each one off as you complete them every day.
Every Night
Fast After 7:00 p.m.
Because of our circadian rhythms, food eaten at night is more fattening than the exact same food eaten earlier in the day, so fast every night for at least twelve hours starting before 7:00 p.m. The fewer calories after sundown, the better.
Get Sufficient Sleep
Check this box if you got at least seven hours of sleep at your regular bedtime.
Experiment with Mild Trendelenburg
Try spending at least four hours a night lying with your body tilted head-down six degrees by elevating the posts at the foot of your bed by eight inches (or by nine inches if you have a California king). Be extremely careful when you get out of bed, as this causes orthostatic intolerance in most people, even if you’re young and healthy—meaning if you get up too fast, you can feel dizzy, faint, or light-headed and could fall and hurt yourself. So get up slowly. Drinking two cups of cold water thirty minutes before rising may also help prevent this potentially hazardous side effect.
IMPORTANT: Do not try this at home at all if you have any heart or lung issues, acid reflux, or problems with your brain (like head trauma) or eyes (even a family history of glaucoma disqualifies you). Also do not try this until you ask your physician if they think it’s safe for you to sleep in mild Trendelenburg.
Tick All the Right Boxes
Between the twenty-four checkboxes in the Daily Dozen and the thirty-seven new checkboxes in the Tweaks, you may feel a bit overwhelmed, but it’s easy to knock off a bunch at a time. For example, starting a meal with a tomato salad sprinkled with some black cumin, garlic powder, and balsamic vinegar hits five boxes right there, including the “Preload with ‘Negative Calorie’ Foods” tweak and the Daily Dozen box for “Other Vegetables.” And if that was one of your implementation intentions, make that six! Ten percent of your boxes nailed with a single appetizer.
Of course, you don’t have to hit all the booster boxes every day. You don’t even have to hit any. A healthy diet, as encapsulated by the Daily Dozen, should be all you need to lose as much weight as you want, but the more of these extra tweaks you can hit, the more successful you may be. I’m working on an entire How Not to Diet Cookbook to try to fit as many of these combinations together into delicious recipes and hearty meal plans—but in the meanwhile, please feel free to download the free, updated Dr. Greger’s Daily Dozen app on your Android or iPhone. Start experimenting with a few of the Twenty-One Tweaks and see which ones work for you. My goal is to provide you with the broadest palette of tools to choose from.
Remember, it’s not what you eat today that matters, or tomorrow, or next week, but rather what you eat over the next months, years, and decades, so you have to find lifestyle changes that fit into your lifestyle.