Should You Get an Annual Health Check-Up?

What are the risks and benefits of getting an annual check-up from your doctor?

Physicians and patients have come to expect the annual check-up as a routine part of care. “However, considerable research has not demonstrated a substantial benefit,” so a “revolt is brewing against the tradition of periodic” check-ups. “Even the Society for General Internal Medicine advised primary care physicians to avoid ‘routine general health checks for asymptomatic adults.’”

As I discuss in my video Is It Worth Getting Annual Health Check-Ups?, routine check-ups do seem to make sense. But, historically, medical practice has included all sorts of interventions that seemed to make sense, such as hormone replacement therapy for menopause—that is, until it was put to the test and found to increase risks of breast cancer, blood clots, heart disease, and stroke. “History repeatedly shows that good intentions and ‘common sense’ kill in the name of prevention (for example, prone sleeping recommendation for infants).” Indeed, doctors killed babies by making the so-called common sense recommendation that infants sleep on their tummies, whereas we now know “Face Up to Wake Up.” “We should always demand evidence rather than succumb to delusion.”

“We check our cars regularly, so why shouldn’t we also check our bodies…?” Well, unlike cars, our bodies have self-healing properties. To see if the benefits outweigh the harms, researchers decided to put it to the test.

“What are the benefits and harms of general health checks for adult populations?” The bottom line is that check-ups were “not associated with lower rates of all-cause mortality, mortality from cardiovascular disease, or mortality from cancer,” meaning they weren’t associated with living longer or a lower risk of dying from heart disease, stroke, or cancer. So, general check-ups may not reduce disease rates or death rates, but they do increase the number of new diagnoses. And, the “[h]armful effects of some tests and subsequent treatment could have balanced out possible beneficial effects of others.”

Possible harms from check-ups include “overdiagnosis, overtreatment, distress or injury from invasive follow-up tests, distress due to false positive test results, false reassurance due to false negative test results, possible continuation of adverse health behaviours due to negative test results, adverse psychosocial effects due to labelling, and difficulties with getting insurance” (now that you have a pre-existing condition), not to mention all of the associated costs. 

Take diabetes, for example. Wouldn’t it be great if we detected cases of diabetes earlier? Perhaps not, if you were one of the people given Avandia, the number one diabetes drug that was then pulled off the market because instead of helping people, it appeared to be killing them. Adverse drug events are now one of our leading causes of death. When it comes to lifestyle diseases like type 2 diabetes, maybe we should focus instead on creating healthier food environments. This is what one of my favorite organizations, Balanced, does to help prevent the diabetes epidemic in the first place.

How many times have you tried to inform someone about healthy eating and evidence-based nutrition, only to have them say, “No, I don’t have to worry. My doctor reassured me I’m fine. I just had a check-up, and everything’s normal.” As if having a normal cholesterol is okay in a society where it’s normal to drop dead of a heart attack, the number one killer of men and women. It would be one thing if you went to see a lifestyle medicine doctor who spent the check-up giving you the tools to prevent 80 percent of chronic disease, but given the way medicine is currently practiced, it’s no wonder why the history of routine check-ups “has been one of glorious failure, but generations of well meaning clinicians and public health physicians struggle to allow themselves to believe it.” But, “policy should be based on evidence…” 

Poor diet may be “on par with tobacco smoking as the most common actual causes of death,” yet the medical profession is inadequately trained in nutrition. Worse, nutrition education in medical school appears to be declining. If you can believe it, there is actually a “shrinking of formalized nutrition education” among health professionals, so the advice you get during your annual check-up may just be from the last tabloid your doctor skimmed while in the supermarket check-out line.

“And screening appointments should not be regarded as a form of ‘health education,’” read one medical journal editorial. “People who are obese know very well that they are, and if we have no means of helping them…then we should shut up.” Well, if you really have nothing to say that will help them, maybe you should shut up, especially those doctors who say they “have no idea what constitutes a ‘healthy’ diet”—although we do know that veggies and nuts are a good start.

Won’t a check-up allow your physician to do a comprehensive physical exam and routine blood testing? I discuss that, as well as the pros and cons, in my vide Is it Worth Getting an Annual Physical Exam?.

Did I say lifestyle medicine? Yes! Learn more about this exciting growing field in Lifestyle Medicine: Treating the Causes of Disease and Convincing Doctors to Embrace Lifestyle Medicine. Make sure your doctor is a member of the American College of Lifestyle Medicine (and even better certified by the American Board of Lifestyle Medicine).

Still don’t understand how there can be risks? See Why Prevention Is Worth a Ton of Cure. Unfortunately, physicians and patients alike wildly overestimate the benefits of pills and procedures. See, for example, The Actual Benefit of Diet vs. Drugs.

The fact is Physicians May Be Missing Their Most Important Tool.


And what about mammograms? See my video series:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

Helpful Foods to Support People with Autism

The sulforaphane found in five cents’ worth of broccoli sprouts has been shown to benefit autism in a way no drug ever has in a randomized, double-blind, placebo-controlled study.

You may remember my series of videos, which includes Prevent Cancer from Going on TOR, about target of rapamycin (TOR), the engine-of-aging enzyme. Kids with autism tend to have higher TOR activity in their bodies, and this hyperactive TOR signaling may play a role in causing autism, which makes TOR a potential target to treat autism or even theoretically reverse it if we could target downstream TOR signaling, like between TOR and S6K1, as you can see at 0:29 in my video Best Foods for Autism. In fact, that’s one of the ways sulforaphane, a compound in broccoli and other cruciferous vegetables, kills off prostate cancer cells—by inhibiting the signal transduction between TOR and S6K1. Sulforaphane is also “a potent inhibitor” of breast cancer cells because “it targets downstream elements of the [TOR] pathway.”

So, if broccoli blocks TOR and if we give it to those with autism, maybe it would block some of the synaptic dysfunction that contributes to the features of autism—and that’s in addition to blocking autism pathways four other ways: oxidative stress, lower antioxidant capacity, mitochondrial dysfunction, and brain inflammation. What’s more, this doesn’t only occur in a petri dish. “Importantly, sulforaphane can cross the blood-brain-barrier,” so when you eat broccoli, sulforaphane quickly reaches your brain “to exert its protective effects”—at least it does in theory. You don’t know, of course, until you put it to the test.

You can understand why such a study could attract researchers from such leading institutions as Harvard and Johns Hopkins, and get published in one of our most prestigious journals, the Proceedings of the National Academy of Sciences. What did they find? First, what did they do? “In a placebo-controlled, double-blind, randomized trial, young men (aged 13–27) with moderate to severe ASD [autism] received sulforaphane from broccoli sprouts or an indistinguishable sugar pill. They were dosed according to body weight: Those under 100 pounds got about a tablespoon of broccoli sprouts’ worth of sulforaphane a day, which is about a cup’s worth of broccoli, those weighing between 100 and 200 pounds got about the equivalent of two cups of broccoli or two tablespoons of fresh broccoli sprouts, and those over 200 pounds got three cups’ worth a day or a little under a quarter cup of broccoli sprouts. Why didn’t the researchers use actual broccoli or actual sprouts? If they had, it wouldn’t have been a blinded study. The patients, doctors, and parents would know who was and who wasn’t getting the special treatment, which could introduce bias through the placebo effect. Instead, with this study set-up, no one knew until the end who got the sulforaphane and who got the placebo.

The researchers chose dietary sulforaphane because of its capacity to reverse oxidation, dysfunction, and inflammation, but when put to the test, did it actually work? The placebo didn’t. Give people with autism nothing, and nothing much happens. But effectively secretly sneak them some broccoli, and substantial improvements in behavior, social interaction, and verbal communication occurred. However, it all disappeared once the broccoli was stopped. As you can see at 3:25 in my video, on the Aberrant Behavior Checklist, which includes things such as repetitive behaviors, there was no big change in the placebo group, which is what you’d expect, but the abnormal behaviors plunged in the sulforaphane group—the group who got the sulforaphane found in only about five cents’ worth of broccoli sprouts a day. The study ended in week 18, however, and a month later, things were heading back to where they started.

There were similar findings on a Social Responsiveness Scale: significant improvements were seen until the treatment was stopped, and then the participants went right back to functioning as poorly as those in the placebo group had continued to function. And these weren’t just scores on a page. “The substantial improvements…were conspicuous”—the doctors, parents, and caregivers could see the improvements. No drug has ever been shown to have these kinds of effects. What’s more, these were young men, starting at age 13. One could imagine it working as well or even better with younger children because their brains are still developing. And, is there a downside? “Broccoli sprouts are widely consumed as a food item all over the world by a very large number of individuals, without any reports of adverse effects”—but remember we’re talking about whole foods, not sulforaphane supplements.

Indeed, broccoli sprouts work, but commercial broccoli sprout supplements hardly work at all. As you can see at 4:55 in my video, broccoli has sulforaphane, with the florets more so than the stems, and broccoli sprouts have about ten times more sulforaphane. In comparison, broccoli pills, powders, and supplements have little or none. So, broccoli and other cruciferous vegetables are for all kids, whether they have autism or not, and they may be for pregnant women as well for the potential prenatal prevention of autism in the first place.

This article covers the big finale to my initial three-part video series on autism. For the background that led researchers down this path of clues, check out Fever Benefits for Autism in a Food and Fighting Autism Brain Inflammation with Food. You can also check: Flashback Friday: The Best Foods for Fighting Autism and Brain Inflammation. 

We understand there may be a variety of challenges pertaining to catering to picky palates, sensory and food texture sensitivities, or kids who are reluctant to try new foods, and we hope this evidence-based article can provide some helpful health information to parents and health practitioners. For more tips and tricks, check out How to Get Kids to Eat Their Vegetables.


For more on autism, see:

My video Broccoli: Sprouts vs. Supplements underscores the importance of plants over pills, and Biggest Nutrition Bang for Your Buck tells you how to grow your own.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

Are Lectins in Food Good or Bad for You?

Might lectins help explain why those who eat more beans and whole grains have less cancer?

Lectins are to blame for the great “white kidney bean incident” of 2006 in Japan. One Saturday evening, a TV program introduced a new method to lose weight. The method was simple: toast some dry, raw, white kidney beans in a frying pan for three minutes, grind the beans into a powder, and then dust it onto rice. Within days, a thousand people fell ill, some with such severe diarrhea and vomiting they ended up in the hospital. Why? Lectin poisoning. Three minutes of dry heat is not enough to destroy the toxic lectins in kidney beans. If you don’t presoak them, you need to boil large kidney beans for a full hour to completely destroy all the lectins, though if you first soak them overnight 98 percent of the lectins are gone after boiling for just 15 minutes and all are gone by half an hour, as you can see at 0:44 in my video Are Lectins in Food Good or Bad for You?. And, indeed, when researchers tested the white beans, they found that toasting them for three minutes didn’t do a thing. It’s no wonder people got sick. But, 95 percent of the lectins were inactivated after boiling them for three minutes and completely inactivated after ten minutes of boiling. Evidently, “‘Do not eat raw beans’ is a traditional admonition in Japan to prevent intestinal problems”—and now we know why.

While canning may completely eliminate lectins from most canned beans, some residual lectin activity may remain in canned kidney beans, though apparently not enough to result in toxicity. And, ironically, “How doses of lectins may be beneficial by stimulating gut function, limiting tumor growth, and ameliorating obesity.” What? I thought lectins were toxic.

For as long as people have speculated dietary lectins are harmful, others have conjectured that they may be protective. “If this theory is correct, appropriate lectins by mouth should be of use in the prophylaxis [prevention] (and possibly treatment) of colon cancer.” Or, of course, we could just eat our beans.

Interest in the purported antitumor effect of plant lectins started with the discovery in 1963 that lectins could distinguish between cancer cells and normal cells. Researchers at Massachusetts General Hospital found a substance in wheat germ—the lectin in whole wheat—that appeared to be “tumor cell specific,” clumping together the tumor cells, while the normal cells were left almost completely alone. In fact, it is so specific that you can take a stool sample from someone and, based on lectin binding to the colon lining cells that get sloughed off into the feces, effectively predict the presence of polyps and cancers.

Subsequently, it was discovered that lectins couldn’t only distinguish between the two types of cells, but also extinguish the cancer cells, while largely leaving the normal cells alone. For example, that same white kidney bean lectin, as you can see at 2:53 in my video, was found to almost completely suppress the growth of human head and neck cancer cells, liver cancer cells, breast cancer cells, and cervical cancer cells (at least most of the way), within about three days—but that was in a petri dish. Those petri dish studies are largely the basis of the evidence for the antitumor activity of plant lectins. How do we even know dietary lectins are absorbed into our body?

Colorectal cancer is one thing. The fact that lectins can kill off colon cancer cells in a petri dish may be applicable, since lectins we eat may come in direct contact with cancerous or precancerous cells in our colon, “providing a mechanism” by which bean consumption may help in “the prevention and treatment of colorectal cancer.” Even more exciting is the potential for effectively rehabilitating cancer cells. The “loss of differentiation and invasion are the histological hallmarks of malignant cells,” meaning that when a normal cell transforms into a cancer cell, it tends to lose its specialized function. Breast cancer cells become less breast-like, and colon cancer cells become less colon-like. What these researchers showed—for the first time—is that the lectin in fava beans could take colon cancer cells and turn them back into looking more like normal cells. As you can see at 4:13 in my video, before exposure to the fava bean lectins, the cancer cells were growing in amorphous clumps. But, after exposure to the fava bean lectins for two weeks, those same cancer cells started to go back to growing glandular structures like normal colon issue. Therefore, dietary lectins or putting them in a pill “may slow the progression of colon cancer,” potentially helping to explain why dietary consumption of beans, split peas, chickpeas, and lentils appears to reduce the risk of colorectal cancer based on 14 studies involving nearly two million participants. Okay, but what about cancers outside of the digestive tract?

“Although lectin containing foods,” like beans and whole grains, “are frequently consumed cooked or otherwise processed, these treatments may not always inactivate the lectins…For example, lectins have been detected in roasted peanuts….” Peanuts are legumes, and we don’t tend to eat them boiled but just roasted or even raw. Are we able to absorb the lectins into our system? Yes. As you can see at 5:12 in my video, within an hour of consumption of raw or roasted peanuts, you can detect the peanut lectin in the bloodstream of most people. Same with tomatoes. Some of the non-toxic lectin in tomatoes also makes it down into our gut and into our blood. Wheat germ agglutinin, the wheat lectin known as WGA, doesn’t seem to make it into our bloodstream, though, even after apparently eating the equivalent amount of wheat germ in more than 80 slices of bread. And, if you ate something like pasta, the boiling in the cooking process might wipe out the lectin in the first place anyway.

In terms of phytochemicals in the fight against cancer, lectins are able to “resist digestion resulting in high bioavailability,” potentially allowing “the cellular mechanisms of the host to utilize the full potential of the…dramatic anti-cancer benefits” lectins have to offer. But, these dramatic benefits have yet to be demonstrated in people. We do know, however, that population studies show “that the consumption of a plant-based diet is strongly associated with a reduced risk of developing certain types of cancer.” People eating a plant-based diet could just be eating fewer carcinogens, but plants do have all those active components that do seem to protect against the “initiation, promotion, or progression” of cancer. So, maybe lectins are one of those protective compounds. We know people who eat more beans and whole grains tend to get less cancer overall, but we’re just not sure exactly why. Now, you could say, “Who cares why?” Well, Big Pharma cares. You can’t make as much money on healthy foods as you can on “lectin based drugs.”

Interested in learning more about lectins? Check out my videos Dr. Gundry’s The Plant Paradox Is Wrong and How to Avoid Lectin Poisoning.


Lectins remind me of the story about phytates. Other components of beans and whole grains, phytates were thought at first to be harmful, but, more recently, evidence is coming to light that suggests the opposite may be true. Check out Phytates for Rehabilitating Cancer Cells and Phytates for the Prevention of Osteoporosis.

What else may explain the protective effect of beans? See, for example, Gut Dysbiosis: Starving Our Microbial Self. Soybeans may be particularly protective against certain cancers, as you can see in BRCA Breast Cancer Genes and Soy.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations: