Which are More Anti-Inflammatory: Sweet Cherries or Tart Cherries?

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Haggis, the national dish of Scotland, is a savory pudding of heart, liver, lungs, and oatmeal traditionally stuffed inside of a stomach. When that stomach goes into our own stomach, our digestive enzymes and stomach acid have no problem digesting it away. How do our bodies digests the stomach lining of a sheep on our plate without digesting our own stomach linings? It's meat and we're meat, so why don't we digest our own stomach every time we eat?

Partly because we have an enzyme called cyclooxygenase (COX) that protects the lining of our stomach. There are two types, COX-1 and COX-2. COX-1 is thought to be the primary protector of our stomach, whereas COX-2 is an enzyme responsible for pain and inflammation. In fact, anti-inflammatory drugs like ibuprofen and naproxen work by inhibiting the COX-2 enzyme. But these are non-selective drugs, so in addition to inhibiting COX-2 they also inhibit COX-1, which is trying to protect our stomach linings. Thus, although drugs like ibuprofen are great at relieving pain and inflammation, they kill thousands every year due to ulcerations through the stomach wall that result in life-threatening bleeding and perforation.

What are the risks on an individual level? On average, one in about 1,200 people who take this class of drugs for at least two months will die as a result. To put this into perspective, we can compare the death rate from anti-inflammatory drug side-effects to the risks associated with some well-known events. For example, it may be safer to go bungee jumping a few hundred times.

What we need is a selective COX-2 inhibitor, inhibiting the pain and inflammation of COX-2 without inhibiting the stomach protection of COX-1. We thought we got it with Vioxx, a blockbuster drug that brought in billions in profits before it started killing tens of thousands of peoples. Internal emails reveal how the drug manufacturer responded to the revelation that they were killing people: They drew up a list of doctors who were trying to warn people to "neutralize" them. If that didn't work, they tried to discredit them (You can see the emails in the video, Anti-inflammatory Life Is a Bowl of Cherries).

We're left then with two options: death from internal bleeding from one type of drug or death from side effects from another type of drug. If only there was some sort of natural COX-2 inhibitor. There is: cherries, which unlike ibuprofen suppress COX-2 more than COX-1.

In videos I did on insomnia and reducing muscle soreness (See Tart Cherries for Insomnia and Reducing Muscle Soreness with Berries), I talked about the benefits of sour cherries, the types of cherries used in baking. But sweet cherries, the kind you eat fresh, seem to be the MVP for COX-2 inhibition. Tart cherries had less of an effect. Regular red sweet cherries (Bing sweet cherries) were shown to have a greater anti-inflammatory activity than tart cherries. This makes sense since we think it may be the anthocyanin phytonutrients, and there are much more in sweet red cherries than in tart, and nearly none in yellow Rainer cherries.

Because fresh cherries have limited availability, what about other cherry products? In terms of anthocyanin phytonutrients, fresh is best, but frozen would appear to be the second-best choice.

Here are two ways I incorporate cherries into my diet:

Other studies in which anti-inflammatory drugs were compared natural dietary remedies include: Turmeric Curcumin and Osteoarthritis and Turmeric Curcumin and Rheumatoid Arthritis.

Anti-inflammatory activity in a test tube is one thing, but can cherries actually be used clinically to treat inflammatory diseases? See Gout Treatment with a Cherry on Top.

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, From Table to Able, and Food as Medicine.

Image Credit: Valdemar Fishmen / Flickr

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We Can End the Heart Disease Epidemic

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Many of the diseases that are common in United States are rare or even nonexistent in populations eating mainly whole plant foods.

These so-called Western Diseases are some of our most common conditions:

  • Obesity, the most important nutritional disease
  • Hiatal hernia, one of the most common stomach problems
  • Hemorrhoids and varicose veins, the most common venous disorders
  • Colorectal cancer, the number two cause of cancer death
  • Diverticulosis, the #1 disease of the intestine
  • Appendicitis, the #1 cause for emergency abdominal surgery
  • Gallbladder disease, the #1 cause for nonemergency abdominal surgery
  • Ischemic heart disease, the #1 cause of death

These diseases are common in the West, but are rarities among plant-based populations.

A landmark study in 1959 I profiled in my video Cavities and Coronaries: Our Choice, for example, suggested that coronary heart disease was practically non-existent among those eating traditional plant-based diets in Uganda.

"Doctors in sub-Saharan Africa during the '30s and '40s recognized that certain diseases commonly seen in Western communities were rare in rural African peasants. This hearsay talk greeted any new doctor on arrival in Africa. Even the teaching manuals stated that diabetes, coronary heart disease, appendicitis, peptic ulcer, gallstones, hemorrhoids, and constipation were rare in African blacks who eat foods that contain many skins and fibers, such as beans and corn, and pass a bulky stool two or three times a day. Surgeons noticed that the common acute abdominal emergencies in Western communities were virtually absent in rural African peasants."

But did they have hard data to back it up? Yes.

Major autopsy series were performed. In one thousand Kenyan autopsies, there were "no cases of appendicitis, not a single heart attack, only three cases of diabetes, one peptic ulcer, no gallstones, and no evidence of high blood pressure" (which alone affects one out of three Americans).

Maybe the Africans were just dying early of other diseases and so never lived long enough to get heart disease? No. In the video One in a Thousand: Ending the Heart Disease Epidemic, you can see the age-matched heart attack rates in Uganda versus St. Louis. Out of 632 autopsies in Uganda, only one myocardial infarction. Out of 632 Missourians--with the same age and gender distribution--there were 136 myocardial infarctions. More than 100 times the rate of our number one killer. In fact, researchers were so blown away that they decided to do another 800 autopsies in Uganda. Still, just that one small healed infarct (meaning it wasn't even the cause of death) out of 1,427 patients. Less than one in a thousand, whereas in the U.S., it's an epidemic.

If heart disease is so rare in rural Africa, how do the local doctors even know what to look for? Though practically unheard of among the native population, the physicians are quite familiar with heart disease because of all the Westerners that immigrate to the country.

The famous surgeon Dr. Denis Burkitt insisted that modern medicine is treating disease all wrong:

"A highly unacceptable fact--that is rarely considered yet indisputable--is that, with rare exceptions, there is no evidence that the incidence of any disease was ever reduced by treatment. Improved therapies may reduce mortality but may not reduce the incidence of the disease."

Take cancer, for example, where the vast majority of effort is devoted to advances in treatment, and second priority is given to screening programs attempting early diagnosis. Is there any evidence that the incidence of any form of cancer has been reduced by improved treatment or by early detection? Early diagnosis may reduce mortality rates, and medical services can have a profoundly beneficial effect on sick people, but neither have little (if any) effect on the number of people becoming ill. No matter how fancy heart disease surgery gets, it's never going to reduce the number of people falling victim to the disease.

Dr. Burkitt compared the situation to an engine left out in the rain:

"If an engine repeatedly stops as a consequence of being exposed to the elements, it is of limited value to rely on the aid of mechanics to detect and remedy the fault. Examination of all engines would reveal that those out in the rain were stopping, but those under cover were running well. The correct approach would then be to provide protection from the offending environment. However, considering the failing engine as the ailing patient, this is seldom the priority of modern medicine."

Dr. Burkitt sums it up with the analogy of The Cliff or the Ambulance:

"If people are falling over the edge of a cliff and sustaining injuries, the problem could be dealt with by stationing ambulances at the bottom or erecting a fence at the top. Unfortunately, we put far too much effort into the provision of ambulances and far too little into the simple approach of erecting fences."

And of course there are all the industries enticing people to the edge, and profiting from pushing people off.

If all plant-based diets could do is reverse our number one killer, then shouldn't that be the default diet until proven otherwise? The fact that it also appears to reverse other leading killers like diabetes and hypertension appears to make the case for plant-based eating overwhelming. So why doesn't the medical profession embrace it? It may be because of The Tomato Effect. Why don't many individual doctors do it? It may be because lifestyle medicine hurts the bottom line (see Lifestyle Medicine: Treating the Causes of Disease). Why doesn't the federal government recommend it? It may be because of the self-interest of powerful industries (see The McGovern Report). But you can take your destiny into your own hands (mouth?) and work with your doctor to clean up your diet and maximize your chances of living happily ever after.

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, and From Table to Able.

Image Credit: Sinn Fien / Flickr

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Cayenne for Irritable Bowel









Cayenne for Irritable Bowel

Nearly 50 million Americans come down with food poisoning every year. Over a hundred thousand are hospitalized and thousands die every year just because of something they ate. If they had ordered something different on the menu or chosen something else at the grocery store, they or their loved one might be alive today. But in the vast majority of cases, food poisoning manifests itself as little more than a case of “stomach flu”—a few days of pain, vomiting, diarrhea, and then it’s gone. So what’s the big deal?

Well, as described in this recent editorial in the American Journal of Gastroenterology, in many cases, that acute infection can trigger a chronic “postinfectious functional gastrointestinal disorder” that can last for years or even forever. The two most common of which are irritable bowel syndrome and functional dyspepsia (chronic indigestion).

Up to 10% of people stricken with Salmonella, E. coli, or Campylobacter are left with irritable bowel syndrome. The thought is that the "transitory inflammation during the infection leads to subtle but permanent changes in the structure and function of the digestive system," causing the lining of the gut to become hyper-sensitized. How do they determine if someone’s rectum is hypersensitive?

Innovative Japanese researchers developed a device to deliver "repetitive painful rectal distention." Basically, the researchers hooked up a half-quart balloon to a fancy bicycle pump that was lubricated with olive oil, inserted it into the rectum and inflated it until the patients couldn’t stand the pain anymore. As you can see in my video, Cayenne Pepper for Irritable Bowel Syndrome and Chronic Indigestion, those with IBS had a significantly lower pain threshold, significantly less “rectal compliance.”

Healthy people felt the pain where we’d expect to feel the pain with, effectively, a balloon animal up their tush. But many with IBS also experienced abdominal pain, indicating a hypersensitivity of the entire gut wall. Well, if that’s the problem, how can we desensitize the gut?

In my video, Hot Sauce in the Nose for Cluster Headaches?, we learned about the ability of hot pepper compounds to deplete pain fibers of substance P, a neurotransmitter used for transmitting pain. It’s bad enough to have to rub hot peppers up our nose, where do we have to stick them for irritable bowel? Thankfully researchers chose the oral route.

The researchers concluded that “the chronic administration of red pepper powder in IBS patients with enteric-coated pills was significantly more effective than placebo in decreasing the intensity of abdominal pain and bloating, and was considered by the patients more effective than placebo," suggesting a "novel way of dealing with this frequent and distressing functional disease.”

After 48 million cases of annual food poisoning, 10% may end up with IBS. Even more may end up with chronic indigestion. How do peppers work against that? We can’t use whole peppers because then we couldn’t blind a placebo, but if we give capsules of red pepper powder to folks suffering from chronic indigestion—about one and a half teaspoons a day worth—and compare that to an identical-looking sugar pill, within a month their overall symptoms improved, including their stomach pain and their feelings of being bloated. They had less nausea, too. The frequently prescribed drug, Propulsid (cisapride), worked almost as well as the red pepper powder, and was considered generally well tolerated… that is, until it killed people. Propulsid was pulled from the market after causing dozens of deaths.

I explore another natural treatment for IBS in Kiwi Fruit for Irritable Bowel Syndrome.

I’ve covered some of the long-term consequences of food poisoning in videos such as Poultry and Paralysis, Fecal Bacteria Survey, and Amnesic Seafood Poisoning. The meat industry is all over it, though: Check out my videos  Viral Meat Spray and Maggot Meat Spray. Why is it legal to sell meat tainted with our leading foodborne killer? Find out in Salmonella in Chicken & Turkey: Deadly But Not Illegal and  

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death and More Than an Apple a Day.

Image credit: Jennifer C. / Flickr

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