Improving Employee Diets Could Save Companies Millions

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The food, alcohol, and tobacco industries have been blamed for "manufacturing epidemics" of chronic disease, but they're just trying to sell more product like everyone else. And so if that means distorting science, creating front groups, compromising scientists, blocking public health policies... they're just trying to protect their business.

It's not about customer satisfaction, but shareholder satisfaction. How else could we have tobacco companies, for example, "continuing to produce products that kill one in two of their most loyal customers?"

Civil society organizations concerned with public health have earned a reputation for being "anti-industry," but the issue is not industry, but that sector of industry whose products are harmful to public health. We like the broccoli industry. In fact, the corporate world might end up leading the lifestyle medicine revolution.

As shown in my video, Plant-Based Workplace Intervention, the annual cost attributable to obesity alone among full-time employees is estimated at 70 billion dollars, primarily because obese employees are not as productive on the job. Having healthy employees is good for the bottom-line. Every dollar spent on wellness programs may offer a $3 return on investment. And if you track the market performance of companies that strive to nurture a culture of health, they appear to outperform their competition.

That's why companies like GEICO are exploring workplace dietary interventions (see my video, Slimming the Gecko). The remarkable success at GEICO headquarters led to an expansion of the program at corporate offices across the country, with test sites from San Diego to Macon, Georgia. Given that previous workplace studies have found that workers who ate a lot of animal protein had nearly five times the odds of obesity, whereas those that ate mostly plant protein appeared protected, obese and diabetic employees were asked to follow a plant-based diet of whole grains, vegetables, beans, and fruit while avoiding meat, dairy, and eggs. Compliance wasn't great. Fewer than half really got their animal product consumption down, but there were definitely improvements such as significant reductions in saturated fat, an increase in protective nutrients, and even noted weight loss, lower blood cholesterol levers, and better blood sugar control in diabetics.

And this was with no calorie counting, no portion control, and no exercise component. The weight reduction appears to result from feeling fuller earlier, due to higher dietary fiber intake. The difference in weight loss could also be the result of an increase in the thermic effect of food, allowing a small extra edge for weight loss in the vegan group. Those eating plant-based diets tend to burn off more calories in heat.

Eating plants appears to boost metabolism. This may be due to increased insulin sensitivity in cells, allowing cells to metabolize carbohydrates more quickly rather than storing them as body fat. "As a result, vegan diets have been shown to increase postprandial calorie burn by about 16%, up to three hours after consuming a meal."

Imagine how much money companies that self-insure their employees could save! See, for example:

Find out more on some of the potential downsides of corporate influence in videos like

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:

Image Credit: Ryan McGuire / Pixabay. This image has been modified.

Original Link

Improving Employee Diets Could Save Companies Millions

Plant-Based Workplace Intervention.jpg

The food, alcohol, and tobacco industries have been blamed for "manufacturing epidemics" of chronic disease, but they're just trying to sell more product like everyone else. And so if that means distorting science, creating front groups, compromising scientists, blocking public health policies... they're just trying to protect their business.

It's not about customer satisfaction, but shareholder satisfaction. How else could we have tobacco companies, for example, "continuing to produce products that kill one in two of their most loyal customers?"

Civil society organizations concerned with public health have earned a reputation for being "anti-industry," but the issue is not industry, but that sector of industry whose products are harmful to public health. We like the broccoli industry. In fact, the corporate world might end up leading the lifestyle medicine revolution.

As shown in my video, Plant-Based Workplace Intervention, the annual cost attributable to obesity alone among full-time employees is estimated at 70 billion dollars, primarily because obese employees are not as productive on the job. Having healthy employees is good for the bottom-line. Every dollar spent on wellness programs may offer a $3 return on investment. And if you track the market performance of companies that strive to nurture a culture of health, they appear to outperform their competition.

That's why companies like GEICO are exploring workplace dietary interventions (see my video, Slimming the Gecko). The remarkable success at GEICO headquarters led to an expansion of the program at corporate offices across the country, with test sites from San Diego to Macon, Georgia. Given that previous workplace studies have found that workers who ate a lot of animal protein had nearly five times the odds of obesity, whereas those that ate mostly plant protein appeared protected, obese and diabetic employees were asked to follow a plant-based diet of whole grains, vegetables, beans, and fruit while avoiding meat, dairy, and eggs. Compliance wasn't great. Fewer than half really got their animal product consumption down, but there were definitely improvements such as significant reductions in saturated fat, an increase in protective nutrients, and even noted weight loss, lower blood cholesterol levers, and better blood sugar control in diabetics.

And this was with no calorie counting, no portion control, and no exercise component. The weight reduction appears to result from feeling fuller earlier, due to higher dietary fiber intake. The difference in weight loss could also be the result of an increase in the thermic effect of food, allowing a small extra edge for weight loss in the vegan group. Those eating plant-based diets tend to burn off more calories in heat.

Eating plants appears to boost metabolism. This may be due to increased insulin sensitivity in cells, allowing cells to metabolize carbohydrates more quickly rather than storing them as body fat. "As a result, vegan diets have been shown to increase postprandial calorie burn by about 16%, up to three hours after consuming a meal."

Imagine how much money companies that self-insure their employees could save! See, for example:

Find out more on some of the potential downsides of corporate influence in videos like

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:

Image Credit: Ryan McGuire / Pixabay. This image has been modified.

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Reversal of Chronic Disease Risk Even Late in Life

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A hundred years ago, the New York Times reported on a rather sophisticated study for the time: 4,600 cases of cancer appearing over a seven year period, suggesting that the increased consumption of animal foods was to blame. A century later, the latest review on the subjects concluded that mortality from all causes put together, ischemic heart disease, circulatory, and cerebrovascular diseases was significantly lower in those eating meat-free diets, in addition to less cancer and diabetes.

I'm surprised they found such significant results given that people in these studies typically didn't stop eating meat until late in life. For example, in the largest study done up until recently, up to a third of subjects ate vegetarian for less than five years, yet they still ended up with lower rates of heart disease whether they were under 60 or over 60, normal weight or overweight, used to smoke or never smoked; those that had stopped eating meat had lower risk, suggesting that decades of higher risk dietary behavior could be reversed within just years of eating healthier.

If you look at countries that switched from eating traditional, more plant-based diets to more Westernized diets, it may take 20 years for cancer rates to shoot up. It takes decades for most tumors to grow. For example, if you look at Asia, their dietary shift was accompanied by a remarkable increase in mortality rates of breast, colon, and prostate cancers. The same thing can be shown with migration studies. Men moving from rural China to the U.S. experience a dramatic increase in cancer risk, but tumors take time to grow.

So it's remarkable to me that after most of a lifetime eating the standard Western diet, one can turn it around and reverse chronic disease risk with a healthier diet, even late in the game... as discussed in my video, Never Too Late to Start Eating Healthier.

So, "should we all start eating vegetarian?" asked an editorial that accompanied the results from the largest study ever published on Americans eating plant-based diets, which found vegetarian diets to be associated with lower all-cause mortality, meaning those who started eating vegetarian live, on average, longer lives. This analysis included so-called semi-vegetarians, who ate meat at least once a month (but no more than once a week), so it's not yet clear how harmful eating meat a few times a month is. What we can all agree on, though, is that we should limit our intake of junk food and animal fat, and eat more fruits and vegetables. Most authorities will also agree that diets should include whole grains, beans, and nuts. Instead of fighting over whose diet is the best, it's time to acknowledge these common features of diets associated with less disease, and instead focus our attention on helping patients avoid the intense commercial pressures to eat otherwise.

How amazing the human body is if we just treat it right! For more on lifestyle medicine, see:

So please don't allow the perfect to become the enemy of the good. Any movement we can make towards improving our diet can help. Though the earlier the better: See Heart Disease Starts in Childhood and Back in Circulation: Sciatica and Cholesterol.

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--2013: Uprooting the Leading Causes of Death, More Than an Apple a Day, 2014: From Table to Able: Combating Disabling Diseases with Food, 2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet, and my latest, 2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers.

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What About Eating Just a Little Meat?

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As you can see in my video, Plant-Based Diets and Diabetes, we've known for decades that a plant-based diet may be protective against diabetes. Studies going back half a century found that those eating meat one or more days a week had significantly higher rates of diabetes, and the more frequently meat was eaten, the more frequent the disease. And this is after controlling for weight, so even at the same weight, those eating more plant-based had but a fraction of the diabetes rates. If anything, vegetarians should have had more diabetes just because they appear to live so much longer, so they had more time to develop these kinds of chronic diseases; but no, apparently lower rates of death and disease.

Fast forward 50 years to the Adventist-2 study, looking at 89,000 people, and we see a stepwise drop in the rates of diabetes as one eats more and more plant-based, down to a 78% lower prevalence among those eating strictly plant-based. Protection building incrementally as one moved from eating meat daily, to eating meat weekly, to just fish, to no meat, and then to no eggs and dairy either. Followed over time, vegetarian diets were associated with a substantially lower incidence of diabetes, indicating the potential of these diets to stem the current diabetes epidemic.

We see the same step-wise drop in rates of another leading killer, high blood pressure. The greater the proportion of plant foods, the lower the rates of hypertension, and the same with excess body fat. The only dietary group not on average overweight were those eating diets composed exclusively of plant foods, but again there was the same incremental drop with fewer and fewer animal products. This suggests that it's not black and white, not all or nothing, any steps we can make along this spectrum of eating healthier may accrue significant benefits.

What about eating a really healthy diet with just a little meat? Is it better to eat none at all? We have new insight last year from Taiwan. Asian diets in general tend to be lower in meat and higher in plant foods compared with Western diet, but whether a diet completely avoiding meat and fish would further extend the protective effect of a plant-based diet wasn't known, until now.

Traditionally, Asian populations have had low rates of diabetes, but a diabetes epidemic has since emerged, and appears to coincide with increased meat, animal protein, and animal fat consumption, but the Westernization of Asian diets also brought along a lot of fast food and junk, and so these researchers at the national university didn't want to just compare those eating vegetarian to typical meateaters. So, they compared Bhuddist vegetarians to Bhuddist non-vegetarians, eating traditional Asian diets. Even the omnivores were eating a predominantly plant-based diet, consuming little meat and fish, with the women eating the equivalent of about a single serving a week, and men eating a serving every few days. That's just 8% of the meat intake in the U.S., 3% for the women. The question: is it better to eat 3% or 0%?

Again, both groups were eating healthy; zero soda consumption, for example, in any group. Despite the similarities in their diet, and after controlling for weight, family history, exercise, and smoking, the men eating vegetarian had just half the rates of diabetes, and the vegetarian women just a quarter of the rates. So even in a population consuming a really plant-based diet with little meat and fish, true vegetarians who completely avoided animal flesh, while eating more healthy plant foods, have lower odds for prediabetes and diabetes after accounting for other risk factors. They wanted to break it up into vegan versus ovo-lacto like in the Adventist-2 study, but they couldn't because there were no cases at all of diabetes found within the vegan group.

More on preventing and treating this terrible disease:

The reason I keep going back to that Adventist-2 study is that it's not only the biggest study of those eating plant based diets in North America, but the largest such study anywhere anytime. We owe those investigators a great debt (not to mention the 96,741 participants!). One thing I'm happy my tax dollars are going towards (via the National Cancer Institute and National Institutes of Health). More from the Adventists in Caloric Restriction vs. Animal Protein Restriction.

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--2013: Uprooting the Leading Causes of Death, More Than an Apple a Day, 2014: From Table to Able: Combating Disabling Diseases with Food, 2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet, and my latest, 2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers.

Image Credit: Reisek / Flickr

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The Saturated Fat Studies: Buttering Up the Public

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Time magazine's cover exhorting people to eat butter could be viewed as a desperate attempt to revive dwindling print sales, but they claimed to be reporting on real science--a systematic review and meta-analysis published in a prestigious journal that concluded that current evidence does not clearly support cardiovascular guidelines that encourage cutting down on saturated fat, like the kind found in meat and dairy products like butter.

No wonder it got so much press, since reducing saturated fat intake is a major focus of most dietary recommendations worldwide, aiming to prevent chronic diseases including coronary heart disease. So, to quote the Center for Science in the Public Interest, "What gives? Evidently, shaky science...and a mission by the global dairy industry to boost sales."

They interviewed an academic insider, who noted that some researchers are intent on showing saturated fat does not cause heart disease, which can be seen in my video The Saturated Fat Studies: Buttering Up the Public. In 2008, the global dairy industry held a meeting where they decided that one of their main priorities was to "neutralize the negative impact of milk fat by regulators and medical professionals." And when they want to do something, they get it done. So they set up a major, well-funded campaign to come up with proof that saturated fat does not cause heart disease. They assembled scientists who were sympathetic to the dairy industry, provided them with funding, encouraged them to put out statements on milk fat and heart disease, and arranged to have them speak at scientific meetings. And the scientific publications we've seen emerging since the Mexico meeting have done just what they set out to do.

During this meeting, the dairy industry discussed what is the key barrier to increasing worldwide demand for dairy. There's global warming issues and other milks competing out there, but number one on the list is the "Negative messages and intense pressure to reduce saturated fats by governments and non- governmental organizations." In short, the negative messages are outweighing the positive, so indeed, their number one priority is to neutralize the negative image of milk fat among regulators and health professionals as related to heart disease.

So if we are the dairy industry, how are we going to do it? Imagine we work for Big Butter. We've got quite the challenge ahead of us. If we look at recommendations from around the globe, there is a global scientific consensus to limit saturated fat intake with most authoritative bodies recommending getting saturated fat at least under 10% of calories, with the prestigious U.S. Institute of Medicine and the European Food Safety Authority recommending to push saturated fat consumption down as low as possible.

The latest guidelines from the American Heart Association and the American College of Cardiology recommend reducing trans fat intake, giving it their strongest A-grade level of evidence. And they say the same same for reducing saturated fat intake. Since saturated and trans fats are found in the same place, meat and dairy, cutting down on foods with saturated fat will have the additional benefit of lowering trans fat intake. They recommend pushing saturated fat intake down to 5 or 6%. People don't realize how small that is. One KFC chicken breast could take us over the top. Or, two pats of butter and two cubes of cheese and we're done for the day--no more dairy, meat, or eggs. That'd be about 200 calories, so they are in effect saying 90% of our diet should be free of saturated fat-containing foods. That's like the American Heart Association saying, "two meals a week can be packed with meat, dairy, and junk, but the entire rest of the week should be unprocessed plant-foods." That's how stringent the new recommendations are.

So this poses a problem for Big Cheese and Chicken. The top contributors of cholesterol-raising saturated fat is cheese, ice cream, chicken, non-ice cream desserts like cake and pie, and then pork. So what are these industries to do? See The Saturated Fat Studies: Set Up to Fail.

For those unfamiliar with Trans Fat in Meat and Dairy (and refined vegetable oils), that's why I made a video about it.

The U.S. National Academy of Sciences Institute of Medicine "as low as possible" position, echoed by the European Food Safety Authority, is described in my video: Trans Fat, Saturated Fat, and Cholesterol: Tolerable Upper Intake of Zero.

What happened when a country tried to put the lower saturated fat guidance into practice? See the remarkable results in Dietary Guidelines: From Dairies to Berries.

Don't think the dietary guidelines process could be undermined by underhanded corporate tactics? Sad but true:

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--2013: Uprooting the Leading Causes of Death, More Than an Apple a Day, 2014: From Table to Able: Combating Disabling Diseases with Food, 2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet, and my latest, 2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers.

Image Credit: Johnathan Nightingale / Flickr

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How to Mitigate and Prevent Crohn’s Disease with Diet

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Crohn's disease is an autoimmune disorder that affects more than a million Americans. It is an inflammatory bowel disease in which the body attacks the intestines. There is currently no known cure for Crohn's disease; current research focuses on controlling symptoms. There is no definitive medical or surgical therapy. The best we have is a plant-based diet, which has afforded the best relapse prevention to date.

Researchers got the idea to try a plant-based diet because diets rich in animal protein and animal fat have been found to cause a decrease in beneficial bacteria in the intestine. So, researchers designed a semi-vegetarian diet to counter that, and 100 percent of subjects stayed in remission the first year and 92 percent the second year. These results are far better than those obtained by current drugs, including new "biological agents" that can cost $40,000 a year, and can cause progressive multifocal leukoencephalopathy, a disabling and deadly brain disease. And a healthy diet appears to work better.

But what about preventing Crohn's disease in the first place? A systematic review of the scientific literature on dietary intake and the risk of developing inflammatory bowel disease found that a high intake of fats and meat was associated with an increased risk of Crohn's disease as well as ulcerative colitis, whereas high fiber and fruit intakes were associated with decreased risk of Crohn's.

These results were supported more recently by the Harvard Nurse's Health Study. Data revealed that long-term intake of dietary fiber, particularly from fruit, was associated with lower risk of Crohn's disease. Women who fell into in the highest long-term fiber consumption group had a 40 percent reduced risk, leading the accompanying editorial to conclude, "advocating for a high-fiber diet may ultimately reduce the incidence of Crohn's disease."

The irony is that the highest fiber group wasn't even eating the official recommended daily minimum of fiber intake. Apparently, even just being less fiber deficient has a wide range of benefits, including a significant reduction in the risk of developing Crohn's disease, but why? The authors suggest it's because "fiber plays a vital role in the maintenance of our intestinal barrier function."

Our skin keeps the outside world outside, and so does the lining of our gut, but in Crohn's disease, this barrier function is impaired. You can see this under an electron microscope as shown in my video Preventing Crohn's Disease With Diet. The tight junctions between the intestinal cells have all sorts of little holes and breaks. The thought is that the increase in prevalence of inflammatory bowel diseases may be that dietary changes lead to the breakdown of our intestinal barrier, potentially allowing the penetration of bacteria into our gut wall, which our body then attacks, triggering the inflammation.

We know fiber acts as a prebiotic in our colon (large intestine), feeding our good bacteria, but what does fiber do in our small intestine where Crohn's often starts? We didn't know, until a landmark study was published. Researchers wanted to find out what could stop Crohn's associated invasive bacteria from tunneling into the gut wall. They found the invasion is inhibited by the presence of certain soluble plant fibers, such as from plantains and broccoli at the kinds of concentrations one might expect after eating them. They wondered if that may explain why plantain-loving populations have lower levels of inflammatory bowel disease. But, the researchers also found that there was something in processed foods that facilitated the invasion of the bacteria. Polysorbate 80 was one of them, found predominantly in ice cream, but also found in Crisco, Cool Whip, condiments, cottage cheese--you just have to read the labels.

What about maltodextrin, which is found in artificial sweeteners like Splenda, snack foods, salad dressings, and fiber supplements? Maltodextrin markedly enhanced the ability of the bacteria to glob onto our intestinal cells, though other additives. Carboxy-methyl cellulose and xanthan gum appeared to have no adverse effects.

This may all help solve the mystery of the increasing prevalence of Crohn's disease in developed nations, where we're eating less fiber-containing whole plant foods and more processed foods. What we need now are interventional studies to see if boosting fiber intake and avoiding these food additives can be effective in preventing and treating Crohn's disease. But until then, what do we tell people? The available evidence points to a diet low in animal fat, with lots of soluble fiber containing plant foods, and avoiding processed fatty foods that contain these emulsifiers. We also want to make sure we're not ingesting traces of dishwashing detergent, which could have the same effect, so make sure to rinse your dishes well. Researchers found that some people wash dishes and then just leave them to dry without rinsing, which is probably not a good idea. We don't currently have studies that show that avoiding polysorbate 80 and rinsing dishes well actually helps. Nevertheless, advice based on 'best available evidence' is better than no advice at all.

Here's a video about using a more plant-based diet to reduce the risk of relapses: Dietary Treatment of Crohn's Disease.

I get a lot of questions about additives like polysorbate 80. I'm glad I was finally able to do a blog about it. Here are some videos on some others:

If you, like me, used to think all fiber was good for was helping with bowel regularity you'll be amazed! See for example, Dr. Burkitt's F-Word Diet.

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--2013: Uprooting the Leading Causes of Death, More Than an Apple a Day, 2014: From Table to Able: Combating Disabling Diseases with Food, 2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet, and my latest, 2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers.

Image Credit: Graphic Stock

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Should Pregnant Women Drink Cow’s Milk?

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Foods of animal origin in general naturally contain hormones, but cow's milk may be of particular concern. The hormones naturally found even in organic cow's milk may have played a role in studies that found a relationship between dairy products and human illnesses, such as acne, certain cancers and male reproductive disorders. Milk consumption has also been associated with an increased risk of early puberty and endometrial cancer in postmenopausal women, but "hormonal levels in food could be particularly dangerous in the case of vulnerable populations, such as young children or pregnant women. To this critical population, even a small hormonal intake could lead to major changes in the metabolism."

If you check out my video Why Do Vegan Women Have 5x Fewer Twins, you can see that children are highly sensitive to sex steroids. Because their levels of sex steroids are very low, even a small variation would account for a major change in the total activity of the involved hormone. Because no lower threshold for estrogenic action has been established, caution should be taken to avoid unnecessary exposure of fetuses and children to exogenous sex steroids, even at very low levels.

In the AMA's Pediatrics Journal, the Chair of Boston Children's Hospital's Obesity Prevention Center along with the chair of Harvard's nutrition department questioned dairy industry recommendations that children should drink three glasses of milk a day. Dairy milk evolved to promote the growth of grazing animals at high risk for predation when small, so they needed to put on a few hundred pounds quickly in the first few months of life.

The consequences of lifetime human exposure to the growth factors in milk have not been well studied. "Milk consumption increases serum concentrations of insulin-like growth factor 1, which is linked to prostate and other cancers. In addition, modern industrial methods maintain dairy cows in active milk production throughout their pregnancies, resulting in a milk supply with high levels of reproductive hormones."

Pregnant cows excrete significantly higher levels of sex steroids into their milk than non-pregnant cows. The subsequent consumption of such dairy products from pregnancy results in additional consumer exposure. And it's not just dairy. Although dairy products are an important source of hormones, other products of animal origin must be considered as well. All edible tissues of animal origin contain estrogen. This may explain why, in a study of over a thousand women eating plant-based diets, vegan women have a twinning rate that is one fifth that of vegetarians and omnivores.

Twin pregnancies are risky pregnancies, with much higher complication rates. Many parents and physicians underestimate the negative consequences of multiple pregnancy, but "women with a multiple pregnancy face greater risks for themselves and their infants." Twin babies may be ten times more likely to die at birth. To avoid these complications, the research team writes, "women attempting conception should avoid milk and dairy products."

Minimizing dairy, our nation's #1 source of saturated fat may be a good idea for dads too: Dairy Estrogen and Male Fertility.

What about the endocrine-disrupting xenoestrogens--how do they compare with the natural hormones in our food supply? That was the topic of my video Estrogen in Meat, Dairy, and Eggs.

Then once they're born, best to stick to human milk:

Then as young children, dairy can sometimes cause another problem: Childhood Constipation and Cow's Milk

Here's a selection of other pregnancy-related videos:

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--2013: Uprooting the Leading Causes of Death, More Than an Apple a Day, 2014: From Table to Able: Combating Disabling Diseases with Food, 2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet, and my latest, 2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers.

Image Credit: LivingLandscapeArchitecture / Flickr

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Estrogen in Meat, Dairy, and Eggs

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Estrogen hormones can be thousands of times more estrogenic than typical endocrine-disrupting chemicals. Dietary exposure to natural sex steroids (in meat, dairy, and eggs) is "therefore highly relevant in the discussion of the impact of estrogens on human development and health." And chicken estrogen is identical to human estrogen--they're identical molecules. So it doesn't matter if it ends up in our drinking supply from women taking birth control pills excreting it in their urine, or cows excreting it into their milk. The source doesn't matter; the quantity does.

If you check out my video Estrogen in Meat, Dairy, and Eggs, you can see that a child's exposure to estrogens in drinking water is about 150 times lower than exposure from cow's milk, so our day-to-day estrogen exposure levels are more likely determined by whether or not we happen to eat dairy products that day.

Human urine is "often cited as the main source of natural and synthetic estrogens in the aquatic environment," but the level of estrogen even in the urine of heavy meat-eaters, who have significantly higher levels, pales in comparison to the estrogen excreted by the farm animals themselves. Pig, sheep, cattle, and chickens produce literally tons of estrogen every year.

Women may excrete 16 mg every day, but farm animals may release ten times more, or in the case of pregnant cows, thousands of times more. Animal waste may contribute an estimated 90% of total estrogens in the environment. Five gallons of runoff water contaminated with chicken manure may contain a birth control pill's worth of estrogen.

Estrogen levels in poultry litter are so high that when farmers feed chicken manure to their animals to save on feed costs, it may trigger premature development. Poultry manure has among the highest hormone content, quadruple the total estrogens, and nine times more 17-beta estradiol, the most potent estrogen and a "complete" carcinogen, as it exerts both tumor initiating and tumor promoting effects.

From a human health standpoint, do we really care about feminized fish, or the appearance of "intersex roaches"? The problem is that the hormones get into the food supply. Endogenous steroid hormones in food of animal origin are unavoidable as they occur naturally in these products. It's not a matter of injected hormones, which are banned in places like Europe in order to protect consumers' health. Sex steroid hormones are part of animal metabolism, and so all foodstuffs of animal origin contain these hormones, which have been connected with several human health problems. (See Why Do Vegan Women Have 5x Fewer Twins?)

What effects might these female hormones have on men? See Dairy Estrogen and Male Fertility.

The implications of this relatively new practice of milking cows even when they're pregnant is further explored in:

More on xenoestrogens in:

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--2013: Uprooting the Leading Causes of Death, More Than an Apple a Day, 2014: From Table to Able: Combating Disabling Diseases with Food, 2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet, and my latest, 2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers.

Image Credit: BruceBlaus

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What to Eat to Protect Against Kidney Cancer

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58,000 Americans are diagnosed with kidney cancer every year, and 13,000 die. And the numbers have been going up. Approximately 4 percent of cases are hereditary, but what about the other 96 percent? The only accepted risk factor has been tobacco use, but cigarette smoking has been declining.

Nitrosamines are one of the most potent carcinogens in cigarette smoke. One hot dog has as many nitrosamines and nitrosamides as five cigarettes. And these carcinogens are also found in fresh meat as well: beef, chicken and pork. So even though smoking rates have dropped, perhaps the rise in kidney cancer over the last few decades may have something to do with meat consumption. But would kidney cancer just be related to the processed meats like bacon, sausage, hot dogs and cold cuts that have nitrate and nitrite additives, or fresh meat as well?

The NIH-AARP study featured in my video Can Diet Protect Against Kidney Cancer? is the largest prospective study on diet and health ever performed--about 500,000 followed for nine years. In addition to examining nitrate and nitrite intake from processed meat, they also looked at intake from other sources such as fresh meat, eggs and dairy. Nitrite from animal sources, not just processed meats, was associated with an increased risk of kidney cancer, and total intake of nitrate and nitrite from processed meat sources was also associated with kidney cancer risk. The researchers found no associations with nitrate or nitrite intake from plant sources, but nitrates from processed meat was associated with cancer.

When meat producers advertise their bacon or lunch meat as "uncured," this means no nitrites or nitrates added. But if you look at the small print you'll see something like, "except for celery juice." That's just a sneaky way to add nitrites. Processed meat producers ferment the nitrates in celery to create nitrites, then add it to the meat; a practice even the industry admits "may be viewed as incorrect at best or deceptive at worst."

But that same fermentation of nitrates to nitrites can happen thanks to bacteria on our tongue when we eat vegetables. So why are nitrates and nitrites from vegetables on our tongue harmless, but nitrates and nitrites from vegetables in meat linked to cancer? The actual carcinogens are not nitrites, but nitrosamines and nitrosamides. In our stomach, to turn nitrites into nitros-amines, and nitros-amides we need amines and amides, which are concentrated in animal products. And vitamin C and other antioxidants in plant foods block the formation of these carcinogens in our stomach. That's why we can safely benefit from the nitrates in vegetables without the cancer risk. In fact some of the highest nitrate vegetables like arugula, kale, and collards are associated with decreased risk of kidney cancer. The more plants, it appears, the better.

Plant-based diets and fiber-rich diets are recommended to prevent cancer directly, as well as chronic conditions associated with kidney cancer, such as obesity, high blood pressure and diabetes. It's similar to sodium intake and kidney cancer. Sodium intake increases kidney disease risk, but that's not just because sodium intake increases blood pressure. It appears the salt is associated with increased cancer risk even independently of hypertension. What about plant-based diets? Turns out the protective association remains even in people who are not obese and have normal blood pressure. So overall, plant-based and fiber-rich diets appear to do both: decrease cancer risk directly and indirectly.

I briefly address kidney health in Preventing Kidney Failure Through Diet and Treating Kidney Failure Through Diet, but have a whole series of more in-depth videos dealing with various kidney issues.

More on the fascinating nitrate/nitrite story in my 17-part series about improving athletic performance with nitrate-rich vegetables such as beets and arugula. Here are a few short highlights:

More on carcinogens caused by cooking meat in videos like:

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--2013: Uprooting the Leading Causes of Death, More Than an Apple a Day, 2014: From Table to Able: Combating Disabling Diseases with Food, 2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet, and my latest, 2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers.

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Paleo Diet May Undermine Benefit of CrossFit Exercise

NF-Sept6 Paleo Diets May Negate Benefits of Exercise.jpeg

Much of the low-carb and paleo reasoning revolves around insulin. To quote a paleo blogger, "carbohydrates increase insulin, the root of all evil when it comes to dieting and health." So the logic follows that because carbs increase insulin, we should stick mostly to meat, which is fat and protein with no carbs, so no increase in insulin, right?

Wrong.

We've known for half a century that if you give someone just a steak: no carbs, no sugar, no starch; their insulin goes up. Carbs make our insulin go up, but so does protein.

In 1997 an insulin index of foods was published, ranking 38 foods to determine which stimulates higher insulin levels. Researchers compared a large apple and all its sugar, a cup of oatmeal packed with carbs, a cup and a half of white flour pasta, a big bun-less burger with no carbs at all, to half of a salmon fillet. As you can see in the graph in my video Paleo Diets May Negate Benefits of Exercise, the meat produced the highest insulin levels.

Researchers only looked at beef and fish, but subsequent data showed that that there's no significant difference between the insulin spike from beef, chicken, or pork--they're all just as high. Thus, protein and fat rich foods may induce substantial insulin secretion. In fact, meat protein causes as much insulin release as pure sugar.

So, based on the insulin logic, if low-carbers and paleo folks really believed insulin to be the root of all evil, then they would be eating big bowls of spaghetti day in and day out before they would ever consume meat.

They are correct in believing that having hyperinsulinemia, high levels of insulin in the blood like type 2 diabetics have, is not a good thing, and may increase cancer risk. But if low-carb and paleo dieters stuck to their own insulin theory, then they would be out telling everyone to start eating plant-based. Vegetarians have significantly lower insulin levels even at the same weight as omnivores. This is true for ovo-lacto-vegetarians, lacto-vegetarians, and vegans. Meat-eaters have up to 50% higher insulin levels.

Researchers from the University of Memphis put a variety of people on a vegan diet (men, women, younger folks, older folks, skinny and fat) and their insulin levels dropped significantly within just three weeks. And then, just by adding egg whites back to their diet, their insulin production rose 60% within four days.

In a study out of MIT, researchers doubled participants' carbohydrate intake, and their insulin levels went down. Why? Because the researchers weren't feeding people jellybeans and sugar cookies, they were feeding people whole, plant foods, lots of whole grains, beans, fruits, and vegetables.

What if we put someone on a very-low carb diet, like an Atkins diet? Low carb advocates such as Dr. Westman assumed that it would lower insulin levels. Dr. Westman is the author of the new Atkins books, after Dr. Atkins died obese with, according to the medical examiner, a history of heart attack, congestive heart failure, and hypertension. But, Dr. Westman was wrong in his assumption. There are no significant drop in insulin levels on very low-carb diets. Instead, there is a significant rise in LDL cholesterol levels, the number one risk factor for our number one killer, heart disease.

Atkins is an easy target though. No matter how many "new" Atkins diets that come out, it's still old news. What about the paleo diet? The paleo movement gets a lot of things right. They tell people to ditch dairy and doughnuts, eat lots of fruits, nuts, and vegetables, and cut out a lot of processed junk food. But a new study published in the International Journal of Exercise Science is pretty concerning. Researchers took young healthy people, put them on a Paleolithic diet along with a CrossFit-based, high-intensity circuit training exercise program.

If you lose enough weight exercising, you can temporarily drop our cholesterol levels no matter what you eat. You can see that with stomach stapling surgery, tuberculosis, chemotherapy, a cocaine habit, etc. Just losing weight by any means can lower cholesterol, which makes the results of the Paleo/Crossfit study all the more troubling. After ten weeks of hardcore workouts and weight loss, the participants' LDL cholesterol still went up. And it was even worse for those who started out the healthiest. Those starting out with excellent LDL's (under 70), had a 20% elevation in LDL cholesterol, and their HDL dropped. Exercise is supposed to boost our good cholesterol, not lower it.

The paleo diet's deleterious impact on blood fats was not only significant, but substantial enough to counteract the improvements commonly seen with improved fitness and body composition. Exercise is supposed to make things better.

On the other hand, if we put people instead on a plant-based diet and a modest exercise program, mostly just walking-based; within three weeks their bad cholesterol can drop 20% and their insulin levels 30%, despite a 75-80% carbohydrate diet, whereas the paleo diets appeared to "negate the positive effects of exercise."

I touched on paleo diets before in Paleolithic Lessons, and I featured a guest blog on the subject: Will The Real Paleo Diet Please Stand Up?

but my favorite paleo videos are probably The Problem With the Paleo Diet Argument and Lose Two Pounds in One Sitting: Taking the Mioscenic Route.

I wrote a book on low carb diets in general (now available free full-text online) and touched on it in Atkins Diet: Trouble Keeping It Up and Low Carb Diets and Coronary Blood Flow.

And if you're thinking, but what about the size of the cholesterol, small and dense versus large and fluffy? Please see my video Does Cholesterol Size Matter?

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--2013: Uprooting the Leading Causes of Death, More Than an Apple a Day, 2014: From Table to Able: Combating Disabling Diseases with Food, 2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet, and my latest, 2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers.

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