Best Foods for Acid Reflux

Best Foods for Acid Reflux.jpeg

Gastroesophageal reflux disease (GERD) is one of the most common disorders of the digestive tract. The two most typical symptoms are heartburn and regurgitation of stomach contents into the back of the throat, but GERD is not just burning pain and a sour taste in your mouth. It causes millions of doctor visits and hospitalizations every year in the United States. The most feared complication is cancer.

You start out with a normal esophagus. If the acid keeps creeping up, your esophagus can get inflamed and result in esophagitis. Esophagitis can transform into Barrett's esophagus, a precancerous condition which can then turn into adenocarcinoma (a type of cancer). To prevent all that, we need to prevent the acid reflux in the first place.

In the last three decades, the incidence of this cancer in the US has increased six-fold, an increase greater than that of melanoma, breast, or prostate cancer. This is because acid reflux is on the rise. In the United States, we're up to about 1 in 4 people suffering at least weekly heartburn and/or acid regurgitation, compared to around 5% in Asia. This suggests that dietary factors may play a role.

In general, high fat intake is associated with increased risk, whereas high fiber foods appear to be protective. The reason fat intake may be associated with GERD symptoms and erosive esophagitis is because when we eat fatty foods, the sphincter at the top of the stomach that's supposed to keep the food down becomes relaxed, so more acid can creep up into the esophagus. In my video Diet & GERD Acid Reflux Heartburn, you can see a study in which researchers fed volunteers a high-fat meal--a McDonald's sausage and egg McMuffin--compared to a low-fat meal (McDonald's hot cakes), and there was significantly more acid squirted up in the esophagus after the high-fat meal.

In terms of later stages of disease progression, over the last twenty years 45 studies have been published in the association between diet and Barrett's esophagus and esophageal cancer. In general, they found that meat and high-fat meals appeared to increase cancer risk. Different meats were associated with cancers in different locations, thoughj. Red meat was more associated with cancer in the esophagus, whereas poultry was more associated with cancer at the top of the stomach. Plant-based sources of protein, such as beans and nuts, were associated with a significantly decreased risk of cancer.

Those eating the most antioxidant-rich foods have half the odds of esophageal cancer, while there is practically no reduction in risk among those who used antioxidant vitamin supplements, such as vitamin C or E pills. The most protective produce may be red-orange vegetables, dark green leafies, berries, apples, and citrus. The benefit may come from more than just eating plants. Eating healthy foods crowds out less healthy foods, so it may be a combination of both.

Based on a study of 3,000 people, the consumption of non-vegetarian foods (including eggs) was an independent predictor of GERD. Egg yolks cause an increase in the hormone cholecystokinin, which may overly relax the sphincter that separates the esophagus from the stomach. The same hormone is increased by meat, which may help explain why plant-based diets appear to be a protective factor for reflux esophagitis.

Researchers found that those eating meat had twice the odds of reflux-induced esophageal inflammation. Therefore, plant-based diets may offer protection, though it's uncertain whether it's attributable to the absence of meat in the diet or the increased consumption of healthy foods. Those eating vegetarian consume greater amounts of fruits and vegetables containing innumerable phytochemicals, dietary fiber, and antioxidants. They also restrict their consumption of animal sources of food, which tend to be fattier and can thus relax that sphincter and aggravate reflux.

GERD is common; its burdens are enormous. It relapses frequently and can cause bleeding, strictures, and a deadly cancer. The mainstay of treatment is proton pump inhibitor drugs, which rake in billions of dollars. We spend four billion dollars on Nexium alone, three billion on Prevacid, two billion on Protonix, one billion on Aciphex. These drugs can cause nutrient deficiencies and increase the risk for pneumonia, food poisoning, and bone fractures. Thus, it is important to find correctable risk factors and correct them. Known correctable risk factors have been things like obesity, smoking and alcohol consumption. Until recently, though, there hadn't been studies on specifically what to eat and what to avoid, but now we have other correctable factors to help prevent this disease.

For more on GERD, see: Diet & Hiatal Hernia, Coffee & Mortality, and Club Soda for Stomach Pain & Constipation.

I also have a video about esophageal cancer, detailing the extraordinary reversal of the kinds of precancerous changes that lead to the devastating condition--with nothing but strawberries: Strawberries versus Esophageal Cancer.

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: PDPics / Pixabay. Image has been modified.

Original Link

Best Foods for Acid Reflux

Best Foods for Acid Reflux.jpeg

Gastroesophageal reflux disease (GERD) is one of the most common disorders of the digestive tract. The two most typical symptoms are heartburn and regurgitation of stomach contents into the back of the throat, but GERD is not just burning pain and a sour taste in your mouth. It causes millions of doctor visits and hospitalizations every year in the United States. The most feared complication is cancer.

You start out with a normal esophagus. If the acid keeps creeping up, your esophagus can get inflamed and result in esophagitis. Esophagitis can transform into Barrett's esophagus, a precancerous condition which can then turn into adenocarcinoma (a type of cancer). To prevent all that, we need to prevent the acid reflux in the first place.

In the last three decades, the incidence of this cancer in the US has increased six-fold, an increase greater than that of melanoma, breast, or prostate cancer. This is because acid reflux is on the rise. In the United States, we're up to about 1 in 4 people suffering at least weekly heartburn and/or acid regurgitation, compared to around 5% in Asia. This suggests that dietary factors may play a role.

In general, high fat intake is associated with increased risk, whereas high fiber foods appear to be protective. The reason fat intake may be associated with GERD symptoms and erosive esophagitis is because when we eat fatty foods, the sphincter at the top of the stomach that's supposed to keep the food down becomes relaxed, so more acid can creep up into the esophagus. In my video Diet & GERD Acid Reflux Heartburn, you can see a study in which researchers fed volunteers a high-fat meal--a McDonald's sausage and egg McMuffin--compared to a low-fat meal (McDonald's hot cakes), and there was significantly more acid squirted up in the esophagus after the high-fat meal.

In terms of later stages of disease progression, over the last twenty years 45 studies have been published in the association between diet and Barrett's esophagus and esophageal cancer. In general, they found that meat and high-fat meals appeared to increase cancer risk. Different meats were associated with cancers in different locations, thoughj. Red meat was more associated with cancer in the esophagus, whereas poultry was more associated with cancer at the top of the stomach. Plant-based sources of protein, such as beans and nuts, were associated with a significantly decreased risk of cancer.

Those eating the most antioxidant-rich foods have half the odds of esophageal cancer, while there is practically no reduction in risk among those who used antioxidant vitamin supplements, such as vitamin C or E pills. The most protective produce may be red-orange vegetables, dark green leafies, berries, apples, and citrus. The benefit may come from more than just eating plants. Eating healthy foods crowds out less healthy foods, so it may be a combination of both.

Based on a study of 3,000 people, the consumption of non-vegetarian foods (including eggs) was an independent predictor of GERD. Egg yolks cause an increase in the hormone cholecystokinin, which may overly relax the sphincter that separates the esophagus from the stomach. The same hormone is increased by meat, which may help explain why plant-based diets appear to be a protective factor for reflux esophagitis.

Researchers found that those eating meat had twice the odds of reflux-induced esophageal inflammation. Therefore, plant-based diets may offer protection, though it's uncertain whether it's attributable to the absence of meat in the diet or the increased consumption of healthy foods. Those eating vegetarian consume greater amounts of fruits and vegetables containing innumerable phytochemicals, dietary fiber, and antioxidants. They also restrict their consumption of animal sources of food, which tend to be fattier and can thus relax that sphincter and aggravate reflux.

GERD is common; its burdens are enormous. It relapses frequently and can cause bleeding, strictures, and a deadly cancer. The mainstay of treatment is proton pump inhibitor drugs, which rake in billions of dollars. We spend four billion dollars on Nexium alone, three billion on Prevacid, two billion on Protonix, one billion on Aciphex. These drugs can cause nutrient deficiencies and increase the risk for pneumonia, food poisoning, and bone fractures. Thus, it is important to find correctable risk factors and correct them. Known correctable risk factors have been things like obesity, smoking and alcohol consumption. Until recently, though, there hadn't been studies on specifically what to eat and what to avoid, but now we have other correctable factors to help prevent this disease.

For more on GERD, see: Diet & Hiatal Hernia, Coffee & Mortality, and Club Soda for Stomach Pain & Constipation.

I also have a video about esophageal cancer, detailing the extraordinary reversal of the kinds of precancerous changes that lead to the devastating condition--with nothing but strawberries: Strawberries versus Esophageal Cancer.

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: PDPics / Pixabay. Image has been modified.

Original Link

What Not to Add to White Rice, Potatoes, or Pasta

What Not to Add to White Rice, Potatoes, or Pasta.jpeg

Rice currently feeds almost half the human population, making it the single most important staple food in the world, but a meta-analysis of seven cohort studies following 350,000 people for up to 20 years found that higher consumption of white rice was associated with a significantly increased risk of type 2 diabetes, especially in Asian populations. They estimated each serving per day of white rice was associated with an 11% increase in risk of diabetes. This could explain why China has almost the same diabetes rates as we do.

Diabetes rates in China are at about 10%; we're at about 11%, despite seven times less obesity in China. Japan has eight times less obesity than we do, yet may have a higher incidence of newly diagnosed diabetes cases than we do--nine per a thousand compared to our eight. They're skinnier and still may have more diabetes. Maybe it's because of all the white rice they eat.

Eating whole fruit is associated with lower risk of diabetes, whereas eating fruit processed into juice may not just be neutral, but actually increases diabetes risk. In the same way, eating whole grains, like whole wheat bread or brown rice is associated with lower risk of diabetes, whereas eating white rice, a processed grain, may not just be neutral, but actually increase diabetes risk.

White rice consumption does not appear to be associated with increased risk of heart attack or stroke, though, which is a relief after an earlier study in China suggested a connection with stroke. But do we want to eat a food that's just neutral regarding some of our leading causes of death, when we can eat whole foods that are associated with lower risk of diabetes, heart attack, stroke, and weight gain?

If the modern diabetes epidemic in China and Japan has been linked to white rice consumption, how can we reconcile that with low diabetes rates just a few decades ago when they ate even more rice? If you look at the Cornell-Oxford-China Project, rural plant-based diets centered around rice were associated with relatively low risk of the so-called diseases of affluence, which includes diabetes. Maybe Asians just genetically don't get the same blood sugar spike when they eat white rice? This is not the case; if anything people of Chinese ethnicity get higher blood sugar spikes.

The rise in these diseases of affluence in China over the last half century has been blamed in part on the tripling of the consumption of animal source foods. The upsurge in diabetes has been most dramatic, and it's mostly just happened over the last decade. That crazy 9.7% diabetes prevalence figure that rivals ours is new--they appeared to have one of the lowest diabetes rates in the world in the year 2000.

So what happened to their diets in the last 20 years or so? Oil consumption went up 20%, pork consumption went up 40%, and rice consumption dropped about 30%. As diabetes rates were skyrocketing, rice consumption was going down, so maybe it's the animal products and junk food that are the problem. Yes, brown rice is better than white rice, but to stop the mounting Asian epidemic, maybe we should focus on removing the cause--the toxic Western diet. That would be consistent with data showing animal protein and fat consumption associated with increased diabetes risk.

But that doesn't explain why the biggest recent studies in Japan and China associate white rice intake with diabetes. One possibility is that animal protein is making the rice worse. If you feed people mashed white potatoes, a high glycemic food like white rice, you can see in my video If White Rice is Linked to Diabetes, What About China? the level of insulin your pancreas has to pump out to keep your blood sugars in check. But what if you added some tuna fish? Tuna doesn't have any carbs, sugar, or starch so it shouldn't make a difference. Or maybe it would even lower the mashed potato spike by lowering the glycemic load of the whole meal? Instead you get twice the insulin spike. This also happens with white flour spaghetti versus white flour spaghetti with meat. The addition of animal protein makes the pancreas work twice as hard.

You can do it with straight sugar water too. If you do a glucose challenge test to test for diabetes, where you drink a certain amount of sugar and add some meat, you get a much bigger spike than without meat. And the more meat you add, the worse it gets. Just adding a little meat to carbs doesn't seem to do much, but once you get up to around a third of a chicken breast's worth, you can elicit a significantly increased surge of insulin. This may help explain why those eating plant-based have such low diabetes rates, because animal protein can markedly potentiate the insulin secretion triggered by carbohydrate ingestion.

The protein exacerbation of the effect of refined carbs could help explain the remarkable results achieved by Dr. Kempner with a don't-try-this-at-home diet composed of mostly white rice and sugar. See my video, Kempner Rice Diet: Whipping Us Into Shape.

Refined grains may also not be good for our blood pressure (see Whole Grains May Work As Well As Drugs).

What should we be eating to best decrease our risk of diabetes? See:

And check out my summary video, How Not to Die from Diabetes.

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: Sally Plank / Flickr. This image has been modified.

Original Link

What Not to Add to White Rice, Potatoes, or Pasta

What Not to Add to White Rice, Potatoes, or Pasta.jpeg

Rice currently feeds almost half the human population, making it the single most important staple food in the world, but a meta-analysis of seven cohort studies following 350,000 people for up to 20 years found that higher consumption of white rice was associated with a significantly increased risk of type 2 diabetes, especially in Asian populations. They estimated each serving per day of white rice was associated with an 11% increase in risk of diabetes. This could explain why China has almost the same diabetes rates as we do.

Diabetes rates in China are at about 10%; we're at about 11%, despite seven times less obesity in China. Japan has eight times less obesity than we do, yet may have a higher incidence of newly diagnosed diabetes cases than we do--nine per a thousand compared to our eight. They're skinnier and still may have more diabetes. Maybe it's because of all the white rice they eat.

Eating whole fruit is associated with lower risk of diabetes, whereas eating fruit processed into juice may not just be neutral, but actually increases diabetes risk. In the same way, eating whole grains, like whole wheat bread or brown rice is associated with lower risk of diabetes, whereas eating white rice, a processed grain, may not just be neutral, but actually increase diabetes risk.

White rice consumption does not appear to be associated with increased risk of heart attack or stroke, though, which is a relief after an earlier study in China suggested a connection with stroke. But do we want to eat a food that's just neutral regarding some of our leading causes of death, when we can eat whole foods that are associated with lower risk of diabetes, heart attack, stroke, and weight gain?

If the modern diabetes epidemic in China and Japan has been linked to white rice consumption, how can we reconcile that with low diabetes rates just a few decades ago when they ate even more rice? If you look at the Cornell-Oxford-China Project, rural plant-based diets centered around rice were associated with relatively low risk of the so-called diseases of affluence, which includes diabetes. Maybe Asians just genetically don't get the same blood sugar spike when they eat white rice? This is not the case; if anything people of Chinese ethnicity get higher blood sugar spikes.

The rise in these diseases of affluence in China over the last half century has been blamed in part on the tripling of the consumption of animal source foods. The upsurge in diabetes has been most dramatic, and it's mostly just happened over the last decade. That crazy 9.7% diabetes prevalence figure that rivals ours is new--they appeared to have one of the lowest diabetes rates in the world in the year 2000.

So what happened to their diets in the last 20 years or so? Oil consumption went up 20%, pork consumption went up 40%, and rice consumption dropped about 30%. As diabetes rates were skyrocketing, rice consumption was going down, so maybe it's the animal products and junk food that are the problem. Yes, brown rice is better than white rice, but to stop the mounting Asian epidemic, maybe we should focus on removing the cause--the toxic Western diet. That would be consistent with data showing animal protein and fat consumption associated with increased diabetes risk.

But that doesn't explain why the biggest recent studies in Japan and China associate white rice intake with diabetes. One possibility is that animal protein is making the rice worse. If you feed people mashed white potatoes, a high glycemic food like white rice, you can see in my video If White Rice is Linked to Diabetes, What About China? the level of insulin your pancreas has to pump out to keep your blood sugars in check. But what if you added some tuna fish? Tuna doesn't have any carbs, sugar, or starch so it shouldn't make a difference. Or maybe it would even lower the mashed potato spike by lowering the glycemic load of the whole meal? Instead you get twice the insulin spike. This also happens with white flour spaghetti versus white flour spaghetti with meat. The addition of animal protein makes the pancreas work twice as hard.

You can do it with straight sugar water too. If you do a glucose challenge test to test for diabetes, where you drink a certain amount of sugar and add some meat, you get a much bigger spike than without meat. And the more meat you add, the worse it gets. Just adding a little meat to carbs doesn't seem to do much, but once you get up to around a third of a chicken breast's worth, you can elicit a significantly increased surge of insulin. This may help explain why those eating plant-based have such low diabetes rates, because animal protein can markedly potentiate the insulin secretion triggered by carbohydrate ingestion.

The protein exacerbation of the effect of refined carbs could help explain the remarkable results achieved by Dr. Kempner with a don't-try-this-at-home diet composed of mostly white rice and sugar. See my video, Kempner Rice Diet: Whipping Us Into Shape.

Refined grains may also not be good for our blood pressure (see Whole Grains May Work As Well As Drugs).

What should we be eating to best decrease our risk of diabetes? See:

And check out my summary video, How Not to Die from Diabetes.

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: Sally Plank / Flickr. This image has been modified.

Original Link

Reversal of Chronic Disease Risk Even Late in Life

NF-Oct18 Never too Late to Start Eating Healthier.jpeg

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.

Image Credit: victorpr / 123RF

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What About Eating Just a Little Meat?

NF-Oct11 Plant-based Diets and Diabetes.jpeg

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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Where are the Lowest Rates of Alzheimer’s in the World?

NF-Nov12 Alzheimer's Disease  Grain Brain or Meathead.jpg

The rates of dementia differ greatly around the world, from the lowest rates in Africa, India, and South Asia, to the highest rates in Western Europe and especially North America. Is it all just genetics? Well, the incidence of dementia and Alzheimer's disease is significantly lower for Africans in Nigeria than for African Americans in Indianapolis, for example--up to five times lower.

Alzheimer's rates of Japanese-Americans living in the U.S. are closer to that of Americans than to Japanese. When people move from their homeland to the United States, Alzheimer's rates can increase dramatically. Therefore, when Africans or Asians live in the United States and adopt a Western diet, their increase in Alzheimer's risk suggests that it's not genetics.

Unfortunately, one doesn't have to move to the West to adopt a Western diet. The prevalence of dementia in Japan has shot up over the last few decades. Mechanisms to explain this in Japan include increases in cholesterol, saturated fat, and iron from increases in the consumption of animal products. Traditional diets are generally weighted toward vegetable products such as grains and away from animal products. But since 1960, the diet in Japan has changed from a more traditional rice-based diet to one with a preponderance of meat. From 1961 to 2008, meat and animal fat increased considerably, whereas the rice supply dropped. The dietary factor most strongly associated with the rise in Alzheimer's disease in Japan was the increased consumption of animal fat.

A similar analysis in China arrived at the same conclusion. As the authors of the Japan study (highlighted in the video, Alzheimer's Disease: Grain Brain or Meathead?) note, on the basis of these findings, the rate of Alzheimer's disease and dementia will "continue to rise unless dietary patterns change to those with less reliance on animal products." This is consistent with data showing those who eat vegetarian appear two to three times less likely to become demented, and the longer one eats meat-free, the lower the associated risk of dementia.

Globally, the lowest validated rates of Alzheimer's in the world are rural India, where they eat low meat, high grain, high bean, high carb diets. It's possible that the apparent protective association between rice and Alzheimer's is due to the fact that the drop of rice consumption was accompanied by a rise in meat consumption, but other population studies have found that dietary grains appear strongly protective in relation to Alzheimer's disease. In other words, perhaps, don't pass on the grain, but "pass the grain to spare the brain."

A few previous videos on Alzheimer's and maintaining cognitive function:

More on the consequences of carbophobia here:

-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: Bob Peters / Flickr

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How Avoiding Eggs Could Help You Avoid Diabetes

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Type 2 diabetes is becoming a global pandemic. We know the consumption of eggs is related to the development of some other chronic diseases, what about diabetes? There appears to be a stepwise increase in risk as more and more eggs are consumed. One study found that eating just a single egg a week increased the odds of diabetes by 76%. Two eggs a week doubled the odds, and an egg a day tripled the odds.

Recent studies, profiled in my video Eggs and Diabetes, have confirmed the link. In 2009, Harvard researchers found that a single egg a day or more was associated with an increased risk of Type 2 diabetes in men and women. This finding has since been confirmed in Asia in 2011 and in Europe in 2012. Reducing egg consumption should start early in life, though, as it appears once we get into our 70s, it may be too late.

For those with diabetes, eggs may then hasten our death. Eating one egg or more a day appears to shorten anyone's lifespan, but may be even worse for those with diabetes, potentially doubling all-cause mortality, meaning egg-eating diabetics seem to live particularly short lives.

This is not good news for the egg industry. From a transcript of a closed meeting I got through the Freedom of Information Act, one egg industry advisor said, "Given the rate at which obesity and incidence of type II diabetes is growing in the US, any association between dietary cholesterol and type II diabetes could be a 'showstopper' that could overshadow the positive attributes in eggs."

More Freedom of Information Act insights into the egg industry can be found in:

Flax seeds may help control blood sugars (Flaxseeds for Diabetes) as well as Indian gooseberries (Amla Versus Diabetes), but our best bet may be a diet composed entirely of plants (How to Prevent Diabetes and How to Treat Diabetes).

-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, and From Table to Able.

Image Credit: Lif / Flickr

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How to Treat Multiple Sclerosis With Diet

NF-July17 Treating Multiple Sclerosis with Diet.jpg

Multiple sclerosis is an unpredictable and frightening degenerative autoimmune inflammatory disease of the central nervous system in which our body attacks our own nerves. It often strikes in the prime of life and can cause symptoms in the brain, such as cognitive impairment; in the eye, such as painful loss of vision; as well as tremors, weakness, loss of bladder control, pain, and fatigue.

The most frequently prescribed drug for multiple sclerosis is interferon beta, which can make one feel lousy and cost $30,000 a year. But hey, it might be worthwhile--if it actually worked. We learned recently that it doesn't seem to prevent or delay long-term disability. That leaves chemo drugs like mitoxantrone that causes irreversible heart damage in one out of every eight people who go on the drug and causes cancer (leukemia) in nearly 1% of people who take it. But MS is no walk in the park either.

If only there was a cheap, simple, safe, side-effect free solution that also just so happened to be the most effective treatment for MS ever prescribed...

Dr. Roy Swank, who we lost recently at age 99, was a distinguished neurologist whose research culminated in over 170 scientific papers. In the video, Treating Multiple Sclerosis with the Swank MS Diet, I highlight a few.

As far back as 1950, we knew there were areas in the world that had a lot of MS--North America, Europe--and other places--Africa and Asia--that hardly had any. And migration studies show that those who move from a high risk area to a low risk area significantly drop their risk, and vice versa. So it seems less genetic and more lifestyle.

Dr. Swank had an idea. As he recounts in an interview with Dr. John McDougall at the ripe young age of 84, "it seemed possible to me that this could be a matter of food, because the further north you go the less vegetarian a life is led and the more people are carnivores, you might say--they spend a lot more time eating meat."

After looking at the multiple sclerosis data from World War II in occupied countries where meat and dairy were rationed, along with his famous study in '52 that found that the frequency of MS related directly to the amount of saturated animal fat consumed daily in different areas of Norway, he concluded that it might be the animal fat that was causing the increased risk. He decided to put it to the test by restricting people's intake of saturated animal fat, most commonly coming from dairy and chicken in the U.S. (See Trans Fat, Saturated Fat, and Cholesterol: Tolerable Upper Intake of Zero).

In Treating Multiple Sclerosis with the Swank MS Diet, you can see data on his first 47 patients before cutting out about 90% of the saturated fat from their diet and after, showing a decrease in both the frequency and severity of MS attacks. Normally, we're lucky if we can get people to stick to a diet for six months, and so that's why most dietary trials last a year at the most. The first study he published reported results from the first three and a half years.

Then came the five and a half year follow-up in which he added about another 100 patients. Then the seven year follow-up, published in the Annals of Internal Medicine. Then the 20 year follow-up, and then the 34 year follow-up.

How did his patients do? If we can get to people early in their disease, when they're only mildly disabled, and restrict their saturated fat intake, Dr. Swank showed he could stop their disease in 95% of cases--no further disability 34 years later. But if they started slacking on their diet--even years in, their disease could become reactivated. They felt so great that some felt that they could cheat a little bit, since they had their disease so well under control. But eating just eight grams of saturated fat more a day was accompanied by a striking increase in disability and a near tripling of their death rate.

How about a 50 year follow-up! They were able to track down 15 of the original patients that stuck to the diet, now in their 70s and 80s, with multiple sclerosis for over 50 years, and 13 out of 15 were walking around normal in all respects. Conclusion: "This study indicated that, in all probability, MS is caused largely by consumption of saturated animal fat."

Dr. Swank thought it was the sludging of the blood caused by even a single meal of saturated fats that can clog tiny capillaries that feed our nervous system. Diets rich in saturated fat and cholesterol can thicken the blood and make our red cells sticky. A single meal of sausage and eggs can stick our blood cells together like rolls of quarters. And that kind of hyperaggregation can lead to a reduction of blood flow and oxygenation of our tissues. What's in sausage and eggs that may cause so much inflammation? See my video series on endotoxins described in my blog How Does Meat Cause Inflammation?

If we put someone's blood through a machine that sucks out about 90% of the cholesterol in their blood, we can demonstrate an immediate improvement in microcirculation in the heart muscle. But what about the brain?

The eyes are the windows... to our brain. We can visualize--in real-time--changes in blood vessel function in the retina at the back of the eye, which gives us a sense of what's happening further back in the brain. And if we lower the cholesterol level in the blood, we can immediately get a significant improvement in vasodilation--the little veins open wider and let the blood flow.

So yes, it could be the animal fat leading to clogging of our capillaries, but now we know animal fats can have all sorts of other deleterious effects such as inflammation, so who knows what the actual mechanism may be by which cutting animal fat can cut MS progression. Regardless, patients with MS that follow a diet with no more than 10 or 15 grams of saturated fat can expect to survive and thrive to a ripe old age. Of course, cutting out saturated fat completely might be better, given that heart disease is our number one killer.

The bottom line is that the results Dr. Swank published remain "the most effective treatment of multiple sclerosis ever reported in the peer reviewed medical literature." In patients with early stage MS, 95% were without progression of their disease 34 years later after adopting his low saturated fat dietary program. Even patients with initially advanced disease showed significant benefit. To date, no medication or invasive procedure has ever even come close, to demonstrating such success.

Doesn't cost $30,000 dollars; doesn't give you leukemia--and works. Better!

This all begs one big obvious question: If Dr. Swanks results are "so stunningly impressive, why haven't other physicians, neurologists, and centers adopted this method of treatment?" One reason may be that MRI machines weren't invented until the 1970s, decades after Dr. Swank's study began. MRIs are how we track the progress of MS today. We don't have to rely on patients' subjective reports or doctor's clinical judgments, we can see the disease get better or worse right there in black and white.

It's like in the 1970s when Nathan Pritikin appeared to reverse heart disease by the thousands but no one took him seriously until angiography was invented and the likes of Ornish and Esselstyn (see Our Number One Killer Can Be Stopped) could hold up angiographic images, proving conclusively that a plant-based diet could help literally open up arteries.

So what we need is someone to repeat Swank's experiment today with MRI scans every step of the way. And I'm happy to report that exact experiment was just completed by Dr. John McDougall. Dr. Swank was one of Dr. McDougall's heroes, and Dr. McDougall is one of mine. Study enrollment was completed last year and we should have the full results soon.

I touched on this in my live 2013 year-in-review lecture More Than an Apple a Day, but I'm excited to be able to take a deeper dive into this extraordinary story.

Those interested in supporting Dr. McDougall's landmark study (headed by Dr. Dennis Bourdette, M.D. and under the supervision of Dr. Vijayshree Yadav) can donate to his nonprofit McDougall Research & Education Foundation (you can also donate to NutritionFacts.org to help keep us bringing you similarly underreported yet life-saving science).

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live 2012 year-in-review presentation Uprooting the Leading Causes of Death.

Image Credit: Theen Moy / Flickr

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Which Seaweed to Help Prevent Breast Cancer?

 

 

 

 

 

 

 

 

Which Seaweed is Protective Against Cancer?

Sushi lovers, rejoice. Nori seaweed may favorably alter estrogen metabolism by modulating women’s gut flora, resulting in decreased breast cancer risk.

As traditional East Asian diets have westernized, breast cancer rates have risen. Some researchers have linked this to a quadrupling of animal product consumption. In my video Which Seaweed Is Most Protective Against Breast Cancer, you can see the breast cancer rate of Japanese women living in Japan. Within 10 years of immigrating to the United States, their risk increases, and if they hang around long enough, their risk goes up even more, although it is still somewhat lower than the U.S. national average. This may be because of some of the dietary habits they carry with them—soy and green tea consumption, perhaps eating more mushrooms and seaweed.

We’ve known for over a decade that in vitro (in a Petri dish) seaweed broth is effective at clearing cancer cells. In the video, you can see three different types of human breast cancer exposed to either a widely used chemotherapy drug or a sea vegetable. The seaweed worked better. And unlike the chemo, it didn’t hurt normal, non-cancerous breast cells. What about outside of the test tube, in people?

Well, a population study comparing women with breast cancer to women without found that consuming a single sheet of nori a day may cut a woman’s odds of breast cancer in half. We think it’s because seaweed favorably alters estrogen metabolism, likely due to modulating women’s gut bacteria. The more seaweed we eat, the less estrogen we have in our system, which may lower breast cancer risk.

The breast cancer protection may be because of all the fiber in sea vegetables, or because seaweed may block the enzyme that undermines our body’s attempt to flush out excess hormones. Or seaweed may somehow interfere with estrogen binding to estrogen receptors. Whatever the cause, to effectively lower their estrogen levels, Asian women may be able to get away with about one sheet of nori a day, but American women are physically so much larger that it may take closer to two. There are lots of yummy seaweed snacks out there to make it a tasty experience—just try to get some low-fat, low-sodium ones. They’re just like kale chips, munchies made out of dark green leafy vegetables—can’t beat that!

For more on lowering breast cancer through diet:

The seaweed used fresh in seaweed salads, wakame, unfortunately did not appear to reduce breast cancer risk. Wakame consumption has, however, been found to lower blood pressure in hypertensives (people with high blood pressure). Just two teaspoons of seaweed salad a day for a month dropped people’s blood pressure 14 points, and two months of wakame was associated with up to a two inch skinnier waistline.

As I’ve mentioned before, I’d recommend avoiding hijike, which tends to have too much arsenic (see Avoiding Iodine Deficiency), and kelp, which tends to have too much iodine (see Too Much Iodine Can Be as Bad as Too Little). In fact, too much seaweed of any type may actually increase our risk for thyroid cancer because of the amount of iodine we’d be taking in, but there does not appear to be any increased risk at the levels of consumption I’m talking about, like a sheet of nori every day. And a study of seaweed eaters in California actually found decreased risk, but, again, we’re talking a modest level of intake.

I’ve frequently talked about the benefits of dietary diversity, eating different families of fruits and vegetables, eating different parts of individual plants—such as beets and beet greens. If we just stick to land plants, though, we’re missing out on all the plants from the other 70% of planet earth. Sea vegetables have phytonutrients found nowhere else, special types of fiber, and unique carotenoids and polysaccharides, and various polyphenol defense compounds, each of which may have anti-cancer properties. I encourage everyone to try experimenting until you find a sea vegetable you like, even if that means just sprinkling some powdered dulse on your food. More on the importance of dietary diversity in Garden Variety Anti-Inflammation, Apples and Oranges: Dietary Diversity, and Constructing a Cognitive Portfolio.

For more on some of the other protective dietary components in the diets of Japanese women, check out Why Do Asian Women Have Less Breast Cancer? and Breast Cancer Survival and Soy.

And if you enjoy anti-cancer comparison videos, make sure to also check out Which Fruit Fights Cancer Better? and #1 Anticancer Vegetable.

-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: srsldy / Flickr

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