Chocolate is Finally Put to the Test

Oct 10 Chocolate copy.jpeg

Botanically speaking, seeds are small embryonic plants--the whole plant stuffed into a tiny seed and surrounded by an outer layer packed with vitamins, minerals, and phytochemicals to protect the seedling plant's DNA from free radicals. No wonder they're so healthy. By seeds, using the formal definition, we're talking all whole grains; grains are seeds--you plant them and they grow. Nuts are just dry fruits with one or two seeds. Legumes (beans, peas, and lentils) are seeds, too, as are cocoa and coffee beans. So, finding health-promoting effects in something like cocoa or coffee should not be all that surprising. There is substantial evidence that increased consumption of all these little plants is associated with lower risk of cardiovascular disease.

Of course, much of chocolate research is just on how to get consumers to eat more. While it didn't seem to matter what kind of music people were listening to when it came to the flavor intensity, pleasantness, or texture of a bell pepper, people liked chocolate more when listening to jazz than classical, rock, or hip hop. Why is this important? So food industries can "integrate specific musical stimuli" in order to maximize their profits. For example, purveyors may play jazz in the background to increase consumers' acceptance of their chocolates. Along these lines, another study demonstrated that people rated the oyster eaten "more pleasant in the presence of the 'sound of the sea' than in the presence of 'farmyard noises.'"

You'd think chocolate would just sell itself, given that it's considered the most commonly craved food in the world. The same degree of interest doesn't seem to exist as to whether or not Brussels sprouts might provide similar cardiovascular protection. So, it's understandable to hope chocolate provides health benefits. Meanwhile, despite their known benefits, Brussels sprouts don't get the love they deserve.

One of the potential downsides of chocolate is weight gain, which is the subject of my Does Chocolate Cause Weight Gain? video. Though cocoa hardly has any calories, chocolate is one of the most calorie-dense foods. For example: A hundred calories of chocolate is less than a quarter of a bar, compared to a hundred calories of strawberries, which is more than two cups..

A few years ago, a study funded by the National Confectioners Association--an organization that, among other things, runs the website voteforcandy.com--reported that Americans who eat chocolate weigh, on average, four pounds less than those who don't. But maybe chocolate-eaters exercise more or eat more fruits and vegetables. The researchers didn't control for any of that.

The findings of a more recent study published in the Archives of Internal Medicine were less easy to dismiss and there were no apparent ties to Big Chocolate. The researchers reported that out of a thousand men and women they studied in San Diego, those who frequently consumed chocolate had a lower BMI--actually weighed less--than those who ate chocolate less often. And this was even after adjusting for physical activity and diet quality. But, it was a cross-sectional study, meaning a snapshot in time, so you can't prove cause and effect. Maybe not eating chocolate leads to being fatter, or maybe being fatter leads to not eating chocolate. Maybe people who are overweight are trying to cut down on sweets. What we need is a study in which people are followed over time.

There was no such prospective study, until now. More than 10,000 people were followed for six years, and a chocolate habit was associated with long-term weight gain in a dose-response manner. This means the greatest weight gain over time was seen in those with the highest frequency of chocolate intake. It appears the reason the cross-sectional studies found the opposite is that subjects diagnosed with obesity-related illnesses tended to reduce their intake of things like chocolate in an attempt to improve their prognosis. This explains why heavier people may, on average, eat less chocolate.

To bolster this finding came the strongest type of evidence--an interventional trial--in which you split people up into two groups and change half their diets. Indeed, adding four squares of chocolate to peoples' daily diets does appear to add a few pounds.

So, what do we tell our patients? In 2013, researchers wrote in the American Family Physician journal that "because many cocoa products are high in sugar and saturated fat, family physicians should refrain from recommending cocoa...." That's a little patronizing, though. You can get the benefits of chocolate without any sugar or fat by adding cocoa powder to a smoothie, for example. Too often, doctors think patients can't handle the truth. Case in point: If your patients inquire, one medical journal editorial suggest, ask them what type of chocolate they prefer. If they respond with milk chocolate, then it is best to answer that it is not good for them. If the answer is dark chocolate, then you can lay out the evidence.


Even better than dark chocolate would be cocoa powder, which contains the phytonutrients without the saturated fat. I've happily (and deliciously) created other videos on cocoa and chocolate, so check out Update on Chocolate, Healthiest Chocolate Fix, A Treatment for Chronic Fatigue Syndrome, and Dark Chocolate and Artery Function.

Whether with Big Candy, Big Chocolate, or some other player, you always have to be careful about conflict of interest. For more information, watch my Food Industry Funded Research Bias video.

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:

Original Link

Chocolate is Finally Put to the Test

Oct 10 Chocolate copy.jpeg

Botanically speaking, seeds are small embryonic plants--the whole plant stuffed into a tiny seed and surrounded by an outer layer packed with vitamins, minerals, and phytochemicals to protect the seedling plant's DNA from free radicals. No wonder they're so healthy. By seeds, using the formal definition, we're talking all whole grains; grains are seeds--you plant them and they grow. Nuts are just dry fruits with one or two seeds. Legumes (beans, peas, and lentils) are seeds, too, as are cocoa and coffee beans. So, finding health-promoting effects in something like cocoa or coffee should not be all that surprising. There is substantial evidence that increased consumption of all these little plants is associated with lower risk of cardiovascular disease.

Of course, much of chocolate research is just on how to get consumers to eat more. While it didn't seem to matter what kind of music people were listening to when it came to the flavor intensity, pleasantness, or texture of a bell pepper, people liked chocolate more when listening to jazz than classical, rock, or hip hop. Why is this important? So food industries can "integrate specific musical stimuli" in order to maximize their profits. For example, purveyors may play jazz in the background to increase consumers' acceptance of their chocolates. Along these lines, another study demonstrated that people rated the oyster eaten "more pleasant in the presence of the 'sound of the sea' than in the presence of 'farmyard noises.'"

You'd think chocolate would just sell itself, given that it's considered the most commonly craved food in the world. The same degree of interest doesn't seem to exist as to whether or not Brussels sprouts might provide similar cardiovascular protection. So, it's understandable to hope chocolate provides health benefits. Meanwhile, despite their known benefits, Brussels sprouts don't get the love they deserve.

One of the potential downsides of chocolate is weight gain, which is the subject of my Does Chocolate Cause Weight Gain? video. Though cocoa hardly has any calories, chocolate is one of the most calorie-dense foods. For example: A hundred calories of chocolate is less than a quarter of a bar, compared to a hundred calories of strawberries, which is more than two cups..

A few years ago, a study funded by the National Confectioners Association--an organization that, among other things, runs the website voteforcandy.com--reported that Americans who eat chocolate weigh, on average, four pounds less than those who don't. But maybe chocolate-eaters exercise more or eat more fruits and vegetables. The researchers didn't control for any of that.

The findings of a more recent study published in the Archives of Internal Medicine were less easy to dismiss and there were no apparent ties to Big Chocolate. The researchers reported that out of a thousand men and women they studied in San Diego, those who frequently consumed chocolate had a lower BMI--actually weighed less--than those who ate chocolate less often. And this was even after adjusting for physical activity and diet quality. But, it was a cross-sectional study, meaning a snapshot in time, so you can't prove cause and effect. Maybe not eating chocolate leads to being fatter, or maybe being fatter leads to not eating chocolate. Maybe people who are overweight are trying to cut down on sweets. What we need is a study in which people are followed over time.

There was no such prospective study, until now. More than 10,000 people were followed for six years, and a chocolate habit was associated with long-term weight gain in a dose-response manner. This means the greatest weight gain over time was seen in those with the highest frequency of chocolate intake. It appears the reason the cross-sectional studies found the opposite is that subjects diagnosed with obesity-related illnesses tended to reduce their intake of things like chocolate in an attempt to improve their prognosis. This explains why heavier people may, on average, eat less chocolate.

To bolster this finding came the strongest type of evidence--an interventional trial--in which you split people up into two groups and change half their diets. Indeed, adding four squares of chocolate to peoples' daily diets does appear to add a few pounds.

So, what do we tell our patients? In 2013, researchers wrote in the American Family Physician journal that "because many cocoa products are high in sugar and saturated fat, family physicians should refrain from recommending cocoa...." That's a little patronizing, though. You can get the benefits of chocolate without any sugar or fat by adding cocoa powder to a smoothie, for example. Too often, doctors think patients can't handle the truth. Case in point: If your patients inquire, one medical journal editorial suggest, ask them what type of chocolate they prefer. If they respond with milk chocolate, then it is best to answer that it is not good for them. If the answer is dark chocolate, then you can lay out the evidence.


Even better than dark chocolate would be cocoa powder, which contains the phytonutrients without the saturated fat. I've happily (and deliciously) created other videos on cocoa and chocolate, so check out Update on Chocolate, Healthiest Chocolate Fix, A Treatment for Chronic Fatigue Syndrome, and Dark Chocolate and Artery Function.

Whether with Big Candy, Big Chocolate, or some other player, you always have to be careful about conflict of interest. For more information, watch my Food Industry Funded Research Bias video.

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:

Original Link

How Much Water Should We Drink Every Day?

How Much Water Should We Drink Every Day?.jpeg

More than 2000 years ago Hippocrates (460-377 BCE) said, "If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health." What does that mean when it comes to water? Water has been described as a neglected, unappreciated, and under-researched subject, and further complicating the issue, a lot of the papers extolling the need for proper hydration are funded by the bottled water industry.

It turns out the often quoted "drink at least eight glasses of water a day" dictum has little underpinning scientific evidence . Where did that idea come from? The recommendation was traced to a 1921 paper, in which the author measured his own pee and sweat and determined we lose about 3% of our body weight in water a day, or about 8 cups (see How Many Glasses of Water Should We Drink in a Day?). Consequently, for the longest time, water requirement guidelines for humanity were based on just one person.

There is evidence that not drinking enough may be associated with falls and fractures, heat stroke, heart disease, lung disorders, kidney disease, kidney stones, bladder and colon cancer, urinary tract infections, constipation, dry mouth, cavities, decreased immune function and cataract formation. The problem with many of these studies is that low water intake is associated with several unhealthy behaviors, such as low fruit and vegetable intake, more fast-food, less shopping at farmers markets. And who drinks lots of water? People who exercise a lot. No wonder they tend to have lower disease rates!

Only large and expensive randomized trials could settle these questions definitively. Given that water cannot be patented, such trials seem unlikely; who's going to pay for them? We're left with studies that find an association between disease and low water intake. But are people sick because they drink less, or are they drinking less because they're sick? There have been a few large prospective studies in which fluid intake is measured before disease develops. For example, a Harvard study of 48,000 men found that the risk of bladder cancer decreased by 7% for every extra daily cup of fluid we drink. Therefore, a high intake of water--like 8 cups a day--may reduce the risk of bladder cancer by about 50%, potentially saving thousands of lives.

The accompanying editorial commented that strategies to prevent the most prevalent cancers in the West are remarkably straightforward in principle. To prevent lung cancer, quit smoking; to prevent breast cancer, maintain your ideal body weight and exercise; and to prevent skin cancer, stay out of the sun. Now comes this seemingly simple way to reduce the risk of bladder cancer: drink more fluids.

Probably the best evidence we have for a cut off of water intake comes from the Adventist Health Study, in which 20,000 men and women were studied. About one-half were vegetarian, so they were also getting extra water by eating more fruits and vegetables. Those drinking 5 or more glasses of water a day had about half the risk of dying from heart disease compared to those who drank 2 or fewer glasses a day. Like the Harvard study, this protection was found after controlling for other factors such as diet and exercise. These data suggest that it was the water itself that was decreasing risk, perhaps by lowering blood viscosity (blood thickness).

Based on all the best evidence to date, authorities from Europe, the U.S. Institute of Medicine, and the World Health Organization recommend between 2.0 and 2.7 liters (8 to 11 cups) of water a day for women, and 2.5 to 3.7 liters (10 to 15 cups) a day for men. This includes water from all sources, not just beverages. We get about a liter from food and the water our body makes. So this translates into a recommendation for women to drink 4 to 7 cups of water a day and men 6 to 11 cups, assuming only moderate physical activity at moderate ambient temperatures.

We can also get water from all the other drinks we consume, including caffeinated drinks, with the exception of stronger alcoholic drinks like wines and spirits. Beer can leave you with more water than you started with, but wine actively dehydrates you. However, in the cancer and heart disease studies I mentioned above, the benefits were only found with increased water consumption, not other beverages.

I've previously touched on the cognitive benefits of proper hydration here: Does a Drink Of Water Make Children Smarter?

Surprised tea is hydrating? See my video Is Caffeinated Tea Dehydrating?

Surprised that the 8-a-day rested on such flimsy evidence? Unfortunately, so much of what we do in medicine has shaky underpinnings. That's the impetus behind the idea of evidence-based medicine (what a concept!). Ironically, this new movement may itself undermine some of the most effective treatments. See Evidence-Based Medicine or Evidence-Biased?

How else can we reduce our risk of bladder cancer? See Raw Broccoli and Bladder Cancer Survival.

What kind of water? I recommend tap water, which tends to be preferable from a chemical and microbial contamination standpoint. What about buying one of those fancy alkalizing machines? See Alkaline Water: a Scam?

It's so nice to have data on such a fundamental question. We have much to thank the Adventists for. You will see their studies cropping up frequently. See, for example, Plant-Based Diets and Diabetes, The Okinawa Diet: Living to 100, and Evidence-Based Eating.

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. Image has been modified.

Original Link

How Much Water Should We Drink Every Day?

How Much Water Should We Drink Every Day?.jpeg

More than 2000 years ago Hippocrates (460-377 BCE) said, "If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health." What does that mean when it comes to water? Water has been described as a neglected, unappreciated, and under-researched subject, and further complicating the issue, a lot of the papers extolling the need for proper hydration are funded by the bottled water industry.

It turns out the often quoted "drink at least eight glasses of water a day" dictum has little underpinning scientific evidence . Where did that idea come from? The recommendation was traced to a 1921 paper, in which the author measured his own pee and sweat and determined we lose about 3% of our body weight in water a day, or about 8 cups (see How Many Glasses of Water Should We Drink in a Day?). Consequently, for the longest time, water requirement guidelines for humanity were based on just one person.

There is evidence that not drinking enough may be associated with falls and fractures, heat stroke, heart disease, lung disorders, kidney disease, kidney stones, bladder and colon cancer, urinary tract infections, constipation, dry mouth, cavities, decreased immune function and cataract formation. The problem with many of these studies is that low water intake is associated with several unhealthy behaviors, such as low fruit and vegetable intake, more fast-food, less shopping at farmers markets. And who drinks lots of water? People who exercise a lot. No wonder they tend to have lower disease rates!

Only large and expensive randomized trials could settle these questions definitively. Given that water cannot be patented, such trials seem unlikely; who's going to pay for them? We're left with studies that find an association between disease and low water intake. But are people sick because they drink less, or are they drinking less because they're sick? There have been a few large prospective studies in which fluid intake is measured before disease develops. For example, a Harvard study of 48,000 men found that the risk of bladder cancer decreased by 7% for every extra daily cup of fluid we drink. Therefore, a high intake of water--like 8 cups a day--may reduce the risk of bladder cancer by about 50%, potentially saving thousands of lives.

The accompanying editorial commented that strategies to prevent the most prevalent cancers in the West are remarkably straightforward in principle. To prevent lung cancer, quit smoking; to prevent breast cancer, maintain your ideal body weight and exercise; and to prevent skin cancer, stay out of the sun. Now comes this seemingly simple way to reduce the risk of bladder cancer: drink more fluids.

Probably the best evidence we have for a cut off of water intake comes from the Adventist Health Study, in which 20,000 men and women were studied. About one-half were vegetarian, so they were also getting extra water by eating more fruits and vegetables. Those drinking 5 or more glasses of water a day had about half the risk of dying from heart disease compared to those who drank 2 or fewer glasses a day. Like the Harvard study, this protection was found after controlling for other factors such as diet and exercise. These data suggest that it was the water itself that was decreasing risk, perhaps by lowering blood viscosity (blood thickness).

Based on all the best evidence to date, authorities from Europe, the U.S. Institute of Medicine, and the World Health Organization recommend between 2.0 and 2.7 liters (8 to 11 cups) of water a day for women, and 2.5 to 3.7 liters (10 to 15 cups) a day for men. This includes water from all sources, not just beverages. We get about a liter from food and the water our body makes. So this translates into a recommendation for women to drink 4 to 7 cups of water a day and men 6 to 11 cups, assuming only moderate physical activity at moderate ambient temperatures.

We can also get water from all the other drinks we consume, including caffeinated drinks, with the exception of stronger alcoholic drinks like wines and spirits. Beer can leave you with more water than you started with, but wine actively dehydrates you. However, in the cancer and heart disease studies I mentioned above, the benefits were only found with increased water consumption, not other beverages.

I've previously touched on the cognitive benefits of proper hydration here: Does a Drink Of Water Make Children Smarter?

Surprised tea is hydrating? See my video Is Caffeinated Tea Dehydrating?

Surprised that the 8-a-day rested on such flimsy evidence? Unfortunately, so much of what we do in medicine has shaky underpinnings. That's the impetus behind the idea of evidence-based medicine (what a concept!). Ironically, this new movement may itself undermine some of the most effective treatments. See Evidence-Based Medicine or Evidence-Biased?

How else can we reduce our risk of bladder cancer? See Raw Broccoli and Bladder Cancer Survival.

What kind of water? I recommend tap water, which tends to be preferable from a chemical and microbial contamination standpoint. What about buying one of those fancy alkalizing machines? See Alkaline Water: a Scam?

It's so nice to have data on such a fundamental question. We have much to thank the Adventists for. You will see their studies cropping up frequently. See, for example, Plant-Based Diets and Diabetes, The Okinawa Diet: Living to 100, and Evidence-Based Eating.

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. 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

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 Food for MGUS to Prevent Multiple Myeloma

Best Food for MGUS to Prevent Multiple Myeloma.jpeg

Multiple myeloma is one of our most dreaded cancers. It's a cancer of our antibody-producing plasma cells, and is considered one of our most intractable blood diseases. The precursor disease is called monoclonal gammopathy of undetermined significance (MGUS). When it was named, it's significance was undetermined, but now we know that multiple myeloma is almost always preceded by MGUS. This makes MGUS one of the most common premalignant disorders, with a prevalence of about 3% in the older white general population, and about 2 to 3 times that in African-American populations.

MGUS itself is asymptomatic, you don't even know you have it until your doctor finds it incidentally doing routine bloodwork. But should it progress to multiple myeloma, you only have about four years to live. So we need to find ways to treat MGUS early, before it turns into cancer. Unfortunately, no such treatment exists. Rather, patients are just placed in a kind of holding pattern with frequent check-ups. If all we're going to do is watch and wait, researchers figured to might as well try some dietary changes.

One such dietary change is adding curcumin, the yellow pigment in the spice turmeric. Why curcumin? It's relatively safe, considering that it has been consumed as a dietary spice for centuries. And it kills multiple myeloma cells. In my video Turmeric Curcumin, MGUS, & Multiple Myeloma, you can see the unimpeded growth of four different cell lines of multiple myeloma. We start out with about 5000 cancer cells at the beginning of the week, which then that doubles, triples, and quadruples in a matter of days. If we add a little bit of curcumin, growth is stunted. If we add a lot of curcumin, growth is stopped. This was in a petri dish, but it is exciting enough to justify trying curcumin in a clinical trial. And six years later, researchers did.

We can measure the progression of the disease by the rise in blood levels of paraprotein, which is what's made by MGUS and myeloma cells. About 1 in 3 of the patients responded to the curcumin with dropping paraprotein levels, whereas there were no responses in the placebo group. These positive findings prompted researchers to commence a double-blind, randomized, controlled trial. The same kind of positive biomarker response was seen in both MGUS patients as well as those with so-called "smoldering" multiple myeloma, an early stage of the cancer. These findings suggest that curcumin might have the potential to slow the disease process in patients, delaying or preventing the progression of MGUS to multiple myeloma. However, we won't know for sure until longer larger studies are done.

The best way to deal with multiple myeloma is to not get it in the first place. In my 2010 video Meat & Multiple Myeloma, I profiled a study suggesting that vegetarians have just a quarter the risk of multiple myeloma compared to meat-eaters. Even just working with chicken meat may double one's risk of multiple myeloma, the thinking being that cancers like leukemias, lymphomas, and myelomas may be induced by so-called zoonotic (animal-to-human) cancer-causing viruses found in both cattle and chickens. Beef, however, was not associated with multiple myeloma.

There are, however, some vegetarian foods we may want to avoid. Harvard researchers reported a controversial link between diet soda and multiple myeloma, implicating aspartame. Studies suggest french fries and potato chips should not be the way we get our vegetables, nor should we probably pickle them. While the intake of shallots, garlic, soy foods, and green tea was significantly associated with a reduced risk of multiple myeloma, intake of pickled vegetables three times a week or more was associated with increased risk.

For dietary links to other blood cancers, see EPIC Findings on Lymphoma.

The turmeric story just never seems to end. I recommend a quarter teaspoon a day:

Why might garlic and tea help? See Cancer, Interrupted: Garlic & Flavonoids and Cancer Interrupted, Green Tea.

More on the effects of NutraSweet in Aspartame and the Brain and acrylamide in Cancer Risk From French Fries.

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. Image has been modified.

Original Link

Best Food for MGUS to Prevent Multiple Myeloma

Best Food for MGUS to Prevent Multiple Myeloma.jpeg

Multiple myeloma is one of our most dreaded cancers. It's a cancer of our antibody-producing plasma cells, and is considered one of our most intractable blood diseases. The precursor disease is called monoclonal gammopathy of undetermined significance (MGUS). When it was named, it's significance was undetermined, but now we know that multiple myeloma is almost always preceded by MGUS. This makes MGUS one of the most common premalignant disorders, with a prevalence of about 3% in the older white general population, and about 2 to 3 times that in African-American populations.

MGUS itself is asymptomatic, you don't even know you have it until your doctor finds it incidentally doing routine bloodwork. But should it progress to multiple myeloma, you only have about four years to live. So we need to find ways to treat MGUS early, before it turns into cancer. Unfortunately, no such treatment exists. Rather, patients are just placed in a kind of holding pattern with frequent check-ups. If all we're going to do is watch and wait, researchers figured to might as well try some dietary changes.

One such dietary change is adding curcumin, the yellow pigment in the spice turmeric. Why curcumin? It's relatively safe, considering that it has been consumed as a dietary spice for centuries. And it kills multiple myeloma cells. In my video Turmeric Curcumin, MGUS, & Multiple Myeloma, you can see the unimpeded growth of four different cell lines of multiple myeloma. We start out with about 5000 cancer cells at the beginning of the week, which then that doubles, triples, and quadruples in a matter of days. If we add a little bit of curcumin, growth is stunted. If we add a lot of curcumin, growth is stopped. This was in a petri dish, but it is exciting enough to justify trying curcumin in a clinical trial. And six years later, researchers did.

We can measure the progression of the disease by the rise in blood levels of paraprotein, which is what's made by MGUS and myeloma cells. About 1 in 3 of the patients responded to the curcumin with dropping paraprotein levels, whereas there were no responses in the placebo group. These positive findings prompted researchers to commence a double-blind, randomized, controlled trial. The same kind of positive biomarker response was seen in both MGUS patients as well as those with so-called "smoldering" multiple myeloma, an early stage of the cancer. These findings suggest that curcumin might have the potential to slow the disease process in patients, delaying or preventing the progression of MGUS to multiple myeloma. However, we won't know for sure until longer larger studies are done.

The best way to deal with multiple myeloma is to not get it in the first place. In my 2010 video Meat & Multiple Myeloma, I profiled a study suggesting that vegetarians have just a quarter the risk of multiple myeloma compared to meat-eaters. Even just working with chicken meat may double one's risk of multiple myeloma, the thinking being that cancers like leukemias, lymphomas, and myelomas may be induced by so-called zoonotic (animal-to-human) cancer-causing viruses found in both cattle and chickens. Beef, however, was not associated with multiple myeloma.

There are, however, some vegetarian foods we may want to avoid. Harvard researchers reported a controversial link between diet soda and multiple myeloma, implicating aspartame. Studies suggest french fries and potato chips should not be the way we get our vegetables, nor should we probably pickle them. While the intake of shallots, garlic, soy foods, and green tea was significantly associated with a reduced risk of multiple myeloma, intake of pickled vegetables three times a week or more was associated with increased risk.

For dietary links to other blood cancers, see EPIC Findings on Lymphoma.

The turmeric story just never seems to end. I recommend a quarter teaspoon a day:

Why might garlic and tea help? See Cancer, Interrupted: Garlic & Flavonoids and Cancer Interrupted, Green Tea.

More on the effects of NutraSweet in Aspartame and the Brain and acrylamide in Cancer Risk From French Fries.

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. Image has been modified.

Original Link

What Are the Benefits of Organic?

What Are the Benefits of Organic?.jpeg

The medical literature has been historically hostile to organic foods, blaming in part erroneous information supplied by the health food movement for our ignorance of nutrition. But until just a few generations ago, all food was organic. It's kind of ironic that what we now call conventional food really isn't very conventional for our species.

By eating organic we can reduce our exposure to pesticides, but it remains unclear whether such a reduction in exposure is clinically relevant. In my video, Are Organic Foods Safer?, I talked about some of the test tube studies comparing health-related properties of organic versus conventional foods. Organic produce was found to have higher antioxidant and antimutagenic activity combined with better inhibition of cancer cell proliferation, but in terms of studies on actual people rather than petri dishes, there isn't much science either way.

Why can't you just compare the health of those who buy organic to those who don't? Organic consumers do report being significantly healthier than conventional consumers, but they also tend to eat more plant foods in general and less soda and alcohol, processed meat, or milk, and just eat healthier in general. No wonder they feel so much better!

Therefore, there is an urgent need for interventional trials, or studies following cohorts of people eating organic over time like the Million Women Study in the UK, which was the first to examine the association between the consumption of organic food and subsequent risk of cancer. The only significant risk reduction they found, though, was for non-Hodgkin's lymphoma. This is consistent with data showing a higher risk of developing lymphoma in those who have higher levels of pesticides stored in their butt fat, a study undertaken because farmworkers have been found to have higher rates of lymphoma.

Parental farmworker exposure is also associated with a birth defect of the penis called hypospadias, and so researchers decided to see if moms who failed to choose organic were at increased risk. Indeed they found that frequent consumption of conventional high-fat dairy products was associated with about double the odds of the birth defect. This could just be because those that choose organic have other related healthy behaviors, or it could be that high-fat foods like dairy products bioamplify the fat-soluble toxins in our environment.

In my video, Are Organic Foods Healthier?, you can see two other general population pesticide studies that have raised concerns. One study found about a 50 to 70% increase in the odds of ADHD among children with pesticide levels in their urine, and another that found triple the odds of testicular cancer among men with higher levels of organochlorine pesticides in their blood. 90% of such pollutants come from fish, meat, and dairy, which may help explain rising testicular cancer rates in many western countries since World War II.

What about interventional trials? All we have in the medical literature so far are studies showing organically grown food provides health benefits to fruit flies raised on diets of conventional versus organic produce when subjected to a variety of tests designed to assess overall fly health. And what do you know--flies raised on diets made from organically grown produce lived longer. Hmm, insects eating insecticides don't do as well. Not exactly much of a breakthrough!


For how to best get pesticides off of conventional produce, see my video How to Make Your Own Fruit and Vegetable Wash.

Pesticides are one thing, but Are Organic Foods More Nutritious?

Overall, Are the Benefits of Organic Food Underrated or Overrated?

For more on the impact of food contaminants during pregnancy, see:

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 Are the Benefits of Organic?

What Are the Benefits of Organic?.jpeg

The medical literature has been historically hostile to organic foods, blaming in part erroneous information supplied by the health food movement for our ignorance of nutrition. But until just a few generations ago, all food was organic. It's kind of ironic that what we now call conventional food really isn't very conventional for our species.

By eating organic we can reduce our exposure to pesticides, but it remains unclear whether such a reduction in exposure is clinically relevant. In my video, Are Organic Foods Safer?, I talked about some of the test tube studies comparing health-related properties of organic versus conventional foods. Organic produce was found to have higher antioxidant and antimutagenic activity combined with better inhibition of cancer cell proliferation, but in terms of studies on actual people rather than petri dishes, there isn't much science either way.

Why can't you just compare the health of those who buy organic to those who don't? Organic consumers do report being significantly healthier than conventional consumers, but they also tend to eat more plant foods in general and less soda and alcohol, processed meat, or milk, and just eat healthier in general. No wonder they feel so much better!

Therefore, there is an urgent need for interventional trials, or studies following cohorts of people eating organic over time like the Million Women Study in the UK, which was the first to examine the association between the consumption of organic food and subsequent risk of cancer. The only significant risk reduction they found, though, was for non-Hodgkin's lymphoma. This is consistent with data showing a higher risk of developing lymphoma in those who have higher levels of pesticides stored in their butt fat, a study undertaken because farmworkers have been found to have higher rates of lymphoma.

Parental farmworker exposure is also associated with a birth defect of the penis called hypospadias, and so researchers decided to see if moms who failed to choose organic were at increased risk. Indeed they found that frequent consumption of conventional high-fat dairy products was associated with about double the odds of the birth defect. This could just be because those that choose organic have other related healthy behaviors, or it could be that high-fat foods like dairy products bioamplify the fat-soluble toxins in our environment.

In my video, Are Organic Foods Healthier?, you can see two other general population pesticide studies that have raised concerns. One study found about a 50 to 70% increase in the odds of ADHD among children with pesticide levels in their urine, and another that found triple the odds of testicular cancer among men with higher levels of organochlorine pesticides in their blood. 90% of such pollutants come from fish, meat, and dairy, which may help explain rising testicular cancer rates in many western countries since World War II.

What about interventional trials? All we have in the medical literature so far are studies showing organically grown food provides health benefits to fruit flies raised on diets of conventional versus organic produce when subjected to a variety of tests designed to assess overall fly health. And what do you know--flies raised on diets made from organically grown produce lived longer. Hmm, insects eating insecticides don't do as well. Not exactly much of a breakthrough!


For how to best get pesticides off of conventional produce, see my video How to Make Your Own Fruit and Vegetable Wash.

Pesticides are one thing, but Are Organic Foods More Nutritious?

Overall, Are the Benefits of Organic Food Underrated or Overrated?

For more on the impact of food contaminants during pregnancy, see:

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