White Meat May Be as Cholesterol-Raising as Red

White Meat May Be as Cholesterol-Raising as Red.jpeg

In light of recommendations for heart healthy eating from national professional organizations encouraging Americans to limit their intake of meat, the beef industry commissioned and co-wrote a review of randomized controlled trials comparing the effects of beef versus chicken and fish on cholesterol levels published over the last 60 years. They found that the impact of beef consumption on the cholesterol profile of humans is similar to that of fish and/or poultry--meaning that switching from red meat to white meat likely wouldn't make any difference. And that's really no surprise, given how fat we've genetically manipulated chickens to be these days, up to ten times more fat than they had a century ago (see Does Eating Obesity Cause Obesity?).

There are a number of cuts of beef that have less cholesterol-raising saturated fat than chicken (see BOLD Indeed: Beef Lowers Cholesterol?), so it's not so surprising that white meat was found to be no better than red, but the beef industry researchers conclusion was that "therefore you can eat beef as part of a balanced diet to manage your cholesterol."

Think of the Coke versus Pepsi analogy. Coke has less sugar than Pepsi: 15 spoonfuls of sugar per bottle instead of 16. If studies on blood sugar found no difference between drinking Coke versus Pepsi, you wouldn't conclude that "Pepsi may be considered when recommending diets for the management of blood sugars," you'd say they're both equally as bad so we should ideally consume neither.

That's a standard drug industry trick. You don't compare your fancy new drug to the best out there, but to some miserable drug to make yours look better. Note they didn't compare beef to plant proteins, like in this study published in the American Journal of Clinical Nutrition. As I started reading it, though, I was surprised that they found no benefit of switching to a plant protein diet either. What were they eating? You can see the comparison in Switching from Beef to Chicken & Fish May Not Lower Cholesterol.

For breakfast, the plant group got a kidney bean and tomato casserole and a salad, instead of a burger. And for dinner, instead of another burger, the plant protein group just got some boring vegetables. So why was the cholesterol of the plant group as bad as the animal group? They had the plant protein group eating three tablespoons of beef tallow every day--three tablespoons of straight beef fat!

This was part of a series of studies that tried to figure out what was so cholesterol-raising about meat--was it the animal protein or was it the animal fat? So, researchers created fake meat products made to have the same amount of saturated fat and cholesterol by adding extracted animal fats and cholesterol. Who could they get to make such strange concoctions? The Ralston Purina dog food company.

But what's crazy is that even when keeping the saturated animal fat and cholesterol the same (by adding meat fats to the veggie burgers and making the plant group swallow cholesterol pills to equal it out), sometimes they still saw a cholesterol lowering advantage in the plant protein group.

If you switch people from meat to tofu, their cholesterol goes down, but what if you switch them from meat to tofu plus lard? Then their cholesterol may stay the same, though tofu and lard may indeed actually be better than meat, since it may result in less oxidized cholesterol. More on the role of oxidized cholesterol can be found in my videos Does Cholesterol Size Matter? and Arterial Acne.

Just swapping plant protein for animal protein may have advantages, but if you really want to maximize the power of diet to lower cholesterol, you may have to move entirely toward plants. The standard dietary advice to cut down on fatty meat, dairy, and eggs may lower cholesterol 5-10%, but flexitarian or vegetarian diets may drop our levels 10 to 15%, vegan diets 15 to 25%, and healthier vegan diets can cut up to 35%, as seen in this study out of Canada showing a whopping 61 point drop in LDL cholesterol within a matter of weeks.


You thought chicken was a low-fat food? It used to be a century ago, but not anymore. It may even be one of the reasons we're getting fatter as well: Chicken Big: Poultry and Obesity and Infectobesity: Adenovirus 36 and Childhood Obesity.

Isn't protein just protein? How does our body know if it's coming from a plant or an animal? How could it have different effects on cardiovascular risk? See Protein and Heart Disease, another reason why Plant Protein [is] Preferable.

Lowering cholesterol in your blood is as simple as reducing one's intake of three things: Trans Fat, Saturated Fat, and Cholesterol: Tolerable Upper Intake of Zero.

What about those news stories on the "vindication" of saturated fat? See the sneaky science in The Saturated Fat Studies: Buttering Up the Public and The Saturated Fat Studies: Set Up to Fail.

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: CDC/Debora Cartagena via Freestockphotos.biz. This image has been modified.

Original Link

White Meat May Be as Cholesterol-Raising as Red

White Meat May Be as Cholesterol-Raising as Red.jpeg

In light of recommendations for heart healthy eating from national professional organizations encouraging Americans to limit their intake of meat, the beef industry commissioned and co-wrote a review of randomized controlled trials comparing the effects of beef versus chicken and fish on cholesterol levels published over the last 60 years. They found that the impact of beef consumption on the cholesterol profile of humans is similar to that of fish and/or poultry--meaning that switching from red meat to white meat likely wouldn't make any difference. And that's really no surprise, given how fat we've genetically manipulated chickens to be these days, up to ten times more fat than they had a century ago (see Does Eating Obesity Cause Obesity?).

There are a number of cuts of beef that have less cholesterol-raising saturated fat than chicken (see BOLD Indeed: Beef Lowers Cholesterol?), so it's not so surprising that white meat was found to be no better than red, but the beef industry researchers conclusion was that "therefore you can eat beef as part of a balanced diet to manage your cholesterol."

Think of the Coke versus Pepsi analogy. Coke has less sugar than Pepsi: 15 spoonfuls of sugar per bottle instead of 16. If studies on blood sugar found no difference between drinking Coke versus Pepsi, you wouldn't conclude that "Pepsi may be considered when recommending diets for the management of blood sugars," you'd say they're both equally as bad so we should ideally consume neither.

That's a standard drug industry trick. You don't compare your fancy new drug to the best out there, but to some miserable drug to make yours look better. Note they didn't compare beef to plant proteins, like in this study published in the American Journal of Clinical Nutrition. As I started reading it, though, I was surprised that they found no benefit of switching to a plant protein diet either. What were they eating? You can see the comparison in Switching from Beef to Chicken & Fish May Not Lower Cholesterol.

For breakfast, the plant group got a kidney bean and tomato casserole and a salad, instead of a burger. And for dinner, instead of another burger, the plant protein group just got some boring vegetables. So why was the cholesterol of the plant group as bad as the animal group? They had the plant protein group eating three tablespoons of beef tallow every day--three tablespoons of straight beef fat!

This was part of a series of studies that tried to figure out what was so cholesterol-raising about meat--was it the animal protein or was it the animal fat? So, researchers created fake meat products made to have the same amount of saturated fat and cholesterol by adding extracted animal fats and cholesterol. Who could they get to make such strange concoctions? The Ralston Purina dog food company.

But what's crazy is that even when keeping the saturated animal fat and cholesterol the same (by adding meat fats to the veggie burgers and making the plant group swallow cholesterol pills to equal it out), sometimes they still saw a cholesterol lowering advantage in the plant protein group.

If you switch people from meat to tofu, their cholesterol goes down, but what if you switch them from meat to tofu plus lard? Then their cholesterol may stay the same, though tofu and lard may indeed actually be better than meat, since it may result in less oxidized cholesterol. More on the role of oxidized cholesterol can be found in my videos Does Cholesterol Size Matter? and Arterial Acne.

Just swapping plant protein for animal protein may have advantages, but if you really want to maximize the power of diet to lower cholesterol, you may have to move entirely toward plants. The standard dietary advice to cut down on fatty meat, dairy, and eggs may lower cholesterol 5-10%, but flexitarian or vegetarian diets may drop our levels 10 to 15%, vegan diets 15 to 25%, and healthier vegan diets can cut up to 35%, as seen in this study out of Canada showing a whopping 61 point drop in LDL cholesterol within a matter of weeks.


You thought chicken was a low-fat food? It used to be a century ago, but not anymore. It may even be one of the reasons we're getting fatter as well: Chicken Big: Poultry and Obesity and Infectobesity: Adenovirus 36 and Childhood Obesity.

Isn't protein just protein? How does our body know if it's coming from a plant or an animal? How could it have different effects on cardiovascular risk? See Protein and Heart Disease, another reason why Plant Protein [is] Preferable.

Lowering cholesterol in your blood is as simple as reducing one's intake of three things: Trans Fat, Saturated Fat, and Cholesterol: Tolerable Upper Intake of Zero.

What about those news stories on the "vindication" of saturated fat? See the sneaky science in The Saturated Fat Studies: Buttering Up the Public and The Saturated Fat Studies: Set Up to Fail.

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: CDC/Debora Cartagena via Freestockphotos.biz. This image has been modified.

Original Link

Four Ways to Improve on the Mediterranean Diet

Improving on the Mediterranean Diet.jpg

The traditional Mediterranean diet can be considered mainly, but not exclusively, as a plant-based diet, and certainly not a whole foods, plant-based diet. Olive oil and wine can be considered essentially fruit juices. Even if one is eating a "vegiterranean diet," an entirely plant-based version, there are a number of problematic nutritional aspects that are rarely talked about. For example, the Mediterranean diet includes lots of white bread, white pasta and not a lot of whole grains.

In an anatomy of the health effects of the Mediterranean diet, the single most important component was the high consumption of plant foods. In contrast, high cereal consumption, meaning high grain consumption, did not appear to help. This may be because most grains that modern Mediterranean dieters eat are refined, like white bread, whereas the traditional Mediterranean diet was characterized by unprocessed cereals--in other words, whole grains. And while whole grains have been associated with lower risk of diabetes, heart disease and cancer, refined grain may increase the risk of diabetes, obesity, heart disease and other chronic diseases. In the PREDIMED study, those who ate the most white bread--but not whole grain bread--gained significant weight.

Alcohol may also be a problem. As a plant-centered diet, adherence to a Mediterranean diet is associated with lower cancer risk, but does not appear to lower breast cancer risk. With all the fruits, veggies, nuts, seeds, beans and low saturated fat content, you'd assume there would be lower breast cancer risk, but alcohol is a known breast carcinogen, even in moderate amounts. When researchers created a special adapted version of the Mediterranean diet score that excluded alcohol, the diet does indeed appear to reduce breast cancer risk.

The wonderful grape phytonutrients in red wine can improve our arterial function such that if you drink nonalcoholic red wine (wine with the alcohol removed), you get a significant boost in endothelial function--the ability of our arteries to relax and dilate normally, increasing blood flow. If you drink the same red wine with alcohol, it abolishes the beneficial effect and counteracts the benefit of the grape phytonutrients. So, it would be better just to eat grapes. You can find more information about this in my video Improving on the Mediterranean Diet.

Similarly, there are components of extra virgin olive oil--the antioxidant phytonutrients, that may help endothelial function, but when consumed as oil, (even extra virgin olive oil), it may impair arterial function. So even if white bread dipped in olive oil is the very symbol of the Mediterranean diet, we can modernize it by removing oils and refined grains.

Another important, albeit frequently ignored issue in the modern Mediterranean diet is sodium intake. Despite evidence linking salt intake to high blood pressure, heart disease and strokes, dietary salt intake in the U.S. is on the rise. Right now, Americans get about seven to ten grams a day, mostly from processed foods. If we were to decrease that just by three grams every year, we could possibly save tens of thousands of people from having a heart attack, prevent tens of thousands of strokes, and tens of thousands of deaths. There is a common misperception that only certain people should reduce their salt intake and that for the vast majority of the population, salt reduction is unnecessary, but in reality, the opposite is true.

There is much we can learn from the traditional Mediterranean diet. A defining characteristic of the Mediterranean diet is an abundance of plant foods, but one thing that seems to have fallen by the wayside. No main Mediterranean meal is replete without lots of greens, a key part of not only a good Mediterranean diet, but of any good diet.

Here are some of my previous videos on the Mediterranean diet:

I touch more on whole grains in How Many Meet the Simple Seven? and Whole Grains May Work As Well As Drugs.

More on breast cancer and alcohol in Breast Cancer and Alcohol: How Much Is Safe?, Preventing Skin Cancer From the Inside Out, and Breast Cancer Risk: Red Wine v. White Wine.

I've touched on olive oil in the other videos in this Mediterranean diet series, but also have an older video Extra Virgin Olive Oil vs. Nuts and more recently, Olive Oil & Artery Function.

More on sodium in Dietary Guidelines: With a Grain of Big Salt, Big Salt - Getting to the Meat of the Matter, and Can Diet Protect Against Kidney Cancer? But what if without salt everything tastes like cardboard? Not to worry! See Changing Our Taste Buds.

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

Four Ways to Improve on the Mediterranean Diet

Improving on the Mediterranean Diet.jpg

The traditional Mediterranean diet can be considered mainly, but not exclusively, as a plant-based diet, and certainly not a whole foods, plant-based diet. Olive oil and wine can be considered essentially fruit juices. Even if one is eating a "vegiterranean diet," an entirely plant-based version, there are a number of problematic nutritional aspects that are rarely talked about. For example, the Mediterranean diet includes lots of white bread, white pasta and not a lot of whole grains.

In an anatomy of the health effects of the Mediterranean diet, the single most important component was the high consumption of plant foods. In contrast, high cereal consumption, meaning high grain consumption, did not appear to help. This may be because most grains that modern Mediterranean dieters eat are refined, like white bread, whereas the traditional Mediterranean diet was characterized by unprocessed cereals--in other words, whole grains. And while whole grains have been associated with lower risk of diabetes, heart disease and cancer, refined grain may increase the risk of diabetes, obesity, heart disease and other chronic diseases. In the PREDIMED study, those who ate the most white bread--but not whole grain bread--gained significant weight.

Alcohol may also be a problem. As a plant-centered diet, adherence to a Mediterranean diet is associated with lower cancer risk, but does not appear to lower breast cancer risk. With all the fruits, veggies, nuts, seeds, beans and low saturated fat content, you'd assume there would be lower breast cancer risk, but alcohol is a known breast carcinogen, even in moderate amounts. When researchers created a special adapted version of the Mediterranean diet score that excluded alcohol, the diet does indeed appear to reduce breast cancer risk.

The wonderful grape phytonutrients in red wine can improve our arterial function such that if you drink nonalcoholic red wine (wine with the alcohol removed), you get a significant boost in endothelial function--the ability of our arteries to relax and dilate normally, increasing blood flow. If you drink the same red wine with alcohol, it abolishes the beneficial effect and counteracts the benefit of the grape phytonutrients. So, it would be better just to eat grapes. You can find more information about this in my video Improving on the Mediterranean Diet.

Similarly, there are components of extra virgin olive oil--the antioxidant phytonutrients, that may help endothelial function, but when consumed as oil, (even extra virgin olive oil), it may impair arterial function. So even if white bread dipped in olive oil is the very symbol of the Mediterranean diet, we can modernize it by removing oils and refined grains.

Another important, albeit frequently ignored issue in the modern Mediterranean diet is sodium intake. Despite evidence linking salt intake to high blood pressure, heart disease and strokes, dietary salt intake in the U.S. is on the rise. Right now, Americans get about seven to ten grams a day, mostly from processed foods. If we were to decrease that just by three grams every year, we could possibly save tens of thousands of people from having a heart attack, prevent tens of thousands of strokes, and tens of thousands of deaths. There is a common misperception that only certain people should reduce their salt intake and that for the vast majority of the population, salt reduction is unnecessary, but in reality, the opposite is true.

There is much we can learn from the traditional Mediterranean diet. A defining characteristic of the Mediterranean diet is an abundance of plant foods, but one thing that seems to have fallen by the wayside. No main Mediterranean meal is replete without lots of greens, a key part of not only a good Mediterranean diet, but of any good diet.

Here are some of my previous videos on the Mediterranean diet:

I touch more on whole grains in How Many Meet the Simple Seven? and Whole Grains May Work As Well As Drugs.

More on breast cancer and alcohol in Breast Cancer and Alcohol: How Much Is Safe?, Preventing Skin Cancer From the Inside Out, and Breast Cancer Risk: Red Wine v. White Wine.

I've touched on olive oil in the other videos in this Mediterranean diet series, but also have an older video Extra Virgin Olive Oil vs. Nuts and more recently, Olive Oil & Artery Function.

More on sodium in Dietary Guidelines: With a Grain of Big Salt, Big Salt - Getting to the Meat of the Matter, and Can Diet Protect Against Kidney Cancer? But what if without salt everything tastes like cardboard? Not to worry! See Changing Our Taste Buds.

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

Do You Meet the Simple Seven?

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In public health school, you learn there are three levels of preventive medicine. Primary prevention would be like trying to prevent someone at risk for heart disease from getting his or her first heart attack. Secondary prevention is when you already have the disease and are trying to prevent your second heart attack, and tertiary prevention is like cardiac rehab, where you're just trying to reduce the complication rates. A fourth level was suggested in 2000, quaternary prevention, trying to reduce the damage from all the drugs and surgery from the first three levels. But people seem to forget about a fifth concept, introduced by the World Health Organization back in 1978, termed primordial prevention, which is being embraced by the American Heart Association's 2020 strategic impact goals.

Primordial prevention was conceived as a strategy to prevent whole societies from experiencing epidemics of the risk factors. The corresponding strategy at the individual level is to prevent the development of risk factors. Instead of trying to prevent someone with high cholesterol from getting a heart attack, why not prevent them from getting high cholesterol in the first place?

So the American Heart Association came up with the simple seven, featured in my video, How Many Meet the Simple Seven?. These health behaviors or factors include not smoking, not being overweight, being "very active" (defined as walking at least 22 minutes a day), eating a few fruits and veggies, having below average cholesterol, normal blood pressure, and normal blood sugars.

Their goal was to reduce heart disease deaths by 20% by 2020. Why so modest an aim? An improvement of 25% was deemed "unrealistic," and 15% was considered insufficient, so they decided on 20. If 90% of risk can be thrown out the window by engaging in simple lifestyle modifications, why is just 25% considered unrealistic? To understand, one must realize just how bad our diets have gotten.

The most common reason patients give for not complying with a cholesterol-lowering diet may be the presumption that they're already eating healthy and so don't need to change. But if you look at the status of cardiovascular health in U.S. adults, only about 1% of Americans have a bare minimum of healthy eating behaviors, such as five-a-day fruits and veggies, eating beans, whole grains, drinking less than three cans of soda a week, etc. What percentage of Americans hit all seven of the simple seven? 14,000 men and women were surveyed, and most had two or three, but hardly any had all seven simple health components. Just how low a prevalence was having seven out of seven? Only about 1 out of 2,000 Americans had all seen factors intact. And the one they were missing the most was diet.

Unfortunately unhealthy behaviors extend into the medical profession. Just like smoking doctors are less likely to tell their patients to stop smoking, and couch potato docs are less likely to push exercise, or things like more fruits and vegetables; we need to role-model healthy behavior. This greatly enhances our credibility and effectiveness. Gone are the days of traditional authority when the fat physician, dropping cigarette ash down his gravy-stained vest, could credibly prescribe a change in behavior.

So What Diet Should Physicians Recommend? Watch the video!

Lifestyle medicine, the use of diet and lifestyle changes to prevent and treat disease, cannot only be cheaper and safer, but also more effective. See, for example:

I've previously noted just how sad the Standard American Diet is in Nation's Diet in Crisis. See how you compare: Calculate Your Healthy Eating Score.

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.

Original Link

Which Dietary Factors Affect Breast Cancer Most?

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One of my favorite cancer-specific charities, the American Institute for Cancer Research, lauds the China Study and the documentary Forks Over Knives, with which they share the same bottom-line message: The healthiest diets are those that revolve around whole plant foods.

They then translate that advice into their Ten Recommendations for Cancer Prevention, featured in my video Which Dietary Factors Affect Breast Cancer Most? We now have evidence that those who follow such advice are actually protected against cancer. Breast cancer risk was reduced by 60% in women who met at least five recommendations compared with those who met none. The most important dietary advice was to be as lean as possible within the normal range of body weight, eat mostly foods of plant origin, and limit alcoholic drinks.

What about other cancers? Greater adherence to the AICR dietary guidelines was also associated with significantly less endometrial, colorectal, lung, kidney, stomach, oral, liver, and esophageal cancer. In other words, adherence to dietary recommendations for cancer prevention may lower the risk of developing most types of cancer. The drop in bladder cancer did not reach statistical significance, but a larger follow-up study following 469,000 people for 11 years (the largest to date) found that just a 3% increase in the consumption of animal protein calories was associated with a 15% higher risk of bladder cancer, whereas just a 2% increase in plant protein was associated with a 23% lower risk.

AICR recommendation number ten is that cancer survivors should follow the recommendations for cancer prevention. The same diet that can help prevent cancer in the first place can be used to help save our life after diagnosis. Adherence to the guidelines for cancer prevention was found to be associated with lower mortality among older female cancer survivors, or breast cancer and other cancers in general.

A cancer diagnosis is considered a teachable moment to get people eating and living healthier. Oncologists revel at the growth in the number of cancer survivors in this country, now ten million strong and growing. It's great that those with cancer are living longer, but even better to prevent it in the first place so we can all live longer. Not only does adherence to the guidelines lower cancer risk, but extends our lifespan because the guidelines are also significantly associated with a lower hazard of dying from heart disease and respiratory disease, suggesting that following the recommendations could "significantly increase longevity."

Just like eating to prevent cancer helps to prevent heart disease, eating to protect our heart helps prevent cancer. It sounds self-evident, but adherence to a healthy lifestyle is therefore associated with a lower risk of mortality overall. And the more healthy behaviors we have, the longer we get to live. Such factors included not smoking, walking every day, or eating green leafy vegetables almost daily.

To help differentiate the effects of diet from other lifestyle behaviors like smoking and drinking on cancer incidence, Adventists were recently compared to Baptists. Both discourage alcohol and tobacco, but the Adventists go further, encouraging a reduction of meat. In general, the Adventists had lower cancer hazard rates than the Baptists, and within Adventist populations, the vegetarians did even better, and those eating the most plants, did the best.

Why do plant-based diets appear to lower the risk of cancer? A number of fascinating mechanisms:

Specific to breast cancer:

Though plant-based beverages may be harmful: Breast Cancer and Alcohol: How Much Is Safe?

In terms of foods associated with breast cancer survival, 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--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: MesserWoland

Image Credit: [Lev Kropotov] © 123RF.com

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Side-Effects of Aspartame on the Brain

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The National Institutes of Health AARP study of hundreds of thousands of Americans followed for years found that frequent consumption of sweetened beverages, especially diet drinks, may increase depression risk among older adults. Whether soda, fruit-flavored drinks, or iced tea, those artificially sweetened drinks appeared to carry higher risk. There was a benefit in coffee drinkers compared to non-drinkers, but if they added sugar, much of the benefits appeared to disappear, and if they added Equal or Sweet-and-Low, the risk appeared to go up.

Various effects of artificial sweeteners, including neurological effects, have been suspected. For example, aspartame--the chemical in Equal and Nutrasweet--may modulate brain neurotransmitters such as dopamine and serotonin, although data have been controversial and inconsistent. Scientific opinions range from "safe under all conditions" to "unsafe at any dose." The controversy started in the 80's soon after aspartame was approved. Researchers at the Mass College of Pharmacy and MIT noted:

"given the very large number of Americans routinely exposed, if only 1% of the 100,000,000 Americans thought to consume aspartame ever exceed the sweetener's acceptable daily intake, and if only 1% of this group happen coincidentally to have an underlying disease that makes their brains vulnerable to the effects, then the number of people who might manifest adverse brain reactions attributable to aspartame could still be about 10,000, a number on the same order as the number of brain and nerve-related consumer complaints already registered with the FDA before they stopped accepting further reports on adverse reactions to the sweetener."

Those with a history of depression might be especially vulnerable. Researchers at Case Western designed a study I highlighted in my video Aspartame and the Brain to ascertain whether individuals with mood disorders are particularly vulnerable to adverse effects of aspartame. Although they had planned on recruiting 40 patients with depression and 40 controls, the project was halted early by the Institutional Review Board for safety reasons because of the severity of reactions to aspartame within the group of patients with a history of depression.

It was decided that it was unethical to continue to expose people to the stuff.

Normally when we study a drug or a food, the company donates the product to the researchers because they're proud of the benefits or safety of their product. But the Nutrasweet company refused to even sell it to these researchers. The researchers managed to get their hands on some, and within a week there were significantly more adverse effects reported in the aspartame group than in the placebo group. They concluded that individuals with mood disorders may be particularly sensitive to aspartame, and therefore its use in this population should be discouraged.

In a review of the direct and indirect cellular effects of aspartame on the brain, it was noted that there are reports of aspartame causing neurological and behavioral disturbances in sensitive individuals, such as headaches, insomnia and seizures. The researchers go even further and propose that excessive aspartame ingestion might be involved in the development of certain mental disorders and also in compromised learning and emotional functioning. They conclude that "due to all the adverse effects caused by aspartame, it is suggested that serious further testing and research be undertaken to eliminate any and all controversies," to which someone responded in the journal that "there really is no controversy," arguing that aspartame was conclusively toxic.

But what do they mean by excessive ingestion? The latest study on the neuro-behavioral effects of aspartame consumption put people on a high aspartame diet compared to a low aspartame diet. But even the high dose at 25 mg/kg was only half the adequate daily intake set by the FDA. The FDA says one can safely consume 50mg a day, but after just eight days on half of that, participants had more irritable mood, exhibited more depression, and performed worse on certain brain function tests. And these weren't people with a pre-existing history of mental illness; these were just regular people. The researchers concluded that "given that the higher intake level tested here was well below the maximum acceptable daily intake level [40mg in Europe, 50mg here] careful consideration is warranted when consuming food products that may affect neurobehavioral health."

Easier said than done, since it's found in more than 6,000 foods, apparently making artificial sweeteners "impossible to completely eradicate from daily exposure." While that may be true for the great majority of Americans, it's only because they elect to eat processed foods. If we stick to whole foods, we don't even have to read the ingredients lists, because the healthiest foods in the supermarket are label-free, they don't even have ingredients lists--produce!

I've previously touched on artificial sweeteners before:

The healthiest caloric sweeteners are blackstrap molasses and date sugar (whole dried powdered dates). The least toxic low-calorie sweetener is probably erythritol (Erythritol May Be a Sweet Antioxidant).

Coffee may decrease suicide and cancer risk (Preventing Liver Cancer with Coffee? and Coffee and Cancer) but may impair blood flow to the heart (Coffee and Artery Function).

Other ways to improve mood include:

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: Mike Mozart / Flickr

Original Link

The Role of Caffeine in Artery Function

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There are dietary guidelines for food, but what about for beverages? A Beverage Guidance Panel was "assembled to provide guidance on the relative health and nutritional benefits and risks of various beverage categories." They ranked them from one to six, and water was ranked number one.

Soda ranked last at number six. Whole milk was grouped with beer, with a recommendation for zero ounces a day, in part out of concern for links between milk and prostate cancer, as well as aggressive ovarian cancer due to IGF-1. Number two on the list, though, after water, was tea and coffee, preferably without creamer or sweetener.

Even without creamer, though, lots of unfiltered coffee can raise cholesterol, but the cholesterol-raising compounds are trapped by the paper filter in brewed coffee, so filtered coffee is probably better.

But about ten years ago, a study was published on the effects of coffee on endothelial function, the function of our arteries. I profile this study in my video Coffee and Artery Function, showing that within 30 minutes of drinking a cup of coffee there was a significant drop in the ability of our arteries to dilate, whereas decaf did not seem to have a significant effect. This was the first study to demonstrate an acute unfavorable effect on arterial function of caffeinated coffee, but one cup of decaf didn't seem to affect performance. And two cups of decaf appeared to have a beneficial effect. So maybe it's a "battle between caffeine and antioxidants." Something in caffeinated coffee appears to be hurting arterial function, whereas something in decaf appears to be helping.

It's similar to red wine. De-alcoholized red wine significantly improves arterial function, as there are grape components trying to help, but the presence of alcohol counteracts and erases the benefit.

Drinking really high antioxidant coffee, by preparing it Greek style for example (where we actually drink the grounds), coffee drinkers may actually be at an advantage

It might not be the caffeine in caffeinated coffee that appears to be harmful, though. In a randomized, double-blind, placebo-controlled, cross-over study, researchers found that caffeine alone--about two and a half cups of coffee worth--significantly improved arterial function in both people with and without heart disease.

Coffee contains more than a thousand different compounds other than caffeine, many of which are also removed by the decaffeination process, so there must be something else in the coffee bean that's causing the problem. In fact, caffeine may even enhance the repair of the fragile inner lining of our arteries by enhancing the migration of our endothelial progenitor cells, the stem cells that patch up potholes in our artery walls.

But how might we get the potential benefit of caffeine without the risky compounds in caffeinated coffee? Tea consumption enhances artery function, and there are substantial beneficial effects of both green tea and black tea. Instead of other components in tea leaves undermining caffeine's potential benefits, they appear to boost the benefit in healthy individuals, as well as heart disease patients, reversing some of their arterial dysfunction, both immediately and long-term.

All the measurements in the studies I've talked about so far were done on the brachial artery, the main artery in the arm (just because it's easier to get to). What we care about, though, is blood flow to the heart. And caffeine appears to impair blood flow to our heart muscle during exercise even in healthy folks, but especially in those with heart disease. Thankfully caffeine in tea form appears to have the opposite effect, significantly improving coronary blood flow, suggesting that tea consumption has a beneficial effect on coronary circulation, though the addition of milk may undermine the protective effects.

I'm fascinated by how complicated such a simple question can get. The take-home is that water is the healthiest beverage, followed by tea.

The effects of coffee on cancer risk are more salutary:

I've previously covered Walnuts and Artery Function and Dark Chocolate and Artery Function. Stay tuned for a few more coming up further exploring the effects of tea, olive oil, and plant-based diets on our lovely endothelium.

Low Carb Diets and Coronary Blood Flow is one of the few other studies I've done that measured blood flow within the coronary arteries themselves. For more background on the brachial artery test, see my video The Power of NO.

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations--2013: Uprooting the Leading Causes of Death, More Than an Apple a Day, 2014: From Table to Able: Combating Disabling Diseases with Food, 2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet, and my latest, 2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers.

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How Big Food Twists the Science

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Just like mosquitos are the vectors of spread for malaria, a landmark article published last year in one of the most prestigious medical journals, Lancet, described large food corporations as the vectors of spread for chronic disease. Unlike "infectious disease epidemics, however, these corporate disease vectors implement sophisticated campaigns to undermine public health interventions." Most mosquitoes don't have as good PR firms.

A key message was that "alcohol and ultra-processed food and drink industries use similar strategies as the tobacco industry to undermine effective public health policies and programs." What they mean by ultra-processed is things like burgers, frozen meals, chicken nuggets, fish sticks, potato chips, doughnuts and soda pop.

But how is the food industry like the tobacco industry? The "first strategy is to bias research findings." For example, Philip Morris implemented the Whitecoat project to hire doctors to publish ghost-written studies purporting to negate links between secondhand smoke and harm, publishing biased cherry-picked scientific reports to deny harm and suppress health information. In my video Food Industry-Funded Research Bias, you can see the actual industry memo describing the Whitecoat Project, designed to reverse the scientific "misconception" that secondhand smoke is harmful.

Similarly, funding from these large food corporations biases research. Studies show systematic bias from industry funding, so we get the same kind of tactics--supplying misinformation, use of supposedly conflicting evidence and hiding negative data.

The same scientists-for-hire that downplayed the risks of secondhand smoke are the same hired by the likes of the National Confectioner's Association to say candy cigarettes are A-OK as well. Of course, they declared "no conflict of interest."

The similarities between strategies used by the tobacco, alcohol, and food and drink corporations are unsurprising in view of the flow of people, funds and activities across these industries, which also have histories of joint ownership--like Philip Morris owned both Kraft and Miller Brewing.

So what's their strategy? As a former FDA commissioner described:

"The tobacco industry's strategy was embodied in a script written by the lawyers. Every tobacco company executive in the public eye was told to learn the script backwards and forwards, no deviation was allowed. The basic premise was simple-- smoking had not been proven to cause cancer. Not proven, not proven, not proven--this would be stated insistently and repeatedly. Inject a thin wedge of doubt, create controversy, never deviate from the prepared line. It was a simple plan and it worked."

Internal industry memos make this explicit, stating "doubt is our product, since it is the best means of competing with the body of fact that exists in the mind of the general public." The internal industry memos list objective number one as "to set aside in the minds of millions the false conviction that cigarette smoking causes lung cancer and other diseases; a conviction based on fanatical assumptions, fallacious rumors, unsupported claims and the unscientific statements and conjectures of publicity-seeking opportunists... [We need] to lift the cigarette from the cancer identification as quickly as possible, and to establish--once and for all--that no scientific evidence has ever been produced, presented or submitted to prove conclusively that cigarette smoking causes cancer," similar to what's now coming out from the food industry, from the same folks that brought us smoke and candy.

This is part of a series of "political" blogs which includes my video, Collaboration with the New Vectors of Disease. Why don't I just "stick to the science"? When there are billions of dollars at stake, the body of evidence can be skewed and manipulated. Funders can determine which studies are performed, how they're performed and whether or not they get published at all. That's why I think it's important to take a broader view to account for the ways the scientific method can be perverted for profit.

Here are some examples:

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations--2013: Uprooting the Leading Causes of Death, More Than an Apple a Day, 2014: From Table to Able: Combating Disabling Diseases with Food, 2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet, and my latest, 2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers.

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What About All the Sugar in Fruit?

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If the fructose in sugar and high fructose corn syrup has been considered "alcohol without the buzz" in terms of the potential to inflict liver damage, what about the source of natural fructose, fruit?

If you compare the effects of a diet restricting fructose from both added sugars and fruit to one just restricting fructose from added sugars, the diet that kept the fruit did better. People lost more weight with the extra fruit present than if all fructose was restricted. Only industrial, not fruit fructose intake, was associated with declining liver function and high blood pressure. Fructose from added sugars was associated with hypertension; fructose from natural fruits is not.

If we have people drink a glass of water with three tablespoons of table sugar in it, which is like a can of soda, they get a big spike in blood sugar within the first hour (as you can see in my video If Fructose is Bad, What About Fruit?). Our body freaks out and releases so much insulin we actually overshoot, and by the second hour we're relatively hypoglycemic, dropping our blood sugar below where they were when we started out fasting. In response, our body dumps fat into our blood stream as if we're starving, because our blood sugars just dropped so low so suddenly.

What if you eat blended berries in addition to the sugar? They have sugars of their own in them, in fact an additional tablespoon of sugar worth, so the blood sugar spike should be worse, right?

Not only is there no additional blood sugar spike, there was no hypoglycemic dip afterwards. Blood sugar just went up and down without that overshoot and without the surge of fat into the blood.

This difference may be attributed to the semisolid consistency of the berry meals, which may have decreased the rate of stomach emptying compared with just guzzling sugar water. In addition, the soluble fiber in the berries has a gelling effect in our intestines that slows the release of sugars. To test to see if it was the fiber, researchers repeated the experiment with berry juice that had all the sugar but none of the fiber. A clear difference was observed early on in the blood sugar insulin responses. At the 15-minute mark, the blood sugar spike was significantly reduced by the berry meals, but not by the juices, but the rest of the beneficial responses were almost the same between the juice and the whole fruit, suggesting that fiber may just be part of it. It turns out there are fruit phytonutrients that inhibit the transportation of sugars through the intestinal wall into our blood stream. Phytonutrients in foods like apples and strawberries can block some of the uptake of sugars by the cells lining our intestines.

Adding berries can actually blunt the insulin spike from high glycemic foods. For example, white bread creates a big insulin spike within two hours after eating it. Eat that same white bread with some berries, though, and we're able to blunt the spike. So, even though we've effectively added more sugars in the form of berries, there's less of an insulin spike, which has a variety of potential short and long-term benefits. So if you're going to make pancakes, make sure they're blueberry pancakes.

Surprised about the juice results? Me too! More on juice:

A few videos I have on industrial sugars:

How else can we blunt the glycemic spike?

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations--2013: Uprooting the Leading Causes of Death, More Than an Apple a Day, 2014: From Table to Able: Combating Disabling Diseases with Food, 2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet, and my latest, 2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers.

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