9 out of 10 That Die From it Never Knew They Even Had This Preventable Disease

9 out of 10 That Die From it Never Knew They Even Had This Preventable Disease.jpeg

Diverticula are out-pouchings of our intestine. Doctors like using a tire analogy: high pressures within the gut can force the intestines to balloon out through weak spots in the intestinal wall like an inner tube poking out through a worn tire tread. You can see what they actually look like in my video, Diverticulosis: When Our Most Common Gut Disorder Hardly Existed. These pockets can become inflamed and infected, and, to carry the tire analogy further, can blow out and spill fecal matter into the abdomen, and lead to death. Symptoms can range from no symptoms at all, to a little cramping and bloating, to "incapacitating pain that is a medical emergency." Nine out of ten people who die from the disease never even knew they had it.

The good news is there may be a way to prevent the disease. Diverticular disease is the most common intestinal disorder, affecting up to 70% of people by age 60. If it's that common, though, is it just an inevitable consequence of aging? No, it's a new disease. In 1907, 25 cases had been reported in the medical literature. Not cases in 25% of people, but 25 cases period. And diverticular disease is kind of hard to miss on autopsy. A hundred years ago, in 1916, it didn't even merit mention in medical and surgical textbooks. The mystery wasn't solved until 1971.

How did a disease that was almost unknown become the most common affliction of the colon in the Western world within one lifespan? Surgeons Painter and Burkitt suggested diverticulosis was a deficiency disease--i.e., a disease caused by a deficiency of fiber. In the late 1800s, roller milling was introduced, further removing fiber from grain, and we started to fill up on other fiber-deficient foods like meat and sugar. A few decades of this and diverticulosis was rampant.

This is what Painter and Burkitt thought was going on: Just as it would be easy to squeeze a lump of butter through a bicycle tube, it's easy to move large, soft, and moist intestinal contents through the gut. In contrast, try squeezing through a lump of tar. When we eat fiber-deficient diets, our feces can become small and firm, and our intestines have to really squeeze down hard to move them along. This buildup of pressure may force out those bulges. Eventually, a low-fiber diet can sometimes lead to the colon literally rupturing itself.

If this theory is true, then populations eating high­-fiber diets would have low rates of diverticulosis. That's exactly what's been found. More than 50% of African Americans in their 50s were found to have diverticulosis, compared to less than 1% in African Africans eating traditional plant-based diets. By less than 1%, we're talking zero out of a series of 2,000 autopsies in South Africa and two out of 4,000 in Uganda. That's about one thousand times lower prevalence.

What, then, do we make of a new study concluding that a low-fiber diet was not associated with diverticulosis. I cover that in my video Does Fiber Really Prevent Diverticulosis?

For more on bowel health, see:

What if your doctor says you shouldn't eat healthy foods like nuts and popcorn because of your diverticulosis? Share with them my Diverticulosis & Nuts 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:

Image Credit: Sean T Evans / Flickr. This image has been modified.

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9 out of 10 That Die From it Never Knew They Even Had This Preventable Disease

9 out of 10 That Die From it Never Knew They Even Had This Preventable Disease.jpeg

Diverticula are out-pouchings of our intestine. Doctors like using a tire analogy: high pressures within the gut can force the intestines to balloon out through weak spots in the intestinal wall like an inner tube poking out through a worn tire tread. You can see what they actually look like in my video, Diverticulosis: When Our Most Common Gut Disorder Hardly Existed. These pockets can become inflamed and infected, and, to carry the tire analogy further, can blow out and spill fecal matter into the abdomen, and lead to death. Symptoms can range from no symptoms at all, to a little cramping and bloating, to "incapacitating pain that is a medical emergency." Nine out of ten people who die from the disease never even knew they had it.

The good news is there may be a way to prevent the disease. Diverticular disease is the most common intestinal disorder, affecting up to 70% of people by age 60. If it's that common, though, is it just an inevitable consequence of aging? No, it's a new disease. In 1907, 25 cases had been reported in the medical literature. Not cases in 25% of people, but 25 cases period. And diverticular disease is kind of hard to miss on autopsy. A hundred years ago, in 1916, it didn't even merit mention in medical and surgical textbooks. The mystery wasn't solved until 1971.

How did a disease that was almost unknown become the most common affliction of the colon in the Western world within one lifespan? Surgeons Painter and Burkitt suggested diverticulosis was a deficiency disease--i.e., a disease caused by a deficiency of fiber. In the late 1800s, roller milling was introduced, further removing fiber from grain, and we started to fill up on other fiber-deficient foods like meat and sugar. A few decades of this and diverticulosis was rampant.

This is what Painter and Burkitt thought was going on: Just as it would be easy to squeeze a lump of butter through a bicycle tube, it's easy to move large, soft, and moist intestinal contents through the gut. In contrast, try squeezing through a lump of tar. When we eat fiber-deficient diets, our feces can become small and firm, and our intestines have to really squeeze down hard to move them along. This buildup of pressure may force out those bulges. Eventually, a low-fiber diet can sometimes lead to the colon literally rupturing itself.

If this theory is true, then populations eating high­-fiber diets would have low rates of diverticulosis. That's exactly what's been found. More than 50% of African Americans in their 50s were found to have diverticulosis, compared to less than 1% in African Africans eating traditional plant-based diets. By less than 1%, we're talking zero out of a series of 2,000 autopsies in South Africa and two out of 4,000 in Uganda. That's about one thousand times lower prevalence.

What, then, do we make of a new study concluding that a low-fiber diet was not associated with diverticulosis. I cover that in my video Does Fiber Really Prevent Diverticulosis?

For more on bowel health, see:

What if your doctor says you shouldn't eat healthy foods like nuts and popcorn because of your diverticulosis? Share with them my Diverticulosis & Nuts 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:

Image Credit: Sean T Evans / Flickr. This image has been modified.

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Topical Application of Turmeric Curcumin for Cancer

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In my video, Turmeric Curcumin and Colon Cancer, I talked about a study where researchers showed that, by taking curcumin, the yellow pigment in the spices turmeric and curry powder, those at high risk for colon cancer could cut down on precancerous and even pre-precancerous lesions, in effect reversing cancer progression. Are there other high risk lesions we can try spicing up?

How about giving turmeric extracts to people who just had bladder cancer taken out? Or to those who have an early stage of squamous cell carcinoma skin cancer caused by arsenic exposure, or early stage cervical cancer, or precancerous lesions in the mouth or stomach? Researchers did this, and in about a quarter of the patients, the lesions started to get better. One out of the two bladder cancer survivors, two out of seven patients with precancerous mouth lesions, one out of six patients with precancerous stomach lesions, one out of four early stage cervical cancer cases, and two out of six patients with early stage skin cancer, all without any noticeable side-effects.

One of the reasons turmeric curcumin may work in some cancers better than others, or in some people better than others, is differences in bioavailability. Megadoses were given, yet just a tiny amount ended up in the bloodstream. If we're treating skin cancer, though, why not just put the curcumin directly on the skin?

I've talked about what turmeric compounds can do to cancer cells in a petri dish. In the video, Topical Application of Turmeric Curcumin for Cancer, you can see some before and after pics. Cervical cancer cells are laid to waste as more and more curcumin is added, and normal cells are unharmed. But to make it to the cervix, curcumin must be absorbed (though a vaginal cream has been invented).

A variety of delivery methods have been devised, including oral, intra-abdominal, intramuscular, under-the-skin injections, straight into the veins or the arteries, on the skin, up the bladder, in the nose, breathed like an inhaler, up where the sun don't shine, or straight into the spinal column, bone marrow, the tumor itself, or implanted somehow. Taken orally, some curcumin does actually get into the tissues. We can measure the amount of curcumin absorbed into the wall of the intestine by examining biopsies and surgical specimens taken after a curcumin regimen. It makes sense to take turmeric orally to try to fight colon cancer, but if we have cancer erupting on our skin why not just rub it on directly?

That's what one group of researchers did. They took some turmeric from the store, made a tincture out of it, dried it, put it in Vaseline, and then had cancer patients rub it on their cancer three times a day. What kind of cancer can you get at with a finger? These were folks with cancers of the mouth, breast, skin, vulva, and elsewhere. Isn't breast cancer under the surface? Not always. Advanced breast cancer can ulcerate right through the skin. The subjects were all people with recurrent ulcerating tumors that had failed to respond to surgery, radiation, and chemo. These open cancers can stink, itch, and ooze, and there was nothing else medicine had to offer. So they rubbed some turmeric ointment to see what happened. It produced remarkable relief. A reduction in smell was noted in 90% of the cases, even in extensively ulcerated cases of breast cancer, and a reduction in itching in almost all cases as well. For example, treatment relieved severe itching in two of the vulva cancer patients. Most of the lesions dried up, and in many cases this relief lasted for months, all from just rubbing on the harmless spice turmeric, which the researchers describe as "an indigenous drug ... highly effective in reducing smell, itching and exudate." The effect of this so-called drug is remarkable. And that "drug" is just some edible spice used in curries for centuries.

More on what this golden spice can do in:

There are ways of Boosting the Bioavailability of Curcumin to get it into our blood stream.

Some should be cautious about turmeric use, though. See Who Shouldn't Consume Curcumin or Turmeric?

-Michael Greger, M.D.

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

Image Credit: Andrea Kirkby / Flickr

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Why are Cancer Rates so Low in India?

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It is estimated that many tumors start around the age of 20. However, detection of cancer is normally around the age of 50 or later. Thus, it takes cancer decades to incubate. Why does it take so long? Recent studies indicate that in any given type of cancer, hundreds of different genes must be modified to change a normal cell into a cancer cell. Although cancers are characterized by the dysregulation of cell signaling pathways at multiple steps, most current anticancer therapies involve the modulation of a single target. Chemotherapy has gotten incredibly specific, but the ineffectiveness, lack of safety, and high cost of these monotargeted therapies has led to real disappointment, and drug companies are now trying to develop chemo drugs that take a multitargeted approach.

Many plant-based products, however, accomplish multitargeting naturally and are inexpensive and safe compared to drugs. However, because drug companies are not usually able to secure intellectual property rights to plants, the development of plant-based anticancer therapies has not been prioritized. They may work (and work better for all we know), and they may be safer, or even fully risk free.

If we were going to choose one plant-based product to start testing, we might choose curcumin, the pigment in the spice turmeric (the reason curry powder looks yellow). Before we start throwing money at research, we might want to ask some basic questions, like "Do populations that eat a lot of turmeric have lower cancer rates?" The incidence of cancer does appear to be significantly lower in regions where turmeric is heavily consumed. Population-based data indicate that some extremely common cancers in the Western world are much less prevalent in regions where turmeric is widely consumed in the diet.

For example, "overall cancer rates are much lower in India than in western countries." U.S. men get 23 times more prostate cancer than men in India. Americans get between 8 and 14 times the rate of melanoma, 10 to 11 times more colorectal cancer, 9 times more endometrial cancer, 7 to 17 times more lung cancer, 7 to 8 times more bladder cancer, 5 times more breast cancer, and 9 to 12 times more kidney cancer. This is not mere 5, 10, or 20 percent more, but 5, 10, or 20 times more. Hundreds of percent more breast cancer, thousands of percent more prostate cancer--differences even greater than some of those found in the China Study.

The researchers in this study, highlighted in my video Back to Our Roots: Curry and Cancer, conclude: "Because Indians account for one-sixth of the world's population, and have some of the highest spice consumption in the world, epidemiological studies in this country have great potential for improving our understanding of the relationship between diet and cancer. The lower rates of cancer may, of course, not be due to higher spice intake. Several dietary factors may contribute to the low overall rate of cancer in India. Among them are a "relatively low intake of meat and a mostly plant-based diet, in addition to the high intake of spices." Forty percent of Indians are vegetarians, and even the ones that do eat meat don't eat a lot. And it's not only what they don't eat, but what they do. India is one of the largest producers and consumers of fresh fruits and vegetables, and Indians eat a lot of pulses (legumes), such as beans, chickpeas, and lentils. They also eat a wide variety of spices in addition to turmeric that constitute, by weight, the most antioxidant-packed class of foods in the world.

Population studies can't prove a correlation between dietary turmeric and decreased cancer risk, but they can certainly inspire a bunch of research. So far, curcumin has been tested against a variety of human cancers, including colorectal cancer, pancreatic cancer, breast, prostate, multiple myeloma, lung cancer, and head and neck cancer, for both prevention and treatment. For more information on turmeric and curcumin, check out Carcinogen Blocking Effects of Turmeric Curcumin and Turmeric Curcumin Reprogramming Cancer Cell Death.

I'm working on another dozen or so videos on this amazing spice. This is what I have so far:

Amla, dried Indian gooseberry powder, is another promising dietary addition:

I add amla to my Pink Juice with Green Foam recipe. Not all natural products from India are safe, though. See, for example, my video Some Ayurvedic Medicine Worse than Lead Paint Exposure.

More on the antioxidant concentration in spices in general in Antioxidants in a Pinch. Why do antioxidants matter? See Food Antioxidants and Cancer and Food Antioxidants, Stroke, and Heart Disease.

Which fruits and vegetables might be best? See #1 Anticancer Vegetable and Best Fruits for Cancer Prevention.

-Michael Greger, M.D.

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

Image Credit: peddhapati / Flickr

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Who Should be Careful About Curcumin?

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Following flax and wheatgrass, turmeric is the third best-selling botanical dietary supplement, racking up $12 million in sales. Currently, sales are increasing at a rate of 20%.

"Curcumin is a natural plant product extracted from the turmeric root and is used commonly as a food additive popular for its pleasant mild aroma and exotic yellow color. It is widely considered unlikely to cause side effects." However, just because something is natural doesn't mean it's not toxic. Strychnine is natural; cyanide is natural. Lead, mercury and plutonium are all elements--can't get more natural than that! But turmeric is just a plant. Surely plants can't be dangerous? Tell that to Socrates.

"In considering the validity of the widely accepted notion that complementary and alternative medicine is a safer approach to therapy, we must remind ourselves and our patients that a therapy that exerts a biologic effect is, by definition, a drug and can have toxicity." It cannot be assumed that diet-derived agents will be innocuous when administered as pharmaceutical formulations at doses likely to exceed those consumed in the diet.

Traditional Indian diets may include as much as a teaspoon of turmeric a day. Doses of turmeric that have been used in human studies range from less than just a 16th of a teaspoon a day to two tablespoons a day for over a month. On the other hand, the curcumin trials have used up to the amount found in cups of the spice, around 100 times more than what curry lovers have been eating for centuries.

Studies have yet to show overt serious side effects in the short-term. However, if we combine high dose curcumin with black pepper, resulting in a 2000% boost in bioavailability (See Boosting the Bioavailability of Curcumin), it could be like consuming the equivalent of 29 cups of turmeric a day. That kind of intake could bring peak blood levels to the range where you start seeing some significant DNA damage in vitro.

So just incorporating turmeric into your cooking may be better than taking curcumin supplements, especially during pregnancy. The only other contraindication cited in the most recent review on curcumin was the potential to trigger gallbladder pain in individuals with gallstones.

If anything, curcumin may help protect liver function and help prevent gallstones by acting as a cholecystokinetic agent, meaning that it facilitates the pumping action of the gallbladder to keep the bile from stagnating. In one study, profiled in my video, Who Shouldn't Consume Turmeric or Curcmin?, researchers gave people a small dose of curcumin, about the amount found in a quarter teaspoon of turmeric and, using ultrasound, were able to visualize the gallbladder squeezing down in response, with an average change in volume of about 29%. Optimally, though we want to squeeze it in half. So the researchers repeated the experiment with different doses. It took about 40 milligrams to get a 50% contraction, or about a third of a teaspoon of turmeric every day.

On one hand that's great--totally doable. On the other hand, that's some incredibly powerful stuff! What if you had a gallbladder obstruction? What if you had a stone blocking your bile duct? If you eat something that makes your gallbladder squeeze so much, it could cause pain. So patients with biliary tract obstruction should be careful about consuming curcumin. For everyone else, these results suggest that curcumin can effectively "induce the gallbladder to empty and thereby reduce the risk of gallstone formation and ultimately even gallbladder cancer."

Too much turmeric, though, may increase the risk of kidney stones. As I mentioned in Oxalates in Cinnamon, turmeric is high in soluble oxalates which can bind to calcium and form insoluble calcium oxalate, which is responsible for approximately 75% of all kidney stones. "The consumption of even moderate amounts of turmeric would therefore not be recommended for people with a tendency to form kidney stones." Such folks should restrict the consumption of total dietary oxalate to less than 40 to 50 mg/day, which means no more than at most a teaspoon of turmeric. Those with gout, for example, are by definition, it appears, at high risk for kidney stones, and so if their doctor wanted to treat gout inflammation with high dose turmeric, he or she might consider curcumin supplements, because to reach high levels of curcumin in turmeric form would incur too much of an oxalate load.

If we are going to take a supplement, how do we choose? The latest review recommends purchasing from Western suppliers that follow recommended Good Manufacturing Practices, which may decrease the likelihood of buying an adulterated product.

I previously discussed the role spices play in squelching inflammation and free radicals in Which Spices Fight Inflammation? and Spicing Up DNA Protection. Then out of the lab into the clinic with attempts to test the ability of turmeric extracts to treat joint inflammation with Turmeric Curcumin and Rheumatoid Arthritis and Turmeric Curcumin and Osteoarthritis.

I wish there was more science on wheatgrass. I just had that one unhelpful anecdote in my video How Much Broccoli Is Too Much? There is good science on flax though. See:

More on gallbladder health can be found in my video Cholesterol Gallstones. And those who are susceptible to kidney stones should try to alkalinize their urine by eating lots of dark green leafy vegetables. See Testing Your Diet with Pee & Purple Cabbage.

Based on this new science on turmeric (lots more to come!), I now try to include it in my family's daily diet.

-Michael Greger, M.D

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

Image Credit: sean dreilinger / Flickr

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Cancer and the Animal-to-Plant Protein Ratio

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It is now eight years since the famous Ornish study was published, suggesting that 12 months on a strictly plant-based diet could reverse the progression of prostate cancer. For those unfamiliar with that landmark Ornish study, see Cancer Reversal Through Diet?, which the Pritikin Foundation followed up on with Ex Vivo Cancer Proliferation Bioassay.

Wait a second. How were they able to get a group of older men to go vegan for a year? They home delivered prepared meals to their doors, I guess figuring men are so lazy they'll just eat whatever is put in front of them.

But what about out in the real world? Realizing that we can't even get most men with cancer to eat a measly five servings of fruits and veggies, in a study profiled in my video, Prostate Cancer Survival: The A/V Ratio, researchers settled on just trying to change their A to V ratio--the ratio of animal to vegetable proteins--and indeed were successful in cutting this ratio by at least half, from about two to one animal to plant, to kind of half vegan, one to one.

How'd the men do? Their cancer appeared to slow down. The average PSA doubling time (an estimate of how fast the tumor may be doubling in size) in the "half vegan" group slowed from 21 months to 58 months. So the cancer kept growing, but with a part-time plant-based diet they were able to slow down the tumor's expansion. What Ornish got, though, was an apparent reversal in cancer growth--the PSA didn't just rise slower, it trended down, which could be an indication of tumor shrinkage. So the ideal A to V ratio may be closer to zero.

If there's just no way grandpa's going vegan, and we just have half-measures, which might be the worst A and the best V? Eggs and poultry may be the worst, respectively doubling and potentially quadrupling the risk of cancer progression in a study out of Harvard. Twice the risk eating less than a single egg a day and up to quadruple the risk eating less than a single daily serving of chicken or turkey.

And if we could only add one thing to our diet, what would it be? Cruciferous vegetables. Less than a single serving a day of either broccoli, Brussels sprouts, cabbage, cauliflower, or kale may cut the risk of cancer progression (defined as the cancer coming back, spreading to the bone, or death) by more than half.

The animal to plant ratio might be useful for cancer prevention as well. For example, in the largest study ever performed on diet and bladder cancer, just a 3% increase in the consumption of animal protein was associated with a 15% higher risk of bladder cancer, whereas a 2% increase in plant protein intake was associated with a 23% lower risk. Even little changes in our diets can have significant effects.

What else might help men with prostate cancer? See Flaxseed vs. Prostate Cancer and Saturated Fat & Cancer Progression. What about preventing it in the first place? See:

Poultry and eggs may be related to cancer risk in a variety of ways:

Crucifers may also help with other cancers. See:

Breast cancer is highlighted in my video Breast Cancer Survival Vegetable.

-Michael Greger, M.D.

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

Image Credit: Greg Habermann / Flickr

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How to Treat Multiple Sclerosis With Diet

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

-Michael Greger, M.D.

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

Image Credit: Theen Moy / Flickr

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A Low Methionine Diet May Help Starve Cancer Cells

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When designing an antibiotic, we can't create a drug that destroys DNA because that's something that both humans and bacteria share in common. It would kill bacteria, but it might kill us, too. Instead, many antibiotics work by attacking bacterial cell walls, which is something bacteria have that we don't.

Similarly, antifungals can attack the unique cell walls of fungus. Pesticides can work by attacking the special exoskeleton of insects. But fighting cancer is harder because cancer cells are our own cells. So fighting cancer comes down to trying to find and exploit differences between cancer cells and normal cells.

Forty years ago, a landmark paper was published showing for the first time that many human cancers have what's called "absolute methionine dependency," meaning that if we try to grow cells in a Petri dish without giving them the amino acid methionine, normal cells thrive, but without methionine, cancer cells die. Normal breast cells grow no matter what, with or without methionine, but cancer cells need that added methionine to grow.

What does cancer do with the methionine? Tumors use it to generate gaseous sulfur-containing compounds that, interestingly, can be detected by specially trained diagnostic dogs. There are mole-sniffing dogs that can pick out skin cancer. There are breath-sniffing dogs that can pick out people with lung cancer. Pee-sniffing dogs that can diagnose bladder cancer and--you guessed it--fart-sniffing dogs for colorectal cancer. Doctors can now bring their lab to the lab!

It gives a whole new meaning to the term pet scan :)

Methionine dependency is not just present in cancer cell lines in a Petri dish. Fresh tumors taken from patients show that many cancers appear to have a biochemical defect that makes them dependent on methionine, including some tumors of the colon, breast, ovary, prostate, and skin. Pharmaceutical companies are fighting to be the first to come out with a drug that decreases methionine levels. But since methionine is sourced mainly from food, a better strategy may be to lower methionine levels by lowering methionine intake, eliminating high methionine foods to control cancer growth as well as improve our lifespan (see Methionine Restriction as a Life-Extension Strategy).

Here's the thinking: smoking cessation, consumption of diets rich in plants, and other lifestyle measures can prevent the majority of cancers. Unfortunately, people don't do them, and as a result hundreds of thousands of Americans develop metastatic cancer each year. Chemotherapy cures only a few types of metastatic cancer. Unfortunately, the vast majority of common metastatic cancers, such as breast, prostate, colon, and lung, are lethal. We therefore desperately need novel treatment strategies for metastatic cancer, and dietary methionine restriction may be one such strategy.

So, where is methionine found? In my video, Starving Cancer with Methionine Restriction, you can see a graph of foods with their respective methionine levels. Chicken and fish have the highest levels. Milk, red meat, and eggs have less, but if we really want to stick with lower methionine foods, fruits, nuts, veggies, grains, and beans are the best. In other words, "In humans, methionine restriction may be achieved using a predominately vegan diet."

There are also compounds in animal products that may actually stimulate tumor growth. See, for example, How Tumors Use Meat to Grow: Xeno-Autoantibodies. Animal protein may also boost levels of the cancer-promoting hormone IGF-1 (The Answer to the Pritikin Puzzle). Combined, this could all help explain why plants and plant-based diets have been found effective in potentially reversing some cancer processes. See Cancer Reversal Through Diet?, Strawberries versus Esophageal Cancer, and Black Raspberries versus Oral Cancer.

So why isn't every oncologist prescribing a low-methionine diet? One researcher notes that "Despite many promising preclinical and clinical studies in recent years, dietary methionine restriction and other dietary approaches to cancer treatment have not yet gained wide clinical application. Most clinicians and investigators are probably unfamiliar with nutritional approaches to cancer." That's an understatement! "Many others may consider amino acid restriction as an 'old idea,' since it has been examined for several decades. However, many good ideas remain latent for decades if not centuries before they prove valuable in the clinic....With the proper development, dietary methionine restriction, either alone or in combination with other treatments, may prove to have a major impact on patients with cancer."

Why might the medical profession be so resistant to therapies proven to be effective? The Tomato Effect may be partially to blame.

In my video, Anti-Angiogenesis: Cutting Off Tumor Supply Lines, researchers come to the same plant-based conclusion from a different perspective, starving cancers of their blood supply.

-Michael Greger, M.D.

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

Image Credit: PNNL - Pacific Northwest National Laboratory / Flickr

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Does Cranberry Juice Work Against Bladder Infections?

 

 

 

 

 

 

 

 

Can Cranberry Juice Treat Bladder Infections?

How could any bacteria cause a bladder infection without just getting flushed away—literally? Bladder infections may make sense if we’re not drinking enough or if we leave behind a stagnant pool because we can’t empty completely (as in men with enlarged prostates).  However, in most people there should be a constant flow of water. The way bladder infection-causing E. coli hold on is that they evolved  finger-like projections (fimbrae) they can use to stick to the walls of the bladder so they don’t get washed away.

Almost 30 years ago, it was demonstrated that if you drip cranberry juice on E. coli, their fimbrae aren’t able to stick as well. Grape juice doesn’t work, nor does orange or apple juice. Even white cranberry juice made from unripened berries doesn’t work, suggesting that it’s one of the red phytonutrients that’s the active ingredient. For more on these natural plant compounds, see Phytochemicals: The Nutrition Facts Missing From the Label and for those doubting the power of plants, Power Plants.

Even if it works in a petri dish, though, we don’t pee cranberry juice. How do we know that the anti-adherence phytonutrients are even absorbed through the gut and make it into the bladder? Subsequent studies have shown that if you drip the urine of someone who drank cranberry juice onto E. coli, they don’t stick as well either. Now we’re getting somewhere. If you check out my 4-min video Can Cranberry Juice Treat Bladder Infections?, you can see the stickiness of strains of E. coli wading in urine from someone drinking water, and the stickiness in the urine of someone drinking cranberry juice. Within hours of consumption there’s a drop in E. coli adherence that appears to last throughout much of the day. So might cranberries really help prevent bladder infections?

The best way to prevent infections is to not get infected in the first place, which may involve the avoidance of chicken so you’re not constantly re-infecting yourself (see my last video Avoiding Chicken to Avoid Bladder Infections).

If that doesn’t work, however—if your gut remains stubbornly colonized with these bad bladder bugs—various tested cranberry products appear to reduce the recurrence of bladder infections by about 35 percent. Not as effective as antibiotics, but cranberry juice doesn’t foster antibiotic resistance and has fewer side effects.

There’s no good evidence to suggest cranberries are an effective treatment, though, which makes sense. Cranberries prevent the initial adherence, but that occurs at the start of the infection. When the infection is present and already stuck, there’s no clinical data to suggest that cranberries are effective in the treatment of urinary tract infections, meaning it doesn’t work better than placebo—but placebos work! For example, ibuprofen seems to work just as well as antibiotics for the treatment of uncomplicated urinary tract infections.

Some people really do need antibiotics—pregnant women, children, men, those with kidney infections, and systemic symptoms like nausea and vomiting. For most healthy women, though, bladder infections just go away on their own without antibiotics. Women who drink cranberry juice and have their symptoms disappear may falsely attribute their recovery to the juice. However, when it comes to most UTIs, nothing works–as in nothing, a sugar pill, actually works!

I discuss the controversy around doctors giving placebos in The Lie That Heals: Should Doctors Give Placebos?

What else can cranberries do? Check out my recent videos Which Fruit Fights Cancer Better? and Cranberries Versus Cancer.

How can you consume cranberries palatably? Check out my recipe for Pink Juice with Green Foam.

If cranberries are so good at keeping bacteria from sticking to the wall of the bladder, what about keeping bacteria from sticking to other places like our teeth? I touch on that in my video Childhood Tea Drinking May Increase Fluorosis Risk.

-Michael Greger, M.D.

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

Image credit: ztephen / Flickr

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