Should Cancer Patients Avoid Raw Fruits and Vegetables?

Should Cancer Patients Avoid Raw Fruits and Vegetables?.jpeg

Back in the 1960s, a patient isolator unit was developed for cancer patients undergoing chemotherapy. Because our immune system cells were often caught in the friendly fire, up to 50% of cancer patients died of infections before they could even complete the chemo because their immune systems had become so compromised. So, a bubble boy-like contraption was developed. The patient was shaved, dipped in disinfectant, rinsed off with alcohol, rubbed with antibiotic ointment into every orifice, and placed on a rotating regimen of a dozen of the most powerful antibiotics they had. Procedures were performed through plastic sleeves on the sides of the unit, and everything in and out had to be sterilized and passed through airlocks. So, the patient wasn't allowed any fresh fruits or vegetables.

People went crazy cooped up in these bubble-like units, with 38% even experiencing hallucinations. Fifteen years later the results were in: it simply didn't work. People were still dying at the same rate, so the whole thing was scrapped--except the diet. The airlocks and alcohol baths were abandoned, but they continued to make sure no one got to eat a salad.

Neutrophils are white blood cells that serve as our front line of defense. When we're immunocompromised and don't have enough neutrophils, we're called "neutropenic." So, the chemotherapy patients were put on a so-called neutropenic diet without any fresh fruits and vegetables. The problem is there's a glaring lack of evidence that such a neutropenic diet actually helps (see my video Is a Neutropenic Diet Necessary for Cancer Patients?).

Ironically, the neutropenic diet is the one remaining component of those patient isolator unit protocols that's still practiced, yet it has the least evidence supporting its use. Why? The rationale is: there are bacteria in salads, bacteria cause infections, immunocompromised patients are at increased risk for infections, and therefore, no salad. What's more, they were actually glad there aren't any studies on this because it could be way too risky to give a cancer patient an apple or something. So, its continued use seems to be based on a ''better safe than sorry'' philosophy.

The problem is that kids diagnosed with cancer are already low in dietary antioxidants, so the last thing we should do is tell them they can't have any fresh fruit or veggies. In addition to the lack of clinical evidence for this neutropenic diet, there may be some drawbacks. Restricting fruits and vegetables may even increase the risk of infection and compromise their nutritional status.

So, are neutropenic diets for cancer patients "reasonable prudence" or "clinical superstition"? Starting in the 1990s, there was a resurgence of research when greater importance was placed on the need to "support clinical practice with evidence."

What a concept!

Three randomized controlled trials were published, and not one supported the neutropenic diet. In the biggest study, an all-cooked diet was compared to one that allowed raw fruits and veggies, and there was no difference in infection and death rates. As a result of the study, the principal investigator at the MD Anderson Cancer Center described how their practice has changed and now everyone is allowed to eat their vegetables--a far cry from "please don't eat the salads" 31 years earlier.

Today, neither the Food and Drug Administration, the Centers for Disease Control and Prevention, nor the American Cancer Society support the neutropenic diet. The real danger comes from pathogenic food-poisoning bacteria like Campylobacter, Salmonella, and E. coli. So we still have to keep patients away from risky foods like undercooked eggs, meat, dairy, and sprouts. At this point, though, there really shouldn't be a debate about whether cancer patients should be on a neutropenic diet. Nevertheless, many institutions still tell cancer patients they shouldn't eat fresh fruits and veggies. According to the latest survey, more than half of pediatric cancer doctors continue to prescribe these diets, though it's quite variable even among those at the same institution.

Why are doctors still reluctant to move away from the neutropenic diet? There are several reasons why physicians may be hesitant to incorporate evidence-based medicine into their practices. They may have limited time to review the literature. They'd like to dig deep into studies, but simply don't have the time to look at the evidence. Hmm, if only there was a website... :)

Bone marrow transplants are the final frontier. Sometimes it's our immune system itself that is cancerous, such as in leukemia or lymphoma. In these cases, the immune system is wiped out on purpose to rebuild it from scratch. So, inherent in the procedure is a profound immunodeficiency for which a neutropenic diet is often recommended. This has also had never been tested--until now.

Not only did it not work, a strict neutropenic diet was actually associated with an increased risk for infection, maybe because you don't get the good bugs from fruits and vegetables crowding out the bad guys in the gut. So not only was the neutropenic diet found to be unbeneficial; there was a suggestion that it has the potential to be harmful. This wouldn't be the first time an intervention strategy made good sense theoretically, but, when put to the test, was ultimately ineffective.

Unfortunately, there's an inertia in medicine that can result in medical practice that is at odds with the available evidence. Sometimes this disconnect can have devastating consequences. See, for example, Evidence-Based Medicine or Evidence-Biased? and The Tomato Effect.

The reason it is so important to straighten out the neutropenic diet myth is that fruits and vegetables may actually improve cancer survival:

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

Original Link

Should Cancer Patients Avoid Raw Fruits and Vegetables?

Should Cancer Patients Avoid Raw Fruits and Vegetables?.jpeg

Back in the 1960s, a patient isolator unit was developed for cancer patients undergoing chemotherapy. Because our immune system cells were often caught in the friendly fire, up to 50% of cancer patients died of infections before they could even complete the chemo because their immune systems had become so compromised. So, a bubble boy-like contraption was developed. The patient was shaved, dipped in disinfectant, rinsed off with alcohol, rubbed with antibiotic ointment into every orifice, and placed on a rotating regimen of a dozen of the most powerful antibiotics they had. Procedures were performed through plastic sleeves on the sides of the unit, and everything in and out had to be sterilized and passed through airlocks. So, the patient wasn't allowed any fresh fruits or vegetables.

People went crazy cooped up in these bubble-like units, with 38% even experiencing hallucinations. Fifteen years later the results were in: it simply didn't work. People were still dying at the same rate, so the whole thing was scrapped--except the diet. The airlocks and alcohol baths were abandoned, but they continued to make sure no one got to eat a salad.

Neutrophils are white blood cells that serve as our front line of defense. When we're immunocompromised and don't have enough neutrophils, we're called "neutropenic." So, the chemotherapy patients were put on a so-called neutropenic diet without any fresh fruits and vegetables. The problem is there's a glaring lack of evidence that such a neutropenic diet actually helps (see my video Is a Neutropenic Diet Necessary for Cancer Patients?).

Ironically, the neutropenic diet is the one remaining component of those patient isolator unit protocols that's still practiced, yet it has the least evidence supporting its use. Why? The rationale is: there are bacteria in salads, bacteria cause infections, immunocompromised patients are at increased risk for infections, and therefore, no salad. What's more, they were actually glad there aren't any studies on this because it could be way too risky to give a cancer patient an apple or something. So, its continued use seems to be based on a ''better safe than sorry'' philosophy.

The problem is that kids diagnosed with cancer are already low in dietary antioxidants, so the last thing we should do is tell them they can't have any fresh fruit or veggies. In addition to the lack of clinical evidence for this neutropenic diet, there may be some drawbacks. Restricting fruits and vegetables may even increase the risk of infection and compromise their nutritional status.

So, are neutropenic diets for cancer patients "reasonable prudence" or "clinical superstition"? Starting in the 1990s, there was a resurgence of research when greater importance was placed on the need to "support clinical practice with evidence."

What a concept!

Three randomized controlled trials were published, and not one supported the neutropenic diet. In the biggest study, an all-cooked diet was compared to one that allowed raw fruits and veggies, and there was no difference in infection and death rates. As a result of the study, the principal investigator at the MD Anderson Cancer Center described how their practice has changed and now everyone is allowed to eat their vegetables--a far cry from "please don't eat the salads" 31 years earlier.

Today, neither the Food and Drug Administration, the Centers for Disease Control and Prevention, nor the American Cancer Society support the neutropenic diet. The real danger comes from pathogenic food-poisoning bacteria like Campylobacter, Salmonella, and E. coli. So we still have to keep patients away from risky foods like undercooked eggs, meat, dairy, and sprouts. At this point, though, there really shouldn't be a debate about whether cancer patients should be on a neutropenic diet. Nevertheless, many institutions still tell cancer patients they shouldn't eat fresh fruits and veggies. According to the latest survey, more than half of pediatric cancer doctors continue to prescribe these diets, though it's quite variable even among those at the same institution.

Why are doctors still reluctant to move away from the neutropenic diet? There are several reasons why physicians may be hesitant to incorporate evidence-based medicine into their practices. They may have limited time to review the literature. They'd like to dig deep into studies, but simply don't have the time to look at the evidence. Hmm, if only there was a website... :)

Bone marrow transplants are the final frontier. Sometimes it's our immune system itself that is cancerous, such as in leukemia or lymphoma. In these cases, the immune system is wiped out on purpose to rebuild it from scratch. So, inherent in the procedure is a profound immunodeficiency for which a neutropenic diet is often recommended. This has also had never been tested--until now.

Not only did it not work, a strict neutropenic diet was actually associated with an increased risk for infection, maybe because you don't get the good bugs from fruits and vegetables crowding out the bad guys in the gut. So not only was the neutropenic diet found to be unbeneficial; there was a suggestion that it has the potential to be harmful. This wouldn't be the first time an intervention strategy made good sense theoretically, but, when put to the test, was ultimately ineffective.

Unfortunately, there's an inertia in medicine that can result in medical practice that is at odds with the available evidence. Sometimes this disconnect can have devastating consequences. See, for example, Evidence-Based Medicine or Evidence-Biased? and The Tomato Effect.

The reason it is so important to straighten out the neutropenic diet myth is that fruits and vegetables may actually improve cancer survival:

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

Original Link

“Biggest Loser” Producer Debuts First Plant-Based Reality Show, “The Big Fat Truth”

The king of weight-loss television, JD Roth (former executive producer of The Biggest Loser), discovered the benefits of a whole-food, plant-based lifestyle two-and-a-half years ago, and now he wants to help bring the movement to the masses. The Big Fat... Read more

Original Link

Goldmine! Plant-Based Diet Gets An Entire Special Issue in a Medical Journal

Plant-Based Nutrition for Healthcare Professionals

goldmineDouble celebration as my new article, Plant-Based Nutrition for Healthcare Professionals: Implementing Diet as a Primary Modality in the Prevention and Treatment of Chronic Disease, with Ray Cronise just published in The Journal of Geriatric Cardiology.

You can view it here: bit.ly/GeriatricPBN

This is the full-text: bit.ly/GeriatricPBN-pdf

Further, this issue of the journal is a (very) special issue as it is the first one ever to be completely dedicated to plant-based diets!

Here is the table of contents for the entire journal issue, which as you may notice, is a goldmine of information that can be shared with your physicians, dietitians, colleagues, friends, family, and anyone else who is seeking to dig deeper into this most health-promoting way of eating.

 

The post Goldmine! Plant-Based Diet Gets An Entire Special Issue in a Medical Journal appeared first on Plant Based Dietitian.

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How Much Nutrition Education Do Doctors Get?

How Much Nutrition Education Do Doctors Get?.jpeg

In the United States, most deaths are preventable and related to nutrition. Given that the number-one cause of death and the number-one cause of disability in this country is diet, surely nutrition is the number-one subject taught in medical school, right? Sadly, that is not the case.

As shown in my video, Physician's May Be Missing Their Most Important Tool, a group of prominent physicians wrote in 2014 that "nutrition receives little attention in medical practice" and "the reason stems, in large part, from the severe deficiency of nutrition education at all levels of medical training." They note this is particularly shocking since it has been proven that a whole foods, plant-based diet low in animal products and refined carbohydrates can reverse coronary heart disease--our number-one killer--and provide potent protection against other leading causes fof death such as cancer and type 2 diabetes.

So, how has medical education been affected by this knowledge? Medical students are still getting less than 20 hours of nutrition education over 4 years, and even most of that has limited clinical relevance. Thirty years ago, only 37 percent of medical schools had a single course in nutrition. According to the most recent national survey, that number has since dropped to 27 percent. And it gets even worse after students graduate.

According to the official list of all the requirements for those specializing in cardiology, Fellows must perform at least 50 stress tests, participate in at least 100 catheterizations, and so on. But nowhere in the 34-page list of requirements is there any mention of nutrition. Maybe they leave that to the primary care physicians? No. In the official 35-page list of requirements for internal medicine doctors, once again, nutrition doesn't get even a single mention.

There are no requirements for nutrition before medical school either. Instead, aspiring doctors need to take courses like calculus, organic chemistry, and physics. Most of these common pre-med requirements are irrelevant to the practice of medicine and are primarily used to "weed out" students. Shouldn't we be weeding out based on skills a physician actually uses? An important paper published in the Archives of Internal Medicine states: "The pernicious and myopic nature of this process of selection becomes evident when one realizes that those qualities that may lead to success in a premedical organic chemistry course...[like] a brutal competitiveness, an unquestioning, meticulous memorization, are not necessarily the same qualities that are present in a competent clinician."

How about requiring a course in nutrition instead of calculus, or ethics instead of physics?

Despite the neglect of nutrition in medical education, physicians are considered by the public to be among the most trusted sources for information related to nutrition. But if doctors don't know what they're talking about, they could actually be contributing to diet-related disease. If we're going to stop the prevailing trend of chronic illness in the United States, physicians need to become part of the solution.

There's still a lot to learn about the optimal diet, but we don't need a single additional study to take nutrition education seriously right now. It's health care's low-hanging fruit. While we've had the necessary knowledge for some time, what we've been lacking is the will to put that knowledge into practice. If we emphasized the powerful role of nutrition, we could dramatically reduce suffering and needless death.

Take, for example, the "Million Hearts" initiative. More than 2 million Americans have a heart attack or stroke each year. In 2011, U.S. federal, state, and local government agencies launched the Million Hearts initiative to prevent 1 million of the 10 million heart attacks and strokes that will occur in the next 5 years. "But why stop at a million?" a doctor asked in the American Journal of Cardiology. Already, we possess all the information needed to eradicate atherosclerotic disease, which is our number-one killer while being virtually nonexistent in populations who consume plant-based diets. Some of the world's most renowned cardiovascular pathologists have stated we just need to get our cholesterol low enough in order to not only prevent--but also reverse--the disease in more than 80% of patients. We can open up arteries without drugs and surgery, and stabilize or improve blood flow in 99% of those who choose to eat healthily and clean up their bad habits. We can essentially eliminate our risk of having a heart attack even in the most advanced cases of heart disease.

Despite this, medical students aren't even taught these concepts while they're in school. Instead, the focus is on cutting people open, which frequently provides only symptomatic relief because we're not treating the actual cause of the disease. Fixing medical education is the solution to this travesty. Knowledge of nutrition can help doctors eradicate the world's leading killer.

I've previously addressed how Doctors Tend to Know Less Than They Think About Nutrition, which is no surprise given most medical schools in the United States fail to provide even a bare minimum of nutrition training (see Medical School Nutrition Education), with mainstream medical associations even actively lobbying against additional nutrition training.

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

Original Link

How Much Nutrition Education Do Doctors Get?

How Much Nutrition Education Do Doctors Get?.jpeg

In the United States, most deaths are preventable and related to nutrition. Given that the number-one cause of death and the number-one cause of disability in this country is diet, surely nutrition is the number-one subject taught in medical school, right? Sadly, that is not the case.

As shown in my video, Physician's May Be Missing Their Most Important Tool, a group of prominent physicians wrote in 2014 that "nutrition receives little attention in medical practice" and "the reason stems, in large part, from the severe deficiency of nutrition education at all levels of medical training." They note this is particularly shocking since it has been proven that a whole foods, plant-based diet low in animal products and refined carbohydrates can reverse coronary heart disease--our number-one killer--and provide potent protection against other leading causes fof death such as cancer and type 2 diabetes.

So, how has medical education been affected by this knowledge? Medical students are still getting less than 20 hours of nutrition education over 4 years, and even most of that has limited clinical relevance. Thirty years ago, only 37 percent of medical schools had a single course in nutrition. According to the most recent national survey, that number has since dropped to 27 percent. And it gets even worse after students graduate.

According to the official list of all the requirements for those specializing in cardiology, Fellows must perform at least 50 stress tests, participate in at least 100 catheterizations, and so on. But nowhere in the 34-page list of requirements is there any mention of nutrition. Maybe they leave that to the primary care physicians? No. In the official 35-page list of requirements for internal medicine doctors, once again, nutrition doesn't get even a single mention.

There are no requirements for nutrition before medical school either. Instead, aspiring doctors need to take courses like calculus, organic chemistry, and physics. Most of these common pre-med requirements are irrelevant to the practice of medicine and are primarily used to "weed out" students. Shouldn't we be weeding out based on skills a physician actually uses? An important paper published in the Archives of Internal Medicine states: "The pernicious and myopic nature of this process of selection becomes evident when one realizes that those qualities that may lead to success in a premedical organic chemistry course...[like] a brutal competitiveness, an unquestioning, meticulous memorization, are not necessarily the same qualities that are present in a competent clinician."

How about requiring a course in nutrition instead of calculus, or ethics instead of physics?

Despite the neglect of nutrition in medical education, physicians are considered by the public to be among the most trusted sources for information related to nutrition. But if doctors don't know what they're talking about, they could actually be contributing to diet-related disease. If we're going to stop the prevailing trend of chronic illness in the United States, physicians need to become part of the solution.

There's still a lot to learn about the optimal diet, but we don't need a single additional study to take nutrition education seriously right now. It's health care's low-hanging fruit. While we've had the necessary knowledge for some time, what we've been lacking is the will to put that knowledge into practice. If we emphasized the powerful role of nutrition, we could dramatically reduce suffering and needless death.

Take, for example, the "Million Hearts" initiative. More than 2 million Americans have a heart attack or stroke each year. In 2011, U.S. federal, state, and local government agencies launched the Million Hearts initiative to prevent 1 million of the 10 million heart attacks and strokes that will occur in the next 5 years. "But why stop at a million?" a doctor asked in the American Journal of Cardiology. Already, we possess all the information needed to eradicate atherosclerotic disease, which is our number-one killer while being virtually nonexistent in populations who consume plant-based diets. Some of the world's most renowned cardiovascular pathologists have stated we just need to get our cholesterol low enough in order to not only prevent--but also reverse--the disease in more than 80% of patients. We can open up arteries without drugs and surgery, and stabilize or improve blood flow in 99% of those who choose to eat healthily and clean up their bad habits. We can essentially eliminate our risk of having a heart attack even in the most advanced cases of heart disease.

Despite this, medical students aren't even taught these concepts while they're in school. Instead, the focus is on cutting people open, which frequently provides only symptomatic relief because we're not treating the actual cause of the disease. Fixing medical education is the solution to this travesty. Knowledge of nutrition can help doctors eradicate the world's leading killer.

I've previously addressed how Doctors Tend to Know Less Than They Think About Nutrition, which is no surprise given most medical schools in the United States fail to provide even a bare minimum of nutrition training (see Medical School Nutrition Education), with mainstream medical associations even actively lobbying against additional nutrition training.

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

Original Link

Using a Smell Test to Diagnose Alzheimer’s Disease

Using a Smell Test to Diagnose Alzheimer's Disease.jpeg

Alzheimer's disease (AD) pathology appears to start in the part of the brain that handles smell before subsequently spreading to additional brain regions and then, ultimately, taking over much of the rest of the brain. This led some to speculate that Alzheimer's disease may begin in the nose. Perhaps there's some environmental agent that might enter the brain through some portal in the nostrils?

This is the so-called olfactory vector hypothesis. The anatomy of the nose is well suited for the transfer of things directly into the brain, since the olfactory nerves that stick out into the nose project directly into the brain, bypassing the blood-brain barrier. The nose was actually a major infection route for the polio virus. Public health officials you started cauterizing the nasal passages of schoolchildren by spraying caustic chemicals up their noses in an effort to prevent the disease.

The concern is if people breathe in some ionized metals like aluminum dust, for example, it could be transported into the brain through these olfactory nerves at a rate of about 2 millimeters an hour, which is practically 2 inches a day. Doubt has been cast on this theory, however, by a case report of a woman born with a birth defect in which she had no smell nerves yet still developed Alzheimer's-like pathology. And so, to date, all the supporting evidence is really just circumstantial. It is clear, though, that changes in the sense of smell is among the first clinical signs of Alzheimer's, occurring during the preclinical phase--that is, before there's any noticeable cognitive decline. Could we use these changes to predict or diagnose the disease?

For years, researchers have been trying to find markers of brain illness hidden in people's ability to smell using all sorts of fancy gadgets. For example, functional MRI scans can detect differences in brain activation in response to an odor. In my video, Peanut Butter Smell Test for Alzheimer's, you can see the responses to lavender. You'll see a representation of a normal brain's responses to the odor versus an Alzheimer's brain. This unequivocally demonstrates that we can pick up changes in smell function due to Alzheimer's. But do we really need a million-dollar machine?

An ingenious group of researchers at the University of Florida discovered all we may need is some peanut butter and a ruler.

Considering that the left side of the brain primarily processes what we smell through our left nostril and the right side of our brain covers the right nostril, and understanding that Alzheimer's strikes the left side more than the right, what if you performed the following experiment: Close your eyes and mouth, breathe normally through the nose, then close one nostril, and hold a foot-long ruler out from the open nostril. Once your eyes, mouth, and one nostril are closed, open a container of peanut butter at the bottom of the ruler (one foot away from your open nostril). Move the peanut butter closer by 1 centimeter upon each exhale until you can detect the odor. Then repeat the whole procedure again using your other nostril.

This is exactly what the University of Florida researchers did with their subjects. What did they find? The normal elderly control subjects in the study smelled the peanut butter as soon as it came within an average of 18 centimeters (about 7 inches) from either nostril. It was about the same, roughly 7 inches, in the right nostrils of Alzheimer's patients. But in their left nostrils, it was a mere 2 inches! The peanut butter had to be only 2 inches away before the Alzheimer's patients could detect it through their left nostrils. This happened every single time. Indeed, the researchers found that a "left nostril impairment of odor detection was present in all the patients with probable AD." There was no left-right difference in the control group; they could smell the peanut butter when it was the same distance away from both their left and right nostrils. In the Alzheimer's group, however, there was a 12-centimeter difference.

The disparity was so great that we may be able to set a cutoff value for the diagnosis of Alzheimer's. The researchers reported that "[c]ompared to patients with other causes of dementia this nostril asymmetry of odor detection...was 100% sensitive and 100% specific for probable AD," meaning no false positives and no false negatives. Compared to healthy people, it was 100% sensitive in picking up cases of probable Alzheimer's and 92% specific. What exactly does that mean? In this study, if you had Alzheimer's, there was a 100% chance of having that wide left-right discrepancy. But, if you did have that discrepancy, the chance of having Alzheimer's was only 92%. This means there were some false positives.

The reason it's only "probable" Alzheimer's is because the only way we can really confirm someone has the disease is on autopsy. The current criteria for diagnosing Alzheimer's require an extensive evaluation, combined with fancy positron emission tomography (PET) scans and spinal taps. All of these tests are expensive and hard to get, can be invasive, and can have potential complications. On top of that, they are neither highly sensitive nor specific. The left-right nostril / peanut butter odor detection test, however, was fast, simple, non-invasive, and inexpensive. They concluded that may make peanut butter an ideal instrument for the early detection of Alzheimer's disease.

Does all this sound a bit too good to be true? It may be. A University of Pennsylvania research team was unable to replicate the results. Click here to read their paper. So at this point, the data are mixed. I'll do another post once more studies are published and we have a better handle on whether it's useful or not.

Of course, it's better to prevent Alzheimer's in the first place. Check out these videos for more information.

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

Original Link

Using a Smell Test to Diagnose Alzheimer’s Disease

Using a Smell Test to Diagnose Alzheimer's Disease.jpeg

Alzheimer's disease (AD) pathology appears to start in the part of the brain that handles smell before subsequently spreading to additional brain regions and then, ultimately, taking over much of the rest of the brain. This led some to speculate that Alzheimer's disease may begin in the nose. Perhaps there's some environmental agent that might enter the brain through some portal in the nostrils?

This is the so-called olfactory vector hypothesis. The anatomy of the nose is well suited for the transfer of things directly into the brain, since the olfactory nerves that stick out into the nose project directly into the brain, bypassing the blood-brain barrier. The nose was actually a major infection route for the polio virus. Public health officials you started cauterizing the nasal passages of schoolchildren by spraying caustic chemicals up their noses in an effort to prevent the disease.

The concern is if people breathe in some ionized metals like aluminum dust, for example, it could be transported into the brain through these olfactory nerves at a rate of about 2 millimeters an hour, which is practically 2 inches a day. Doubt has been cast on this theory, however, by a case report of a woman born with a birth defect in which she had no smell nerves yet still developed Alzheimer's-like pathology. And so, to date, all the supporting evidence is really just circumstantial. It is clear, though, that changes in the sense of smell is among the first clinical signs of Alzheimer's, occurring during the preclinical phase--that is, before there's any noticeable cognitive decline. Could we use these changes to predict or diagnose the disease?

For years, researchers have been trying to find markers of brain illness hidden in people's ability to smell using all sorts of fancy gadgets. For example, functional MRI scans can detect differences in brain activation in response to an odor. In my video, Peanut Butter Smell Test for Alzheimer's, you can see the responses to lavender. You'll see a representation of a normal brain's responses to the odor versus an Alzheimer's brain. This unequivocally demonstrates that we can pick up changes in smell function due to Alzheimer's. But do we really need a million-dollar machine?

An ingenious group of researchers at the University of Florida discovered all we may need is some peanut butter and a ruler.

Considering that the left side of the brain primarily processes what we smell through our left nostril and the right side of our brain covers the right nostril, and understanding that Alzheimer's strikes the left side more than the right, what if you performed the following experiment: Close your eyes and mouth, breathe normally through the nose, then close one nostril, and hold a foot-long ruler out from the open nostril. Once your eyes, mouth, and one nostril are closed, open a container of peanut butter at the bottom of the ruler (one foot away from your open nostril). Move the peanut butter closer by 1 centimeter upon each exhale until you can detect the odor. Then repeat the whole procedure again using your other nostril.

This is exactly what the University of Florida researchers did with their subjects. What did they find? The normal elderly control subjects in the study smelled the peanut butter as soon as it came within an average of 18 centimeters (about 7 inches) from either nostril. It was about the same, roughly 7 inches, in the right nostrils of Alzheimer's patients. But in their left nostrils, it was a mere 2 inches! The peanut butter had to be only 2 inches away before the Alzheimer's patients could detect it through their left nostrils. This happened every single time. Indeed, the researchers found that a "left nostril impairment of odor detection was present in all the patients with probable AD." There was no left-right difference in the control group; they could smell the peanut butter when it was the same distance away from both their left and right nostrils. In the Alzheimer's group, however, there was a 12-centimeter difference.

The disparity was so great that we may be able to set a cutoff value for the diagnosis of Alzheimer's. The researchers reported that "[c]ompared to patients with other causes of dementia this nostril asymmetry of odor detection...was 100% sensitive and 100% specific for probable AD," meaning no false positives and no false negatives. Compared to healthy people, it was 100% sensitive in picking up cases of probable Alzheimer's and 92% specific. What exactly does that mean? In this study, if you had Alzheimer's, there was a 100% chance of having that wide left-right discrepancy. But, if you did have that discrepancy, the chance of having Alzheimer's was only 92%. This means there were some false positives.

The reason it's only "probable" Alzheimer's is because the only way we can really confirm someone has the disease is on autopsy. The current criteria for diagnosing Alzheimer's require an extensive evaluation, combined with fancy positron emission tomography (PET) scans and spinal taps. All of these tests are expensive and hard to get, can be invasive, and can have potential complications. On top of that, they are neither highly sensitive nor specific. The left-right nostril / peanut butter odor detection test, however, was fast, simple, non-invasive, and inexpensive. They concluded that may make peanut butter an ideal instrument for the early detection of Alzheimer's disease.

Does all this sound a bit too good to be true? It may be. A University of Pennsylvania research team was unable to replicate the results. Click here to read their paper. So at this point, the data are mixed. I'll do another post once more studies are published and we have a better handle on whether it's useful or not.

Of course, it's better to prevent Alzheimer's in the first place. Check out these videos for more information.

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

Original Link

Follow-up Researcher Training, Upcoming CME, and The Big Fat Truth



Bulgarian_HNTD.jpeg

Reaching More People Than Ever Before

A long time dream of mine is finally coming true!

NutritionFacts.org will be partnering with the American College of Lifestyle Medicine to offer online courses for Continuing Medical Education credits. To maintain an active license, most medical professionals are required to stay on top of new developments by getting a certain number of hours of CME every year. And soon they'll be able to fulfill part of that requirement by learning the latest in evidence-based nutrition! We're working on the first course right now. but if your license is expiring and you can't wait, the Physicians Committee for Responsible Medicine offers some wonderful (and free!) CME at NutritionCME.org

Follow-Up Research Training

One of the first CME courses we'll be offering will be based on the research training webinar I hosted in early May. It was a huge success and I'm excited to announce that a 2-hour follow-up training will take place on Saturday, June 17th at 2pm ET. Go to NutritionFacts.org/webinar for more information and to register.

Basically, I'm just going to be putting into practice all the stuff we learned in last month's webinar to run practice searches on topics of your choosing. Submit your suggestions and vote on ideas proposed by others here.

If you missed the 4-hour May 6th training, a recording is available along with the slides and notes.

Our Growing Global Reach

It's been a whirlwind 18 months since How Not to Die was first released, and thanks to all of you, we're still in the top 100 on Amazon's best seller's list with 1,000+ five star reviews. The book is reaching audiences across the globe and has already been translated into 16 different languages including Serbian, Swedish, French and Bulgarian, with many more on the way!

I also want to remind everyone that we have more than 3,000 videos translated, covering 43 languages. For help accessing the translations, we have instructions here. To figure out what videos are in which language do a blank search on NutritionFacts.org and then choose your Video Translation Language.

Mandarin Translators Wanted

The latest official dietary guidelines in China call for cutting meat consumption in half in addition to restricting junk food, eggs, and dairy. Just in the last few months, we've gotten more than 100,000 new Chinese subscribers, and so it looks like the public might be taking the new recommendations to heart! We are working to share more of our videos on the popular video platforms Miaopai and Youku. Please consider applying here if you are fluent and able to translate in (Simplified) Mandarin.

Coming Soon: The Big Fat Truth

J.D. Roth, best known for his show The Biggest Loser, has created a new TV series called The Big Fat Truth. The series focuses on addressing the root causes of obesity, and how our diet can play a role in improving our overall health. I was honored to be featured as a guest on the show. The episodes that I'm in premiere June 18th and July 16th. For more info on the show and where to watch it, go here.

And if you haven't watched it yet, check out my appearance on the new show Prescription: Nutrition. You can watch the first episode here.

This month I'm also taping my first PBS TV special based on How Not to Die. It will start airing this Fall--I can't wait!

Help Spread the Word

Ever been in a situation where the subject of diet or disease came up and you wish there were a quick and easy way to help them cut through all the nonsense out there? You can help spread the message of dietary sanity with our outreach cards. Share them with friends, colleagues, patients, or anyone else you think could benefit from life-saving nutritional science. They are available at cost here.

Live Q&A

Every month I do Q&As live from my treadmill and this month, Thursday, June 29th is the day:

Facebook Live: At 2pm ET go to our Facebook page to watch live and ask questions.

YouTube Live Stream: At 1:30pm ET go here to watch live and ask even more questions!

Have a super summer (or wonderful winter to all our southern hemispherians!).

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:

2012: Uprooting the Leading Causes of Death
2013: 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
2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers

Original Link

Follow-up Researcher Training, Upcoming CME, and The Big Fat Truth



Bulgarian_HNTD.jpeg

Reaching More People Than Ever Before

A long time dream of mine is finally coming true!

NutritionFacts.org will be partnering with the American College of Lifestyle Medicine to offer online courses for Continuing Medical Education credits. To maintain an active license, most medical professionals are required to stay on top of new developments by getting a certain number of hours of CME every year. And soon they'll be able to fulfill part of that requirement by learning the latest in evidence-based nutrition! We're working on the first course right now. but if your license is expiring and you can't wait, the Physicians Committee for Responsible Medicine offers some wonderful (and free!) CME at NutritionCME.org

Follow-Up Research Training

One of the first CME courses we'll be offering will be based on the research training webinar I hosted in early May. It was a huge success and I'm excited to announce that a 2-hour follow-up training will take place on Saturday, June 17th at 2pm ET. Go to NutritionFacts.org/webinar for more information and to register.

Basically, I'm just going to be putting into practice all the stuff we learned in last month's webinar to run practice searches on topics of your choosing. Submit your suggestions and vote on ideas proposed by others here.

If you missed the 4-hour May 6th training, a recording is available along with the slides and notes.

Our Growing Global Reach

It's been a whirlwind 18 months since How Not to Die was first released, and thanks to all of you, we're still in the top 100 on Amazon's best seller's list with 1,000+ five star reviews. The book is reaching audiences across the globe and has already been translated into 16 different languages including Serbian, Swedish, French and Bulgarian, with many more on the way!

I also want to remind everyone that we have more than 3,000 videos translated, covering 43 languages. For help accessing the translations, we have instructions here. To figure out what videos are in which language do a blank search on NutritionFacts.org and then choose your Video Translation Language.

Mandarin Translators Wanted

The latest official dietary guidelines in China call for cutting meat consumption in half in addition to restricting junk food, eggs, and dairy. Just in the last few months, we've gotten more than 100,000 new Chinese subscribers, and so it looks like the public might be taking the new recommendations to heart! We are working to share more of our videos on the popular video platforms Miaopai and Youku. Please consider applying here if you are fluent and able to translate in (Simplified) Mandarin.

Coming Soon: The Big Fat Truth

J.D. Roth, best known for his show The Biggest Loser, has created a new TV series called The Big Fat Truth. The series focuses on addressing the root causes of obesity, and how our diet can play a role in improving our overall health. I was honored to be featured as a guest on the show. The episodes that I'm in premiere June 18th and July 16th. For more info on the show and where to watch it, go here.

And if you haven't watched it yet, check out my appearance on the new show Prescription: Nutrition. You can watch the first episode here.

This month I'm also taping my first PBS TV special based on How Not to Die. It will start airing this Fall--I can't wait!

Help Spread the Word

Ever been in a situation where the subject of diet or disease came up and you wish there were a quick and easy way to help them cut through all the nonsense out there? You can help spread the message of dietary sanity with our outreach cards. Share them with friends, colleagues, patients, or anyone else you think could benefit from life-saving nutritional science. They are available at cost here.

Live Q&A

Every month I do Q&As live from my treadmill and this month, Thursday, June 29th is the day:

Facebook Live: At 2pm ET go to our Facebook page to watch live and ask questions.

YouTube Live Stream: At 1:30pm ET go here to watch live and ask even more questions!

Have a super summer (or wonderful winter to all our southern hemispherians!).

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:

2012: Uprooting the Leading Causes of Death
2013: 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
2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers

Original Link