Are Sugar Pills Better than Antidepressant Drugs?

Do Antidepressant Drugs Really Work.jpg

We've learned that exercise compares favorably to antidepressant medications as a first-line treatment for mild to moderate depression (in my video Exercise vs. Drugs for Depression). But how much is that really saying? How effective are antidepressant drugs in the first place?

A recent meta-analysis sparked huge scientific and public controversy by stating that the placebo effect can explain the apparent clinical benefits of antidepressants. But aren't there thousands of clinical trials providing compelling evidence for antidepressant effectiveness? If a meta-analysis compiles together all the best published research, how could it say they don't work much better than sugar pills?

The key word is "published."

What if a drug company decided only to publish studies that showed a positive effect, but quietly shelved and concealed any studies showing the drug didn't work? If you didn't know any better, you'd look at the published medical literature and think "Wow, this drug is great." And what if all the drug companies did that? To find out if this was the case, researchers applied to the FDA under the Freedom of Information Act to get access to the published and unpublished studies submitted by pharmaceutical companies, and what they found was shocking.

According to the published literature, the results of nearly all the trials of antidepressants were positive, meaning they worked. In contrast, FDA analysis of the trial data showed only roughly half of the trials had positive results. In other words, about half the studies showed the drugs didn't work. Thus, when published and unpublished data are combined, they fail to show a clinically significant advantage for antidepressant medication over a sugar pill. Not publishing negative results undermines evidence-based medicine and puts millions of patients at risk for using ineffective or unsafe drugs, and this was the case with these antidepressant drugs.

These revelations hit first in 2008. Prozac, Serzone, Paxil and Effexor worked, but so did sugar pills, and the difference between the drug and placebo was small. That was 2008. Where were we by 2014? Analyses of the published data and the unpublished data that were hidden by drug companies reveals that most (if not all) of the benefits of antidepressants are due to the placebo effect. And what's even worse, Freedom of Information Act documents show the FDA knew about it but made an explicit decision to keep this information from the public and from prescribing physicians.

How could drug companies get away with this?

The pharmaceutical industry is considered the most profitable and politically influential industry in the United States, and mental illness can be thought of as the drug industry's golden goose: incurable, common, long term and involving multiple medications. Antidepressant medications are prescribed to 8.7 percent of the U.S. population. It's a multi-billion dollar market.

To summarize, there is a strong therapeutic response to antidepressant medication; it's just that the response to placebo is almost as strong. Indeed, antidepressants offer substantial benefits to millions of people suffering from depression, and to cast them as ineffective is inaccurate. Just because they may not work better than fake pills doesn't mean they don't work. It's like homeopathy--just because it doesn't work better than the sugar pills, doesn't mean that homeopathy doesn't work. The placebo effect is real and powerful.

In one psychopharmacology journal, a psychiatrist funded by the Prozac company defends the drugs stating, "A key issue is disregarded by the naysaying critics. If the patient is benefiting from antidepressant treatment does it matter whether this is being achieved via drug or placebo effects?"

Of course it matters!

Among the side effects of antidepressants are: sexual dysfunction in up to three quarters of people, long-term weight gain, insomnia, nausea and diarrhea. About one in five show withdrawal symptoms when they try to quit. And perhaps more tragically, the drugs may make people more likely to become depressed in the future. Let me say that again: People are more likely to become depressed after treatment by antidepressants than after treatment by other means - including placebo.

So if doctors are willing to give patients placebo-equivalent treatments, maybe it'd be better for them to just lie to patients and give them actual sugar pills. Yes, that involves deception, but isn't that preferable than deception with a side of side effects? See more on this in my video Do Antidepressant Drugs Really Work?

If different treatments are equally effective, then choice should be based on risk and harm, and of all of the available treatments, antidepressant drugs may be among the riskiest and most harmful. If they are to be used at all, it should be as a last resort, when depression is extremely severe and all other treatment alternatives have been tried and failed.

Antidepressants may not work better than placebo for mild and moderate depression, but for very severe depression, the drugs do beat out sugar pills. But that's just a small fraction of the people taking these drugs. That means that the vast majority of depressed patients--as many as nine out of ten--are being prescribed medications that have negligible benefits to them.

Too many doctors quickly decide upon a depression diagnosis without necessarily listening to what the patient has to say and end up putting them on antidepressants without considering alternatives. And fortunately, there are effective alternatives. Physical exercise, for example can have lasting effects, and if that turns out to also be a placebo effect, it is at least a placebo with an enviable list of side effects. Whereas side effects of antidepressants include things like sexual dysfunction and insomnia, side effects of exercise include enhanced libido, better sleep, decreased body fat, improved muscle tone and a longer life.


There are other ways meta-analyses can be misleading. See The Saturated Fat Studies: Buttering Up the Public and The Saturated Fat Studies: Set Up to Fail.

More on the ethical challenges facing doctors and whether or not to prescribe sugar pills in The Lie That Heals: Should Doctors Give Placebos?

I've used the Freedom of Information Act myself to get access to behind the scenes industry shenanigans. See, for example, what I found out about the egg industry in Who Says Eggs Aren't Healthy or Safe? and Eggs and Cholesterol: Patently False and Misleading Claims.

This isn't the only case of the medical profession overselling the benefits of drugs. See How Smoking in 1956 is Like Eating in 2016, The Actual Benefit of Diet vs. Drugs and Why Prevention is Worth a Ton of Cure (though if you're worried about your mood they might make you even more depressed!)

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: GraphicStock. This image has been modified.

Original Link

Are Sugar Pills Better than Antidepressant Drugs?

Do Antidepressant Drugs Really Work.jpg

We've learned that exercise compares favorably to antidepressant medications as a first-line treatment for mild to moderate depression (in my video Exercise vs. Drugs for Depression). But how much is that really saying? How effective are antidepressant drugs in the first place?

A recent meta-analysis sparked huge scientific and public controversy by stating that the placebo effect can explain the apparent clinical benefits of antidepressants. But aren't there thousands of clinical trials providing compelling evidence for antidepressant effectiveness? If a meta-analysis compiles together all the best published research, how could it say they don't work much better than sugar pills?

The key word is "published."

What if a drug company decided only to publish studies that showed a positive effect, but quietly shelved and concealed any studies showing the drug didn't work? If you didn't know any better, you'd look at the published medical literature and think "Wow, this drug is great." And what if all the drug companies did that? To find out if this was the case, researchers applied to the FDA under the Freedom of Information Act to get access to the published and unpublished studies submitted by pharmaceutical companies, and what they found was shocking.

According to the published literature, the results of nearly all the trials of antidepressants were positive, meaning they worked. In contrast, FDA analysis of the trial data showed only roughly half of the trials had positive results. In other words, about half the studies showed the drugs didn't work. Thus, when published and unpublished data are combined, they fail to show a clinically significant advantage for antidepressant medication over a sugar pill. Not publishing negative results undermines evidence-based medicine and puts millions of patients at risk for using ineffective or unsafe drugs, and this was the case with these antidepressant drugs.

These revelations hit first in 2008. Prozac, Serzone, Paxil and Effexor worked, but so did sugar pills, and the difference between the drug and placebo was small. That was 2008. Where were we by 2014? Analyses of the published data and the unpublished data that were hidden by drug companies reveals that most (if not all) of the benefits of antidepressants are due to the placebo effect. And what's even worse, Freedom of Information Act documents show the FDA knew about it but made an explicit decision to keep this information from the public and from prescribing physicians.

How could drug companies get away with this?

The pharmaceutical industry is considered the most profitable and politically influential industry in the United States, and mental illness can be thought of as the drug industry's golden goose: incurable, common, long term and involving multiple medications. Antidepressant medications are prescribed to 8.7 percent of the U.S. population. It's a multi-billion dollar market.

To summarize, there is a strong therapeutic response to antidepressant medication; it's just that the response to placebo is almost as strong. Indeed, antidepressants offer substantial benefits to millions of people suffering from depression, and to cast them as ineffective is inaccurate. Just because they may not work better than fake pills doesn't mean they don't work. It's like homeopathy--just because it doesn't work better than the sugar pills, doesn't mean that homeopathy doesn't work. The placebo effect is real and powerful.

In one psychopharmacology journal, a psychiatrist funded by the Prozac company defends the drugs stating, "A key issue is disregarded by the naysaying critics. If the patient is benefiting from antidepressant treatment does it matter whether this is being achieved via drug or placebo effects?"

Of course it matters!

Among the side effects of antidepressants are: sexual dysfunction in up to three quarters of people, long-term weight gain, insomnia, nausea and diarrhea. About one in five show withdrawal symptoms when they try to quit. And perhaps more tragically, the drugs may make people more likely to become depressed in the future. Let me say that again: People are more likely to become depressed after treatment by antidepressants than after treatment by other means - including placebo.

So if doctors are willing to give patients placebo-equivalent treatments, maybe it'd be better for them to just lie to patients and give them actual sugar pills. Yes, that involves deception, but isn't that preferable than deception with a side of side effects? See more on this in my video Do Antidepressant Drugs Really Work?

If different treatments are equally effective, then choice should be based on risk and harm, and of all of the available treatments, antidepressant drugs may be among the riskiest and most harmful. If they are to be used at all, it should be as a last resort, when depression is extremely severe and all other treatment alternatives have been tried and failed.

Antidepressants may not work better than placebo for mild and moderate depression, but for very severe depression, the drugs do beat out sugar pills. But that's just a small fraction of the people taking these drugs. That means that the vast majority of depressed patients--as many as nine out of ten--are being prescribed medications that have negligible benefits to them.

Too many doctors quickly decide upon a depression diagnosis without necessarily listening to what the patient has to say and end up putting them on antidepressants without considering alternatives. And fortunately, there are effective alternatives. Physical exercise, for example can have lasting effects, and if that turns out to also be a placebo effect, it is at least a placebo with an enviable list of side effects. Whereas side effects of antidepressants include things like sexual dysfunction and insomnia, side effects of exercise include enhanced libido, better sleep, decreased body fat, improved muscle tone and a longer life.


There are other ways meta-analyses can be misleading. See The Saturated Fat Studies: Buttering Up the Public and The Saturated Fat Studies: Set Up to Fail.

More on the ethical challenges facing doctors and whether or not to prescribe sugar pills in The Lie That Heals: Should Doctors Give Placebos?

I've used the Freedom of Information Act myself to get access to behind the scenes industry shenanigans. See, for example, what I found out about the egg industry in Who Says Eggs Aren't Healthy or Safe? and Eggs and Cholesterol: Patently False and Misleading Claims.

This isn't the only case of the medical profession overselling the benefits of drugs. See How Smoking in 1956 is Like Eating in 2016, The Actual Benefit of Diet vs. Drugs and Why Prevention is Worth a Ton of Cure (though if you're worried about your mood they might make you even more depressed!)

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: GraphicStock. This image has been modified.

Original Link

Improving Employee Diets Could Save Companies Millions

Plant-Based Workplace Intervention.jpg

The food, alcohol, and tobacco industries have been blamed for "manufacturing epidemics" of chronic disease, but they're just trying to sell more product like everyone else. And so if that means distorting science, creating front groups, compromising scientists, blocking public health policies... they're just trying to protect their business.

It's not about customer satisfaction, but shareholder satisfaction. How else could we have tobacco companies, for example, "continuing to produce products that kill one in two of their most loyal customers?"

Civil society organizations concerned with public health have earned a reputation for being "anti-industry," but the issue is not industry, but that sector of industry whose products are harmful to public health. We like the broccoli industry. In fact, the corporate world might end up leading the lifestyle medicine revolution.

As shown in my video, Plant-Based Workplace Intervention, the annual cost attributable to obesity alone among full-time employees is estimated at 70 billion dollars, primarily because obese employees are not as productive on the job. Having healthy employees is good for the bottom-line. Every dollar spent on wellness programs may offer a $3 return on investment. And if you track the market performance of companies that strive to nurture a culture of health, they appear to outperform their competition.

That's why companies like GEICO are exploring workplace dietary interventions (see my video, Slimming the Gecko). The remarkable success at GEICO headquarters led to an expansion of the program at corporate offices across the country, with test sites from San Diego to Macon, Georgia. Given that previous workplace studies have found that workers who ate a lot of animal protein had nearly five times the odds of obesity, whereas those that ate mostly plant protein appeared protected, obese and diabetic employees were asked to follow a plant-based diet of whole grains, vegetables, beans, and fruit while avoiding meat, dairy, and eggs. Compliance wasn't great. Fewer than half really got their animal product consumption down, but there were definitely improvements such as significant reductions in saturated fat, an increase in protective nutrients, and even noted weight loss, lower blood cholesterol levers, and better blood sugar control in diabetics.

And this was with no calorie counting, no portion control, and no exercise component. The weight reduction appears to result from feeling fuller earlier, due to higher dietary fiber intake. The difference in weight loss could also be the result of an increase in the thermic effect of food, allowing a small extra edge for weight loss in the vegan group. Those eating plant-based diets tend to burn off more calories in heat.

Eating plants appears to boost metabolism. This may be due to increased insulin sensitivity in cells, allowing cells to metabolize carbohydrates more quickly rather than storing them as body fat. "As a result, vegan diets have been shown to increase postprandial calorie burn by about 16%, up to three hours after consuming a meal."

Imagine how much money companies that self-insure their employees could save! See, for example:

Find out more on some of the potential downsides of corporate influence in videos like

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: Ryan McGuire / Pixabay. This image has been modified.

Original Link

Improving Employee Diets Could Save Companies Millions

Plant-Based Workplace Intervention.jpg

The food, alcohol, and tobacco industries have been blamed for "manufacturing epidemics" of chronic disease, but they're just trying to sell more product like everyone else. And so if that means distorting science, creating front groups, compromising scientists, blocking public health policies... they're just trying to protect their business.

It's not about customer satisfaction, but shareholder satisfaction. How else could we have tobacco companies, for example, "continuing to produce products that kill one in two of their most loyal customers?"

Civil society organizations concerned with public health have earned a reputation for being "anti-industry," but the issue is not industry, but that sector of industry whose products are harmful to public health. We like the broccoli industry. In fact, the corporate world might end up leading the lifestyle medicine revolution.

As shown in my video, Plant-Based Workplace Intervention, the annual cost attributable to obesity alone among full-time employees is estimated at 70 billion dollars, primarily because obese employees are not as productive on the job. Having healthy employees is good for the bottom-line. Every dollar spent on wellness programs may offer a $3 return on investment. And if you track the market performance of companies that strive to nurture a culture of health, they appear to outperform their competition.

That's why companies like GEICO are exploring workplace dietary interventions (see my video, Slimming the Gecko). The remarkable success at GEICO headquarters led to an expansion of the program at corporate offices across the country, with test sites from San Diego to Macon, Georgia. Given that previous workplace studies have found that workers who ate a lot of animal protein had nearly five times the odds of obesity, whereas those that ate mostly plant protein appeared protected, obese and diabetic employees were asked to follow a plant-based diet of whole grains, vegetables, beans, and fruit while avoiding meat, dairy, and eggs. Compliance wasn't great. Fewer than half really got their animal product consumption down, but there were definitely improvements such as significant reductions in saturated fat, an increase in protective nutrients, and even noted weight loss, lower blood cholesterol levers, and better blood sugar control in diabetics.

And this was with no calorie counting, no portion control, and no exercise component. The weight reduction appears to result from feeling fuller earlier, due to higher dietary fiber intake. The difference in weight loss could also be the result of an increase in the thermic effect of food, allowing a small extra edge for weight loss in the vegan group. Those eating plant-based diets tend to burn off more calories in heat.

Eating plants appears to boost metabolism. This may be due to increased insulin sensitivity in cells, allowing cells to metabolize carbohydrates more quickly rather than storing them as body fat. "As a result, vegan diets have been shown to increase postprandial calorie burn by about 16%, up to three hours after consuming a meal."

Imagine how much money companies that self-insure their employees could save! See, for example:

Find out more on some of the potential downsides of corporate influence in videos like

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: Ryan McGuire / Pixabay. This image has been modified.

Original Link

Caloric Restriction vs. Plant-Based Diets

July14.jpg

Hundreds of thousands of deaths in the United States every year are attributed to obesity, now overtaking smoking as perhaps the main preventable cause of illness and premature death. In particular, excess body fatness is an important cause of most cancers, according to a meta-analysis of studies done to date. For some cancers, about half of the cases may be attributable to just being overweight or obese.

What's the connection, though? Why do individuals who are obese have increased cancer risk? To answer this question we must consider the biochemical consequences of obesity, like IGF-1; insulin like growth factor one is a cancer-promoting growth hormone associated with a variety of common cancers in adults, as well as children. Kids who got cancer had about four times the levels of IGF-1 circulating in their bloodstream, whereas people growing up with abnormally low levels of IGF-1 don't seem to get cancer at all.

I've talked about this cancer-proofing mutation (See Cancer-Proofing Mutation), the role animal protein intake plays in boosting IGF-1 production from our liver (Protein Intake & IGF-1 Production), which may explain plant-based protection from cancer (The Answer to the Pritikin Puzzle), and how plant-based one has to eat (How Plant-Based to Lower IGF-1?), but our liver is not the only tissue that produced IGF-1, fat cells produce IGF-1 too. That may help explain this "twenty-first century cancer epidemic caused by obesity."

So of course drug companies have come up with a variety of IGF-1 blocking chemo agents, with cute names like figitumamab, but with not-so-cute side effects "such as early fatal toxicities." So perhaps better to lower IGF-1 the natural way, by eating a plant-based diet, as vegan women and men have lower IGF-1 levels. Maybe, though, it's just because they're so skinny. The only dietary group that comes close to the recommended BMI of 21 to 23 were those eating strictly plant-based diets, so maybe it's the weight loss that did it. Maybe we can eat whatever we want as long as we're skinny.

To put that to the test, we'd have to find a group of people that eat meat, but are still as slim as vegans. And that's what researchers did - long-distance endurance runners, running an average of 48 miles a week for 21 years were as slim as vegans. If we run 50,000 miles we too can maintain a BMI of even a raw vegan. So what did they find?

If we look at blood concentrations of cancer risk factors among the groups of study subjects, we see that only the vegans had significantly lower levels of IGF-1. That makes sense given the role animal protein plays in boosting IGF-1 levels.

But the vegan group didn't just eat less animal protein, they ate fewer calories. And in rodents at least, caloric restriction alone reduces IGF-1 levels. So maybe low IGF-1 among vegans isn't due to their slim figures, but maybe the drop in IGF-1 in vegans is effectively due to their unintentional calorie restriction. So we have to compare vegans to people practicing severe calorie restriction.

To do this, the researchers recruited vegans from the St. Louis Vegetarian Society, and went to the Calorie Restriction Society to find folks practicing severe caloric restriction. What did they find?

Only the vegan group got a significant drop in IGF-1. These findings demonstrate that, unlike in rodents, long-term severe caloric restriction in humans does not reduce the level of this cancer-promoting hormone. It's not how many calories we eat, but the protein intake that may be the key determinant of circulating IGF-1 levels in humans, and so reduced protein intake may become an important component of anti-cancer and anti-aging dietary interventions.

That same data set that compared plant eaters to marathon runners was also featured in Hibiscus Tea vs. Plant-Based Diets for Hypertension and Arteries of Vegans vs. Runners.

These studies are highlighted in my video Caloric Restriction vs. Plant-based Diets.

More on the caloric consumption and longevity:

What exactly is IGF-1 and what is the relationship to animal protein consumption?:

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 Uprooting the Leading Causes of Death, More Than an Apple a Day, From Table to Able, and Food as Medicine.

Image Credit: Heather Hammond / Flickr

Original Link

Virus in Chicken Could Be Linked to Obesity

NF-May31 Infectobesity Adenovirus 36 and Childhood Obesity.jpeg

Recently, there has been research examining the connection between poultry consumption and weight gain. One study out of the Netherlands examining about 4,000 people, correlated chicken consumption with weight gain. Another study followed 89,000 people in four other countries and found that animal protein intake was associated with long-term weight gain, and poultry was the worst, with 40 percent more weight gain than red meat or processed meat.

What makes poultry so bad? Yes, chickens are fatty these days because of the way we've genetically manipulated them--up to ten times more fat and calories than they used to have--but one bizarre theory postulated that it might be due to an obesity-causing chicken virus. In one study, one in five obese humans tested positive to the chicken virus SMAM-1, with those exposed to the chicken virus averaging 33 pounds heavier than those testing negative.

SMAM-1 was the first chicken virus to be associated with human obesity, but not the last. The original obesity-causing chicken virus SMAM-1 was able to effectively transmit obesity from one chicken to another when caged together, similar to a human adenovirus Ad-36, a human obesity-associated virus first associated with obesity in chickens and mice. Ad-36 spreads quickly from one chicken to another via nasal, oral or fecal excretion and contamination, causing obesity in each chicken. This of course raises serious concerns about Ad-36-induced adiposity in humans.

The easiest way to test this hypothesis is to experimentally infect humans with the virus. However, ethical reasons preclude experimental infection of humans, and so the evidence will have to remain indirect. In the absence of direct experimental data, we must rely on population studies, similar to how researchers nailed smoking and lung cancer. About 15 percent of Americans are already infected with Ad-36, so we can follow them and see what happens. That's exactly what a research team out of Taiwan did (highlighted in my video Infectobesity: Adenovirus 36 and Childhood Obesity). They followed 1,400 Hispanic men and women for a decade and found that not only were those exposed to the virus fatter than those who were not, but also over the ten years, those with a history of infection had a greater percentage of body fat over time.

Most studies done to date on adults have found a connection between exposure to Ad-36 and obesity, and all studies done so far on childhood obesity show an increase in prevalence of infection in obese children compared to non-obese children. We're now up to more than a thousand children studied with similar findings. Obese children who tested positive for the virus weighed 35 pounds more than children who tested negative.

The virus appears to both increase the number of fat cells by mobilizing precursor stem cells and increase the accumulation of fat within the cells. If we take liposuction samples of fat from people, the fat cell precursors turn into fat cells at about five times the rate in people who came to the liposuction clinic already infected. Fat taken from non-infected people that was then exposed to the virus start sucking up fat at a faster rate, potentially inducing obesity without increasing food intake.

Just as Ad-36 can be transmitted horizontally from one infected chicken to another in the same cage, subsequently causing obesity in each chicken, this same virus is also easily transmitted among humans, raising the question as to whether at least some cases of childhood obesity can be considered an infectious disease. Researchers publishing in the International Journal of Pediatric Obesity speculate that this animal adenovirus may have mutated to become a human adenovirus capable of infecting humans and causing obesity.

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 Uprooting the Leading Causes of Death, More Than an Apple a Day, From Table to Able, and Food as Medicine.

Image Credit: Glasseyes view / Flickr

Original Link

Dr. Greger’s 2015 Live Year-in-Review Presentation

Food as Medicine

View my new live presentation here: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet

Every year I scour the world's scholarly literature on clinical nutrition, pulling together what I find to be the most interesting, practical, and groundbreaking science on how to best feed ourselves and our families. I start with the thousands of papers published annually on nutrition (27,000 this year--a new record!) and, thanks to a crack team of volunteers (and now staff!), I'm able to whittle those down (to a mere 8,000 this year). They are then downloaded, categorized, read, analyzed, and churned into the few hundred short videos. This allows me to post new videos and articles every day, year-round, to NutritionFacts.org. This certainly makes the site unique. There's no other science-based source for free daily updates on the latest discoveries in nutrition. The problem is that the amount of information can be overwhelming.

Currently I have more than a thousand videos covering 1,931 nutrition topics. Where do you even begin? Many have expressed their appreciation for the breadth of material, but asked that I try to distill it into a coherent summary of how best to use diet to prevent and treat chronic disease. I took this feedback to heart and in 2012 developed Uprooting the Leading Causes of Death, which explored the role diet may play in preventing, arresting, and even reversing our top 15 killers. Not only did it rise to become one of the Top 10 Most Popular Videos of 2012, it remains my single most viewed video to date, watched over a million times (NutritionFacts.org is now up to more than 1.5 million hits a month!).

In 2013 I developed the sequel, More Than an Apple a Day, in which I explored the role diet could play in treating some of our most common conditions. I presented it around the country and it ended up #1 on our Top 10 Most Popular Videos of 2013. Then in 2014 I premiered the sequel-sequel, From Table to Able, in which I explored the role diet could play in treating some of our most disabling diseases, landing #1 on our Top 10 Most Popular Videos of 2014.

Every year I wonder how I'm going to top the year before. Knowing how popular these live presentations can be and hearing all the stories from folks about what a powerful impact they can have on people's lives, I put my all into this new 2015 one. I spent more time putting together this presentation than any other in my life. It took me an entire month, and when you see it I think you'll appreciate why.

This year, I'm honored to bring you Food as Medicine, in which I go through our most dreaded diseases--but that's not even the best part! I'm really proud of what I put together for the ending. I spend the last 20 minutes or so (starting at 56:22) going through a thought experiment that I'm hoping everyone will find compelling. I think it may be my best presentation ever. You be the judge.

You can watch it at no cost online, but it is also available on DVD through my website or on Amazon. If you want to share copies with others, I have a five for $40 special (enter coupon code 5FOR40FAM). All proceeds from the sales of all my books, DVDs, downloads, and presentations go to the 501c3 nonprofit charity that keeps NutritionFacts.org free for all, for all time. If you want to support this initiative to educate millions about eradicating dietary diseases, please consider making a donation.

After you've watched the new presentation, make sure you're subscribed to get my video updates daily, weekly, or monthly to stay on top of all the latest.

-Michael Greger

Original Link

Breast Cancer Cells Feed on Cholesterol

NF-Jul14 Cholesterol Feeds Breast Cancer Cells.jpg

One in eight American women will be diagnosed with breast cancer in her lifetime. There are a number of compounds in plant foods that may protect against breast cancer by a variety of mechanisms. I've talked about the benefits of broccoli, flaxseeds, and soy foods before (See Breast Cancer Survival Vegetable, Flaxseeds & Breast Cancer Prevention, and Breast Cancer Survival and Soy) but a recent German study reported something new. The researchers found that sunflower and pumpkin seeds were associated with reduced breast cancer risk. They initially chalked the association up to the lignans in the seeds (See Breast Cancer Survival and Lignan Intake), but their lignan lead didn't pan out. Maybe it's the phytosterols found concentrated in seeds? (See Optimal Phytosterol Source).

There is evidence that phytosterols may be anticancer nutrients and play a role in reducing breast cancer risk. I thought phytosterols just lowered cholesterol? (See How Phytosterols Lower Cholesterol) What does cancer have to do with cholesterol?

Increasing evidence demonstrates the role that cholesterol may play in the development and progression of breast cancer. Cancer feeds on cholesterol. Transformed cells take up LDL, so-called "bad" cholesterol, and it's capable of stimulating the growth of human breast cancer cells in a petri dish.

The ability to accumulate fat and cholesterol may enable cancer cells to take advantage of people eating high fat and high cholesterol diets and at least partially explain the benefit of a low-fat diet on lowering human breast cancer recurrence. Although the data has been mixed, the largest study to date (highlighted in my video, Cholesterol Feeds Breast Cancer Cells) found a 17% increased breast cancer risk in women who had a total cholesterol over 240 compared to women whose cholesterol was under 160. However, the researchers could not rule out that there may be something else in cholesterol-raising foods that's increasing breast cancer risk.

Tumors suck up so much cholesterol that LDL has been considered a vehicle for delivering antitumor drugs to cancer cells. Since cancer feeds on cholesterol, maybe we could stuff some chemo into it like a Trojan horse poison pill?

The uptake of LDL into tumors may be why people's cholesterol levels drop low after they get cancer--the tumor is eating it up. In fact, patient survival may be lowest when cholesterol uptake is highest. "High LDL receptor content in breast cancer tissue seems to indicate a poor prognosis, [suggesting] that breast tumors rich in LDL receptors may grow rapidly [in the body]." We've known about this for decades. You can tell that wass an old study because, when it was published in the '80s, only 1 in 11 American women got breast cancer.

If cholesterol increases breast cancer risk, what about the use of cholesterol-lowering drugs? See Statin Cholesterol Drugs and Invasive Breast Cancer.

More videos on broccoli and soy's protective effects against breast cancer:

Some I didn't mention include:

-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: Andrew Bennett / Flickr

Original Link

Nuts May Extend Your Lifespan By About 2 years

NF-May14 Nuts May Help Prevent Death.jpg

We've known that increased nut consumption has been associated with a reduced risk of major chronic diseases, such as heart disease and diabetes. But do those who eat nuts actually live longer lives? Clinical trials have shown nuts help lower cholesterol and oxidation, and improve our arterial function and blood sugar levels. Does all this translate into greater longevity?

Researchers at Harvard examined the association between nut consumption and subsequent mortality of over 100,000 people followed for decades. In that time, tens of thousands died, but those that ate nuts every day lived significantly longer. Daily nut consumers had fewer deaths from cancer, heart disease, and respiratory disease, even after controlling for other lifestyle factors. Nut consumers lived significantly longer whether they were older or younger, fat or skinny, whether they exercised more, smoked, drank, or ate other foods that may affect mortality.

But nuts are so filled with fat that there "may be a concern that frequent nut consumption can result in weight gain." However, that's not what the Harvard researchers found. In fact, other studies have associated nut consumption with a slimmer waist, less weight gain, and lower risk of obesity. If we look at all the studies put together, it's pretty much a wash. Diets enriched with nuts do not seem to affect body weight, body mass index, or waist circumference much at all. For example, one of the most recent such studies, highlighted in my video, Nuts May Help Prevent Death, in which subjects were told to add either 0, 70, or 120 pistachios to their daily diet as an afternoon snack every day for three months, found no noticeable difference between the three groups. You couldn't see any difference between those eating no nuts and those eating more than 100 a day. Hence, it appears that the incorporation of nuts (around one to two small handfuls a day) would be advisable to ensure various health benefits without the risk of body weight gain.

How nuts do we have to go? Not much. Just a few servings a week may boost our lifespan and lower cancer rates--but it appears we have to keep it up. In the PREDIMED study, when long-time nut eaters were told to cut down on eating nuts or choose extra virgin olive oil, within five years they apparently lost much of their longevity benefit. Only the group that started out eating nuts and continued to eat at least the same amount of nuts died significantly less often.

You can find more on nuts and heart disease in my videos Nuts and Bolts of Cholesterol Lowering and How Do Nuts Prevent Sudden Cardiac Death?

More on nuts and cancer in Tree Nuts or Peanuts for Breast Cancer Prevention?

Nuts and inflammatory disease: Fighting Inflammation in a Nut Shell.

More than you ever wanted to know about nuts and weight here: Nuts and Obesity: The Weight of Evidence.

What if your physician tells you to not eat nuts because you have diverticulosis? Share this video with them: Diverticulosis & Nuts.

Those 100 pistachios a day may have one side-effect, though: Pistachio Nuts for Erectile Dysfunction.

-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: Aoife mac / Flickr

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Alkylphenol Endocrine Disruptors and Allergies

NF-Apr23 Alkylphenol Endocrine Disruptors and Allergies.jpg

In my video Preventing Childhood Allergies, I noted a study in Japan that found higher maternal intake of meat during pregnancy was significantly associated with about three times the odds of both suspected and physician-diagnosed eczema. The researchers suggest that certain components of meat may affect the fetal immune system. But what about the moms, themselves? A plant-based diet may also help alleviate allergies in adults. See Say No to Drugs by Saying Yes to More Plants and Preventing Allergies in Adulthood.

Seasonal allergies have exploded in Japan in the past few decades, starting with the first reported case in 1964 and now affecting millions every year. We've seen a rising prevalence of allergic diseases around the industrialized world in past decades, but perhaps nothing quite this dramatic.

Some have suggested that profound changes in the Japanese diet may have played a role. Over the latter half of the century total meat, fish, and milk intake rose hundreds of percent in Japan, so researchers decided to look into dietary meat and fat intake and the prevalence of these seasonal pollen allergies. No association with overall fat, but "higher meat intake was significantly associated with an increased prevalence."

Saturated fat wasn't associated with increased prevalence either, so what other constituents in meat may be to blame? The researchers considered the cooked meat carcinogens, the heterocyclic amines, the polycyclic aromatic hydrocarbons, and the nitrosamines.

A new review, highlighted in my video, Alkylphenol Endocrine Disruptors and Allergies, however, raised an intriguing possibility. There's a class of industrial pollutants called alkylphenols, recognized as common toxic endocrine disrupting chemicals that tend to accumulate in the human body and may be associated with allergic diseases. A variety of studies have shown how they may exacerbate allergen-induced inflammation, "suggesting that alkylphenol exposure may influence the onset, progression, and severity of allergic diseases." These toxic xenoestrogens can be found in human breast milk, in our body fat, in our urine, in our bloodstream, and even in the umbilical cord blood going to our babies. How did it get there? Through contaminated food.

It all goes back to a famous study about the reduction of penis size and testosterone levels in alligators living in a contaminated environment. I don't know what you do for a day job, but these researchers observed that a population of juvenile alligators living on one lake in Florida exhibited a "significantly smaller penis size" and lower blood concentrations of testosterone compared to animals on some different lake. The most important difference between the two lakes was that Lake Stubby was fed by relatively polluted waters. They attributed the "short penis phenomenon" to estrogen-mimicking (xenoestrogenic) environmental metabolites of DDT that still pollute our Earth. This seminal work introduced the concept of endocrine disruptors. Environmental xenoestrogens might result in feminization of exposed male animals. And that's just the shriveled tip of the iceberg.

Since then, endocrine-disrupting chemicals have been implicated in the dramatic rise over the last 50 years of diseases like breast cancer, prostate cancer, testicular cancer, diabetes, obesity, and fertility (such as dropping normal sperm counts), genital birth defects such as penile malformations, preterm birth, neurobehavioral disorders in children linked to thyroid disruption, and earlier breast development in young girls. Because genes do not change fast enough to explain these increases, environmental causes must be involved. Since our greatest exposure to the environment is through our gut, it's no surprise that our greatest exposure to these endocrine-disrupting chemicals is through diet.

To find out which foods may contain these alkylphenol endocrine disruptors, check out my video Dietary Sources of Alkylphenol Endocrine Disruptors.

More on endocrine disruptors in:

A different class of chemicals has been found to be associated with smaller penis size in humans. See Chicken Consumption and the Feminization of Male Genitalia.

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videoshere 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: Mark Freeth / Flickr

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