How to Treat Dry Eye Disease Naturally with Diet

Oct 31 Dry Eyes copy.jpeg

One of the most common eye disorders, dry eye disease, causes irritation or discomfort, and can decrease functional vision, sometimes causing a dramatic deterioration in the quality of life. About five million Americans over age 50 suffer from moderate-to-severe dry eyes, and tens of millions more have mild or episodic manifestations of the disease, at a cost of more than $50 billion.

In terms of treatment, there are several drops and drugs that can help. We spend hundreds of millions of dollars on things like artificial tears, but currently there is no therapy available to actually fix the problem. If drugs don't work, doctors can try plugging up the outflow tear ducts, but that can cause complications, such as plugs migrating and eroding into the face, requiring surgical removal. Alternatively, surgeons can just cauterize or stitch up the ducts in the first place.

There has to be a better way.

What about prevention? Dry eyes can be caused by LASIK surgery, affecting about 20-40% of patients six months after the operation. With a million LASIK procedures performed annually, that's a lot of people, and sometimes the long-term symptoms can be severe and disabling.

There's a long list of drugs that can cause it, including antihistamines, decongestants, nearly all the antidepressants, anticonvulsants, antipsychotics, anti-Parkinson's drugs, beta-blockers, and hormone replacement therapy, as well as a few herbal preparations.

In the developing world, vitamin A deficiency can start out as dry eyes and then progress to becoming the leading cause of preventable childhood blindness. Vitamin A deficiency is almost never seen in the developed world, unless you do it intentionally. There was a report in the 1960s of a guy who deliberately ate a vitamin A-deficient diet, living off of bread and lime juice for five years, and his eyes developed vascularization and ulceration of the cornea, which you can see (if you dare) in my Treating Dry Eye Disease with Diet: Just Add Water? video. That was better than what happened to an unfortunate woman who was the member of a cult and tried to live off of brown rice and herbal tea: Her eyes literally melted and collapsed.

There are also a couple case reports of autistic children who refused to eat anything but French fries or menus exclusively comprised of bacon, blueberry muffins, and Kool-Aid, and became vitamin A deficient. A case in the Bronx was written up as vegan diet and vitamin A deficiency, but it had nothing to do with his vegan diet--the kid refused to eat vegetables, consuming only potato chips, puffed rice cereal with non-fortified soymilk, and juice drinks. "His parents lacked particular skill in overcoming the child's tendency to avoid fruits and vegetables."

A plant-based diet may actually be the best thing for patients with dry eye disease, those who wear contact lenses, and those who wish to maximize their tear secretions. People with dry eyes should be advised to lower protein, total fat, and cholesterol intake, and do the following:

  • increase complex carbohydrates;
  • increase vitamin A content (by eating red, orange, yellow, and dark green leafy vegetables);
  • increase zinc and folate intake (by eating whole grains, beans, and raw vegetables, especially spinach);
  • ensure sufficient vitamin B6 and potassium intake (by eating nuts, bananas, and beans);
  • ensure sufficient vitamin C intake (by eating citrus);
  • eliminate alcohol and caffeine;
  • reduce sugar and salt intake; and
  • consume six to eight glasses of water per day.

We know dehydration can cause a dry mouth, but could dehydration cause dry eyes? It may seem kind of obvious, but evidently it was never studied until recently. Is the answer to just drink more water? We know that those suffering from dry eye are comparatively dehydrated, so researchers figured that tear secretion decreases with progressive dehydration just like saliva secretion decreases and gives us a dry mouth. And indeed, as one gets more and more dehydrated, their urine concentrates and so does the tear fluid. But one can reverse that with rehydration, raising the exciting prospect that improving whole-body hydration by getting people to drink more water might bring relief for those with dry eyes. The researchers recommend eight cups of water a day for women and ten cups a day for men.


Find more on the importance of proper hydration in my How Many Glasses of Water Should We Drink a Day?, Does a Drink Of Water Make Children Smarter?, and Can Dehydration Affect Our Mood? videos.

To learn more on other topics related to eye health, check out:

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Original Link

How to Treat Dry Eye Disease Naturally with Diet

Oct 31 Dry Eyes copy.jpeg

One of the most common eye disorders, dry eye disease, causes irritation or discomfort, and can decrease functional vision, sometimes causing a dramatic deterioration in the quality of life. About five million Americans over age 50 suffer from moderate-to-severe dry eyes, and tens of millions more have mild or episodic manifestations of the disease, at a cost of more than $50 billion.

In terms of treatment, there are several drops and drugs that can help. We spend hundreds of millions of dollars on things like artificial tears, but currently there is no therapy available to actually fix the problem. If drugs don't work, doctors can try plugging up the outflow tear ducts, but that can cause complications, such as plugs migrating and eroding into the face, requiring surgical removal. Alternatively, surgeons can just cauterize or stitch up the ducts in the first place.

There has to be a better way.

What about prevention? Dry eyes can be caused by LASIK surgery, affecting about 20-40% of patients six months after the operation. With a million LASIK procedures performed annually, that's a lot of people, and sometimes the long-term symptoms can be severe and disabling.

There's a long list of drugs that can cause it, including antihistamines, decongestants, nearly all the antidepressants, anticonvulsants, antipsychotics, anti-Parkinson's drugs, beta-blockers, and hormone replacement therapy, as well as a few herbal preparations.

In the developing world, vitamin A deficiency can start out as dry eyes and then progress to becoming the leading cause of preventable childhood blindness. Vitamin A deficiency is almost never seen in the developed world, unless you do it intentionally. There was a report in the 1960s of a guy who deliberately ate a vitamin A-deficient diet, living off of bread and lime juice for five years, and his eyes developed vascularization and ulceration of the cornea, which you can see (if you dare) in my Treating Dry Eye Disease with Diet: Just Add Water? video. That was better than what happened to an unfortunate woman who was the member of a cult and tried to live off of brown rice and herbal tea: Her eyes literally melted and collapsed.

There are also a couple case reports of autistic children who refused to eat anything but French fries or menus exclusively comprised of bacon, blueberry muffins, and Kool-Aid, and became vitamin A deficient. A case in the Bronx was written up as vegan diet and vitamin A deficiency, but it had nothing to do with his vegan diet--the kid refused to eat vegetables, consuming only potato chips, puffed rice cereal with non-fortified soymilk, and juice drinks. "His parents lacked particular skill in overcoming the child's tendency to avoid fruits and vegetables."

A plant-based diet may actually be the best thing for patients with dry eye disease, those who wear contact lenses, and those who wish to maximize their tear secretions. People with dry eyes should be advised to lower protein, total fat, and cholesterol intake, and do the following:

  • increase complex carbohydrates;
  • increase vitamin A content (by eating red, orange, yellow, and dark green leafy vegetables);
  • increase zinc and folate intake (by eating whole grains, beans, and raw vegetables, especially spinach);
  • ensure sufficient vitamin B6 and potassium intake (by eating nuts, bananas, and beans);
  • ensure sufficient vitamin C intake (by eating citrus);
  • eliminate alcohol and caffeine;
  • reduce sugar and salt intake; and
  • consume six to eight glasses of water per day.

We know dehydration can cause a dry mouth, but could dehydration cause dry eyes? It may seem kind of obvious, but evidently it was never studied until recently. Is the answer to just drink more water? We know that those suffering from dry eye are comparatively dehydrated, so researchers figured that tear secretion decreases with progressive dehydration just like saliva secretion decreases and gives us a dry mouth. And indeed, as one gets more and more dehydrated, their urine concentrates and so does the tear fluid. But one can reverse that with rehydration, raising the exciting prospect that improving whole-body hydration by getting people to drink more water might bring relief for those with dry eyes. The researchers recommend eight cups of water a day for women and ten cups a day for men.


Find more on the importance of proper hydration in my How Many Glasses of Water Should We Drink a Day?, Does a Drink Of Water Make Children Smarter?, and Can Dehydration Affect Our Mood? videos.

To learn more on other topics related to eye health, check out:

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Original Link

Does Rye Bread Protect Against Cancer?

Sept 14 Rye Bread copy.jpeg

Previously, I've explored the beneficial effects of flaxseeds on prostate cancer (Flaxseeds vs. Prostate Cancer), as well as breast cancer prevention and survival (Flaxseeds & Breast Cancer Prevention and Breast Cancer Survival & Lignan Intake). The cancer-fighting effect of flaxseeds is thought to be because of the lignans, which are cancer-fighting plant compounds found in red wine, whole grains, greens (cruciferous vegetables), and especially sesame seeds and flaxseeds, the most concentrated source on Earth. But this is based on per unit weight. People eat a lot more grains than seeds. Of the grains people eat, the highest concentration of lignans is found in rye. So, can rye intake decrease the risk of cancer? Theoretically yes, but unlike flaxseeds, it's never been directly put to the test... until now.

In my video Does Rye Bread Protect Against Cancer?, I discuss the evidence that does exist. If you measure the levels of lignans in the bloodstream of women living in a region where they eat lots of rye, the odds of breast cancer in women with the highest levels do seem to be just half that of women with the lowest levels. But lignans are also found in tea and berries, so we couldn't be sure where the protection is coming from. To get around this, researchers decided to measure alkylresorcinol metabolites, a class of phytonutrients relatively unique to whole grains.

Researchers collected urine from women with breast cancer and women without, and the women with breast cancer had significantly lower levels compared to those without. This suggests that women at risk for breast cancer consume significantly lower amounts of whole grains like rye. But if we follow older women in their 50s through 60s, the intake of whole grain products was not associated with risk of breast cancer. A similar result was found in older men for prostate cancer. Is it just too late at that point?

We know from data on dairy that diet in our early life may be important in the development of prostate cancer, particularly around puberty when the prostate grows and matures. If you look at what men were drinking in adolescence, daily milk consumption appeared to triple their risk of advanced prostate cancer later in life. (Learn more about milk and prostate cancer in my video Prostate Cancer and Organic Milk vs. Almond Milk.) So, researchers looked at daily rye bread consumption during adolescence.

Those who consumed rye bread daily as kids did appear to only have half the odds of advanced prostate cancer. This is consistent with immigrant studies suggesting that the first two decades of life may be most important for setting the pattern for cancer development in later life. These findings are certainly important for how we should feed our kids, but if we're already middle-aged, is it too late to change course? To answer this question, researchers in Sweden put it to the test.

Researchers took men with prostate cancer and split them into two groups. One group got lots of rye bread, while the other got lots of high-fiber, but low-lignan, wheat bread. There's been some indirect evidence that rye may be active against prostate cancer--like lower cancer rates in regions with high rye consumption--but it had never been directly investigated... until this study. Biopsies were taken from the subjects' tumors before and after three weeks of bread eating, and the number of cancer cells that were dying off were counted. Though there was no change in the cancer cell clearance of the control bread group, there was a 180% increase in the number of cancer cells being killed off in the rye group. A follow-up study lasting 6 weeks found a 14% decrease in PSA levels, a cancer marker suggesting a shrinkage of the tumor.

The researchers note they used very high rye bread intakes, and it remains to be tested if more normal intake levels would have effects that are of clinical importance. As a sadly typical American, my lack of intimate familiarity of the metric system did not flag the "485 grams" of rye bread a day as far out of the ordinary, but that translates to 15 slices! Rather than eating a loaf a day, the same amount of lignans can be found in a single teaspoon of ground flaxseeds.


I've created several videos on flaxseeds for both breast cancer prevention and treatment, including Flaxseeds & Breast Cancer Prevention, Breast Cancer Survival and Lignan Intake, Flaxseeds & Breast Cancer Survival Epidemiological Evidence, and Flaxseeds & Breast Cancer Survival: Clinical Evidence.

What's more, flaxseeds may help with cyclical breast pain (Flaxseeds for Breast Pain), prostate cancer (Flaxseed vs. Prostate Cancer), diabetes (Flaxseeds vs. Diabetes), and hypertension (Flaxseeds for Hypertension).

And if you're wondering Which Are Better: Chia Seeds or Flaxseeds?, get the answer in the video!

The wonders of whole grains are also discussed in Whole Grains May Work as Well as Drugs, Can Oatmeal Reverse Heart Disease?, and Can Oatmeal Help Fatty Liver Disease?.

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Original Link

Does Rye Bread Protect Against Cancer?

Sept 14 Rye Bread copy.jpeg

Previously, I've explored the beneficial effects of flaxseeds on prostate cancer (Flaxseeds vs. Prostate Cancer), as well as breast cancer prevention and survival (Flaxseeds & Breast Cancer Prevention and Breast Cancer Survival & Lignan Intake). The cancer-fighting effect of flaxseeds is thought to be because of the lignans, which are cancer-fighting plant compounds found in red wine, whole grains, greens (cruciferous vegetables), and especially sesame seeds and flaxseeds, the most concentrated source on Earth. But this is based on per unit weight. People eat a lot more grains than seeds. Of the grains people eat, the highest concentration of lignans is found in rye. So, can rye intake decrease the risk of cancer? Theoretically yes, but unlike flaxseeds, it's never been directly put to the test... until now.

In my video Does Rye Bread Protect Against Cancer?, I discuss the evidence that does exist. If you measure the levels of lignans in the bloodstream of women living in a region where they eat lots of rye, the odds of breast cancer in women with the highest levels do seem to be just half that of women with the lowest levels. But lignans are also found in tea and berries, so we couldn't be sure where the protection is coming from. To get around this, researchers decided to measure alkylresorcinol metabolites, a class of phytonutrients relatively unique to whole grains.

Researchers collected urine from women with breast cancer and women without, and the women with breast cancer had significantly lower levels compared to those without. This suggests that women at risk for breast cancer consume significantly lower amounts of whole grains like rye. But if we follow older women in their 50s through 60s, the intake of whole grain products was not associated with risk of breast cancer. A similar result was found in older men for prostate cancer. Is it just too late at that point?

We know from data on dairy that diet in our early life may be important in the development of prostate cancer, particularly around puberty when the prostate grows and matures. If you look at what men were drinking in adolescence, daily milk consumption appeared to triple their risk of advanced prostate cancer later in life. (Learn more about milk and prostate cancer in my video Prostate Cancer and Organic Milk vs. Almond Milk.) So, researchers looked at daily rye bread consumption during adolescence.

Those who consumed rye bread daily as kids did appear to only have half the odds of advanced prostate cancer. This is consistent with immigrant studies suggesting that the first two decades of life may be most important for setting the pattern for cancer development in later life. These findings are certainly important for how we should feed our kids, but if we're already middle-aged, is it too late to change course? To answer this question, researchers in Sweden put it to the test.

Researchers took men with prostate cancer and split them into two groups. One group got lots of rye bread, while the other got lots of high-fiber, but low-lignan, wheat bread. There's been some indirect evidence that rye may be active against prostate cancer--like lower cancer rates in regions with high rye consumption--but it had never been directly investigated... until this study. Biopsies were taken from the subjects' tumors before and after three weeks of bread eating, and the number of cancer cells that were dying off were counted. Though there was no change in the cancer cell clearance of the control bread group, there was a 180% increase in the number of cancer cells being killed off in the rye group. A follow-up study lasting 6 weeks found a 14% decrease in PSA levels, a cancer marker suggesting a shrinkage of the tumor.

The researchers note they used very high rye bread intakes, and it remains to be tested if more normal intake levels would have effects that are of clinical importance. As a sadly typical American, my lack of intimate familiarity of the metric system did not flag the "485 grams" of rye bread a day as far out of the ordinary, but that translates to 15 slices! Rather than eating a loaf a day, the same amount of lignans can be found in a single teaspoon of ground flaxseeds.


I've created several videos on flaxseeds for both breast cancer prevention and treatment, including Flaxseeds & Breast Cancer Prevention, Breast Cancer Survival and Lignan Intake, Flaxseeds & Breast Cancer Survival Epidemiological Evidence, and Flaxseeds & Breast Cancer Survival: Clinical Evidence.

What's more, flaxseeds may help with cyclical breast pain (Flaxseeds for Breast Pain), prostate cancer (Flaxseed vs. Prostate Cancer), diabetes (Flaxseeds vs. Diabetes), and hypertension (Flaxseeds for Hypertension).

And if you're wondering Which Are Better: Chia Seeds or Flaxseeds?, get the answer in the video!

The wonders of whole grains are also discussed in Whole Grains May Work as Well as Drugs, Can Oatmeal Reverse Heart Disease?, and Can Oatmeal Help Fatty Liver Disease?.

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Original Link

Treating Kidney Stones with Diet

Treating Kidney Stones with Diet.jpeg

Studies suggest that excessive consumption of animal protein poses a risk of kidney stone formation, likely due to the acid load contributed by the high content of sulfur-containing amino acids in animal protein, a topic I explore in my video, Preventing Kidney Stones with Diet. What about treating kidney stones, though? I discuss that in How to Treat Kidney Stones with Diet. Most stones are calcium oxalate, formed like rock candy when the urine becomes supersaturated. Doctors just assumed that if stones are made out of calcium, we simply have to tell people to reduce their calcium intake. That was the dietary gospel for kidney stone sufferers until a 2002 study published in the New England Journal of Medicine pitted two diets against one another--a low-calcium diet versus a diet low in animal protein and salt. The restriction of animal protein and salt provided greater protection, cutting the risk of having another kidney stone within five years in half.

What about cutting down on oxalates, which are concentrated in certain vegetables? A recent study found there was no increased risk of stone formation with higher vegetable intake. In fact, greater dietary intake of whole plant foods, fruits, and vegetables were each associated with reduced risk independent of other known risk factors for kidney stones. This means we may get additional benefits bulking up on plant foods in addition to just restricting animal foods.

A reduction in animal protein not only reduces the production of acids within the body, but should also limit the excretion of urate, uric acid crystals that can act as seeds to form calcium stones or create entire stones themselves. (Uric acid stones are the second most common kidney stones after calcium.)

There are two ways to reduce uric acid levels in the urine: a reduction of animal protein ingestion, or a variety of drugs. Removing all meat--that is, switching from the standard Western diet to a vegetarian diet--can remove 93% of uric acid crystallization risk within days.

To minimize uric acid crystallization, the goal is to get our urine pH up to ideally as high as 6.8. A number of alkalinizing chemicals have been developed for just this purpose, but we can naturally alkalize our urine up to the recommended 6.8 using purely dietary means. Namely, by removing all meat, someone eating the standard Western diet can go from a pH of 5.95 to the goal target of 6.8--simply by eating plant-based. As I describe in my video, Testing Your Diet with Pee & Purple Cabbage, we can inexpensively test our own diets with a little bathroom chemistry, for not all plant foods are alkalinizing and not all animal foods are equally acidifying.

A Load of Acid to Kidney Evaluation (LAKE) score has been developed to take into account both the acid load of foods and their typical serving sizes. It can be used to help people modify their diet for the prevention of both uric acid and calcium kidney stones, as well as other diseases. What did researchers find? The single most acid-producing food is fish, like tuna. Then, in descending order, are pork, then poultry, cheese (though milk and other dairy are much less acidifying), and beef followed by eggs. (Eggs are actually more acidic than beef, but people tend to eat fewer eggs in one sitting.) Some grains, like bread and rice, can be a little acid-forming, but pasta is not. Beans are significantly alkaline-forming, but not as much as fruits or even better, vegetables, which are the most alkaline-forming of all.

Through dietary changes alone, we may be able to dissolve uric acid stones completely and cure patients without drugs or surgery.

To summarize, the most important things we can do diet-wise is to drink 10 to 12 cups of water a day, reduce animal protein, reduce salt, and eat more vegetables and more vegetarian.

Want to try to calculate their LAKE score for the day? Just multiply the number of servings you have of each of the food groups listed in the graph in the video times the score.

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Sally Plank

Original Link

Treating Kidney Stones with Diet

Treating Kidney Stones with Diet.jpeg

Studies suggest that excessive consumption of animal protein poses a risk of kidney stone formation, likely due to the acid load contributed by the high content of sulfur-containing amino acids in animal protein, a topic I explore in my video, Preventing Kidney Stones with Diet. What about treating kidney stones, though? I discuss that in How to Treat Kidney Stones with Diet. Most stones are calcium oxalate, formed like rock candy when the urine becomes supersaturated. Doctors just assumed that if stones are made out of calcium, we simply have to tell people to reduce their calcium intake. That was the dietary gospel for kidney stone sufferers until a 2002 study published in the New England Journal of Medicine pitted two diets against one another--a low-calcium diet versus a diet low in animal protein and salt. The restriction of animal protein and salt provided greater protection, cutting the risk of having another kidney stone within five years in half.

What about cutting down on oxalates, which are concentrated in certain vegetables? A recent study found there was no increased risk of stone formation with higher vegetable intake. In fact, greater dietary intake of whole plant foods, fruits, and vegetables were each associated with reduced risk independent of other known risk factors for kidney stones. This means we may get additional benefits bulking up on plant foods in addition to just restricting animal foods.

A reduction in animal protein not only reduces the production of acids within the body, but should also limit the excretion of urate, uric acid crystals that can act as seeds to form calcium stones or create entire stones themselves. (Uric acid stones are the second most common kidney stones after calcium.)

There are two ways to reduce uric acid levels in the urine: a reduction of animal protein ingestion, or a variety of drugs. Removing all meat--that is, switching from the standard Western diet to a vegetarian diet--can remove 93% of uric acid crystallization risk within days.

To minimize uric acid crystallization, the goal is to get our urine pH up to ideally as high as 6.8. A number of alkalinizing chemicals have been developed for just this purpose, but we can naturally alkalize our urine up to the recommended 6.8 using purely dietary means. Namely, by removing all meat, someone eating the standard Western diet can go from a pH of 5.95 to the goal target of 6.8--simply by eating plant-based. As I describe in my video, Testing Your Diet with Pee & Purple Cabbage, we can inexpensively test our own diets with a little bathroom chemistry, for not all plant foods are alkalinizing and not all animal foods are equally acidifying.

A Load of Acid to Kidney Evaluation (LAKE) score has been developed to take into account both the acid load of foods and their typical serving sizes. It can be used to help people modify their diet for the prevention of both uric acid and calcium kidney stones, as well as other diseases. What did researchers find? The single most acid-producing food is fish, like tuna. Then, in descending order, are pork, then poultry, cheese (though milk and other dairy are much less acidifying), and beef followed by eggs. (Eggs are actually more acidic than beef, but people tend to eat fewer eggs in one sitting.) Some grains, like bread and rice, can be a little acid-forming, but pasta is not. Beans are significantly alkaline-forming, but not as much as fruits or even better, vegetables, which are the most alkaline-forming of all.

Through dietary changes alone, we may be able to dissolve uric acid stones completely and cure patients without drugs or surgery.

To summarize, the most important things we can do diet-wise is to drink 10 to 12 cups of water a day, reduce animal protein, reduce salt, and eat more vegetables and more vegetarian.

Want to try to calculate their LAKE score for the day? Just multiply the number of servings you have of each of the food groups listed in the graph in the video times the score.

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Sally Plank

Original Link

Benefits of Oatmeal for Fatty Liver Disease

Benefits of Oatmeal for Fatty Liver Disease.jpeg

If oatmeal is so powerful that it can clear up some of the ravages of chemotherapy just applied to the skin (see my video Oatmeal Lotion for Chemotherapy-Induced Rash), what might it do if we actually ate it? Oats are reported to possess varied drug-like activities like lowering blood cholesterol and blood sugar, boosting our immune system, anticancer, antioxidant, and anti-atherosclerosis activites, in addition to being a topical anti-inflammatory, and reprtedly may also be useful in controlling childhood asthma and body weight.

Whole-grain intake in general is associated with lower risk of type 2 diabetes, cardiovascular disease, and weight gain, as shown in my video Can Oatmeal Help Fatty Liver Disease?. All of the cohort studies on type 2 diabetes and heart disease show whole grain intake is associated with lower risk.

Researchers have observed the same for obesity--consistently less weight gain for those who consumed a few servings of whole grains every day. All the forward-looking population studies demonstrate that a higher intake of whole grains is associated with lower body mass index and body weight gain. However, these results do not clarify whether whole grain consumption is simply a marker of a healthier lifestyle or a factor favoring lower body weight.

For example, high whole grain consumers--those who eat whole wheat, brown rice, and oatmeal for breakfast--tend to be more physically active, smoke less, and consume more fruit, vegetables, and dietary fiber than those that instead reach for fruit loops. Statistically, one can control these factors, effectively comparing nonsmokers to nonsmokers with similar exercise and diet as most of the studies did, and they still found whole grains to be protective via a variety of mechanisms.

For example, in terms of helping with weight control, the soluble fiber of oatmeal forms a gel in the stomach, delaying stomach emptying, making one feel full for a longer period. It seems plausible that whole grain intake does indeed offer direct benefits, but only results of randomized controlled intervention studies can provide direct evidence of cause and effect. In other words, the evidence is clear that oatmeal consumers have lower rates of disease, but that's not the same as proving that if we start eating more oatmeal, our risk will drop. To know that, we need an interventional trial, ideally a blinded study where you give half the people oatmeal, and the other half fake placebo oatmeal that looks and tastes like oatmeal, to see if it actually works. And that's what we finally got--a double-blinded randomized trial of overweight and obese men and women. Almost 90% of the real oatmeal-treated subjects had reduced body weight, compared to no weight loss in the control group. They saw a slimmer waist on average, a 20 point drop in cholesterol, and an improvement in liver function.

Nonalcoholic fatty liver disease, meaning a fatty liver caused by excess food rather than excess drink, is now the most common cause of liver disease in the United States, and can lead in rare cases to cirrhosis of the liver, cancer of the liver, and death. Theoretically, whole grains could help prevent and treat fatty liver disease, but this is the first time it had been put to the test. A follow-up study in 2014 confirmed these findings of a protective role of whole grains, but refined grains was associated with increased risk. So one would not expect to get such wonderful results from wonder bread.

How can you make your oatmeal even healthier? See Antioxidants in a Pinch.

Whole Grains May Work As Well As Drugs for hypertension, but refined grain intake may linked with high blood pressure and diseases like diabetes. But If White Rice is Linked to Diabetes, What About China?.

More on keeping the liver healthy 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: Sally Plank / Flickr. This image has been modified.

Original Link

Benefits of Oatmeal for Fatty Liver Disease

Benefits of Oatmeal for Fatty Liver Disease.jpeg

If oatmeal is so powerful that it can clear up some of the ravages of chemotherapy just applied to the skin (see my video Oatmeal Lotion for Chemotherapy-Induced Rash), what might it do if we actually ate it? Oats are reported to possess varied drug-like activities like lowering blood cholesterol and blood sugar, boosting our immune system, anticancer, antioxidant, and anti-atherosclerosis activites, in addition to being a topical anti-inflammatory, and reprtedly may also be useful in controlling childhood asthma and body weight.

Whole-grain intake in general is associated with lower risk of type 2 diabetes, cardiovascular disease, and weight gain, as shown in my video Can Oatmeal Help Fatty Liver Disease?. All of the cohort studies on type 2 diabetes and heart disease show whole grain intake is associated with lower risk.

Researchers have observed the same for obesity--consistently less weight gain for those who consumed a few servings of whole grains every day. All the forward-looking population studies demonstrate that a higher intake of whole grains is associated with lower body mass index and body weight gain. However, these results do not clarify whether whole grain consumption is simply a marker of a healthier lifestyle or a factor favoring lower body weight.

For example, high whole grain consumers--those who eat whole wheat, brown rice, and oatmeal for breakfast--tend to be more physically active, smoke less, and consume more fruit, vegetables, and dietary fiber than those that instead reach for fruit loops. Statistically, one can control these factors, effectively comparing nonsmokers to nonsmokers with similar exercise and diet as most of the studies did, and they still found whole grains to be protective via a variety of mechanisms.

For example, in terms of helping with weight control, the soluble fiber of oatmeal forms a gel in the stomach, delaying stomach emptying, making one feel full for a longer period. It seems plausible that whole grain intake does indeed offer direct benefits, but only results of randomized controlled intervention studies can provide direct evidence of cause and effect. In other words, the evidence is clear that oatmeal consumers have lower rates of disease, but that's not the same as proving that if we start eating more oatmeal, our risk will drop. To know that, we need an interventional trial, ideally a blinded study where you give half the people oatmeal, and the other half fake placebo oatmeal that looks and tastes like oatmeal, to see if it actually works. And that's what we finally got--a double-blinded randomized trial of overweight and obese men and women. Almost 90% of the real oatmeal-treated subjects had reduced body weight, compared to no weight loss in the control group. They saw a slimmer waist on average, a 20 point drop in cholesterol, and an improvement in liver function.

Nonalcoholic fatty liver disease, meaning a fatty liver caused by excess food rather than excess drink, is now the most common cause of liver disease in the United States, and can lead in rare cases to cirrhosis of the liver, cancer of the liver, and death. Theoretically, whole grains could help prevent and treat fatty liver disease, but this is the first time it had been put to the test. A follow-up study in 2014 confirmed these findings of a protective role of whole grains, but refined grains was associated with increased risk. So one would not expect to get such wonderful results from wonder bread.

How can you make your oatmeal even healthier? See Antioxidants in a Pinch.

Whole Grains May Work As Well As Drugs for hypertension, but refined grain intake may linked with high blood pressure and diseases like diabetes. But If White Rice is Linked to Diabetes, What About China?.

More on keeping the liver healthy 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: Sally Plank / Flickr. This image has been modified.

Original Link

Four Ways to Improve on the Mediterranean Diet

Improving on the Mediterranean Diet.jpg

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

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

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

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

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

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

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

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

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

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

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

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

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Sally Plank / Flickr. This image has been modified.

Original Link

Four Ways to Improve on the Mediterranean Diet

Improving on the Mediterranean Diet.jpg

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

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

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

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

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

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

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

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

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

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

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

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

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Sally Plank / Flickr. This image has been modified.

Original Link