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

Who Should Avoid Coffee?

Oct 19 Coffee copy.jpeg

Do coffee drinkers live longer than non-coffee drinkers? Is it "wake up and smell the coffee" or don't wake up at all? I discuss these questions in my video, Coffee and Mortality.

The largest study ever conducted on diet and health put that question to the test, examining the association between coffee drinking and subsequent mortality among hundreds of thousands of older men and women in the United States. Coffee drinkers won, though the effect was modest, a 10-15% lower risk of death for those drinking six or more cups a day. This was due specifically to lower risk of dying from heart disease, respiratory disease, stroke, injuries and accidents, diabetes, and infections.

However, another study that amount of coffee was found to increase the death rate of younger people under age 55. It may be appropriate, then, to recommend that you avoid drinking more than four cups a day. But if you review all the studies, the bottom line is that coffee consumption is associated with no change or a small reduction in mortality starting around one or two cups a day, for both men and women. The risk of dying was 3% lower for each cup of coffee consumed daily, which provides reassurance for the concern that coffee drinking might adversely affect health, or at least longevity.

A recent population study found no link between coffee consumption and symptoms of GERD, reflux diseases such as heartburn and regurgitation. If you actually stick a tube down people's throats and measure pH, though, coffee induces significant acid reflux, whereas tea does not. Is this just because tea has less caffeine? No. If you reduce the caffeine content of the coffee down to that of tea, coffee still causes significantly more acid reflux. Decaf causes even less, so GERD patients might want to choose decaffeinated coffee or, even better, opt for tea.

Coffee intake is also associated with urinary incontinence, so a decrease in caffeine intake should be discussed with patients who have the condition. About two cups of coffee a day worth of caffeine may worsen urinary leakage.

A 2014 meta-analysis suggested that daily coffee consumption was associated with a slightly increased risk of bone fractures in women, but a decreased risk of fractures in men. However, no significant association was found between coffee consumption and the risk of hip fracture specifically. Tea consumption may actually protect against hip fracture, though it appears to have no apparent relationship with fracture risk in general.

Certain populations, in particular, may want to stay away from caffeine, including those with glaucoma or a family history of glaucoma, individuals with epilepsy, and, not surprisingly, people who have trouble sleeping. Even a single cup at night can cause a significant deterioration in sleep quality.

We used to think caffeine might increase the risk of an irregular heart rhythm called atrial fibrillation, but that was based on anecdotal case reports like one of a young woman who suffered atrial fibrillation after "chocolate intake abuse." These cases invariably involved the acute ingestion of very large quantities of caffeine. As a result, the notion that caffeine ingestion may trigger abnormal heart rhythms had become "common knowledge," and this assumption led to changes in medical practice.

We now have evidence that caffeine does not increase the risk of atrial fibrillation. Low-dose caffeine--defined as less than about five cups of coffee a day--may even have a protective effect. Tea consumption also appears to lower cardiovascular disease risk, especially when it comes to stroke. But given the proliferation of energy drinks that contain massive quantities of caffeine, one might temper any message that suggests that caffeine is beneficial. Indeed, 12 highly caffeinated energy drinks within a few hours could be lethal.


To learn more about various health aspects of coffee, see my videos Coffee and Cancer, What About the Caffeine?, Preventing Liver Cancer with Coffee?, and Coffee and Artery Function.

What else can we consume to live longer? Check out Nuts May Help Prevent Death, Increased Lifespan from Beans, Fruits and Longevity: How Many Minutes per Mouthful?, and Finger on the Pulse of Longevity.

And, for more on controlling acid reflux, see Diet and GERD Acid Reflux Heartburn and Diet and Hiatal Hernia.

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

Who Should Avoid Coffee?

Oct 19 Coffee copy.jpeg

Do coffee drinkers live longer than non-coffee drinkers? Is it "wake up and smell the coffee" or don't wake up at all? I discuss these questions in my video, Coffee and Mortality.

The largest study ever conducted on diet and health put that question to the test, examining the association between coffee drinking and subsequent mortality among hundreds of thousands of older men and women in the United States. Coffee drinkers won, though the effect was modest, a 10-15% lower risk of death for those drinking six or more cups a day. This was due specifically to lower risk of dying from heart disease, respiratory disease, stroke, injuries and accidents, diabetes, and infections.

However, another study that amount of coffee was found to increase the death rate of younger people under age 55. It may be appropriate, then, to recommend that you avoid drinking more than four cups a day. But if you review all the studies, the bottom line is that coffee consumption is associated with no change or a small reduction in mortality starting around one or two cups a day, for both men and women. The risk of dying was 3% lower for each cup of coffee consumed daily, which provides reassurance for the concern that coffee drinking might adversely affect health, or at least longevity.

A recent population study found no link between coffee consumption and symptoms of GERD, reflux diseases such as heartburn and regurgitation. If you actually stick a tube down people's throats and measure pH, though, coffee induces significant acid reflux, whereas tea does not. Is this just because tea has less caffeine? No. If you reduce the caffeine content of the coffee down to that of tea, coffee still causes significantly more acid reflux. Decaf causes even less, so GERD patients might want to choose decaffeinated coffee or, even better, opt for tea.

Coffee intake is also associated with urinary incontinence, so a decrease in caffeine intake should be discussed with patients who have the condition. About two cups of coffee a day worth of caffeine may worsen urinary leakage.

A 2014 meta-analysis suggested that daily coffee consumption was associated with a slightly increased risk of bone fractures in women, but a decreased risk of fractures in men. However, no significant association was found between coffee consumption and the risk of hip fracture specifically. Tea consumption may actually protect against hip fracture, though it appears to have no apparent relationship with fracture risk in general.

Certain populations, in particular, may want to stay away from caffeine, including those with glaucoma or a family history of glaucoma, individuals with epilepsy, and, not surprisingly, people who have trouble sleeping. Even a single cup at night can cause a significant deterioration in sleep quality.

We used to think caffeine might increase the risk of an irregular heart rhythm called atrial fibrillation, but that was based on anecdotal case reports like one of a young woman who suffered atrial fibrillation after "chocolate intake abuse." These cases invariably involved the acute ingestion of very large quantities of caffeine. As a result, the notion that caffeine ingestion may trigger abnormal heart rhythms had become "common knowledge," and this assumption led to changes in medical practice.

We now have evidence that caffeine does not increase the risk of atrial fibrillation. Low-dose caffeine--defined as less than about five cups of coffee a day--may even have a protective effect. Tea consumption also appears to lower cardiovascular disease risk, especially when it comes to stroke. But given the proliferation of energy drinks that contain massive quantities of caffeine, one might temper any message that suggests that caffeine is beneficial. Indeed, 12 highly caffeinated energy drinks within a few hours could be lethal.


To learn more about various health aspects of coffee, see my videos Coffee and Cancer, What About the Caffeine?, Preventing Liver Cancer with Coffee?, and Coffee and Artery Function.

What else can we consume to live longer? Check out Nuts May Help Prevent Death, Increased Lifespan from Beans, Fruits and Longevity: How Many Minutes per Mouthful?, and Finger on the Pulse of Longevity.

And, for more on controlling acid reflux, see Diet and GERD Acid Reflux Heartburn and Diet and Hiatal Hernia.

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

The Role of Caffeine in Artery Function

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

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

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

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

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

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

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

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

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

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

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

The effects of coffee on cancer risk are more salutary:

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

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

In health,
Michael Greger, M.D.

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

Original Link

Why are Chickens Fed Prozac?

NF-Jan28 Illegal Drugs in Chicken Feathers.jpeg

Between 1940 and 1971, the synthetic estrogen DES was prescribed to several million pregnant women with the promise that it would "help prevent miscarriages." Problems were first highlighted in 1953 when it became clear that DES was not only ineffective but potentially harmful. However, a powerful and emotive advertising campaign ensured that its use continued until 1971, when it was found to cause cancer of the vagina in the daughters of the mothers who took it. DES was also used to stunt the growth of girls who were predicted to grow "abnormally tall." As one pediatric textbook put it in 1968, "excessive tallness in girls can be a handicap ... it provides difficulty in the purchase of smart clothes; the victim is ineligible for certain sought-after professional positions such as air line hostess; and poses problems in selecting suitable dancing partners."

What most people don't know is that the greatest usage of DES was by the livestock industry, used to improve "feed conversion" in cattle and chickens. Within a year of approval, DES was fed to millions of farm animals. Although it was shown to be a human carcinogen in 1971, DES used in meat production was not completely banned until 1979. (Now, the meat industry just uses different synthetic estrogen implants.) Even decades after DES was banned, we're still seeing its effects--an elevation of birth defects even down to the third generation.

Arsenic is another human carcinogen that was fed to chickens. This time by the billions. The arsenic not only ends up in the meat (as I've talked about previously in Arsenic in Chicken and How Many Cancers Caused by Arsenic Laced Chicken?), but also in the feathers, which are fed back to the animals. Because a third of the bird is inedible, the industry takes billions of pounds of heads, bones, guts, and feathers and uses them as fertilizer and animal feed. This feather meal is fed back to chickens, pigs, cows, sheep, and fish. Straight feathers are not particularly nutritious; so guts, heads, and feet may be added for a little extra protein, and manure added for minerals. The problem is that feather meal used as animal feed could contribute to additional arsenic exposure in persons who consume meat. This gave researchers at John Hopkins University and Arizona State an idea. By testing feather meal, they might be able to find out what else chickens are fed. In their study, "Feather Meal: A Previously Unrecognized Route for Reentry into the Food Supply of Multiple Pharmaceuticals and Personal Care Products," (highlighted in my video, Illegal Drugs in Chicken Feathers) they found that all feather samples tested positive for antibiotic type drugs (between two and ten different kinds in each sample), including fluoroquinolones, which have been banned for years. Either the poultry industry is illegally still using the stuff, or it's being used in other animals fed to the chicken. Regardless, when feather meal is fed back to chickens, they are getting exposed to this drug that is against the law to feed to chickens, creating a cycle of re-exposure to banned drugs.

Then it just gets weirder. The feathers contained a half dozen other drugs: Prozac, an antihistamine, a fungicide, a sex hormone, and caffeine. Why doesn't the poultry industry just say no? Evidently, the antihistamines are to combat the respiratory problems from packing so many tens of thousands into the confinement sheds, and the caffeine helps keeps the chickens stay awake so they eat more and grow faster.

The drugs fed to chickens are one reason used to explain why poultry has been tied to increased cancer risk. See Chicken Dioxins, Viruses, or Antibiotics?.

The most concerning drugs currently in the U.S. poultry supply are the antibiotics, though. See, for example:

Ironically, not only may antibiotics in chicken contribute to antibiotic resistant infections, but to the infections in the first place. Check out my video Avoiding Chicken to Avoid Bladder Infections.

Then as if adding potentially harmful chemicals to the chickens themselves wasn't bad enough, more are added in the processing plant: Phosphate Additives in Chicken.

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: U.S. Department of Agriculture / Flickr

Original Link

Coffee for Hepatitis C

NF-Dec10 Preventing Liver Cancer with Coffee?.jpg

Decades ago, researchers in Norway came upon an unexpected finding. Alcohol consumption was associated with liver inflammation (no surprise), but a protective association was found for coffee consumption. These findings were replicated in the U.S. and around the world. Those at risk for liver disease--who drank a lot of alcohol or were overweight--appeared to cut their risk in half if they drank more than two cups of coffee a day.

Liver cancer is one of the most feared complications of liver inflammation. Hepatocellular carcinoma is the third leading cause of cancer death, and the incidence has been rapidly rising in the United States and Europe, largely driven by the burden of hepatitis C infection and fatty liver disease. Putting together all the best studies done to date, those drinking the most coffee had half the risk of liver cancer compared to those that drank the least. Since the meta-analysis was published, a new study found that male smokers may be able to cut their risk of liver cancer more than 90% by drinking four or more cups of coffee a day. (Of course, they could also stop smoking!). It's similar to heavy drinkers of alcohol: drinking more coffee may decrease liver inflammation, but not as much as drinking less alcohol.

Liver cancers are among the most avoidable cancers, through hepatitis B vaccination, control of hepatitis C transmission, and reduction of alcohol drinking. These three measures could, in principle, wipe out 90% of liver cancers worldwide. It remains unclear whether coffee drinking has an additional role on top of that, but in any case such a role would be limited compared to preventing liver damage in the first place. But what if you already have hepatitis C or are among the 30% of Americans with non-alcoholic fatty liver disease due to obesity, which may quadruple one's risk of dying from liver cancer? Coffee seems to help with hepatitis C, reducing liver damage, disease activity, and mortality. It was only the lack of randomized, interventional studies on the topic that prevented us from concluding that coffee has a protective effect.

But in 2013 we got such a study, a randomized controlled trial on the effects of coffee consumption in chronic hepatitis C (highlighted in my video, Preventing Liver Cancer with Coffee). Forty patients with chronic hepatitis C were randomized into two groups: the first consumed four cups of coffee/day for 30 days, while the second remained coffee "abstinent." Then the groups switched for the second month. Two months is too soon to detect changes in cancer rates, but the researchers were able to demonstrate that coffee consumption reduces oxidative DNA damage, increases the death of virus infected cells, stabilizes chromosomes, and reduces fibrosis, all of which could explain the role coffee appears to play in reducing the risk of disease progression and of evolution to cancer.

Is it time to write a prescription for coffee for those at risk for liver disease? Some say no: "[A]lthough the results are promising, additional work is needed to identify which specific component of coffee is the contributing factor in reducing liver disease and related mortality." There are, after all, more than 1000 compounds that could be responsible for its beneficial effects. But that's such a pharmacological worldview. Why do we have to know exactly what it is in the coffee bean before we can start using them to help people? Yes, more studies are needed, but in the interim; moderate, daily, unsweetened coffee ingestion is a reasonable adjunct to therapy for people at high risk such as those with fatty liver disease.

Daily consumption of caffeinated beverages can lead to physical dependence. Caffeine withdrawal symptoms can include days of headache, fatigue, difficulty with concentration, and mood disturbances. But this dependence could be a good thing: "The tendency for coffee to promote habitual consumption may ultimately be advantageous if its myriad potential health benefits are confirmed."

More on coffee in:

Broccoli can boost the liver's detoxifying enzymes (Prolonged Liver Function Enhancement from Broccoli) but one can overdo it (Liver Toxicity Due to Broccoli Juice?).

What other foods might reduce DNA damage? See:

-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: Matthew Wicks / Flickr

Original Link

How Grapefruit Affects Prescription Drugs

NF-Aug5 How Grapefruit Affects Prescription Drugs.jpg

Does grapefruit in particular help people lose weight?

If someone eats half of a grapefruit three times a day before each meal for a couple months, they may lose about two pounds -- but that's no more than if they ate three apples or pears a day. In one study, the grapefruit eaters not only saw their weight go down, but their waist got slimmer, and their body fat melted away. If, however, we repeat the experiment and instead ask people to drink a half cup of water before each meal, we get the same result. So this belief that grapefruit has some special fat-burning quality appears to be just a long-held myth.

The researchers reported that grapefruit consumers had a drop in weight, a significant drop in cholesterol, and a significant drop in blood pressure. They concluded that consumption of grapefruit daily for six weeks does not significantly decrease body weight, cholesterol, or blood pressure, though. That made me do a little double take, but again, it's because the grapefruit didn't do any better than placebo.

Other studies have found a legitimate cholesterol-lowering benefit of grapefruit, and even a little dip in triglycerides, especially eating red as opposed to white . For example, one study showed a decrease in cholesterol, but only from one life-threatening cholesterol level to another life-threatening cholesterol level. To prevent heart disease, we really have to get down to a total cholesterol of around 150, which is the average cholesterol of those eating diets composed exclusively of plant foods, not just grapefruits (See, for example, One in a Thousand: Ending the Heart Disease Epidemic).

Even though grapefruits alone don't do much, the researchers suggest that people might be more likely to stick with them than cholesterol lowering drugs, noting that most people with heart disease stop taking their statin drugs within a couple years because of the adverse side effects (see Statin Muscle Toxicity). While grapefruits alone don't have any side effects, ironically, combining grapefruits and drugs can make drug side effects even worse.

If we eat lots of fruits and vegetables, we hopefully won't need a lot of drugs (Say No to Drugs by Saying Yes to More Plants), but certain phytochemicals in plants can affect the metabolism of drugs in the body. Grapefruit is the poster child, described as a "pharmacologist's nightmare." Natural phytochemicals in grapefruit suppress the enzymes that help clear more than half of commonly prescribed drugs, and less drug clearance means higher drug levels in the body. This may actually be good if we want a better caffeine buzz from our morning coffee, or our doctors want to help us save thousands of dollars by boosting the effects of expensive drugs instead of just peeing them away.

But higher drug levels may mean higher risk of side effects. Women taking the Pill are normally at a higher risk of blood clots, but even more so, perhaps, if they have been consuming grapefruit. Taking the Pill with grapefruit juice may increase blood drug concentrations by 137 percent.

If suppressing our drug clearance enzymes with grapefruit juice elevates levels of ingested estrogen, what might it be doing to our own estrogen levels? A study associating grapefruit consumption with breast cancer freaked out the medical community, but subsequent studies on even larger groups of women found no evidence of a link. The Harvard Nurses' Study even found a decreased risk of the scariest breast cancer type, so it doesn't look like we have to worry about grapefruit affecting our natural chemistry.

For those prescribed unnatural chemistries, it may be a good idea to discontinue grapefruit consumption for 72 hours before use of a drug that may interact with it. If you don't want to give up your grapefruit, you can ask your doctor about switching from a grapefruit-affected drug like Lipitor to one of the citrus-proof alternatives (the replacement drug chart can be seen in my video, Tell Your Doctor If You Eat Grapefruit).

Other videos on citrus include:

And another video on the risks associated with taking estrogens: Plant-Based Bioidentical Hormones.

Can't eat grapefruit without sprinkling sugar on top? Try erythritol instead to avoid so many empty calories: Erythritol May Be a Sweet Antioxidant.

-Michael Greger, M.D.

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

Image Credit: Liz West / Flickr

Original Link

Treating Breast Pain with Flax Seeds

 

 

 

 

 

 

 

 

Treating Breast Pain with Flax Seeds

A tablespoon a day of ground flax seeds appears to improve ovarian function and is considered a first-line therapy for breast pain associated with one’s period (cyclical mastalgia).

A study I profile in my video Flax Seeds For Breast Pain on the effect of flax seed ingestion on the menstrual cycle found a tablespoon a day lengthened the luteal phase (latter half of the cycle), effectively delaying one’s next period by about a day. Flax seeds also resulted in fewer anovulatory cycles (months in which you fail to ovulate). These are the same kind of improvements in ovarian function that have been found in women eating plant-based diets. In fact, women eating vegan never failed to ovulate in a study comparing meateaters, vegetarians, and vegans, which is similar to what was found in women eating flax daily.

Since the same hormonal changes associated with eating more plant-based diets seemed to improve premenstrual and menstrual symptoms such as breast pain (see my video Plant-Based Diets For Breast Pain), researchers decided to test whether flax seeds would help as well. Although hormone treatments can be helpful, they often cause unpleasant side effects and there may be risks associated with long-term hormonal therapy.  Dietary flaxseed is therefore an attractive alternative for controlling these symptoms.

So, 116 young women with severe menstrual breast pain were randomized in a double-blind study and given either a muffin containing about 3 and a half tablespoons of flax seed or a placebo muffin with no flax, and then followed for a few cycles. There was some placebo muffin effect, but there was a significantly greater reduction in reported breast pain, breast swelling, and breast lumpiness in the flax seed group. The study concluded that “flax seed is effective in relieving symptoms of cyclical mastalgia without significant side effects and might be considered as an alternative treatment for cyclical mastalgia.”

But if flaxseed works, and there are only good side effects, why is it an alternative treatment? Why isn’t it the primary, first-line therapy? Well, the American Congress of Obstetricians and Gynecologists has not issued treatment guidelines, but the Society of Obstetricians and Gynaecologists of Canada has. In their official guidelines they dispel the myth that caffeine is to blame or that vitamin E supplements are helpful. Instead, they prescribe dietary flaxseed “as a first-line therapy for cyclical breast pain.” Drugs are to be considered only if the flax doesn’t work.

So nice to see a professional medical association prioritize safe, natural therapies! See my video series that includes Medical Associations Oppose Bill to Mandate Nutrition Training to see the mentality here in the States.

Do Doctors Make the Grade? Unfortunately, Doctors Know Less Than They Think About Nutrition. This is largely due to the lack of Medical School Nutrition Education, though there also may be The Tomato Effect.

I’ve previously hailed the power of flax in videos such as:

-Michael Greger, M.D.

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

Image credit: Chasqui (Luis Tamayo) / Flickr

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Treating Parkinson’s Disease With Diet

 

 

 

 

 

 

 

 

 

Caffeine consumption appears to help prevent Parkinson’s, but what if you already have the condition? A recent study found that giving folks the equivalent of about two cups of coffee a day worth of caffeine significantly improved symptoms of the disease. Of course, there’s only so much you can charge for coffee, so drug companies took caffeine and added a few side groups so they could patent it into new drugs (Preladenant and Istradefylline). These drugs appear to work no better than plain caffeine, which is dramatically cheaper and probably safer. You can see more of the risks and benefits of coffee and caffeine in Coffee and Cancer and What About the Caffeine?

Similarly, certain plants, such as berries, and plant-based diets in general may help prevent Parkinson’s. See my last post Avoiding Dairy to Prevent Parkinson’s. This may be partially because of pollutants that magnify up the food chain into the meat and dairy supply, but it could also be from the protective phytonutrients in healthy plant foods. For example, as you can see in my 3-min video Treating Parkinson’s Disease With Diet, I profile a case report in which a dietician struck with Parkinson’s was able to successfully clear most of her symptoms with a plant-based diet rich in strawberries, whole wheat, and brown rice. These are rich sources of two particular phytonutrients, N-hexacosanol and fisetin, but there hadn’t been a formal interventional trial published, until now.

At its root, Parkinson’s is a dopamine deficiency disease due to a die-off of dopamine-generating cells in the brain. These cells make dopamine from L-dopa derived from an amino acid in our diet. Just like we saw with the serotonin story I described in my three-part series The Wrong Way to Boost SerotoninA Better Way to Boost Serotonin, and The Best Way to Boost Serotonin, the consumption of animal products blocks the transport of L-dopa into the brain, crowding it out.  With this knowledge, researchers first tried what’s called a “protein redistribution diet.” This is where people could only eat meat for supper so the patients would hopefully be sleeping by the time the negative effects of the animal protein hit.

The researchers didn’t consider cutting out all animal products altogether until it was discovered that fiber consumption naturally boosts L-dopa levels. Thus, a plant-based diet would be expected to raise levodopa bioavailability and bring some advantages in the management of the disease through two mechanisms: reduced animal protein intake and an increased fiber intake. That’s why plant protein is superior, because that’s where fiber is found. So researchers put folks on a strictly vegan diet, saving beans for the end of the day, and indeed found a significant improvement in symptoms.

More on what fiber can do for us in videos such as:

-Michael Greger, M.D.

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

Image credit:  royalconstantinesociety/Flickr

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