Can Peppermint Improve Athletic Performance?

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Ever since smoking was prohibited in night clubs, customers have increasingly noticed other unpleasant smells present in the club--like body odors. So, researchers in Europe thought they'd try to cover them up. The researchers measured the effects of peppermint, for example, on dancing activity and asked people to rate their energy level. They found that with peppermint scent, people felt more cheerful and danced more, and so, concluded the researchers, "environmental fragrancing may be expected to have a positive effects on club revenue." Innovative nightclubs are already inviting "aroma jockeys" to smell the places up.

The business community caught whiff of this and thought maybe peppermint smell would get their secretaries to type faster. And it worked! There was improved performance on clerical tasks associated with the administration of peppermint odor.

In an age where athletic competitions are frequently won or lost by mere hundredths of a second, athletes are continually looking for new ways to excel in their sport. Researchers threw some collegiate athletes onto a treadmill and piped different smell into their nostrils, and those on peppermint reported feeling less fatigued, more vigorous, less frustrated, and felt they performed better. But did they actually perform better? See my video, Enhancing Athletic Performance with Peppermint.

A different study published in the Journal of Sport and Exercise Psychology measured actual performance, and participants were actually able to squeeze out one extra pushup before collapsing and cut almost two seconds off a quarter mile dash with an odorized adhesive strip stuck to their upper lip. Interestingly there was no significant difference in basketball free throws. The researchers think the reason is that free throws actually require some skill, and all the peppermint can do is really improve athlete's motivation.

Unfortunately follow-up studies were not able to replicate these results, showing no beneficial effect of smelling peppermint on athletic performance, so how about eating peppermint? Researchers measured the effects of peppermint on exercise performance before and after ten days of having subjects drink bottles of water with a single drop of peppermint essential oil in them. And all the subjects' performance parameters shot up, churning out 50 percent more work, 20 percent more power, and a 25 percent greater time to exhaustion. Improvements were found across the board in all those physiological parameters, indicating increased respiratory efficiency. They attribute these remarkable results to the peppermint opening up their airways, increasing ventilation and oxygen delivery.

Now, you can overdose on the stuff, but a few drops shouldn't be toxic. Why not get the best of both worls by blending fresh mint leaves in water rather than use the oil?

Sometimes aromatherapy alone may actually help, though:

Beet juice can also enhance athletic performance. See the dozen or so videos in the series starting with Doping With Beet Juice. Other ways healthy food can synergize with exercise:

I use peppermint in my Pink Juice with Green Foam recipe and talk about using the dried in Antioxidants in a Pinch. It can also help reduce IBS symptoms, as seen in Peppermint Oil for Irritable Bowel Syndrome.

Some other tea caveats, though:

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.

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Estrogen in Meat, Dairy, and Eggs

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Estrogen hormones can be thousands of times more estrogenic than typical endocrine-disrupting chemicals. Dietary exposure to natural sex steroids (in meat, dairy, and eggs) is "therefore highly relevant in the discussion of the impact of estrogens on human development and health." And chicken estrogen is identical to human estrogen--they're identical molecules. So it doesn't matter if it ends up in our drinking supply from women taking birth control pills excreting it in their urine, or cows excreting it into their milk. The source doesn't matter; the quantity does.

If you check out my video Estrogen in Meat, Dairy, and Eggs, you can see that a child's exposure to estrogens in drinking water is about 150 times lower than exposure from cow's milk, so our day-to-day estrogen exposure levels are more likely determined by whether or not we happen to eat dairy products that day.

Human urine is "often cited as the main source of natural and synthetic estrogens in the aquatic environment," but the level of estrogen even in the urine of heavy meat-eaters, who have significantly higher levels, pales in comparison to the estrogen excreted by the farm animals themselves. Pig, sheep, cattle, and chickens produce literally tons of estrogen every year.

Women may excrete 16 mg every day, but farm animals may release ten times more, or in the case of pregnant cows, thousands of times more. Animal waste may contribute an estimated 90% of total estrogens in the environment. Five gallons of runoff water contaminated with chicken manure may contain a birth control pill's worth of estrogen.

Estrogen levels in poultry litter are so high that when farmers feed chicken manure to their animals to save on feed costs, it may trigger premature development. Poultry manure has among the highest hormone content, quadruple the total estrogens, and nine times more 17-beta estradiol, the most potent estrogen and a "complete" carcinogen, as it exerts both tumor initiating and tumor promoting effects.

From a human health standpoint, do we really care about feminized fish, or the appearance of "intersex roaches"? The problem is that the hormones get into the food supply. Endogenous steroid hormones in food of animal origin are unavoidable as they occur naturally in these products. It's not a matter of injected hormones, which are banned in places like Europe in order to protect consumers' health. Sex steroid hormones are part of animal metabolism, and so all foodstuffs of animal origin contain these hormones, which have been connected with several human health problems. (See Why Do Vegan Women Have 5x Fewer Twins?)

What effects might these female hormones have on men? See Dairy Estrogen and Male Fertility.

The implications of this relatively new practice of milking cows even when they're pregnant is further explored in:

More on xenoestrogens in:

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.

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Side-Effects of Aspartame on the Brain

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The National Institutes of Health AARP study of hundreds of thousands of Americans followed for years found that frequent consumption of sweetened beverages, especially diet drinks, may increase depression risk among older adults. Whether soda, fruit-flavored drinks, or iced tea, those artificially sweetened drinks appeared to carry higher risk. There was a benefit in coffee drinkers compared to non-drinkers, but if they added sugar, much of the benefits appeared to disappear, and if they added Equal or Sweet-and-Low, the risk appeared to go up.

Various effects of artificial sweeteners, including neurological effects, have been suspected. For example, aspartame--the chemical in Equal and Nutrasweet--may modulate brain neurotransmitters such as dopamine and serotonin, although data have been controversial and inconsistent. Scientific opinions range from "safe under all conditions" to "unsafe at any dose." The controversy started in the 80's soon after aspartame was approved. Researchers at the Mass College of Pharmacy and MIT noted:

"given the very large number of Americans routinely exposed, if only 1% of the 100,000,000 Americans thought to consume aspartame ever exceed the sweetener's acceptable daily intake, and if only 1% of this group happen coincidentally to have an underlying disease that makes their brains vulnerable to the effects, then the number of people who might manifest adverse brain reactions attributable to aspartame could still be about 10,000, a number on the same order as the number of brain and nerve-related consumer complaints already registered with the FDA before they stopped accepting further reports on adverse reactions to the sweetener."

Those with a history of depression might be especially vulnerable. Researchers at Case Western designed a study I highlighted in my video Aspartame and the Brain to ascertain whether individuals with mood disorders are particularly vulnerable to adverse effects of aspartame. Although they had planned on recruiting 40 patients with depression and 40 controls, the project was halted early by the Institutional Review Board for safety reasons because of the severity of reactions to aspartame within the group of patients with a history of depression.

It was decided that it was unethical to continue to expose people to the stuff.

Normally when we study a drug or a food, the company donates the product to the researchers because they're proud of the benefits or safety of their product. But the Nutrasweet company refused to even sell it to these researchers. The researchers managed to get their hands on some, and within a week there were significantly more adverse effects reported in the aspartame group than in the placebo group. They concluded that individuals with mood disorders may be particularly sensitive to aspartame, and therefore its use in this population should be discouraged.

In a review of the direct and indirect cellular effects of aspartame on the brain, it was noted that there are reports of aspartame causing neurological and behavioral disturbances in sensitive individuals, such as headaches, insomnia and seizures. The researchers go even further and propose that excessive aspartame ingestion might be involved in the development of certain mental disorders and also in compromised learning and emotional functioning. They conclude that "due to all the adverse effects caused by aspartame, it is suggested that serious further testing and research be undertaken to eliminate any and all controversies," to which someone responded in the journal that "there really is no controversy," arguing that aspartame was conclusively toxic.

But what do they mean by excessive ingestion? The latest study on the neuro-behavioral effects of aspartame consumption put people on a high aspartame diet compared to a low aspartame diet. But even the high dose at 25 mg/kg was only half the adequate daily intake set by the FDA. The FDA says one can safely consume 50mg a day, but after just eight days on half of that, participants had more irritable mood, exhibited more depression, and performed worse on certain brain function tests. And these weren't people with a pre-existing history of mental illness; these were just regular people. The researchers concluded that "given that the higher intake level tested here was well below the maximum acceptable daily intake level [40mg in Europe, 50mg here] careful consideration is warranted when consuming food products that may affect neurobehavioral health."

Easier said than done, since it's found in more than 6,000 foods, apparently making artificial sweeteners "impossible to completely eradicate from daily exposure." While that may be true for the great majority of Americans, it's only because they elect to eat processed foods. If we stick to whole foods, we don't even have to read the ingredients lists, because the healthiest foods in the supermarket are label-free, they don't even have ingredients lists--produce!

I've previously touched on artificial sweeteners before:

The healthiest caloric sweeteners are blackstrap molasses and date sugar (whole dried powdered dates). The least toxic low-calorie sweetener is probably erythritol (Erythritol May Be a Sweet Antioxidant).

Coffee may decrease suicide and cancer risk (Preventing Liver Cancer with Coffee? and Coffee and Cancer) but may impair blood flow to the heart (Coffee and Artery Function).

Other ways to improve mood include:

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.

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Is Monsanto’s Roundup Pesticide Glyphosate Safe?

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GMO soy has been found to be contaminated with pesticide residues (see Are GMOs Safe? The Case of Roundup Ready Soy), but are these levels anything to worry about? I explore this question in my video Is Monsanto's Roundup Pesticide Glyphosate Safe?.

Researchers out of Norway described the amount of pesticide residues found in GMO soy as high compared to the maximum allowable residue levels. The legal limit for glyphosate in foods had been set at 0.1-0.2 mg/kg; so these exceed the legal limits by an average of about 2000%, whereas organic and conventional non-GMO soy both had none.

So what did Monsanto do? Did the industry ditch the whole GMO thing, go back to using less pesticides so that residue levels wouldn't be so high? Or, they could just change the definition of high. What if they could get authorities to raise the maximum residue level from 0.1 or 0.2 up to 20? Then the residue levels won't look so high anymore. And this is exactly what they did. The acceptance level of glyphosate in food and animal feed has been increased by authorities in countries that use Roundup-Ready GM crops. In Brazil, they went up to ten, and the U.S. and Europe now accept up to 20. In all of these cases, the maximum residue level values appear to have been adjusted, not based on new evidence indicating glyphosate toxicity was less than previously understood, but pragmatically in response to actual observed increases in the content of residues in GMO soybeans--otherwise it wouldn't be legal to sell the stuff.

What evidence do we have, though, that these kinds of residues are harmful? For 12 years we've heard that Roundup interferes with embryonic development, but that study was about sea urchin embryos. For 14 years we heard that Roundup may disrupt hormones, but that's in mouse testicles.

Blogs will dish about concerning new studies implicating Roundup in male fertility, but if we look at the study, it's about rat testicles. Some blogs cite studies with disturbing titles like "prepubertal exposure alters testosterone levels and testicular shape," but they're talking about puberty in rats, though that doesn't make as catchy a blog title.

Why not use human tissue? Women are having babies every day--why not just experiment on human placentas, which would otherwise just get thrown away? In 2005, researchers did just that. And despite all the negative effects in rodents, glyphosate, the active ingredient in Roundup didn't seem to have much of a toxic effect on human cells even at high doses, or have much effect on a hormone regulating enzyme, leading Monsanto-funded reviewers to conclude that regardless of what hazards might be alleged based on animal studies, "glyphosate is not anticipated to produce adverse developmental and reproductive effects in humans."

But pure glyphosate isn't sprayed on crops, Roundup is, which contains a variety of adjuvants and surfactants meant to help the glyphosate penetrate into tissues. And indeed when the study was repeated with what's actually sprayed on GMO crops, there were toxic and hormonal effects even at doses smaller than the 1 or 2% concentration that's used out on the fields.

Similar results were found for other major pesticides. It took until 2014, but eight out of nine pesticide formulations tested were up to one thousand times more toxic than their so-called active ingredients, so when we just test the isolated chemicals, we may not get the whole story. Roundup was found to be 100 times more toxic than glyphosate itself. Moreover, Roundup turned out to be among the most toxic pesticides they tested. It's commonly believed that Roundup is among the safest, though, an idea spread by Monsanto, the manufacturer. However, this inconsistency between scientific fact and industrial claim may be attributed to the huge economic interests involved.

What is glyphosate? Check out: Are GMOs Safe? The Case of BT Corn.

It's the dose that makes the poison, though. Do we have evidence that the levels of Roundup chemicals not only found on crops, but also in our bodies after eating those crops actually have adverse effects? That's the subject of the video: GMO Soy and Breast Cancer.

Commercial interests can have a corrupting effect on the science of nutrition and hold sway over institutions that are supposed to operate in the public interest. See for example:

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

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Why Does the Meat Industry Routinely Feed Animals Antibiotics?

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When farm animals are fed antibiotics, they can develop antibiotic-resistant bacteria in their guts. Manure contamination of meat can then transfer these gut bacteria to humans. These bacteria can even spread to vegetarians, since drug-resistant bacteria in the animal feces can also spread to people through crops or the environment. Exhaust fans can blow MRSA superbugs straight out into the surrounding area from pig or poultry operations. This may explain why human MRSA infections in Europe have been tied to just living in a region with industrial pig production, whether or not people have direct contact with livestock. These findings may not just be limited to Europe.

European factory farms pale in comparison to what we have here in the U.S. From an article published in the Journal of the American Medical Association's Internal Medicine: "proximity to swine manure application to crop fields and livestock operations was each associated with MRSA and skin and soft-tissue infections [in people in the U.S]. These findings contribute to the growing concern about the potential public health impacts of high-density livestock production."

An article published in Lancet Infectious Diseases explains that, "achievements in modern medicine, such as surgery, the treatment of preterm babies, and cancer chemotherapy, which we today take for granted, would not be possible without access to effective treatment for bacterial infections. Within just a few years, we might be faced with dire setbacks, medically, socially, and economically, unless real and unprecedented global coordinated actions are immediately taken" to protect these wonder drugs. Therefore, the use of antibiotics just to promote the growth of farm animals to slaughter weights should be banned worldwide. Europe stopped feeding pigs and chickens tetracycline and penicillin to promote growth about 40 years ago, something the U.S. meat industry continues to do to this day.

The Pew Commission recently published a five year update on their landmark blue ribbon commission report on current agricultural practices that found "the present system of producing food animals in the United States presents an unacceptable level of risk to public health." Their number one recommendation was to ban the non-therapeutic use of antibiotics, but agriculture lobbies are not going to give up the use of antibiotics without a fight (See Antibiotics: Agribusinesses' Pound of Flesh).

In December 2013, the FDA released "Guidance for Industry," their voluntary, non-binding recommendation for industry. They recommend antibiotics no longer be used to just fatten animals for slaughter, but emphasize that they are just that: toothless, non-legally enforceable suggestions. As mentioned in the Pew Commission report, "this voluntary approach has come under withering criticism from the public health and medical communities concerned about the increase in antibiotic-resistant bacterial pathogens."

The USDA is even considering going backwards, eliminating the requirement to even test for Staph aureus at all in the Federal School Lunch Program. They understand that "school-aged children are considered a 'sensitive population', hence, more stringent requirements, including sampling plans, may be considered to help assure safety and public confidence. However, the cost of such programs must be weighed against the cost of buying the food needed to support the program."

As one University of Iowa epidemiologist said, "although human health should take priority over farm animals, farmers will be reluctant to change until researchers can come up with safe and cost-effective practices to replace the use of antibiotics." How much are antibiotics really saving the industry? The net bottom-line benefit from the use of antibiotic feed additives may only be about $0.25 per animal, which means eliminating the risky practice of feeding antibiotics by the ton to farm animals would raise the price of meat less than a penny per pound.

For those not familiar with MRSA, please see my past videos on the topic:

For more on antibiotic use on the farm, see:

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.

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Dietary Estrogens and Male Fertility

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In my video, The Role of Diet in Declining Sperm Counts, I discussed the association between high saturated fat intake and reduced semen quality. But what's the connection? One of the most recent papers on the topic found that a significant percentage of the saturated fat intake in the study was derived from dairy products. Residues of industrial chemicals may bioaccumulate up the food chain into animal fat, and some of these lipophilic (fat-loving) chemicals may have hormone-disrupting abilities.

The U.S. Environmental Protection Agency performed a national survey of persistent, bioaccumulative, and toxic pollutants in the U.S. milk supply (highlighted in my video, Dairy Estrogen and Male Fertility). The EPA team noted that since milk fat is likely to be among the highest dietary sources of exposure to these pollutants, it's important to understand the levels in the dairy supply. The team tested milk from all over the country and found a veritable witches brew of chemicals. They estimate that dairy products alone contribute about 30% to 50% of our dioxin exposure. And "like dioxin, other toxic pollutants tend to be widely dispersed in the environment, bioaccumulated through the food chain and ultimately result in low-level contamination in most animal fats."

This may explain higher pollutant concentrations in fish eaters. Xenoestrogens like polychlorinated biphenyls (PCBs) are associated with the fats of fish or animal flesh and cannot be fully removed by washing and cooking, and so can accumulate in our fat, too. Xenoestrogens are chemicals with demasculinizing or feminizing effects. But even in a non-polluted world, animal foods also have actual estrogen, which are unavoidable constituents of animal products. All foodstuff of animal origin contains estradiol, which is at least 10,000-fold more potent than most xenoestrogens. Dietary exposure--meat, dairy products and eggs--to these natural sex steroids is therefore highly relevant, as the hormones in these animals are identical to our own.

Estrogens are present in meat and eggs, but the major sources are milk and dairy products. By drinking a glass of milk, a child's intake of estradiol is 4,000 times the intake of xenoestrogens in terms of hormone activity. Modern genetically-improved dairy cows can lactate throughout their pregnancy. The problem is that during pregnancy, estrogen levels can jump as much as 30-fold.

Cheese intake has specifically been associated with lower sperm concentration, whereas dairy food intake in general has been associated with abnormal sperm shape and movement. Lower sperm concentrations by themselves may just represent a potential suppression of sperm production due to higher estrogen levels, but abnormal shape and movement suggests that dairy intake may be implicated in actual direct testicular damage.

While milk products supply most of our ingested female sex steroids, eggs are a considerable source as well, contributing about as much as meat and fish. This could be expected, as eggs are produced directly in the hens' ovaries.

Meat may also contain added hormones. In the U.S. anabolic sex steroids may be administered to animals for growth promotion, a practice banned in Europe twenty-five years ago. A study in New York found progressively lower sperm counts associated with processed meat consumption. However, similar studies in Europe after the ban found the same thing, so it may not be the implanted hormones, but rather a consequence of other meat components, such as the saturated fat raising cholesterol levels.

We've known for decades that men with high cholesterol levels show abnormalities in their "spermiograms": decreased sperm concentration, about a third of the normal sperm movement, and half the normal sperm shape. Twenty-five years later, we're finding the same thing. In the largest study to date, higher blood cholesterol levels were associated with a significantly lower percentage of normal sperm. Cholesterol was also associated with reductions in semen volume and live sperm count. These results highlight the role of fats in the blood in male fertility, and should be of concern given the rising prevalence of obesity and cholesterol problems. Although a healthier diet may be associated with healthier sperm counts, cholesterol-lowering statin drugs do not seem to help.

What about the phytoestrogens in soy? See The Effect of Soy on Precocious Puberty.

More on hormones in dairy in:

Neurotoxic chemicals in the dairy supply have been blamed for neurological conditions as well. See my video Preventing Parkinson's Disease with Diet.

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.

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Starch-Blocking Foods for Diabetics?

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How did doctors treat diabetes before insulin? Almost a thousand medicinal plants are known antidiabetic agents, including beans, most of which have been used in traditional medicine. Of course, just because something has been used for centuries doesn't mean it's safe. Other treatments for diabetes in the past included arsenic and uranium. Thankfully many of these other remedies fell by the wayside, but scientific interest in the antidiabetic potential of beans was renewed in the past decade.

Diabetes is a global public health epidemic. Although oral hypoglycemic medications and injected insulin are the mainstay of treatment of diabetes and are effective in controlling high blood sugars, they have side effects such as weight gain, swelling, and liver disease. They also are not shown to significantly alter the progression of the disease. Thankfully, lifestyle modifications have proven to be greatly effective in the management of this disease. And if there is one thing diabetics should eat, it's legumes (beans, chickpeas, split peas, and lentils).

Increased consumption of whole grains and legumes for health-promoting diets is widely promoted by health professionals. One of the reasons is that they may decrease insulin resistance, the defining trait of type 2 diabetes. The European Association for the Study of Diabetes, the Canadian Diabetes Association and the American Diabetes Association all recommend the consumption of dietary pulses as a means of optimizing diabetes control. What are pulses? They're peas and beans that come dried, and are therefore a subset of legumes. They exclude green beans and fresh green peas, which are considered more vegetable crops, and the so-called oil seeds--soybeans and peanuts.

A review out of Canada (highlighted in my video, Diabetes Should Take Their Pulses) compiled 41 randomized controlled experimental trials, totaling more than a thousand patients, and corroborated the diabetes association nutrition guidelines recommending the consumption of pulses as a means of optimizing diabetes control. They discovered that some pulses are better than others. Some of the best results came from the studies that used chickpeas. In terms of beans, pintos and black beans may beat out kidney beans. Compared to the blood sugar spike of straight white rice, the combination of black or pinto beans with rice appeared to reduce the spike more than kidney beans and rice.

Dark red kidney beans may not be as effective because they have lower levels of indigestible starch. One of the reasons beans are so healthy is they contain compounds that partially block our starch-digesting enzyme, which allows some starch to make it down to our colon to feed our good gut bacteria. In fact, the inhibition of this starch-eating enzyme amylase, just by eating beans, approximates that of a carbohydrate-blocking drug called acarbose (sold as Precose), a popular diabetes medication. The long-term use of beans may normalize hemoglobin A1C levels (which is how you track diabetes) almost as well as the drug.

What about avoiding metabolic derangements in the first place? See my video Preventing Prediabetes By Eating More.

What else may help?

What may hurt?

-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.

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Coffee for Hepatitis C

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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.

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Where are the Lowest Rates of Alzheimer’s in the World?

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The rates of dementia differ greatly around the world, from the lowest rates in Africa, India, and South Asia, to the highest rates in Western Europe and especially North America. Is it all just genetics? Well, the incidence of dementia and Alzheimer's disease is significantly lower for Africans in Nigeria than for African Americans in Indianapolis, for example--up to five times lower.

Alzheimer's rates of Japanese-Americans living in the U.S. are closer to that of Americans than to Japanese. When people move from their homeland to the United States, Alzheimer's rates can increase dramatically. Therefore, when Africans or Asians live in the United States and adopt a Western diet, their increase in Alzheimer's risk suggests that it's not genetics.

Unfortunately, one doesn't have to move to the West to adopt a Western diet. The prevalence of dementia in Japan has shot up over the last few decades. Mechanisms to explain this in Japan include increases in cholesterol, saturated fat, and iron from increases in the consumption of animal products. Traditional diets are generally weighted toward vegetable products such as grains and away from animal products. But since 1960, the diet in Japan has changed from a more traditional rice-based diet to one with a preponderance of meat. From 1961 to 2008, meat and animal fat increased considerably, whereas the rice supply dropped. The dietary factor most strongly associated with the rise in Alzheimer's disease in Japan was the increased consumption of animal fat.

A similar analysis in China arrived at the same conclusion. As the authors of the Japan study (highlighted in the video, Alzheimer's Disease: Grain Brain or Meathead?) note, on the basis of these findings, the rate of Alzheimer's disease and dementia will "continue to rise unless dietary patterns change to those with less reliance on animal products." This is consistent with data showing those who eat vegetarian appear two to three times less likely to become demented, and the longer one eats meat-free, the lower the associated risk of dementia.

Globally, the lowest validated rates of Alzheimer's in the world are rural India, where they eat low meat, high grain, high bean, high carb diets. It's possible that the apparent protective association between rice and Alzheimer's is due to the fact that the drop of rice consumption was accompanied by a rise in meat consumption, but other population studies have found that dietary grains appear strongly protective in relation to Alzheimer's disease. In other words, perhaps, don't pass on the grain, but "pass the grain to spare the brain."

A few previous videos on Alzheimer's and maintaining cognitive function:

More on the consequences of carbophobia here:

-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: Bob Peters / Flickr

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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

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