How to Treat High Blood Pressure with Diet

How to Treat High Blood Pressure with Diet.jpeg

High blood pressure ranks as the number-one risk factor for death and disability in the world. In my video, How to Prevent High Blood Pressure with Diet, I showed how a plant-based diet may prevent high blood pressure. But what do we do if we already have it? That's the topic of How to Treat High Blood Pressure with Diet.

The American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention recommend lifestyle modification as the first-line treatment. If that doesn't work, patients may be prescribed a thiazide diuretic (commonly known as a water pill) before getting even more meds until their blood pressure is forced down. Commonly, people will end up on three drugs, though researchers are experimenting with four at a time. Some patients even end up on five different meds.

What's wrong with skipping the lifestyle modification step and jumping straight to the drugs? Because drugs don't treat the underlying cause of high blood pressure yet can cause side effects. Less than half of patients stick with even the first-line drugs, perhaps due to such adverse effects as erectile dysfunction, fatigue, and muscle cramps.

What are the recommended lifestyle changes? The AHA, ACC, and CDC recommend controlling one's weight, salt, and alcohol intake, engaging in regular exercise, and adopting a DASH eating plan.

The DASH diet has been described as a lactovegetarian diet, but it's not. It emphasizes fruits, vegetables, and low-fat dairy, but only a reduction in meat consumption. Why not vegetarian? We've known for decades that animal products are significantly associated with blood pressure. In fact, if we take vegetarians and give them meat (and pay them enough to eat it!), we can watch their blood pressures go right up.

I've talked about the benefits to getting blood pressure down as low as 110 over 70. But who can get that low? Populations centering their diets around whole plant foods. Rural Chinese have been recorded with blood pressures averaging around 110 over 70 their whole lives. In rural Africa, the elderly have perfect blood pressure as opposed to hypertension. What both diets share in common is that they're plant-based day-to-day, with meat only eaten on special occasion.

How do we know it's the plant-based nature of their diets that was so protective? Because in the Western world, as the American Heart Association has pointed out, the only folks getting down that low were those eating strictly plant-based diets, coming out about 110 over 65.

So were the creators of the DASH diet just not aware of this landmark research done by Harvard's Frank Sacks? No, they were aware. The Chair of the Design Committee that came up with the DASH diet was Dr. Sacks himself. In fact, the DASH diet was explicitly designed with the number-one goal of capturing the blood pressure-lowering benefits of a vegetarian diet, yet including enough animal products to make it "palatable" to the general public.

You can see what they were thinking. Just like drugs never work--unless you actually take them. Diet never work--unless you actually eat them. So what's the point of telling people to eat strictly plant-based if few people will do it? So by soft-peddling the truth and coming up with a compromise diet you can imagine how they were thinking that on a population clae they might be doing more good. Ok, but tell that to the thousand U.S. families a day that lose a loved one to high blood pressure. Maybe it's time to start telling the American public the truth.

Sacks himself found that the more dairy the lactovegetarians ate, the higher their blood pressures. But they had to make the diet acceptable. Research has since shown that it's the added plant foods--not the changes in oil, sweets, or dairy--that appears to the critical component of the DASH diet. So why not eat a diet composed entirely of plant foods?

A recent meta-analysis showed vegetarian diets are good, but strictly plant-based diets may be better. In general, vegetarian diets provide protection against cardiovascular diseases, some cancers, and even death. But completely plant-based diets seem to offer additional protection against obesity, hypertension, type-2 diabetes, and heart disease mortality. Based on a study of more than 89,000 people, those eating meat-free diets appear to cut their risk of high blood pressure in half. But those eating meat-free, egg-free, and dairy-free may have 75% lower risk.

What if we're already eating a whole food, plant-based diet, no processed foods, no table salt, yet still not hitting 110 over 70? Here are some foods recently found to offer additional protection: Just a few tablespoons of ground flaxseeds a day was 2 to 3 times more potent than instituting an aerobic endurance exercise program and induced one of the most powerful, antihypertensive effects ever achieved by a diet-related intervention. Watermelon also appears to be extraordinary, but you'd have to eat around 2 pounds a day. Sounds like my kind of medicine, but it's hard to get year-round (at least in my neck of the woods). Red wine may help, but only if the alcohol has been taken out. Raw vegetables or cooked? The answer is both, though raw may work better. Beans, split peas, chickpeas, and lentils may also help a bit.

Kiwifruits don't seem to work at all, even though the study was funded by a kiwifruit company. Maybe they should have taken direction from the California Raisin Marketing Board, which came out with a study showing raisins can reduce blood pressure, but only, apparently, compared to fudge cookies, Cheez-Its, and Chips Ahoy.

The DASH diet is one of the best studied, and it consistently ranks as US News & World Report's #1 diet. It's one of the few diets that medical students are taught about in medical school. I was so fascinated to learn of its origins as a compromise between practicality and efficacy.

I've talked about the patronizing attitude many doctors have that patients can't handle the truth in:

What would hearing the truth from your physician sound like? See Fully Consensual Heart Disease Treatment and The Actual Benefit of Diet vs. Drugs.

For more on what plants can do for high blood pressure, 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:

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

Original Link

How to Treat High Blood Pressure with Diet

How to Treat High Blood Pressure with Diet.jpeg

High blood pressure ranks as the number-one risk factor for death and disability in the world. In my video, How to Prevent High Blood Pressure with Diet, I showed how a plant-based diet may prevent high blood pressure. But what do we do if we already have it? That's the topic of How to Treat High Blood Pressure with Diet.

The American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention recommend lifestyle modification as the first-line treatment. If that doesn't work, patients may be prescribed a thiazide diuretic (commonly known as a water pill) before getting even more meds until their blood pressure is forced down. Commonly, people will end up on three drugs, though researchers are experimenting with four at a time. Some patients even end up on five different meds.

What's wrong with skipping the lifestyle modification step and jumping straight to the drugs? Because drugs don't treat the underlying cause of high blood pressure yet can cause side effects. Less than half of patients stick with even the first-line drugs, perhaps due to such adverse effects as erectile dysfunction, fatigue, and muscle cramps.

What are the recommended lifestyle changes? The AHA, ACC, and CDC recommend controlling one's weight, salt, and alcohol intake, engaging in regular exercise, and adopting a DASH eating plan.

The DASH diet has been described as a lactovegetarian diet, but it's not. It emphasizes fruits, vegetables, and low-fat dairy, but only a reduction in meat consumption. Why not vegetarian? We've known for decades that animal products are significantly associated with blood pressure. In fact, if we take vegetarians and give them meat (and pay them enough to eat it!), we can watch their blood pressures go right up.

I've talked about the benefits to getting blood pressure down as low as 110 over 70. But who can get that low? Populations centering their diets around whole plant foods. Rural Chinese have been recorded with blood pressures averaging around 110 over 70 their whole lives. In rural Africa, the elderly have perfect blood pressure as opposed to hypertension. What both diets share in common is that they're plant-based day-to-day, with meat only eaten on special occasion.

How do we know it's the plant-based nature of their diets that was so protective? Because in the Western world, as the American Heart Association has pointed out, the only folks getting down that low were those eating strictly plant-based diets, coming out about 110 over 65.

So were the creators of the DASH diet just not aware of this landmark research done by Harvard's Frank Sacks? No, they were aware. The Chair of the Design Committee that came up with the DASH diet was Dr. Sacks himself. In fact, the DASH diet was explicitly designed with the number-one goal of capturing the blood pressure-lowering benefits of a vegetarian diet, yet including enough animal products to make it "palatable" to the general public.

You can see what they were thinking. Just like drugs never work--unless you actually take them. Diet never work--unless you actually eat them. So what's the point of telling people to eat strictly plant-based if few people will do it? So by soft-peddling the truth and coming up with a compromise diet you can imagine how they were thinking that on a population clae they might be doing more good. Ok, but tell that to the thousand U.S. families a day that lose a loved one to high blood pressure. Maybe it's time to start telling the American public the truth.

Sacks himself found that the more dairy the lactovegetarians ate, the higher their blood pressures. But they had to make the diet acceptable. Research has since shown that it's the added plant foods--not the changes in oil, sweets, or dairy--that appears to the critical component of the DASH diet. So why not eat a diet composed entirely of plant foods?

A recent meta-analysis showed vegetarian diets are good, but strictly plant-based diets may be better. In general, vegetarian diets provide protection against cardiovascular diseases, some cancers, and even death. But completely plant-based diets seem to offer additional protection against obesity, hypertension, type-2 diabetes, and heart disease mortality. Based on a study of more than 89,000 people, those eating meat-free diets appear to cut their risk of high blood pressure in half. But those eating meat-free, egg-free, and dairy-free may have 75% lower risk.

What if we're already eating a whole food, plant-based diet, no processed foods, no table salt, yet still not hitting 110 over 70? Here are some foods recently found to offer additional protection: Just a few tablespoons of ground flaxseeds a day was 2 to 3 times more potent than instituting an aerobic endurance exercise program and induced one of the most powerful, antihypertensive effects ever achieved by a diet-related intervention. Watermelon also appears to be extraordinary, but you'd have to eat around 2 pounds a day. Sounds like my kind of medicine, but it's hard to get year-round (at least in my neck of the woods). Red wine may help, but only if the alcohol has been taken out. Raw vegetables or cooked? The answer is both, though raw may work better. Beans, split peas, chickpeas, and lentils may also help a bit.

Kiwifruits don't seem to work at all, even though the study was funded by a kiwifruit company. Maybe they should have taken direction from the California Raisin Marketing Board, which came out with a study showing raisins can reduce blood pressure, but only, apparently, compared to fudge cookies, Cheez-Its, and Chips Ahoy.

The DASH diet is one of the best studied, and it consistently ranks as US News & World Report's #1 diet. It's one of the few diets that medical students are taught about in medical school. I was so fascinated to learn of its origins as a compromise between practicality and efficacy.

I've talked about the patronizing attitude many doctors have that patients can't handle the truth in:

What would hearing the truth from your physician sound like? See Fully Consensual Heart Disease Treatment and The Actual Benefit of Diet vs. Drugs.

For more on what plants can do for high blood pressure, 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:

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

Original Link

Can Peppermint Improve Athletic Performance?

NF-Oct20 Enhancing Athletic Performance With Peppermint.jpeg

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.

Image Credit: Cory Denton / Flickr

Original Link

Drugs vs. Lifestyle for Preventing Diabetes

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In just one decade, the number of people with diabetes has more than doubled. According to the Center for Disease Control and Prevention, by 2050, one out of every three of us may have diabetes.

What's the big deal?

Well, the "consequences of diabetes are legion." Diabetes is the number one cause of adult-onset blindness, the number one cause of kidney failure, and the number one cause of surgical amputations.

What can we do to prevent it?

The onset of Type 2 diabetes is gradual, with most individuals progressing through a state of prediabetes, a condition now striking approximately one in three Americans, but only about one in ten even knows they have it. Since current methods of treating diabetes remain inadequate, prevention is preferable, but what works better: lifestyle changes or drugs? We didn't know until a landmark study, highlighted in my video, How to Prevent Prediabetes from Turning into Diabetes, was published in the New England Journal of Medicine.

Thousands were randomized to get a double dose of the leading anti-diabetes drug, or diet and exercise. The drug, metformin, is probably the safest diabetes drug there is. It causes diarrhea in about half, makes one in four nauseous, about one in ten suffer from asthenia (physical weakness and fatigue), but only about 1 in 67,000 are killed by the drug every year.

And the drug worked. Compared to placebo, in terms of the percentage of people developing diabetes within the four-year study period, fewer people in the drug group developed diabetes.

But diet and exercise alone worked better. The lifestyle intervention reduced diabetes incidence by 58 percent, compared to only 31 percent with the drug. The lifestyle intervention was significantly more effective than the drug, and had fewer side-effects. More than three quarters of those on the drug reported gastrointestinal symptoms, though there was more muscle soreness reported in the lifestyle group, on account of them actually exercising.

That's what other studies have subsequently found: non-drug approaches superior to drug-based approaches for diabetes prevention. And the average 50 percent or so drop in risk was just for those instructing people to improve their diet and lifestyle, whether or not they actually did it.

In one of the most famous diabetes prevention studies, 500 people with prediabetes were randomized into a lifestyle intervention or control group. During the trial, the risk of diabetes was reduced by that same 50-60 percent, but only a fraction of the patients met the modest goals. Even in the lifestyle intervention group, only about a quarter were able to eat enough fiber, meaning whole, plant foods, and cut down on enough saturated fat, which in North America is mostly dairy, dessert, chicken and pork. But they did better than the control group, and fewer of them developed diabetes because of it. But what if you looked just at the folks that actually made the lifestyle changes? They had zero diabetes--none of them got diabetes. That's effectively a 100 percent drop in risk.

I often hear the diet and exercise intervention described as 60 percent effective. That's still nearly twice as effective as the drug, but what the other study really showed it may be more like 100 percent in people who actually do it. So is diet and exercise 100 percent effective or only 60 percent effective? On a population scale, since so many people won't actually do it, it may only be 60 percent effective. But on an individual level, if you want to know what are the chances you won't get diabetes if you change your lifestyle, then the 100 percent answer is more accurate. Lifestyle interventions only work when we do them. Kale is only healthy if it actually gets into our mouth. It's not healthy just sitting on the shelf.


How about preventing prediabetes in the first place? See Preventing Prediabetes By Eating More and my video How to Prevent Prediabetes in Children.

Some things we may want to avoid can be found in my videos Eggs and Diabetes and Fish and Diabetes.

And what if we already have the disease? See Diabetics Should Take Their Pulses and my live presentation From Table to Able: Combating Disabling Diseases with Diet.

What if you don't have time for exercise? Check out Standing Up for Your Health.

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, and Food as Medicine.

Image Credit: Heather Aitken / Flickr

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What To Do if You Suspect Gluten Problems

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Symptoms of gluten sensitivity include irritable bowel type symptoms such as bloating, abdominal pain, and changes in bowel habits, as well as systemic manifestations such as brain fog, headache, fatigue, depression, joint and muscle aches, numbness in the extremities, skin rash, or anemia. I previously discussed why people who suspect they might be gluten sensitive should not go on a gluten-free diet. But if that's true, what should they do?

The first thing is a formal evaluation for celiac disease, which currently involves blood tests and a small intestinal biopsy. If the evaluation is positive, then a gluten-free diet is necessary. If it's negative, it's best to try a healthier diet with more fruits, vegetables, whole grains and beans while avoiding processed junk. In the past, a gluten-free diet had many benefits over the traditional American diet because it required increasing fruit and vegetable intake--so no wonder people felt better eating gluten-free: no more unhealthy bread products, no more fast food restaurants. Now, there is just as much gluten-free junk out there.

If a healthy diet doesn't help, then the next step is to try ruling out other causes of chronic gastrointestinal distress. In a study of 84 people who claim gluten causes them adverse reactions (they're referred to in the literature as"PWAWGs," People Who Avoid Wheat and/or Gluten), highlighted in my video, How to Diagnose Gluten Intolerance, about a third didn't appear to have gluten sensitivity at all. Instead, they either had an overgrowth of bacteria in their small intestine, were fructose or lactose intolerant, or had a neuromuscular disorder like gastroparesis or pelvic floor dysfunction. Only if those are also ruled out, would I suggest people suffering from chronic suspicious symptoms try a gluten-free diet. If symptoms improve, stick with it and maybe re-challenge with gluten periodically.

Unlike the treatment for celiac disease, a gluten-free diet for gluten sensitivity is ideal not only to prevent serious complications from an autoimmune reaction, but to resolve symptoms and try to improve a patient's quality of life. However, a gluten-free diet itself can also reduce quality of life, so it's a matter of trying to continually strike the balance. For example, gluten-free foods can be expensive, averaging about triple the cost. Most people would benefit from buying an extra bunch of kale or blueberries instead.

No current data suggests that that general population should maintain a gluten-free lifestyle, but for those with celiac disease, a wheat allergy, or a sensitivity diagnosis, gluten-free diets can be a lifesaver.

For more on gluten, check out Is Gluten Sensitivity Real? and Gluten-Free Diets: Separating the Wheat from the Chat.

Some food strategies that may help with irritable bowel symptoms are covered in a few of my previous videos, such as Kiwifruit for Irritable Bowel Syndrome and Cayenne Pepper for Irritable Bowel Syndrome and Chronic Indigestion.

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: Jeremy Segrott/ Flickr

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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

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Foods for Computer Eye Strain

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What happens to our eyesight when we sit in front of a computer all day?

As researchers from the SUNY College of Optometry note, the rise in computer screens "has led to an increase in ocular and visual problems, including eye discomfort, blurring of distant objects, eye strain, and asthenopia (visual fatigue)." This has caused so-called "nearwork-induced transient myopia." That's when after staring at a computer screen for a while we look out the window and things start out all blurry. Our vision becomes blurred because our poor little ciliary muscles pulling at our lens are locked in this constant state of contraction to keep that near focus. Over time, this may have long-term adverse consequences.

How to Combat Computer Eye Strain

Experts in the field recommend taking 4-12 minute breaks staring out the window every hour.

We can also aid our vision with our diet. A double-blind placebo-controlled crossover study, for example, found a significant improvement in refractive values and eyestrain symptoms when subjects ate black currants compared to a placebo.

However, what passes for currants in the U.S. are usually champagne grape raisins, not actual black currants, which were banned in the U.S. a century ago at the behest of the lumber industry. The lumber industry feared that they might spread a plant disease that affects white pine (which we hardly even harvest any more). Black currants are, however, currently making a comeback (and the ban has been lifted in some states), though any anthocyanin-rich berry might have similar benefits (such as bilberries, blueberries, cranberries, black raspberries and red raspberries).

Foods vs. Supplements

Why bother with whole bilberries or black currants when we could just take powder capsules? Because, as we've seen over and over again, when we test supplements, we're lucky if they actually contain what is listed on the label. Furthermore, even for products containing bilberries, one study found that labeling was often uninformative, misleading, or both, something or which the herbal supplement market is infamous. The largest study to date found that it appears most herbal supplement labels lie.

A Brief History of Bilberries

Bilberries gained notoriety during World War II when it was said that pilots in the British Royal Air Force "were eating bilberry jam to improve their night vision." It turns out this may have been a story concocted to fool the Germans. The real reason the Brits were able to suddenly target Nazi bombers in the middle of the night before the bombers even made it to the English channel was likely not because of bilberries, but because of a top secret new invention the British needed to keep quiet: radar.

For best results when it comes to computer eye strain, stick to whole berries with blue and red pigments, and don't forget to give your eyes a break each hour.

For other videos on protecting our vision, check out Greens vs. Glaucoma, where I listed the best foods to help prevent glaucoma; in Dietary Prevention of Age-Related Macular Degeneration I did the same for age-related macular degeneration. I've also addressed the Dietary Treatment of Glaucoma.

By using a standing or treadmill desk, we can avoid some of the other adverse health effects of sitting at a computer all day. See my video Standing Up for Your Health. I'm now up to 17 miles a day!

-Michael Greger, M.D

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

Image Credit: GBloniarz / Flickr

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Why Athletes Should Eat Nutritional Yeast

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Does powering up at the gym also power up our immune system? Research has shown that moderate exercise improves immunity and decreases illness rates. According to an article in the American Journal of Lifestyle Medicine, "the most important finding that has emerged from exercise immunology studies during the past two decades is that positive changes in our immune system take place during each bout of moderate physical activity. Over time, this translates to fewer days of sickness from, for example, the common cold and other upper respiratory infections." The best available evidence suggests a 25% to 50% reduction in sick days. Name one drug or supplement that can do that!

And it doesn't take much. Let kids run around for just six minutes and we can boost the number of immune cells circulating in their blood stream by more than a third.

At the other end of the life cycle, exercise may help prevent age-related immune decline. Sedentary women in their 70s may have a 50% chance of getting an upper respiratory illness during the fall season every year. But with just a half-hour walk each day, their risk is down to 20%. The runners in the group got it under 10%-five times better!

While regular physical activity improves immune function and lowers upper respiratory infection risk, sustained and intense exertion may have the opposite effect, forming a so-called J-shaped curve relationship (you can see this curve diagram in my video, Preserving Immune Function in Athletes With Nutritional Yeast). As we go from inactive to active, our infection risk declines. But if we overtrain, as hardcore athletes do, we may actually put excessive stress on our body and increase our risk of infection. Then we could lose training days, and our performance could suffer.

So how can we fight off sickness while continuing to train? Traditional sports medicine doesn't appear to offer much help, advising athletes to basically not pick their nose, avoid sick people, and get a flu shot.

But there there may be a natural solution. A new study found that we can better maintain our level of circulating white blood cells after exhaustive exercise by consuming a special type of fiber found in baker's, brewer's, and nutritional yeast. (Brewer's yeast is bitter, but nutritional yeast has a nice cheesy flavor. I use it mostly to sprinkle on popcorn). Normally, two hours after hardcore cycling, there can be a dip in circulating white blood cells, one of our first lines of defense. However, after strenuous exercise, those who ate the equivalent of less than three quarters of a teaspoon a day of nutritional yeast ended up even better than when they started. But does this increase in immune cells translate into fewer illnesses? Researchers studied competitors in the Carlsbad Marathon to find out.

In the weeks following the race, a significant number of runners began experiencing upper respiratory tract infection symptoms while taking a placebo. Those runners who were taking the equivalent of a daily spoonful of nutritional yeast cut their rates of infection in half. And they felt better, too. They were asked how they felt on a scale of one to ten. People taking the sugar pills were okay, down around four or five, but those taking identical looking capsules of the fiber found in nutritional yeast were up at six or seven. Elite athletes tend to normally experience deterioration in mood state during intense training periods, and before and after a marathon race. Sprinkle on a little spoonful of nutritional yeast, though, and you may feel less tense, less fatigued, less confused, even less angry (and my personal favorite, they had significantly "increased vigor").

Don't have time to exercise? Yes you do! See Standing Up for Your Health.

Find more on the benefits of exercise in:

What else can we do to preserve our immune function? See:

Nutritional yeast that's fortified can also be a convenient source of vitamin B12 (Safest Source of B12).

-Michael Greger, M.D.

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

Image Credit: Jeff Gunn / Flickr

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How to Treat Multiple Sclerosis With Diet

NF-July17 Treating Multiple Sclerosis with Diet.jpg

Multiple sclerosis is an unpredictable and frightening degenerative autoimmune inflammatory disease of the central nervous system in which our body attacks our own nerves. It often strikes in the prime of life and can cause symptoms in the brain, such as cognitive impairment; in the eye, such as painful loss of vision; as well as tremors, weakness, loss of bladder control, pain, and fatigue.

The most frequently prescribed drug for multiple sclerosis is interferon beta, which can make one feel lousy and cost $30,000 a year. But hey, it might be worthwhile--if it actually worked. We learned recently that it doesn't seem to prevent or delay long-term disability. That leaves chemo drugs like mitoxantrone that causes irreversible heart damage in one out of every eight people who go on the drug and causes cancer (leukemia) in nearly 1% of people who take it. But MS is no walk in the park either.

If only there was a cheap, simple, safe, side-effect free solution that also just so happened to be the most effective treatment for MS ever prescribed...

Dr. Roy Swank, who we lost recently at age 99, was a distinguished neurologist whose research culminated in over 170 scientific papers. In the video, Treating Multiple Sclerosis with the Swank MS Diet, I highlight a few.

As far back as 1950, we knew there were areas in the world that had a lot of MS--North America, Europe--and other places--Africa and Asia--that hardly had any. And migration studies show that those who move from a high risk area to a low risk area significantly drop their risk, and vice versa. So it seems less genetic and more lifestyle.

Dr. Swank had an idea. As he recounts in an interview with Dr. John McDougall at the ripe young age of 84, "it seemed possible to me that this could be a matter of food, because the further north you go the less vegetarian a life is led and the more people are carnivores, you might say--they spend a lot more time eating meat."

After looking at the multiple sclerosis data from World War II in occupied countries where meat and dairy were rationed, along with his famous study in '52 that found that the frequency of MS related directly to the amount of saturated animal fat consumed daily in different areas of Norway, he concluded that it might be the animal fat that was causing the increased risk. He decided to put it to the test by restricting people's intake of saturated animal fat, most commonly coming from dairy and chicken in the U.S. (See Trans Fat, Saturated Fat, and Cholesterol: Tolerable Upper Intake of Zero).

In Treating Multiple Sclerosis with the Swank MS Diet, you can see data on his first 47 patients before cutting out about 90% of the saturated fat from their diet and after, showing a decrease in both the frequency and severity of MS attacks. Normally, we're lucky if we can get people to stick to a diet for six months, and so that's why most dietary trials last a year at the most. The first study he published reported results from the first three and a half years.

Then came the five and a half year follow-up in which he added about another 100 patients. Then the seven year follow-up, published in the Annals of Internal Medicine. Then the 20 year follow-up, and then the 34 year follow-up.

How did his patients do? If we can get to people early in their disease, when they're only mildly disabled, and restrict their saturated fat intake, Dr. Swank showed he could stop their disease in 95% of cases--no further disability 34 years later. But if they started slacking on their diet--even years in, their disease could become reactivated. They felt so great that some felt that they could cheat a little bit, since they had their disease so well under control. But eating just eight grams of saturated fat more a day was accompanied by a striking increase in disability and a near tripling of their death rate.

How about a 50 year follow-up! They were able to track down 15 of the original patients that stuck to the diet, now in their 70s and 80s, with multiple sclerosis for over 50 years, and 13 out of 15 were walking around normal in all respects. Conclusion: "This study indicated that, in all probability, MS is caused largely by consumption of saturated animal fat."

Dr. Swank thought it was the sludging of the blood caused by even a single meal of saturated fats that can clog tiny capillaries that feed our nervous system. Diets rich in saturated fat and cholesterol can thicken the blood and make our red cells sticky. A single meal of sausage and eggs can stick our blood cells together like rolls of quarters. And that kind of hyperaggregation can lead to a reduction of blood flow and oxygenation of our tissues. What's in sausage and eggs that may cause so much inflammation? See my video series on endotoxins described in my blog How Does Meat Cause Inflammation?

If we put someone's blood through a machine that sucks out about 90% of the cholesterol in their blood, we can demonstrate an immediate improvement in microcirculation in the heart muscle. But what about the brain?

The eyes are the windows... to our brain. We can visualize--in real-time--changes in blood vessel function in the retina at the back of the eye, which gives us a sense of what's happening further back in the brain. And if we lower the cholesterol level in the blood, we can immediately get a significant improvement in vasodilation--the little veins open wider and let the blood flow.

So yes, it could be the animal fat leading to clogging of our capillaries, but now we know animal fats can have all sorts of other deleterious effects such as inflammation, so who knows what the actual mechanism may be by which cutting animal fat can cut MS progression. Regardless, patients with MS that follow a diet with no more than 10 or 15 grams of saturated fat can expect to survive and thrive to a ripe old age. Of course, cutting out saturated fat completely might be better, given that heart disease is our number one killer.

The bottom line is that the results Dr. Swank published remain "the most effective treatment of multiple sclerosis ever reported in the peer reviewed medical literature." In patients with early stage MS, 95% were without progression of their disease 34 years later after adopting his low saturated fat dietary program. Even patients with initially advanced disease showed significant benefit. To date, no medication or invasive procedure has ever even come close, to demonstrating such success.

Doesn't cost $30,000 dollars; doesn't give you leukemia--and works. Better!

This all begs one big obvious question: If Dr. Swanks results are "so stunningly impressive, why haven't other physicians, neurologists, and centers adopted this method of treatment?" One reason may be that MRI machines weren't invented until the 1970s, decades after Dr. Swank's study began. MRIs are how we track the progress of MS today. We don't have to rely on patients' subjective reports or doctor's clinical judgments, we can see the disease get better or worse right there in black and white.

It's like in the 1970s when Nathan Pritikin appeared to reverse heart disease by the thousands but no one took him seriously until angiography was invented and the likes of Ornish and Esselstyn (see Our Number One Killer Can Be Stopped) could hold up angiographic images, proving conclusively that a plant-based diet could help literally open up arteries.

So what we need is someone to repeat Swank's experiment today with MRI scans every step of the way. And I'm happy to report that exact experiment was just completed by Dr. John McDougall. Dr. Swank was one of Dr. McDougall's heroes, and Dr. McDougall is one of mine. Study enrollment was completed last year and we should have the full results soon.

I touched on this in my live 2013 year-in-review lecture More Than an Apple a Day, but I'm excited to be able to take a deeper dive into this extraordinary story.

Those interested in supporting Dr. McDougall's landmark study (headed by Dr. Dennis Bourdette, M.D. and under the supervision of Dr. Vijayshree Yadav) can donate to his nonprofit McDougall Research & Education Foundation (you can also donate to NutritionFacts.org to help keep us bringing you similarly underreported yet life-saving science).

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live 2012 year-in-review presentation Uprooting the Leading Causes of Death.

Image Credit: Theen Moy / Flickr

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Citrus to Reduce Muscle Fatigue

 

 

 

 

 

 

 

 

Citrus to Reduce Muscle Fatigue

The lactic acid that makes yogurt tangy is the same lactic acid that builds up in our muscles when we exercise strenuously. Instead of bacteria fermenting the sugar in milk to make energy for themselves, our muscles ferment sugar in our diet to produce energy to contract. If, like when we’re sprinting, lactic acid builds up in our muscles faster than it can be removed we can end up with a burning sensation in our muscles, forcing us to stop.

Now if we train, we can increase the number of blood vessels in our muscles and clear out the lactate faster. For example, when researchers took some overweight sedentary women and started them on an aerobic training program of running and walking, at the end of three months, their lactate levels during exercise dropped 17%. But those on the same program who drank two cups of orange juice a day dropped their levels 27%. They did the same exercise program, but the citrus group experienced a significant decrease in blood lactate concentration, indicating an improvement in physical performance with less muscle fatigue.

I don’t recommend drinking juice, though, because we’re losing all that wonderful fiber that slows the rate of fruit sugar absorption into our system. In my video, Reducing Muscle Fatigue with Citrus, we can see the blood sugar spike one might expect after drinking Coca-Cola. Compare that to the spike we see with orange juice? No difference. However, if we eat the same quantity of sugar in the form of orange slices we experience a significantly smaller spike in blood sugar.

So the whole fruit is nearly always better than fruit juice. Now this is not to say OJ isn’t better than coke. OJ has those citrus phytonutrients like hesperidin, which may be why the women’s triglycerides didn’t go up even though they were drinking two cups of fruit juice every day. Hesperidin may actually help lower our digestion of fats, but once we get up to three cups a day, we really can start bumping our triglycerides.

The burning sensation during strenuous exercise may be related to the build-up of lactic acid in our muscles, but that’s different than the delayed onset muscle soreness that occurs in the days following a bout of extreme physical activity. That’s thought to be due to inflammation caused by muscle cell damage, little micro-tears in the muscle. If it’s an inflammatory reaction then might anti-inflammatory phytonutrients help? Find out in my video Reducing Muscle Soreness with Berries.

For more about what citrus phytonutrients can do can be found in my video, Keeping Your Hands Warm with Citrus.

-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: Rennett Stowe / Flickr

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