Benefits of Nutritional Yeast to Prevent the Common Cold

Benefits of Nutritional Yeast to Prevent the Common Cold.jpeg

Natural immunomodulators that can help regulate our immune system without side-effects have been sought for centuries, and all the while they've been sitting in the produce aisle. Plants produce thousand of active compounds, many of which modulate our immune system, but we can't forget the fungi (see Boosting Immunity While Reducing Inflammation).

Mushrooms have used for centuries as folk remedies, and for good reason. Some have been shown to boost immune function, so much so that a type of fiber found in shiitake mushrooms is approved for use as adjunct chemotherapy, injected intravenously to help treat a variety of cancers by rallying our immune defenses.

More than 6,000 papers have been published on these so-called beta glucans, but almost all of the data about preventing infections had come from petri dish or lab animal studies, until a few years ago when a series of experiments on athletes showed beneficial effects in marathon runners (see Preserving Immune Function in Athletes With Nutritional Yeast). What about the rest of us? We didn't know... until now.

As I explore in my video, Nutritional Yeast to Prevent the Common Cold, beta glucan fiber found in baker's, brewer's and nutritional yeast helps to maintain our body's defense against pathogens even in nonathletes, according to a double-blind, randomized, placebo-controlled trial. The recurrence of infections with the common cold was reduced by 25% in those that ate the equivalent of about a spoonful of nutritional yeast a day, and had fewer cold-related sleeping difficulties when they did get sick.

What about half a spoonful a day? Still worked! Subjects experienced a big drop in common cold incidence and a reduction in symptoms as well. Why is this? This study found that not only were upper respiratory infection symptoms diminished, but that mood states appeared to improve, for example a significant boost in feelings of "vigor." So the researchers suggest that maybe the yeast fiber is able to counteract the negative effects of stress on the immune system.

In terms of side-effects, two folks reported stomachaches, but they were both in the placebo group.

Unlike antibiotics and antivirals, which are designed to kill the pathogen directly, these yeast compounds instead appear to work by stimulating our immune defenses, and as such don't share the same antibiotic side effects. They stimulate our immune defenses presumably because our body recognizes them as foreign. But if it's treated like an invader, might it trigger an inflammatory response? Turns out these fiber compounds may actually have an anti-inflammatory effect, suggesting nutritional yeast may offer the best of both worlds, boosting the infection fighting side of the immune system while suppressing inflammatory components.

Yeast is high in purines, so those with gout, uric acid kidney stones, and new organ transplant recipients may want to keep their intake to less than a teaspoon a day. But is there any downside for everyone else? In California some packages of nutritional yeast are slapped with prop 65 warning stickers, suggesting there's something in it exceeding cancer or birth defect safety limits. I called around to the companies and it turns out the problem is lead. California state law says a product cannot contain more than half of a microgram of lead per daily serving, so I contacted the six brands I knew about and asked them how much lead was in their products.

KAL originally said "<5 ppm," but when we called back they said "<3 ppm." Even if it's 3, that translates into less than 45 micrograms per serving, nearly a 100 times more than the California limit. But perhaps that's better than Bob's Red Mill or Frontier Coop, who evidently don't test at all. But at least they got back to me. Redstar brand failed to respond to multiple attempts to contact them. Now Foods said they test for lead and claim that at least their recent batches meet the less than a half a microgram California standard. Unfortunately, despite repeated requests they would not provide me with documentation to substantiate their numbers. My favorite response was from Bragg's who sent me the analysis certificate from the lab showing less than 0.01 ppm, which means at most less than half the California standard, which I believe is the most stringent in the world. To put the numbers in context, in determining how much lead manufacturers can put into candy likely to be frequently consumed by small children, the Food and Drug Administration would allow about 2 micrograms a day in the form of lollipops, but as far as I'm concerned the less lead the better.

I was so frustrated by the lack of transparency I decided to test them for lead myself. NutritionFacts.org hired an independent lab to conduct our own tests for lead and shipped out 8 samples of nutritional yeast in their original package. The lab used standard practices for lead testing known as Official Methods of Analysis set by AOAC International. Lab technicians determined the lead values based on California Prop 65 standards. Here are the results from the brands we tested:

Bob's Red Mill - Test report shows no detectable lead (<0.01 ppm).

Bragg - Test report shows no detectable lead (< 0.01 ppm).

Dr. Fuhrman - Test report shows no detectable lead (< 0.01 ppm).

Frontier Coop - Test report shows lead levels at 0.021 ppm. It would take six tablespoons a day (based on the manufacture's listed density) to exceed the California Office of Environmental Health Hazard Assessment Maximum Allowable Dose Level (MADL) for chemicals causing reproductive toxicity.*

KAL - Test report shows lead levels at 0.011 ppm. It would take seven tablespoons a day to exceed the MADL.*

NOW Foods - Test report shows no detectable lead (< 0.01 ppm).

Red Star - Test report shows no detectable lead (< 0.01 ppm).

Whole Foods - Test report shows lead levels at 0.012 ppm. It would take six tablespoons a day to exceed the MADL.*

So what do all those numbers mean? None of the brands tested exceeded California prop 65 standards. No matter what brand, consuming a typical serving (2 tablespoons) per day is still well within safe limits.

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:

* The Maximum Allowable Dose Level for lead as a developmental toxin is 0.5 micrograms a day. How are MADL's calculated? Basically scientists figure out what the "no observable effect level" is, the level at which no birth defects or reproductive toxicity can be found, and then introduce a 1000-fold safety buffer. So for example, let's say there's some chemical that causes birth defects if expectant moms are exposed to two drops of the chemical a day, but there's no evidence that one drop a day is harmful. Do they set the Maximum Allowable Dose Level at one drop? No, they set it at 1/1000th of a drop to account for scientific uncertainty and to err on the side of caution. So by saying six tablespoons a day of nutritional yeast may exceed the MADL is in effect saying that the level of lead found in 6,000 tablespoons of nutritional yeast may cause birth defects. Like mercury, though, as far as I'm concerned the less lead exposure the better. I hope this will inspire companies to do further testing to see if the levels we found were just flukes.

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

Original Link

Benefits of Nutritional Yeast to Prevent the Common Cold

Benefits of Nutritional Yeast to Prevent the Common Cold.jpeg

Natural immunomodulators that can help regulate our immune system without side-effects have been sought for centuries, and all the while they've been sitting in the produce aisle. Plants produce thousand of active compounds, many of which modulate our immune system, but we can't forget the fungi (see Boosting Immunity While Reducing Inflammation).

Mushrooms have used for centuries as folk remedies, and for good reason. Some have been shown to boost immune function, so much so that a type of fiber found in shiitake mushrooms is approved for use as adjunct chemotherapy, injected intravenously to help treat a variety of cancers by rallying our immune defenses.

More than 6,000 papers have been published on these so-called beta glucans, but almost all of the data about preventing infections had come from petri dish or lab animal studies, until a few years ago when a series of experiments on athletes showed beneficial effects in marathon runners (see Preserving Immune Function in Athletes With Nutritional Yeast). What about the rest of us? We didn't know... until now.

As I explore in my video, Nutritional Yeast to Prevent the Common Cold, beta glucan fiber found in baker's, brewer's and nutritional yeast helps to maintain our body's defense against pathogens even in nonathletes, according to a double-blind, randomized, placebo-controlled trial. The recurrence of infections with the common cold was reduced by 25% in those that ate the equivalent of about a spoonful of nutritional yeast a day, and had fewer cold-related sleeping difficulties when they did get sick.

What about half a spoonful a day? Still worked! Subjects experienced a big drop in common cold incidence and a reduction in symptoms as well. Why is this? This study found that not only were upper respiratory infection symptoms diminished, but that mood states appeared to improve, for example a significant boost in feelings of "vigor." So the researchers suggest that maybe the yeast fiber is able to counteract the negative effects of stress on the immune system.

In terms of side-effects, two folks reported stomachaches, but they were both in the placebo group.

Unlike antibiotics and antivirals, which are designed to kill the pathogen directly, these yeast compounds instead appear to work by stimulating our immune defenses, and as such don't share the same antibiotic side effects. They stimulate our immune defenses presumably because our body recognizes them as foreign. But if it's treated like an invader, might it trigger an inflammatory response? Turns out these fiber compounds may actually have an anti-inflammatory effect, suggesting nutritional yeast may offer the best of both worlds, boosting the infection fighting side of the immune system while suppressing inflammatory components.

Yeast is high in purines, so those with gout, uric acid kidney stones, and new organ transplant recipients may want to keep their intake to less than a teaspoon a day. But is there any downside for everyone else? In California some packages of nutritional yeast are slapped with prop 65 warning stickers, suggesting there's something in it exceeding cancer or birth defect safety limits. I called around to the companies and it turns out the problem is lead. California state law says a product cannot contain more than half of a microgram of lead per daily serving, so I contacted the six brands I knew about and asked them how much lead was in their products.

KAL originally said "<5 ppm," but when we called back they said "<3 ppm." Even if it's 3, that translates into less than 45 micrograms per serving, nearly a 100 times more than the California limit. But perhaps that's better than Bob's Red Mill or Frontier Coop, who evidently don't test at all. But at least they got back to me. Redstar brand failed to respond to multiple attempts to contact them. Now Foods said they test for lead and claim that at least their recent batches meet the less than a half a microgram California standard. Unfortunately, despite repeated requests they would not provide me with documentation to substantiate their numbers. My favorite response was from Bragg's who sent me the analysis certificate from the lab showing less than 0.01 ppm, which means at most less than half the California standard, which I believe is the most stringent in the world. To put the numbers in context, in determining how much lead manufacturers can put into candy likely to be frequently consumed by small children, the Food and Drug Administration would allow about 2 micrograms a day in the form of lollipops, but as far as I'm concerned the less lead the better.

I was so frustrated by the lack of transparency I decided to test them for lead myself. NutritionFacts.org hired an independent lab to conduct our own tests for lead and shipped out 8 samples of nutritional yeast in their original package. The lab used standard practices for lead testing known as Official Methods of Analysis set by AOAC International. Lab technicians determined the lead values based on California Prop 65 standards. Here are the results from the brands we tested:

Bob's Red Mill - Test report shows no detectable lead (<0.01 ppm).

Bragg - Test report shows no detectable lead (< 0.01 ppm).

Dr. Fuhrman - Test report shows no detectable lead (< 0.01 ppm).

Frontier Coop - Test report shows lead levels at 0.021 ppm. It would take six tablespoons a day (based on the manufacture's listed density) to exceed the California Office of Environmental Health Hazard Assessment Maximum Allowable Dose Level (MADL) for chemicals causing reproductive toxicity.*

KAL - Test report shows lead levels at 0.011 ppm. It would take seven tablespoons a day to exceed the MADL.*

NOW Foods - Test report shows no detectable lead (< 0.01 ppm).

Red Star - Test report shows no detectable lead (< 0.01 ppm).

Whole Foods - Test report shows lead levels at 0.012 ppm. It would take six tablespoons a day to exceed the MADL.*

So what do all those numbers mean? None of the brands tested exceeded California prop 65 standards. No matter what brand, consuming a typical serving (2 tablespoons) per day is still well within safe limits.

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:

* The Maximum Allowable Dose Level for lead as a developmental toxin is 0.5 micrograms a day. How are MADL's calculated? Basically scientists figure out what the "no observable effect level" is, the level at which no birth defects or reproductive toxicity can be found, and then introduce a 1000-fold safety buffer. So for example, let's say there's some chemical that causes birth defects if expectant moms are exposed to two drops of the chemical a day, but there's no evidence that one drop a day is harmful. Do they set the Maximum Allowable Dose Level at one drop? No, they set it at 1/1000th of a drop to account for scientific uncertainty and to err on the side of caution. So by saying six tablespoons a day of nutritional yeast may exceed the MADL is in effect saying that the level of lead found in 6,000 tablespoons of nutritional yeast may cause birth defects. Like mercury, though, as far as I'm concerned the less lead exposure the better. I hope this will inspire companies to do further testing to see if the levels we found were just flukes.

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

Original Link

Are Sugar Pills Better than Antidepressant Drugs?

Do Antidepressant Drugs Really Work.jpg

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

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

The key word is "published."

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

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

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

How could drug companies get away with this?

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

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

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

Of course it matters!

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

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

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

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

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


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

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

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

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

In health,

Michael Greger, M.D.

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

Image Credit: GraphicStock. This image has been modified.

Original Link

Are Sugar Pills Better than Antidepressant Drugs?

Do Antidepressant Drugs Really Work.jpg

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

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

The key word is "published."

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

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

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

How could drug companies get away with this?

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

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

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

Of course it matters!

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

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

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

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

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


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

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

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

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

In health,

Michael Greger, M.D.

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

Image Credit: GraphicStock. This image has been modified.

Original Link

How May Eating Plants Help Prevent Alzheimer’s Disease?

NF-Oct27 Preventing Alzheimers Disease with Plants.jpeg

Intake of saturated fats and added sugars, two of the primary components of a modern Western diet, is linked with the development of Alzheimer's disease. There has been a global shift in dietary composition, from traditional diets high in starches and fiber, to what has been termed the Western diet, high in fat and sugar, low in whole, plant foods. What's so great about fruits and vegetables?

Plant-derived foods contain thousands of compounds with antioxidant properties, some of which can traverse the blood-brain barrier and may have neuroprotective effects by assisting with antioxidant defense. There's this concept of "brain rust," that neurodegenerative diseases arise from excess oxidative stress. But Nature has gifted humankind with a plethora of plants--fruits, vegetables, and nuts, and the diverse array of bioactive nutrients present in these natural products may play a pivotal role in prevention and one day, perhaps, even the cure of various neurodegenerative diseases, such as Alzheimer's disease.

Accumulated evidence suggests that naturally occurring plant compounds may potentially hinder neurodegeneration, and even improve memory and cognitive function, as I've shared in my videos Preventing Alzheimer's Disease with Plants and How to Slow Brain Aging By Two Years) and treating Alzheimer's with spices such as saffron or turmeric (See Saffron for the Treatment of Alzheimer's and Treating Alzheimer's with Turmeric).

Vegetables may be particularly protective, in part because of certain compounds we eat that concentrate in the brain, found in dark green leafy vegetables, the consumption of which are associated with lower rates of age-related cognitive decline.

Yet when you look at systemic reviews on what we can do to prevent cognitive decline, you'll see conclusions like this: "The current literature does not provide adequate evidence to make recommendations for interventions." The same is said for Alzheimer's, "Currently, insufficient evidence exists to draw firm conclusions on the association of any modifiable factors with risk of Alzheimer's disease." Doctors cite the lack of randomized controlled trials (RCTs) as the basis for their conclusions. RCTs are the gold standard used to test new medicines. This is where researchers randomize people into two groups, half get the drug and half don't, to control for confounding factors. The highest level of evidence is necessary because drugs may kill a hundred thousand Americans every year - not medication errors or illicit drugs, just regular, FDA-approved prescription drugs, making medication alone the sixth leading cause of death in the United States. So, you better make absolutely sure the benefits of new drugs outweigh the often life-threatening risks.

But we're talking about diet and exercise--the side effects are all good, so we don't need the same level of rigorous evidence to prescribe them.

A "modest proposal" was published recently in the Journal of Alzheimer's Disease, an editorial calling for a longitudinal study of dementia prevention. They agreed that definitive evidence for the effectiveness of dementia prevention methods was lacking, so we need large-scaled randomized trials. They suggested we start with 10,000 healthy volunteers in their 20's and split them into five groups. There's evidence, for example, that traumatic brain injury is a risk factor for Alzheimer's, because people with head injuries appear more likely to get the disease, but it's never been put to the test. So, they say, let's take two thousand people and beat half of them in the head with baseball bats, and the other half we'll use Styrofoam bats as a control. Afterall, until we have randomized controls, how can't physicians recommend patients not get hit in the head? They go further saying we should probably chain a thousand people to a treadmill for 40 years, and a thousand people to a couch before recommending exercise. A thousand will be forced to do crossword puzzles; another thousand forced to watch Jerry Springer reruns, lots of meat and dairy or not prescribed for another group for the next 40 years, and we can hook a thousand folks on four packs a day just to be sure.

We help our patients to quit smoking despite the fact that there's not a single randomized controlled trial where they held people down and piped smoke into their lungs for a few decades. It is time to realize that the ultimate study in regard to lifestyle and cognitive health cannot be done. Yet the absence of definitive evidence should not restrict physicians from making reasonable recommendations based on the evidence that is available.

I've discussed how drug-centric approaches to evidence-based medicine may neglect some of the most convincing data: Evidence-Based Medicine or Evidence-Biased?

To see how and why I built NutritionFacts.org on evidence-based principles, see my recent introductory videos:

A sampling of some of my Alzheimer's videos:

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: Michael Heim / 123rf

Original Link

Side-Effects of Aspartame on the Brain

NF-Sept1 Aspartame and the Brain.jpeg

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.

Image Credit: Mike Mozart / Flickr

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How Big Food Twists the Science

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Just like mosquitos are the vectors of spread for malaria, a landmark article published last year in one of the most prestigious medical journals, Lancet, described large food corporations as the vectors of spread for chronic disease. Unlike "infectious disease epidemics, however, these corporate disease vectors implement sophisticated campaigns to undermine public health interventions." Most mosquitoes don't have as good PR firms.

A key message was that "alcohol and ultra-processed food and drink industries use similar strategies as the tobacco industry to undermine effective public health policies and programs." What they mean by ultra-processed is things like burgers, frozen meals, chicken nuggets, fish sticks, potato chips, doughnuts and soda pop.

But how is the food industry like the tobacco industry? The "first strategy is to bias research findings." For example, Philip Morris implemented the Whitecoat project to hire doctors to publish ghost-written studies purporting to negate links between secondhand smoke and harm, publishing biased cherry-picked scientific reports to deny harm and suppress health information. In my video Food Industry-Funded Research Bias, you can see the actual industry memo describing the Whitecoat Project, designed to reverse the scientific "misconception" that secondhand smoke is harmful.

Similarly, funding from these large food corporations biases research. Studies show systematic bias from industry funding, so we get the same kind of tactics--supplying misinformation, use of supposedly conflicting evidence and hiding negative data.

The same scientists-for-hire that downplayed the risks of secondhand smoke are the same hired by the likes of the National Confectioner's Association to say candy cigarettes are A-OK as well. Of course, they declared "no conflict of interest."

The similarities between strategies used by the tobacco, alcohol, and food and drink corporations are unsurprising in view of the flow of people, funds and activities across these industries, which also have histories of joint ownership--like Philip Morris owned both Kraft and Miller Brewing.

So what's their strategy? As a former FDA commissioner described:

"The tobacco industry's strategy was embodied in a script written by the lawyers. Every tobacco company executive in the public eye was told to learn the script backwards and forwards, no deviation was allowed. The basic premise was simple-- smoking had not been proven to cause cancer. Not proven, not proven, not proven--this would be stated insistently and repeatedly. Inject a thin wedge of doubt, create controversy, never deviate from the prepared line. It was a simple plan and it worked."

Internal industry memos make this explicit, stating "doubt is our product, since it is the best means of competing with the body of fact that exists in the mind of the general public." The internal industry memos list objective number one as "to set aside in the minds of millions the false conviction that cigarette smoking causes lung cancer and other diseases; a conviction based on fanatical assumptions, fallacious rumors, unsupported claims and the unscientific statements and conjectures of publicity-seeking opportunists... [We need] to lift the cigarette from the cancer identification as quickly as possible, and to establish--once and for all--that no scientific evidence has ever been produced, presented or submitted to prove conclusively that cigarette smoking causes cancer," similar to what's now coming out from the food industry, from the same folks that brought us smoke and candy.

This is part of a series of "political" blogs which includes my video, Collaboration with the New Vectors of Disease. Why don't I just "stick to the science"? When there are billions of dollars at stake, the body of evidence can be skewed and manipulated. Funders can determine which studies are performed, how they're performed and whether or not they get published at all. That's why I think it's important to take a broader view to account for the ways the scientific method can be perverted for profit.

Here are some examples:

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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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.

Image Credit: AJC ajcann.wordpress.com / Flickr

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Treating Pancreatic Cancer with Turmeric Curcumin

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Pancreatic cancer is among the most aggressive forms of human cancer, characterized by a very high mortality rate. It represents the fourth leading cause of cancer death in United States, killing 32,000 people annually. With a five-year survival rate of only three percent and a median survival rate of less than six months, pancreatic cancer carries one of the poorest prognoses. The diagnosis of pancreatic cancer is one of the worst things a doctor ever has to tell a patient. The only FDA-approved therapies for it, Gemcitabine and Erlotinib, produce objective responses in less than ten percent of patients, while causing severe side-effects in the majority. There is a desperate need for new options.

Clinical research to test new treatments is split into phases. Phase I trials are just to make sure the treatment is safe, to see how much you can give before it becomes toxic. Curcumin, the natural yellow pigment in the spice turmeric has passed a number of those. In fact, there was so little toxicity, the dosing appeared limited only by the number of pills patients were willing to swallow.

Phase II trials are conducted to see if the drug actually has an effect. Curcumin did, in 2 of the 21 patients that were evaluated. One patient had a 73 percent tumor reduction, but the effect was short-lived. One lesion remained small, but a curcumin-resistant tumor clone emerged. The other patient, who had a stable disease for over 18 months, showed slow improvement over a year. The only time that patient's cancer markers bumped up was during a brief three-week stint where the curcumin was stopped.

So curcumin does seem to help some patients with pancreatic cancer, and most importantly, there appears to be little downside. No curcumin-related toxic effects were observed in up to doses of eight grams per day. What happens after eight grams? We don't know because no one was willing to take that many pills. The patients were willing to go on one of the nastiest chemotherapy regimens on the planet, but didn't want to be inconvenienced with swallowing a lot of capsules.

The only surefire way to beat pancreatic cancer is to prevent it in the first place. In 2010 I profiled a study conducted by the National Institutes of Health, the largest such study in history, which found that dietary fat of animal origin was associated with increased pancreatic cancer risk.

Which animal fat is the worst? The second largest study (highlighted in my video: Turmeric Curcumin and Pancreatic Cancer) has since chimed in to help answer that question. Researchers found that poultry was the worst, with 72 percent increased risk of pancreatic cancer associated with every 50 grams of daily poultry consumption. Fifty grams is just about a quarter of a chicken breast. The reason white meat came out worse than red may be because of the cooked meat carcinogens in chicken, the heterocyclic amines that build up in grilled and baked chicken. These mutagenic chemicals have been associated with a doubling of pancreatic cancer risk (See Estrogenic Cooked Meat Carcinogens).

Meat has been associated with significantly increased risk, whereas fake meat is associated with significantly less risk. Those who eat plant-based meats like veggie burgers or veggie dogs three or more times a week had less than half the risk of fatal pancreatic cancer. Legumes and dried fruit appear to be similarly protective.

My grandfather died of pancreatic cancer. By the time the first symptom arose, a dull ache in his gut, it was too late. That's why we need to work on preventing it.

I previously touched on pancreatic cancer prevention in Poultry Exposure Tied to Liver and Pancreatic Cancer and attempts at pancreatic cancer treatment in Gerson Therapy for Cancer and Gerson-style Therapy vs. Chemotherapy.

For more on the heterocyclic amine cooked meat carcinogens:

I've done a bunch of videos on turmeric and various cancers:

And more on this amazing spice (and more to come):

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: Sara Marlowe / Flickr

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Dioxins in U.S. Farm-Raised Catfish

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Dioxins are highly toxic pollutants that accumulate in tissue fat. Almost all dioxins found in people who don't work in toxic waste dumps or something similarly hazardous are believed to come from food, especially meat, milk, and fish, which account for about 95% of human exposure. We tend to only hear about it in the news, though, when there's some mass poisoning.

In 1957, for example, millions of chickens began dying, blamed on toxic components in certain feed fats. Factory farming was taking off, and the industry needed cheap feed to fatten up the birds. They ended up using a toxic fleshing grease from hide stripping operations in the leather industry that were using dioxin-containing preservatives. A subsequent outbreak in 1969 resulted from a pipe mix-up at a refinery that was producing both pesticides and animal feed.

In the 1990's, a supermarket survey found the highest concentrations of dioxins in farm-raised catfish. The source of dioxins was determined to be the feed, but that's surprising, since catfish aren't fed a lot of animal fat. Turns out it was dioxin-contaminated clay added to the feed as an anti-caking agent, which may have originally come from sewage sludge. The same contaminated feed was fed to chickens, so what may have started out in sewage sludge ended up on the plates of consumers in the form of farm-raised catfish and chicken.

How widespread of a problem did it become? This affected five percent of U.S. poultry production, that's people eating hundreds of millions of contaminated chickens. And if it's in the chickens, it's in the eggs. Elevated dioxin levels were found in chicken eggs too. When the source of the feed contamination was identified, the USDA estimated that less than 1% of animal feed was contaminated, but 1% of egg production means over a million eggs a day. But the catfish were the worst. More than a third of all U.S. farm-raised catfish were found contaminated with dioxins thanks to that ball clay. So the FDA requested that ball clay not be used in animal feeds. They even asked nicely, writing "Dear producer or user of clay products in animal feeds, continued exposure to elevated dioxin levels in animal feed increases the risk of adverse health effects in those consuming animal-derived food products... we are recommending that the use of ball clay in animal feeds be discontinued...We look forward to the industry's cooperation." (You can see the original letter in my video, Dioxins in U.S. Farm-Raised Catfish).

So how cooperative did the industry end up being? Half a billion pounds of catfish continued to be churned out of U.S. fish farms every year but only recently did the government go back and check. Published in 2013, samples of catfish were collected from all over the country. Dioxins were found in 96% of samples tested. Yeah, but just because catfish are bought in the U.S. doesn't mean they came from the U.S. And indeed some of the catfish were imported from China or Taiwan, but they were found to be ten times less contaminated. And indeed, when they checked the feed fed to U.S. catfish, more than half were contaminated, and so it seems likely that mined clay products are still being used in U.S. catfish feeds. Even "just small amounts of mineral clays added to fish feeds, together with the fact that catfish can be bottom-feeders may lead to higher than acceptable dioxin residues in the final catfish products."

The Institute of Medicine suggests strategies to reduce dioxin intake exposure, such as trimming the fat from meat, poultry, and fish, and avoiding the recycling of animal fat into gravy, but if almost all dioxin intake comes from animal fat, then eating a more plant-based diet could wipe out about 98% of exposure. Thus "a vegetarian diet or even just eating more plants might have previously unsuspected health advantages along with the more commonly recognized cardiovascular benefits and decreased cancer risk."

This is a good illustration of how we can't necessarily rely on regulators to protect our families' health. More on dietary dioxins and what we can do about it in Dioxins in the Food Supply and Counteracting the Effects of Dioxins Through Diet.

Even wild fish are exposed to industrial pollutants spewed into our waterways. See, for example:

Farmed fish is the worst, though: Farmed Fish vs. Wild-Caught.

Other pollutants in our food supply and how to avoid them:

Though the best way to detox is not to tox in the first place, our bodies can eventually get rid of much of the toxin load:

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: Brent Moore / Flickr

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