How to Treat Dry Eye Disease Naturally with Diet

Oct 31 Dry Eyes copy.jpeg

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

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

There has to be a better way.

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

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

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

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

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

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

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


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

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

In health,

Michael Greger, M.D.

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

Original Link

How to Treat Dry Eye Disease Naturally with Diet

Oct 31 Dry Eyes copy.jpeg

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

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

There has to be a better way.

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

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

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

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

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

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

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


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

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

In health,

Michael Greger, M.D.

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

Original Link

Foods to Eat to Help Prevent Diabetes

Oct 26 Foods to Eat copy.jpeg

Why is meat consumption a risk factor for diabetes? Why does there appear to be a stepwise reduction in diabetes rates as meat consumption drops? Instead of avoiding something in meat, it may be that people are getting something protective from plants. Free radicals may be an important trigger for insulin resistance, and antioxidants in plant foods may help. Put people on a plant-based diet, and their antioxidant enzymes shoot up. So not only do plants provide antioxidants, but may boost our own anti-endogenous antioxidant defenses, whereas, on the conventional diabetic diet, they get worse.

In my video, How May Plants Protect Against Diabetes, I discuss how there are phytonutrients in plant foods that may help lower chronic disease prevalence by acting as antioxidants and anti-cancer agents, and by lowering cholesterol and blood sugar. Some, we're now theorizing, may even be lipotropes, which have the capacity to hasten the removal of fat from our liver and other organs, counteracting the inflammatory cascade believed to be directly initiated by saturated-fat-containing foods. Fat in the bloodstream--from the fat on our bodies or the fat we eat--not only causes insulin resistance, but also produces a low-grade inflammation that can contribute to heart disease and non-alcoholic fatty liver disease.

Fiber may also decrease insulin resistance. One of the ways it may do so is by helping to rid the body of excess estrogen. There is strong evidence for a direct role of estrogens in the cause of diabetes, and it's been demonstrated that certain gut bacteria can produce estrogens in our colon. High-fat, low-fiber diets appear to stimulate the metabolic activity of these estrogen-producing intestinal bacteria. This is a problem for men, too. Obesity is associated with low testosterone levels and marked elevations of estrogens produced not only by fat cells but also by some of the bacteria in our gut. Our intestinal bacteria may produce these so-called diabetogens (diabetes-causing compounds) from the fats we eat. By eating lots of fiber, though, we can flush this excess estrogen out of our bodies.

Vegetarian women, for example, excrete two to three times more estrogens in their stools than omnivorous women, which may be why omnivorous women have 50% higher estrogen blood levels. These differences in estrogen metabolism may help explain the lower incidence of diabetes in those eating more plant-based diets, as well as the lower incidence of breast cancer in vegetarian women, who get rid of twice as much estrogen because they get rid of twice as much daily waste in general.

Either way, "[m]eat consumption is consistently associated with diabetes risk. Dietary habits are readily modifiable, but individuals and clinicians will consider dietary changes only if they are aware of the potential benefits of doing so." The identification of meat consumption as a risk factor for diabetes provides helpful guidance that sets the stage for beneficial behavioral changes. Meat consumption is something doctors can easily ask about, and, once identified, at-risk individuals can then be encouraged to familiarize themselves with meatless options.


Plant foods may also protect against diabetes by replacing animal foods. Learn more with my Why Is Meat a Risk Factor for Diabetes? video.

What if your entire diet was filled with plants? See Plant-Based Diets and Diabetes. Find out which plants may be particularly protective with these videos: Amla Versus Diabetes, Flaxseed vs. Diabetes, and Diabetics Should Take Their Pulses.

Unfortunately, cinnamon has fallen out of favor. See my Update on Cinnamon for Blood Sugar Control.

I also have an ever-growing series on the science behind type 2 diabetes:

For more on the estrogen connection, see Relieving Yourself of Excess Estrogen and Breast Cancer and Constipation.

In health,

Michael Greger, M.D.

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

Original Link

Foods to Eat to Help Prevent Diabetes

Oct 26 Foods to Eat copy.jpeg

Why is meat consumption a risk factor for diabetes? Why does there appear to be a stepwise reduction in diabetes rates as meat consumption drops? Instead of avoiding something in meat, it may be that people are getting something protective from plants. Free radicals may be an important trigger for insulin resistance, and antioxidants in plant foods may help. Put people on a plant-based diet, and their antioxidant enzymes shoot up. So not only do plants provide antioxidants, but may boost our own anti-endogenous antioxidant defenses, whereas, on the conventional diabetic diet, they get worse.

In my video, How May Plants Protect Against Diabetes, I discuss how there are phytonutrients in plant foods that may help lower chronic disease prevalence by acting as antioxidants and anti-cancer agents, and by lowering cholesterol and blood sugar. Some, we're now theorizing, may even be lipotropes, which have the capacity to hasten the removal of fat from our liver and other organs, counteracting the inflammatory cascade believed to be directly initiated by saturated-fat-containing foods. Fat in the bloodstream--from the fat on our bodies or the fat we eat--not only causes insulin resistance, but also produces a low-grade inflammation that can contribute to heart disease and non-alcoholic fatty liver disease.

Fiber may also decrease insulin resistance. One of the ways it may do so is by helping to rid the body of excess estrogen. There is strong evidence for a direct role of estrogens in the cause of diabetes, and it's been demonstrated that certain gut bacteria can produce estrogens in our colon. High-fat, low-fiber diets appear to stimulate the metabolic activity of these estrogen-producing intestinal bacteria. This is a problem for men, too. Obesity is associated with low testosterone levels and marked elevations of estrogens produced not only by fat cells but also by some of the bacteria in our gut. Our intestinal bacteria may produce these so-called diabetogens (diabetes-causing compounds) from the fats we eat. By eating lots of fiber, though, we can flush this excess estrogen out of our bodies.

Vegetarian women, for example, excrete two to three times more estrogens in their stools than omnivorous women, which may be why omnivorous women have 50% higher estrogen blood levels. These differences in estrogen metabolism may help explain the lower incidence of diabetes in those eating more plant-based diets, as well as the lower incidence of breast cancer in vegetarian women, who get rid of twice as much estrogen because they get rid of twice as much daily waste in general.

Either way, "[m]eat consumption is consistently associated with diabetes risk. Dietary habits are readily modifiable, but individuals and clinicians will consider dietary changes only if they are aware of the potential benefits of doing so." The identification of meat consumption as a risk factor for diabetes provides helpful guidance that sets the stage for beneficial behavioral changes. Meat consumption is something doctors can easily ask about, and, once identified, at-risk individuals can then be encouraged to familiarize themselves with meatless options.


Plant foods may also protect against diabetes by replacing animal foods. Learn more with my Why Is Meat a Risk Factor for Diabetes? video.

What if your entire diet was filled with plants? See Plant-Based Diets and Diabetes. Find out which plants may be particularly protective with these videos: Amla Versus Diabetes, Flaxseed vs. Diabetes, and Diabetics Should Take Their Pulses.

Unfortunately, cinnamon has fallen out of favor. See my Update on Cinnamon for Blood Sugar Control.

I also have an ever-growing series on the science behind type 2 diabetes:

For more on the estrogen connection, see Relieving Yourself of Excess Estrogen and Breast Cancer and Constipation.

In health,

Michael Greger, M.D.

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

Original Link

Foods to Avoid to Help Prevent Diabetes

Oct 24 Foods to Avoid copy.jpeg

We've known that being overweight and obese are important risk factors for type 2 diabetes, but, until recently, not much attention has been paid to the role of specific foods. I discuss this issue in my video, Why Is Meat a Risk Factor for Diabetes?

A 2013 meta-analysis of all the cohorts looking at the connection between meat and diabetes found a significantly higher risk associated with total meat consumption--especially consumption of processed meat, particularly poultry. But why? There's a whole list of potential culprits in meat: saturated fat, animal fat, trans fats naturally found in meat, cholesterol, or animal protein. It could be the heme iron found in meat, which can lead to free radicals and iron-induced oxidative stress that may lead to chronic inflammation and type 2 diabetes, or advanced glycation end (AGE) products, which promote oxidative stress and inflammation. Food analyses show that the highest levels of these so-called glycotoxins are found in meat--particularly roasted, fried, or broiled meat, though any foods from animal sources (and even high fat and protein plant foods such as nuts) exposed to high dry temperatures can be potent sources of these pro-oxidant chemicals.

In another study, researchers fed diabetics glycotoxin-packed foods, like chicken, fish, and eggs, and their inflammatory markers--tumor necrosis factor, C-reactive protein, and vascular adhesion molecules--shot up. "Thus, in diabetes, environmental (dietary) AGEs promote inflammatory mediators, leading to tissue injury." The good news is that restriction of these kinds of foods may suppress these inflammatory effects. Appropriate measures to limit AGE intake, such as eliminating meat or using only steaming and boiling as methods for cooking it, "may greatly reduce the already heavy burden of these toxins in the diabetic patient." These glycotoxins may be the missing link between the increased consumption of animal fat and meats and the development of type 2 diabetes.

Since the 2013 meta-analysis was published, another study came out in which approximately 17,000 people were followed for about a dozen years. Researchers found an 8% increased risk for every 50 grams of daily meat consumption. Just one quarter of a chicken breast's worth of meat for the entire day may significantly increase the risk of diabetes. Yes, we know there are many possible culprits: the glycotoxins or trans fat in meat, saturated fat, or the heme iron (which could actually promote the formation of carcinogens called nitrosamines, though they could also just be produced in the cooking process itself). However, we did learn something new: There also appears to be a greater incidence of diabetes among those who handle meat for a living. Maybe there are some diabetes-causing zoonotic infectious agents--such as viruses--present in fresh cuts of meat, including poultry.

A "crucial factor underlying the diabetes epidemic" may be the overstimulation of the aging enzyme TOR pathway by excess food consumption--but not by the consumption of just any food: Animal proteins not only stimulate the cancer-promoting hormone insulin growth factor-1 but also provide high amounts of leucine, which stimulates TOR activation and appears to contribute to the burning out of the insulin-producing beta cells in the pancreas, contributing to type 2 diabetes. So, it's not just the high fat and added sugars that are implicated; critical attention must be paid to the daily intake of animal proteins as well.

According to a study, "[i]n general, lower leucine levels are only reached by restriction of animal proteins." To reach the leucine intake provided by dairy or meat, we'd have to eat 9 pounds of cabbage or 100 apples to take an extreme example. That just exemplifies the extreme differences in leucine amounts provided by a more standard diet in comparison with a more plant-based diet.

I reviewed the role endocrine-disrupting industrial pollutants in the food supply may play in a three-part video series: Fish and Diabetes, Diabetes and Dioxins, and Pollutants in Salmon and Our Own Fat. Clearly, the standard America diet and lifestyle contribute to the epidemic of diabetes and obesity, but the contribution of these industrial pollutants can no longer be ignored. We now have experimental evidence that exposure to industrial toxins alone induces weight gain and insulin resistance, and, therefore, may be an underappreciated cause of obesity and diabetes. Consider what's happening to our infants: Obesity in a six-month-old is obviously not related to diet or lack of exercise. They're now exposed to hundreds of chemicals from their moms, straight through the umbilical cord, some of which may be obesogenic (that is, obesity-generating).

The millions of pounds of chemicals and heavy metals released every year into our environment should make us all stop and think about how we live and the choices we make every day in the foods we eat. A 2014 review of the evidence on pollutants and diabetes noted that we can be exposed through toxic spills, but "most of the human exposure nowadays is from the ingestion of contaminated food as a result of bioaccumulation up the food chain. The main source (around 95%) of [persistent pollutant] intake is through dietary intake of animal fats."


For more on the information mentioned here, see the following videos that take a closer look at these major topics:

AGEs: Glycotoxins, Avoiding a Sugary Grave, and Reducing Glycotoxin Intake to Prevent Alzheimer's.

TOR: Why Do We Age?, Caloric Restriction vs. Animal Protein Restriction, Prevent Cancer From Going on TOR, and Saving Lives By Treating Acne With Diet

Viruses: Infectobesity: Adenovirus 36 and Childhood Obesity

Poultry workers: Poultry Exposure and Neurological Disease, Poultry Exposure Tied to Liver and Pancreatic Cancer, and Eating Outside Our Kingdom

Industrial pollutants: Obesity-Causing Pollutants in Food, Fish and Diabetes, Diabetes and Dioxins, and Pollutants in Salmon and Our Own Fat

The link between meat and diabetes may also be due to a lack of sufficient protective components of plants in the diet, which is discussed in my videos How May Plants Protect Against Diabetes?, Plant-Based Diets for Diabetes, Plant-Based Diets and Diabetes, and How Not to Die from Diabetes.

In health,

Michael Greger, M.D.

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

Original Link

Foods to Avoid to Help Prevent Diabetes

Oct 24 Foods to Avoid copy.jpeg

We've known that being overweight and obese are important risk factors for type 2 diabetes, but, until recently, not much attention has been paid to the role of specific foods. I discuss this issue in my video, Why Is Meat a Risk Factor for Diabetes?

A 2013 meta-analysis of all the cohorts looking at the connection between meat and diabetes found a significantly higher risk associated with total meat consumption--especially consumption of processed meat, particularly poultry. But why? There's a whole list of potential culprits in meat: saturated fat, animal fat, trans fats naturally found in meat, cholesterol, or animal protein. It could be the heme iron found in meat, which can lead to free radicals and iron-induced oxidative stress that may lead to chronic inflammation and type 2 diabetes, or advanced glycation end (AGE) products, which promote oxidative stress and inflammation. Food analyses show that the highest levels of these so-called glycotoxins are found in meat--particularly roasted, fried, or broiled meat, though any foods from animal sources (and even high fat and protein plant foods such as nuts) exposed to high dry temperatures can be potent sources of these pro-oxidant chemicals.

In another study, researchers fed diabetics glycotoxin-packed foods, like chicken, fish, and eggs, and their inflammatory markers--tumor necrosis factor, C-reactive protein, and vascular adhesion molecules--shot up. "Thus, in diabetes, environmental (dietary) AGEs promote inflammatory mediators, leading to tissue injury." The good news is that restriction of these kinds of foods may suppress these inflammatory effects. Appropriate measures to limit AGE intake, such as eliminating meat or using only steaming and boiling as methods for cooking it, "may greatly reduce the already heavy burden of these toxins in the diabetic patient." These glycotoxins may be the missing link between the increased consumption of animal fat and meats and the development of type 2 diabetes.

Since the 2013 meta-analysis was published, another study came out in which approximately 17,000 people were followed for about a dozen years. Researchers found an 8% increased risk for every 50 grams of daily meat consumption. Just one quarter of a chicken breast's worth of meat for the entire day may significantly increase the risk of diabetes. Yes, we know there are many possible culprits: the glycotoxins or trans fat in meat, saturated fat, or the heme iron (which could actually promote the formation of carcinogens called nitrosamines, though they could also just be produced in the cooking process itself). However, we did learn something new: There also appears to be a greater incidence of diabetes among those who handle meat for a living. Maybe there are some diabetes-causing zoonotic infectious agents--such as viruses--present in fresh cuts of meat, including poultry.

A "crucial factor underlying the diabetes epidemic" may be the overstimulation of the aging enzyme TOR pathway by excess food consumption--but not by the consumption of just any food: Animal proteins not only stimulate the cancer-promoting hormone insulin growth factor-1 but also provide high amounts of leucine, which stimulates TOR activation and appears to contribute to the burning out of the insulin-producing beta cells in the pancreas, contributing to type 2 diabetes. So, it's not just the high fat and added sugars that are implicated; critical attention must be paid to the daily intake of animal proteins as well.

According to a study, "[i]n general, lower leucine levels are only reached by restriction of animal proteins." To reach the leucine intake provided by dairy or meat, we'd have to eat 9 pounds of cabbage or 100 apples to take an extreme example. That just exemplifies the extreme differences in leucine amounts provided by a more standard diet in comparison with a more plant-based diet.

I reviewed the role endocrine-disrupting industrial pollutants in the food supply may play in a three-part video series: Fish and Diabetes, Diabetes and Dioxins, and Pollutants in Salmon and Our Own Fat. Clearly, the standard America diet and lifestyle contribute to the epidemic of diabetes and obesity, but the contribution of these industrial pollutants can no longer be ignored. We now have experimental evidence that exposure to industrial toxins alone induces weight gain and insulin resistance, and, therefore, may be an underappreciated cause of obesity and diabetes. Consider what's happening to our infants: Obesity in a six-month-old is obviously not related to diet or lack of exercise. They're now exposed to hundreds of chemicals from their moms, straight through the umbilical cord, some of which may be obesogenic (that is, obesity-generating).

The millions of pounds of chemicals and heavy metals released every year into our environment should make us all stop and think about how we live and the choices we make every day in the foods we eat. A 2014 review of the evidence on pollutants and diabetes noted that we can be exposed through toxic spills, but "most of the human exposure nowadays is from the ingestion of contaminated food as a result of bioaccumulation up the food chain. The main source (around 95%) of [persistent pollutant] intake is through dietary intake of animal fats."


For more on the information mentioned here, see the following videos that take a closer look at these major topics:

AGEs: Glycotoxins, Avoiding a Sugary Grave, and Reducing Glycotoxin Intake to Prevent Alzheimer's.

TOR: Why Do We Age?, Caloric Restriction vs. Animal Protein Restriction, Prevent Cancer From Going on TOR, and Saving Lives By Treating Acne With Diet

Viruses: Infectobesity: Adenovirus 36 and Childhood Obesity

Poultry workers: Poultry Exposure and Neurological Disease, Poultry Exposure Tied to Liver and Pancreatic Cancer, and Eating Outside Our Kingdom

Industrial pollutants: Obesity-Causing Pollutants in Food, Fish and Diabetes, Diabetes and Dioxins, and Pollutants in Salmon and Our Own Fat

The link between meat and diabetes may also be due to a lack of sufficient protective components of plants in the diet, which is discussed in my videos How May Plants Protect Against Diabetes?, Plant-Based Diets for Diabetes, Plant-Based Diets and Diabetes, and How Not to Die from Diabetes.

In health,

Michael Greger, M.D.

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

Original Link

Who Should Avoid Coffee?

Oct 19 Coffee copy.jpeg

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

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

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

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

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

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

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

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

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


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

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

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

In health,

Michael Greger, M.D.

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

Original Link

Who Should Avoid Coffee?

Oct 19 Coffee copy.jpeg

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

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

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

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

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

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

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

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

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


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

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

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

In health,

Michael Greger, M.D.

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

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What About Extra Virgin Olive Oil?

Oct 17 Olive Oil copy.jpeg

The relative paralysis of our arteries for hours after eating fast food and cheesecake may also occur after consuming olive oil. Olive oil was found to have the same impairment to endothelial function as high-fat foods like sausage and egg breakfast sandwiches. (See my Olive Oil and Artery Function video for an illustrative chart with different foods.)

Studies that have suggested endothelial benefits after olive oil consumption have measured something different: ischemia-induced dilation as opposed to flow-mediated dilation. There's just not good evidence that's actually an accurate index of endothelial function, which is what predicts heart disease. Hundreds of studies have shown that the ischemia-induced dilation test can give a false negative result.

Other oils have also been shown to have deleterious results on endothelial function. A significant and constant decrease in endothelial function appears within three hours after each meal, independent of the type of oil and whether the oil was fresh or deep fried. Olive oil may be better than omega-6-rich oils or saturated fats, but it still showed adverse effects. This was the case with regular, refined olive oil. But what about extra-virgin olive oil?

Extra-virgin olive oil retains a fraction of the anti-inflammatory phytonutrients found in the olive fruit, and so doesn't appear to induce the spike in inflammatory markers caused by regular olive oil. What does that mean for our arteries? Extra-virgin olive oil may have more of a neutral effect compared to butter, which exerted a noxious effect that lasted for up to six hours--basically right up until our next meal. In the largest prospective study ever to assess the relationship between olive oil consumption and cardiac events like heart attacks, there was a suggestion that virgin olive oil may be better than regular olive oil, but neither was found to significantly reduce heart attack rates after controlling for healthy dietary behaviors like vegetable intake, which tends to go hand-in-hand with olive oil intake.

There have also been studies showing that even extra-virgin olive oil, contrary to expectations, may significantly impair endothelial function. Why then do some studies suggest endothelial function improves on a Mediterranean diet, which is rich in olive oil? It may be because the Mediterranean diet is also rich in whole grains, fruits, vegetables, beans, and walnuts. Fruits and vegetables appear to provide some protection against the direct impairment of endothelial function produced by high-fat foods, including olive oil; therefore, improvements in health may be in spite of, rather than because of, the oil. In terms of their effects on post-meal endothelial function, the beneficial components of the Mediterranean diet may primarily be the antioxidant-rich foods, the vegetables, fruits, and their derivatives, such as balsamic vinegar. Adding some vegetables to a fatty meal may partially restore arterial functioning and blood flow.


If olive oil can impair our arterial function, Why Was Heart Disease Rare in the Mediterranean? I've got a whole series of videos on the Mediterranean diet that I invite you to check out.

Fatty Meals May Impair Artery Function so much that a single high-fat meal can trigger angina chest pain. But, whole-food sources of fat such as nuts appear to be the exception. See Extra Virgin Olive Oil vs. Nuts and Walnuts and Artery Function.

I've also examined artery function with several other foods: eggs, dark chocolate, coffee, vinegar, tea, and plant-based diets.

In health,

Michael Greger, M.D.

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

Original Link

What About Extra Virgin Olive Oil?

Oct 17 Olive Oil copy.jpeg

The relative paralysis of our arteries for hours after eating fast food and cheesecake may also occur after consuming olive oil. Olive oil was found to have the same impairment to endothelial function as high-fat foods like sausage and egg breakfast sandwiches. (See my Olive Oil and Artery Function video for an illustrative chart with different foods.)

Studies that have suggested endothelial benefits after olive oil consumption have measured something different: ischemia-induced dilation as opposed to flow-mediated dilation. There's just not good evidence that's actually an accurate index of endothelial function, which is what predicts heart disease. Hundreds of studies have shown that the ischemia-induced dilation test can give a false negative result.

Other oils have also been shown to have deleterious results on endothelial function. A significant and constant decrease in endothelial function appears within three hours after each meal, independent of the type of oil and whether the oil was fresh or deep fried. Olive oil may be better than omega-6-rich oils or saturated fats, but it still showed adverse effects. This was the case with regular, refined olive oil. But what about extra-virgin olive oil?

Extra-virgin olive oil retains a fraction of the anti-inflammatory phytonutrients found in the olive fruit, and so doesn't appear to induce the spike in inflammatory markers caused by regular olive oil. What does that mean for our arteries? Extra-virgin olive oil may have more of a neutral effect compared to butter, which exerted a noxious effect that lasted for up to six hours--basically right up until our next meal. In the largest prospective study ever to assess the relationship between olive oil consumption and cardiac events like heart attacks, there was a suggestion that virgin olive oil may be better than regular olive oil, but neither was found to significantly reduce heart attack rates after controlling for healthy dietary behaviors like vegetable intake, which tends to go hand-in-hand with olive oil intake.

There have also been studies showing that even extra-virgin olive oil, contrary to expectations, may significantly impair endothelial function. Why then do some studies suggest endothelial function improves on a Mediterranean diet, which is rich in olive oil? It may be because the Mediterranean diet is also rich in whole grains, fruits, vegetables, beans, and walnuts. Fruits and vegetables appear to provide some protection against the direct impairment of endothelial function produced by high-fat foods, including olive oil; therefore, improvements in health may be in spite of, rather than because of, the oil. In terms of their effects on post-meal endothelial function, the beneficial components of the Mediterranean diet may primarily be the antioxidant-rich foods, the vegetables, fruits, and their derivatives, such as balsamic vinegar. Adding some vegetables to a fatty meal may partially restore arterial functioning and blood flow.


If olive oil can impair our arterial function, Why Was Heart Disease Rare in the Mediterranean? I've got a whole series of videos on the Mediterranean diet that I invite you to check out.

Fatty Meals May Impair Artery Function so much that a single high-fat meal can trigger angina chest pain. But, whole-food sources of fat such as nuts appear to be the exception. See Extra Virgin Olive Oil vs. Nuts and Walnuts and Artery Function.

I've also examined artery function with several other foods: eggs, dark chocolate, coffee, vinegar, tea, and plant-based diets.

In health,

Michael Greger, M.D.

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

Original Link