Ginger Root for Migraines

Ginger Root for Migraines.jpeg

Many successful herbal treatments start like this: Some doctor learns that some plant has been used in some ancient medical tradition, like ginger for headaches. Well, the physician has patients with headaches and so tries advising one with migraines to give it a try since it's just some safe, common spice. At the first sign of a migraine coming on, the patient mixed a quarter teaspoon of powdered ginger in some water, drank it down, and poof! Within a half-hour, the migraine went away. It worked every time for them with no side effects. That's what's called a case report.

In my video, Ginger for Migraines, I show the remarkable case report, but case reports are really just glorified anecdotes. Case reports have played an important role in the history of medicine, though. AIDS was first discovered as a series of case reports. Some young guy walks into a clinic in Los Angeles with a bad case of thrush, and the rest is history. Reports of an unusual side effect of a failed chest pain drug led to the billion-dollar blockbuster, Viagra. Case reports may represent the weakest level of evidence, but they are often the first line of evidence, where everything starts. The ginger and migraine report isn't helpful in itself, but it can inspire researchers to put the treatment to the test.

The problem is, who's going to fund it? The market for migraine drugs is worth billions of dollars. A quarter teaspoon of powdered ginger costs about a penny. Who would fund a study pitting ginger versus the leading migraine drug?

No one... that is, until now. A double-blinded, randomized, controlled, clinical trial compared the efficacy of ginger to sumatriptan, also known as Imitrex, one of the top-selling billion-dollar drugs in the world in the treatment of migraine headaches. Researchers tried using only one-eighth of a teaspoon of powdered ginger versus a good dose of the drug.

They both worked just as well and just as fast.

Most patients started out in moderate or severe pain but, after taking the ginger or the drug, ended up in mild pain or completely pain-free. The same proportion of migraine sufferers reported satisfaction with the results either way. As far as I'm concerned, ginger won--not only because it's a few billion dollars cheaper than the drug, but because there were significantly fewer side effects in the ginger group. People taking sumatriptan reported dizziness, a sedative effect, vertigo, and heartburn. The only thing reported for ginger was an upset tummy in about 1 out of 25 people. (As a note of caution, taking a whole tablespoon of ginger powder at one time on an empty stomach could irritate anyone's stomach.)

An eighth of a teaspoon of ginger is not only up to 3000-times cheaper than the drug, but you're also less likely to end up as a case report yourself of someone who had a heart attack or died after taking the drug--tragedies that have occurred due to sumatriptan.

These are my favorite kinds of posts to do because I can offer something that is immediately practical, cheap, safe, and effective to reduce suffering. If this kind of information helps you or someone you love, I hope you'll consider making a tax-deductible donation to support the nonprofit organization that runs NutritionFacts.org. We have a growing staff and server costs to cover, and any help you could give would be much appreciated (and there are perks!).

For more on ginger root:

Avoiding aspartame (Aspartame and the Brain) and using lavender may also help (Lavender for Migraine Headaches). If you have cluster headaches, ask your physician about capsaicin (Hot Sauce in the Nose for Cluster Headaches?).

In health,

Michael Greger, M.D.

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

Image Credit: Sally Plank

Original Link

Ginger Root for Migraines

Ginger Root for Migraines.jpeg

Many successful herbal treatments start like this: Some doctor learns that some plant has been used in some ancient medical tradition, like ginger for headaches. Well, the physician has patients with headaches and so tries advising one with migraines to give it a try since it's just some safe, common spice. At the first sign of a migraine coming on, the patient mixed a quarter teaspoon of powdered ginger in some water, drank it down, and poof! Within a half-hour, the migraine went away. It worked every time for them with no side effects. That's what's called a case report.

In my video, Ginger for Migraines, I show the remarkable case report, but case reports are really just glorified anecdotes. Case reports have played an important role in the history of medicine, though. AIDS was first discovered as a series of case reports. Some young guy walks into a clinic in Los Angeles with a bad case of thrush, and the rest is history. Reports of an unusual side effect of a failed chest pain drug led to the billion-dollar blockbuster, Viagra. Case reports may represent the weakest level of evidence, but they are often the first line of evidence, where everything starts. The ginger and migraine report isn't helpful in itself, but it can inspire researchers to put the treatment to the test.

The problem is, who's going to fund it? The market for migraine drugs is worth billions of dollars. A quarter teaspoon of powdered ginger costs about a penny. Who would fund a study pitting ginger versus the leading migraine drug?

No one... that is, until now. A double-blinded, randomized, controlled, clinical trial compared the efficacy of ginger to sumatriptan, also known as Imitrex, one of the top-selling billion-dollar drugs in the world in the treatment of migraine headaches. Researchers tried using only one-eighth of a teaspoon of powdered ginger versus a good dose of the drug.

They both worked just as well and just as fast.

Most patients started out in moderate or severe pain but, after taking the ginger or the drug, ended up in mild pain or completely pain-free. The same proportion of migraine sufferers reported satisfaction with the results either way. As far as I'm concerned, ginger won--not only because it's a few billion dollars cheaper than the drug, but because there were significantly fewer side effects in the ginger group. People taking sumatriptan reported dizziness, a sedative effect, vertigo, and heartburn. The only thing reported for ginger was an upset tummy in about 1 out of 25 people. (As a note of caution, taking a whole tablespoon of ginger powder at one time on an empty stomach could irritate anyone's stomach.)

An eighth of a teaspoon of ginger is not only up to 3000-times cheaper than the drug, but you're also less likely to end up as a case report yourself of someone who had a heart attack or died after taking the drug--tragedies that have occurred due to sumatriptan.

These are my favorite kinds of posts to do because I can offer something that is immediately practical, cheap, safe, and effective to reduce suffering. If this kind of information helps you or someone you love, I hope you'll consider making a tax-deductible donation to support the nonprofit organization that runs NutritionFacts.org. We have a growing staff and server costs to cover, and any help you could give would be much appreciated (and there are perks!).

For more on ginger root:

Avoiding aspartame (Aspartame and the Brain) and using lavender may also help (Lavender for Migraine Headaches). If you have cluster headaches, ask your physician about capsaicin (Hot Sauce in the Nose for Cluster Headaches?).

In health,

Michael Greger, M.D.

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

Image Credit: Sally Plank

Original Link

Sushi Worm Parasite

Sushi Worm Parasite.jpeg

There was a report recently of a woman in San Francisco suffering from gnathostomiasis. I had learned about the disease while I was in medical school, but never actually saw a case. Evidently, it's now on the rise. Clinically, the disease commonly presents as "migratory cutaneous swelling" (bumps on the skin that move around). Why? Because there's a worm under there that migrates through the tissues under the skin and causes recurring episodes of migratory swelling or creeping eruptions. The worm's head has rings of little hooks that allow it to burrow through tissue. There is no effective treatment, other than removal of the worm. Since humans are basically dead-end hosts for the larva, they can't develop into mature worms. The symptoms patients experience are due to the organism wandering throughout the body (see Migratory Skin Worms from Sushi).

In addition to burrowing under our skin, it can also crawl into our eyeballs. The 42-year-old woman is described as having a four-year history of migratory swellings on her face, then a little bleeding from the eyelid... and we know where this is going. No problem, though! We can make a little cut, stick in some forceps, locate the worm, and then just pull the sucker right out of the eyeball. If you have any pimples on your face that move around, better to have your doctor grab them before they start swimming around in your eyes.

By far the most serious manifestation is when they get into your brain. As the worm migrates along the nerves, the patient can experience excruciating pain. The condition can lead to paralysis, bleeding in the brain, and finally death. However, in non-cerebral disease, it's the worms that die, though it may take about 12 years.

How do the worms get into our brain, causing so-called neurognathostomiasis? Gnathostoma worms are highly invasive parasites. After you leave the sushi bar, the larvae can penetrate the wall of your intestine. They can then enter the brain through the base of the skull, crawling along the spinal nerves and vessels. They start out in the nerve roots, enter the spinal cord, and then can climb up into the brain. The worm isn't poisonous or anything; it's just the migration of the worm through the body that causes direct mechanical injury because of tearing of nerve tissues.

The bottom line: This diagnosis should be considered in patients who present with nonspecific little lumps and bumps, especially when there is a history of frequent consumption of raw fish.

Thankfully, most raw foodists stick to plants and thereby avoid scenarios like this: A 21-year-old woman experienced acute, severe pain in her mouth immediately after swallowing a raw squid. It seems consuming a squid with "sperm bags and an active ejaculatory apparatus" can result in the "unintended ejection of the sperm bag" and injury to the oral cavity. The researchers conclude that eating raw food, especially living organisms, can be risky. Though some living organisms (plants!) may be substantially less risky than others.

This is like my Tongue Worm in Human Eye or Cheese Mites and Maggots videos. Extremely rare, but extremely fascinating (to me at least!).

There is one parasitic infection that is much more common and a major cause of disability worldwide,though, neurocysticercosis:

I think the only other sushi videos I have are Fecal Contamination of Sushi and Allergenic Fish Worms, though the nori seaweed is good for you (Which Seaweed Is Most Protective Against Breast Cancer? and Avoiding Iodine Deficiency).

In health,

Michael Greger, M.D.

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

Image Credit: Sally Plank

Original Link

Sushi Worm Parasite

Sushi Worm Parasite.jpeg

There was a report recently of a woman in San Francisco suffering from gnathostomiasis. I had learned about the disease while I was in medical school, but never actually saw a case. Evidently, it's now on the rise. Clinically, the disease commonly presents as "migratory cutaneous swelling" (bumps on the skin that move around). Why? Because there's a worm under there that migrates through the tissues under the skin and causes recurring episodes of migratory swelling or creeping eruptions. The worm's head has rings of little hooks that allow it to burrow through tissue. There is no effective treatment, other than removal of the worm. Since humans are basically dead-end hosts for the larva, they can't develop into mature worms. The symptoms patients experience are due to the organism wandering throughout the body (see Migratory Skin Worms from Sushi).

In addition to burrowing under our skin, it can also crawl into our eyeballs. The 42-year-old woman is described as having a four-year history of migratory swellings on her face, then a little bleeding from the eyelid... and we know where this is going. No problem, though! We can make a little cut, stick in some forceps, locate the worm, and then just pull the sucker right out of the eyeball. If you have any pimples on your face that move around, better to have your doctor grab them before they start swimming around in your eyes.

By far the most serious manifestation is when they get into your brain. As the worm migrates along the nerves, the patient can experience excruciating pain. The condition can lead to paralysis, bleeding in the brain, and finally death. However, in non-cerebral disease, it's the worms that die, though it may take about 12 years.

How do the worms get into our brain, causing so-called neurognathostomiasis? Gnathostoma worms are highly invasive parasites. After you leave the sushi bar, the larvae can penetrate the wall of your intestine. They can then enter the brain through the base of the skull, crawling along the spinal nerves and vessels. They start out in the nerve roots, enter the spinal cord, and then can climb up into the brain. The worm isn't poisonous or anything; it's just the migration of the worm through the body that causes direct mechanical injury because of tearing of nerve tissues.

The bottom line: This diagnosis should be considered in patients who present with nonspecific little lumps and bumps, especially when there is a history of frequent consumption of raw fish.

Thankfully, most raw foodists stick to plants and thereby avoid scenarios like this: A 21-year-old woman experienced acute, severe pain in her mouth immediately after swallowing a raw squid. It seems consuming a squid with "sperm bags and an active ejaculatory apparatus" can result in the "unintended ejection of the sperm bag" and injury to the oral cavity. The researchers conclude that eating raw food, especially living organisms, can be risky. Though some living organisms (plants!) may be substantially less risky than others.

This is like my Tongue Worm in Human Eye or Cheese Mites and Maggots videos. Extremely rare, but extremely fascinating (to me at least!).

There is one parasitic infection that is much more common and a major cause of disability worldwide,though, neurocysticercosis:

I think the only other sushi videos I have are Fecal Contamination of Sushi and Allergenic Fish Worms, though the nori seaweed is good for you (Which Seaweed Is Most Protective Against Breast Cancer? and Avoiding Iodine Deficiency).

In health,

Michael Greger, M.D.

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

Image Credit: Sally Plank

Original Link

Sushi Worm Parasite

Sushi Worm Parasite.jpeg

There was a report recently of a woman in San Francisco suffering from gnathostomiasis. I had learned about the disease while I was in medical school, but never actually saw a case. Evidently, it's now on the rise. Clinically, the disease commonly presents as "migratory cutaneous swelling" (bumps on the skin that move around). Why? Because there's a worm under there that migrates through the tissues under the skin and causes recurring episodes of migratory swelling or creeping eruptions. The worm's head has rings of little hooks that allow it to burrow through tissue. There is no effective treatment, other than removal of the worm. Since humans are basically dead-end hosts for the larva, they can't develop into mature worms. The symptoms patients experience are due to the organism wandering throughout the body (see Migratory Skin Worms from Sushi).

In addition to burrowing under our skin, it can also crawl into our eyeballs. The 42-year-old woman is described as having a four-year history of migratory swellings on her face, then a little bleeding from the eyelid... and we know where this is going. No problem, though! We can make a little cut, stick in some forceps, locate the worm, and then just pull the sucker right out of the eyeball. If you have any pimples on your face that move around, better to have your doctor grab them before they start swimming around in your eyes.

By far the most serious manifestation is when they get into your brain. As the worm migrates along the nerves, the patient can experience excruciating pain. The condition can lead to paralysis, bleeding in the brain, and finally death. However, in non-cerebral disease, it's the worms that die, though it may take about 12 years.

How do the worms get into our brain, causing so-called neurognathostomiasis? Gnathostoma worms are highly invasive parasites. After you leave the sushi bar, the larvae can penetrate the wall of your intestine. They can then enter the brain through the base of the skull, crawling along the spinal nerves and vessels. They start out in the nerve roots, enter the spinal cord, and then can climb up into the brain. The worm isn't poisonous or anything; it's just the migration of the worm through the body that causes direct mechanical injury because of tearing of nerve tissues.

The bottom line: This diagnosis should be considered in patients who present with nonspecific little lumps and bumps, especially when there is a history of frequent consumption of raw fish.

Thankfully, most raw foodists stick to plants and thereby avoid scenarios like this: A 21-year-old woman experienced acute, severe pain in her mouth immediately after swallowing a raw squid. It seems consuming a squid with "sperm bags and an active ejaculatory apparatus" can result in the "unintended ejection of the sperm bag" and injury to the oral cavity. The researchers conclude that eating raw food, especially living organisms, can be risky. Though some living organisms (plants!) may be substantially less risky than others.

This is like my Tongue Worm in Human Eye or Cheese Mites and Maggots videos. Extremely rare, but extremely fascinating (to me at least!).

There is one parasitic infection that is much more common and a major cause of disability worldwide,though, neurocysticercosis:

I think the only other sushi videos I have are Fecal Contamination of Sushi and Allergenic Fish Worms, though the nori seaweed is good for you (Which Seaweed Is Most Protective Against Breast Cancer? and Avoiding Iodine Deficiency).

In health,

Michael Greger, M.D.

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

Image Credit: Sally Plank

Original Link

Plant versus Animal Iron

Plant versus Animal Iron.jpeg

It is commonly thought that those who eat plant-based diets may be more prone to iron deficiency, but it turns out that they're no more likely to suffer from iron deficiency anemia than anybody else. This may be because not only do those eating meat-free diets tend to get more fiber, magnesium, and vitamins like A, C, and E, but they also get more iron.

The iron found predominantly in plants is non-heme iron, which isn't absorbed as well as the heme iron found in blood and muscle, but this may be a good thing. As seen in my video, The Safety of Heme vs. Non-Heme Iron, avoidance of heme iron may be one of the key elements of plant-based protection against metabolic syndrome, and may also be beneficial in lowering the risk from other chronic diseases such as heart disease.

The data linking coronary heart disease and the intake of iron, in general, has been mixed. This inconsistency of evidence may be because of where the iron comes from. The majority of total dietary iron is non-heme iron, coming mostly from plants. So, total iron intake is associated with lower heart disease risk, but iron intake from meat is associated with significantly higher risk for heart disease. This is thought to be because iron can act as a pro-oxidant, contributing to the development of atherosclerosis by oxidizing cholesterol with free radicals. The risk has been quantified as a 27% increase in coronary heart disease risk for every 1 milligram of heme iron consumed daily.

The same has been found for stroke risk. The studies on iron intake and stroke have had conflicting results, but that may be because they had never separated out heme iron from non-heme iron... until now. Researchers found that the intake of meat (heme) iron, but not plant (non-heme) iron, was associated with an increased risk of stroke.

The researchers also found that higher intake of heme iron--but not total or plant (non-heme) iron--was significantly associated with greater risk for type 2 diabetes. There may be a 16% increase in risk for type 2 diabetes for every 1 milligram of heme iron consumed daily.

The same has also been found for cancer, with up to 12% increased risk for every milligram of daily heme iron exposure. In fact, we can actually tell how much meat someone is eating by looking at their tumors. To characterize the mechanisms underlying meat-related lung cancer development, researchers asked lung cancer patients how much meat they ate and examined the gene expression patterns in their tumors. They identified a signature pattern of heme-related gene expression. Although they looked specifically at lung cancer, they expect these meat-related gene expression changes may occur in other cancers as well.

We do need to get enough iron, but only about 3% of premenopausal white women have iron deficiency anemia these days. However, the rates are worse in African and Mexican Americans. Taking into account our leading killers--heart disease, cancer, and diabetes--the healthiest source of iron appears to be non-heme iron, found naturally in abundance in whole grains, beans, split peas, chickpeas, lentils, dark green leafy vegetables, dried fruits, nuts, and seeds.

But how much money can be made on beans, though? The processed food industry came up with a blood-based crisp bread, made out of rye flour and blood from cattle and pigs, which is one of the most concentrated sources of heme iron, about two-thirds more than blood from chickens. If blood-based crackers don't sound particularly appetizing, you can always snack on cow blood cookies. And there are always blood-filled biscuits, whose filling has been described as "a dark-colored, chocolate flavored paste with a very pleasant taste." (It's dark-colored because spray-dried pig blood can have a darkening effect on the food product's color.) The worry is not the color or taste, it's the heme iron, which, because of its potential cancer risk, is not considered safe to add to foods intended for the general population.

Previously, I've touched on the double-edged iron sword in Risk Associated With Iron Supplements and Phytates for the Prevention of Cancer. It may also help answer Why Was Heart Disease Rare in the Mediterranean?

Those eating plant-based diets get more of most nutrients since whole plant foods are so nutrient dense. See Nutrient-Dense Approach to Weight Management.

In health,

Michael Greger, M.D.

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

Image Credit: Sally Plank

Original Link

Plant versus Animal Iron

Plant versus Animal Iron.jpeg

It is commonly thought that those who eat plant-based diets may be more prone to iron deficiency, but it turns out that they're no more likely to suffer from iron deficiency anemia than anybody else. This may be because not only do those eating meat-free diets tend to get more fiber, magnesium, and vitamins like A, C, and E, but they also get more iron.

The iron found predominantly in plants is non-heme iron, which isn't absorbed as well as the heme iron found in blood and muscle, but this may be a good thing. As seen in my video, The Safety of Heme vs. Non-Heme Iron, avoidance of heme iron may be one of the key elements of plant-based protection against metabolic syndrome, and may also be beneficial in lowering the risk from other chronic diseases such as heart disease.

The data linking coronary heart disease and the intake of iron, in general, has been mixed. This inconsistency of evidence may be because of where the iron comes from. The majority of total dietary iron is non-heme iron, coming mostly from plants. So, total iron intake is associated with lower heart disease risk, but iron intake from meat is associated with significantly higher risk for heart disease. This is thought to be because iron can act as a pro-oxidant, contributing to the development of atherosclerosis by oxidizing cholesterol with free radicals. The risk has been quantified as a 27% increase in coronary heart disease risk for every 1 milligram of heme iron consumed daily.

The same has been found for stroke risk. The studies on iron intake and stroke have had conflicting results, but that may be because they had never separated out heme iron from non-heme iron... until now. Researchers found that the intake of meat (heme) iron, but not plant (non-heme) iron, was associated with an increased risk of stroke.

The researchers also found that higher intake of heme iron--but not total or plant (non-heme) iron--was significantly associated with greater risk for type 2 diabetes. There may be a 16% increase in risk for type 2 diabetes for every 1 milligram of heme iron consumed daily.

The same has also been found for cancer, with up to 12% increased risk for every milligram of daily heme iron exposure. In fact, we can actually tell how much meat someone is eating by looking at their tumors. To characterize the mechanisms underlying meat-related lung cancer development, researchers asked lung cancer patients how much meat they ate and examined the gene expression patterns in their tumors. They identified a signature pattern of heme-related gene expression. Although they looked specifically at lung cancer, they expect these meat-related gene expression changes may occur in other cancers as well.

We do need to get enough iron, but only about 3% of premenopausal white women have iron deficiency anemia these days. However, the rates are worse in African and Mexican Americans. Taking into account our leading killers--heart disease, cancer, and diabetes--the healthiest source of iron appears to be non-heme iron, found naturally in abundance in whole grains, beans, split peas, chickpeas, lentils, dark green leafy vegetables, dried fruits, nuts, and seeds.

But how much money can be made on beans, though? The processed food industry came up with a blood-based crisp bread, made out of rye flour and blood from cattle and pigs, which is one of the most concentrated sources of heme iron, about two-thirds more than blood from chickens. If blood-based crackers don't sound particularly appetizing, you can always snack on cow blood cookies. And there are always blood-filled biscuits, whose filling has been described as "a dark-colored, chocolate flavored paste with a very pleasant taste." (It's dark-colored because spray-dried pig blood can have a darkening effect on the food product's color.) The worry is not the color or taste, it's the heme iron, which, because of its potential cancer risk, is not considered safe to add to foods intended for the general population.

Previously, I've touched on the double-edged iron sword in Risk Associated With Iron Supplements and Phytates for the Prevention of Cancer. It may also help answer Why Was Heart Disease Rare in the Mediterranean?

Those eating plant-based diets get more of most nutrients since whole plant foods are so nutrient dense. See Nutrient-Dense Approach to Weight Management.

In health,

Michael Greger, M.D.

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

Image Credit: Sally Plank

Original Link

Should Cancer Patients Avoid Raw Fruits and Vegetables?

Should Cancer Patients Avoid Raw Fruits and Vegetables?.jpeg

Back in the 1960s, a patient isolator unit was developed for cancer patients undergoing chemotherapy. Because our immune system cells were often caught in the friendly fire, up to 50% of cancer patients died of infections before they could even complete the chemo because their immune systems had become so compromised. So, a bubble boy-like contraption was developed. The patient was shaved, dipped in disinfectant, rinsed off with alcohol, rubbed with antibiotic ointment into every orifice, and placed on a rotating regimen of a dozen of the most powerful antibiotics they had. Procedures were performed through plastic sleeves on the sides of the unit, and everything in and out had to be sterilized and passed through airlocks. So, the patient wasn't allowed any fresh fruits or vegetables.

People went crazy cooped up in these bubble-like units, with 38% even experiencing hallucinations. Fifteen years later the results were in: it simply didn't work. People were still dying at the same rate, so the whole thing was scrapped--except the diet. The airlocks and alcohol baths were abandoned, but they continued to make sure no one got to eat a salad.

Neutrophils are white blood cells that serve as our front line of defense. When we're immunocompromised and don't have enough neutrophils, we're called "neutropenic." So, the chemotherapy patients were put on a so-called neutropenic diet without any fresh fruits and vegetables. The problem is there's a glaring lack of evidence that such a neutropenic diet actually helps (see my video Is a Neutropenic Diet Necessary for Cancer Patients?).

Ironically, the neutropenic diet is the one remaining component of those patient isolator unit protocols that's still practiced, yet it has the least evidence supporting its use. Why? The rationale is: there are bacteria in salads, bacteria cause infections, immunocompromised patients are at increased risk for infections, and therefore, no salad. What's more, they were actually glad there aren't any studies on this because it could be way too risky to give a cancer patient an apple or something. So, its continued use seems to be based on a ''better safe than sorry'' philosophy.

The problem is that kids diagnosed with cancer are already low in dietary antioxidants, so the last thing we should do is tell them they can't have any fresh fruit or veggies. In addition to the lack of clinical evidence for this neutropenic diet, there may be some drawbacks. Restricting fruits and vegetables may even increase the risk of infection and compromise their nutritional status.

So, are neutropenic diets for cancer patients "reasonable prudence" or "clinical superstition"? Starting in the 1990s, there was a resurgence of research when greater importance was placed on the need to "support clinical practice with evidence."

What a concept!

Three randomized controlled trials were published, and not one supported the neutropenic diet. In the biggest study, an all-cooked diet was compared to one that allowed raw fruits and veggies, and there was no difference in infection and death rates. As a result of the study, the principal investigator at the MD Anderson Cancer Center described how their practice has changed and now everyone is allowed to eat their vegetables--a far cry from "please don't eat the salads" 31 years earlier.

Today, neither the Food and Drug Administration, the Centers for Disease Control and Prevention, nor the American Cancer Society support the neutropenic diet. The real danger comes from pathogenic food-poisoning bacteria like Campylobacter, Salmonella, and E. coli. So we still have to keep patients away from risky foods like undercooked eggs, meat, dairy, and sprouts. At this point, though, there really shouldn't be a debate about whether cancer patients should be on a neutropenic diet. Nevertheless, many institutions still tell cancer patients they shouldn't eat fresh fruits and veggies. According to the latest survey, more than half of pediatric cancer doctors continue to prescribe these diets, though it's quite variable even among those at the same institution.

Why are doctors still reluctant to move away from the neutropenic diet? There are several reasons why physicians may be hesitant to incorporate evidence-based medicine into their practices. They may have limited time to review the literature. They'd like to dig deep into studies, but simply don't have the time to look at the evidence. Hmm, if only there was a website... :)

Bone marrow transplants are the final frontier. Sometimes it's our immune system itself that is cancerous, such as in leukemia or lymphoma. In these cases, the immune system is wiped out on purpose to rebuild it from scratch. So, inherent in the procedure is a profound immunodeficiency for which a neutropenic diet is often recommended. This has also had never been tested--until now.

Not only did it not work, a strict neutropenic diet was actually associated with an increased risk for infection, maybe because you don't get the good bugs from fruits and vegetables crowding out the bad guys in the gut. So not only was the neutropenic diet found to be unbeneficial; there was a suggestion that it has the potential to be harmful. This wouldn't be the first time an intervention strategy made good sense theoretically, but, when put to the test, was ultimately ineffective.

Unfortunately, there's an inertia in medicine that can result in medical practice that is at odds with the available evidence. Sometimes this disconnect can have devastating consequences. See, for example, Evidence-Based Medicine or Evidence-Biased? and The Tomato Effect.

The reason it is so important to straighten out the neutropenic diet myth is that fruits and vegetables may actually improve cancer survival:

In health,

Michael Greger, M.D.

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

Image Credit: Sally Plank

Original Link

Should Cancer Patients Avoid Raw Fruits and Vegetables?

Should Cancer Patients Avoid Raw Fruits and Vegetables?.jpeg

Back in the 1960s, a patient isolator unit was developed for cancer patients undergoing chemotherapy. Because our immune system cells were often caught in the friendly fire, up to 50% of cancer patients died of infections before they could even complete the chemo because their immune systems had become so compromised. So, a bubble boy-like contraption was developed. The patient was shaved, dipped in disinfectant, rinsed off with alcohol, rubbed with antibiotic ointment into every orifice, and placed on a rotating regimen of a dozen of the most powerful antibiotics they had. Procedures were performed through plastic sleeves on the sides of the unit, and everything in and out had to be sterilized and passed through airlocks. So, the patient wasn't allowed any fresh fruits or vegetables.

People went crazy cooped up in these bubble-like units, with 38% even experiencing hallucinations. Fifteen years later the results were in: it simply didn't work. People were still dying at the same rate, so the whole thing was scrapped--except the diet. The airlocks and alcohol baths were abandoned, but they continued to make sure no one got to eat a salad.

Neutrophils are white blood cells that serve as our front line of defense. When we're immunocompromised and don't have enough neutrophils, we're called "neutropenic." So, the chemotherapy patients were put on a so-called neutropenic diet without any fresh fruits and vegetables. The problem is there's a glaring lack of evidence that such a neutropenic diet actually helps (see my video Is a Neutropenic Diet Necessary for Cancer Patients?).

Ironically, the neutropenic diet is the one remaining component of those patient isolator unit protocols that's still practiced, yet it has the least evidence supporting its use. Why? The rationale is: there are bacteria in salads, bacteria cause infections, immunocompromised patients are at increased risk for infections, and therefore, no salad. What's more, they were actually glad there aren't any studies on this because it could be way too risky to give a cancer patient an apple or something. So, its continued use seems to be based on a ''better safe than sorry'' philosophy.

The problem is that kids diagnosed with cancer are already low in dietary antioxidants, so the last thing we should do is tell them they can't have any fresh fruit or veggies. In addition to the lack of clinical evidence for this neutropenic diet, there may be some drawbacks. Restricting fruits and vegetables may even increase the risk of infection and compromise their nutritional status.

So, are neutropenic diets for cancer patients "reasonable prudence" or "clinical superstition"? Starting in the 1990s, there was a resurgence of research when greater importance was placed on the need to "support clinical practice with evidence."

What a concept!

Three randomized controlled trials were published, and not one supported the neutropenic diet. In the biggest study, an all-cooked diet was compared to one that allowed raw fruits and veggies, and there was no difference in infection and death rates. As a result of the study, the principal investigator at the MD Anderson Cancer Center described how their practice has changed and now everyone is allowed to eat their vegetables--a far cry from "please don't eat the salads" 31 years earlier.

Today, neither the Food and Drug Administration, the Centers for Disease Control and Prevention, nor the American Cancer Society support the neutropenic diet. The real danger comes from pathogenic food-poisoning bacteria like Campylobacter, Salmonella, and E. coli. So we still have to keep patients away from risky foods like undercooked eggs, meat, dairy, and sprouts. At this point, though, there really shouldn't be a debate about whether cancer patients should be on a neutropenic diet. Nevertheless, many institutions still tell cancer patients they shouldn't eat fresh fruits and veggies. According to the latest survey, more than half of pediatric cancer doctors continue to prescribe these diets, though it's quite variable even among those at the same institution.

Why are doctors still reluctant to move away from the neutropenic diet? There are several reasons why physicians may be hesitant to incorporate evidence-based medicine into their practices. They may have limited time to review the literature. They'd like to dig deep into studies, but simply don't have the time to look at the evidence. Hmm, if only there was a website... :)

Bone marrow transplants are the final frontier. Sometimes it's our immune system itself that is cancerous, such as in leukemia or lymphoma. In these cases, the immune system is wiped out on purpose to rebuild it from scratch. So, inherent in the procedure is a profound immunodeficiency for which a neutropenic diet is often recommended. This has also had never been tested--until now.

Not only did it not work, a strict neutropenic diet was actually associated with an increased risk for infection, maybe because you don't get the good bugs from fruits and vegetables crowding out the bad guys in the gut. So not only was the neutropenic diet found to be unbeneficial; there was a suggestion that it has the potential to be harmful. This wouldn't be the first time an intervention strategy made good sense theoretically, but, when put to the test, was ultimately ineffective.

Unfortunately, there's an inertia in medicine that can result in medical practice that is at odds with the available evidence. Sometimes this disconnect can have devastating consequences. See, for example, Evidence-Based Medicine or Evidence-Biased? and The Tomato Effect.

The reason it is so important to straighten out the neutropenic diet myth is that fruits and vegetables may actually improve cancer survival:

In health,

Michael Greger, M.D.

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

Image Credit: Sally Plank

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Goldmine! Plant-Based Diet Gets An Entire Special Issue in a Medical Journal

Plant-Based Nutrition for Healthcare Professionals

goldmineDouble celebration as my new article, Plant-Based Nutrition for Healthcare Professionals: Implementing Diet as a Primary Modality in the Prevention and Treatment of Chronic Disease, with Ray Cronise just published in The Journal of Geriatric Cardiology.

You can view it here: bit.ly/GeriatricPBN

This is the full-text: bit.ly/GeriatricPBN-pdf

Further, this issue of the journal is a (very) special issue as it is the first one ever to be completely dedicated to plant-based diets!

Here is the table of contents for the entire journal issue, which as you may notice, is a goldmine of information that can be shared with your physicians, dietitians, colleagues, friends, family, and anyone else who is seeking to dig deeper into this most health-promoting way of eating.

 

The post Goldmine! Plant-Based Diet Gets An Entire Special Issue in a Medical Journal appeared first on Plant Based Dietitian.

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