How Doctors Responded to Being Named a Leading Killer

Sept 19 Doctors copy.jpeg

In my video Why Prevention Is Worth a Ton of Cure, I profiled a paper that added up all the deaths caused by medical care in this country, including the hundred thousand deaths from medication side effects, all the deaths caused by errors, and so on. The author of the paper concluded that the third leading cause of death in America is the American medical system.

What was the medical community's reaction to this revelation? After all, the paper was published in one of the most prestigious medical journals, the Journal of the American Medical Association, and was authored by one of our most prestigious physicians, Barbara Starfield, who literally wrote the book on primary care. When she was asked in an interview what the response was, Starfield replied that her primary care work had been widely embraced, but her findings on how harmful and ineffective healthcare could be received almost no attention.

This inspires the recollection of "the dark dystopia of George Orwell's 1984, where awkward facts are swallowed up by the 'memory hole' as if they had never existed at all." Report after report has come out, and the response has been a deafening silence both in deed and in word, failing to even openly discuss the problem, leading to thousands of additional deaths. We can't just keep putting out reports, we have to actually do something.

As I discuss in my video How Doctors Responded to Being Named a Leading Killer, the first report was published in 1978, suggesting about 120,000 preventable hospital deaths a year. The response? Silence for another 16 years until another scathing reminder was published. If we multiply 120,000 by those 16 years, we get 1.9 million preventable deaths, about which there was near total doctor silence. There was no substantial effort to reduce the number of those deaths. The Institute of Medicine (IOM) then released its landmark study in 1999, asserting that yet another 600,000 patients died during that time when providers could have acted.

Some things have finally changed. Work hour limits were instituted for medical trainees. Interns and residents could no longer be worked more than 80 hours a week, at least on paper, and the shifts couldn't be more than 30 hours long. That may not sound like a big step, but when I started out my internship, I worked 36 hour shifts every three days, 117-hour work weeks.

When interns and residents are forced to pull all-nighters, they make 36% more serious medical errors, five times more diagnostic errors, and have twice as many "attentional failures." That doesn't sound so bad, until you realize that means things like nodding off during surgery.

The patient is supposed to be asleep during surgery, not the surgeon.

Performance is impaired as much as a blood alcohol level that would make it illegal to drive a car--but these overworked interns and residents can still do surgery. No surprise there were 300% more patient deaths. Residents consider themselves lucky if they get through training without killing anyone. Not that the family would ever find out. With rare exceptions, doctors are unaccountable for their actions.

The IOM report did break the silence and prompted widespread promises of change, but what they did not do is act as if they really believed their own findings. If we truly believed that a minimum of 120 people every day were dying preventable deaths in hospitals, we would draw a line in the sand. If an airliner was crashing every day, we'd expect that the FAA would step in and do something. The Institute of Medicine could insistently demand that doctors and hospitals immediately adopt at least a minimum set of preventive practices--for example, bar-coding drugs so there aren't any mix-ups, like they do for even a pack of Tic Tacs at the grocery store. Rather than just going on to write yet another report, they could bluntly warn colleagues they would publicly censure those who resisted implementing these minimum practices, calling for some kind of stringent sanctions.

Instead, we get silence. But not for Barbara Starfield, who is unfortunately no longer with us. Ironically, she may have died from one of the adverse drug reactions she so vociferously warned us about. She was placed on aspirin and the blood-thinner Plavix to keep a stent she had to have placed in her coronary artery from clogging up. She told her cardiologist she was bruising more, bleeding longer, but those side effects are the risks you hope don't outweigh the benefits. Starfield apparently hit her head while swimming and bled into her brain.

The question for me is not whether she should have been on two blood-thinners for that long or even whether she should have had the stent inserted. Instead, I question whether or not she could have outright avoided the heart disease, which is 96% avoidable in women.

The number-one killer of women need almost never happen.


For those curious about my time in medical training, you can read my memoir of sorts, Heart Failure: Diary of a Third Year Medical Student.

It isn't just medical treatment that can be harmful. Even medical diagnosis can be dangerous, as I discuss in my video Cancer Risk From CT Scan Radiation.

And, just as we're (finally) seeing some changes in training protocols, the times, they are a-changin' with the emergence of the field of lifestyle medicine, as I present in several videos, including:

I recently made some videos to give people a closer look at why I believe it's so important for us to take responsibility for our own health. You can see all of them on our new Introductory Videos page.

I'm excited to be part of this revolution in medicine. Please consider joining me by supporting the 501c3 nonprofit organization that keeps NutritionFacts.org alive by making a tax-deductible donation. Thank you so much for helping me help so many others.

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 Doctors Responded to Being Named a Leading Killer

Sept 19 Doctors copy.jpeg

In my video Why Prevention Is Worth a Ton of Cure, I profiled a paper that added up all the deaths caused by medical care in this country, including the hundred thousand deaths from medication side effects, all the deaths caused by errors, and so on. The author of the paper concluded that the third leading cause of death in America is the American medical system.

What was the medical community's reaction to this revelation? After all, the paper was published in one of the most prestigious medical journals, the Journal of the American Medical Association, and was authored by one of our most prestigious physicians, Barbara Starfield, who literally wrote the book on primary care. When she was asked in an interview what the response was, Starfield replied that her primary care work had been widely embraced, but her findings on how harmful and ineffective healthcare could be received almost no attention.

This inspires the recollection of "the dark dystopia of George Orwell's 1984, where awkward facts are swallowed up by the 'memory hole' as if they had never existed at all." Report after report has come out, and the response has been a deafening silence both in deed and in word, failing to even openly discuss the problem, leading to thousands of additional deaths. We can't just keep putting out reports, we have to actually do something.

As I discuss in my video How Doctors Responded to Being Named a Leading Killer, the first report was published in 1978, suggesting about 120,000 preventable hospital deaths a year. The response? Silence for another 16 years until another scathing reminder was published. If we multiply 120,000 by those 16 years, we get 1.9 million preventable deaths, about which there was near total doctor silence. There was no substantial effort to reduce the number of those deaths. The Institute of Medicine (IOM) then released its landmark study in 1999, asserting that yet another 600,000 patients died during that time when providers could have acted.

Some things have finally changed. Work hour limits were instituted for medical trainees. Interns and residents could no longer be worked more than 80 hours a week, at least on paper, and the shifts couldn't be more than 30 hours long. That may not sound like a big step, but when I started out my internship, I worked 36 hour shifts every three days, 117-hour work weeks.

When interns and residents are forced to pull all-nighters, they make 36% more serious medical errors, five times more diagnostic errors, and have twice as many "attentional failures." That doesn't sound so bad, until you realize that means things like nodding off during surgery.

The patient is supposed to be asleep during surgery, not the surgeon.

Performance is impaired as much as a blood alcohol level that would make it illegal to drive a car--but these overworked interns and residents can still do surgery. No surprise there were 300% more patient deaths. Residents consider themselves lucky if they get through training without killing anyone. Not that the family would ever find out. With rare exceptions, doctors are unaccountable for their actions.

The IOM report did break the silence and prompted widespread promises of change, but what they did not do is act as if they really believed their own findings. If we truly believed that a minimum of 120 people every day were dying preventable deaths in hospitals, we would draw a line in the sand. If an airliner was crashing every day, we'd expect that the FAA would step in and do something. The Institute of Medicine could insistently demand that doctors and hospitals immediately adopt at least a minimum set of preventive practices--for example, bar-coding drugs so there aren't any mix-ups, like they do for even a pack of Tic Tacs at the grocery store. Rather than just going on to write yet another report, they could bluntly warn colleagues they would publicly censure those who resisted implementing these minimum practices, calling for some kind of stringent sanctions.

Instead, we get silence. But not for Barbara Starfield, who is unfortunately no longer with us. Ironically, she may have died from one of the adverse drug reactions she so vociferously warned us about. She was placed on aspirin and the blood-thinner Plavix to keep a stent she had to have placed in her coronary artery from clogging up. She told her cardiologist she was bruising more, bleeding longer, but those side effects are the risks you hope don't outweigh the benefits. Starfield apparently hit her head while swimming and bled into her brain.

The question for me is not whether she should have been on two blood-thinners for that long or even whether she should have had the stent inserted. Instead, I question whether or not she could have outright avoided the heart disease, which is 96% avoidable in women.

The number-one killer of women need almost never happen.


For those curious about my time in medical training, you can read my memoir of sorts, Heart Failure: Diary of a Third Year Medical Student.

It isn't just medical treatment that can be harmful. Even medical diagnosis can be dangerous, as I discuss in my video Cancer Risk From CT Scan Radiation.

And, just as we're (finally) seeing some changes in training protocols, the times, they are a-changin' with the emergence of the field of lifestyle medicine, as I present in several videos, including:

I recently made some videos to give people a closer look at why I believe it's so important for us to take responsibility for our own health. You can see all of them on our new Introductory Videos page.

I'm excited to be part of this revolution in medicine. Please consider joining me by supporting the 501c3 nonprofit organization that keeps NutritionFacts.org alive by making a tax-deductible donation. Thank you so much for helping me help so many others.

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

Can Dehydration Affect Our Mood?

Sept 7 Dehydration copy.jpeg

Water is by far the number-one nutrient in our diet. Studies have suggested that proper hydration may lower our risk of heart disease and cancer, and may even make us better kissers. Brushing artificial skin against the lips of young women, researchers found that hydrated lips showed greater sensitivity to light touch.

Although it is well known that water is essential for human survival, it's only recently that we have begun to understand its role in the maintenance of brain function. It makes sense. Our brain is 75% water. When we get dehydrated, our brain actually shrinks. Even mild dehydration, which can be caused by simply exercising on a hot day, has been shown to change brain function.

I've talked about the role of hydration for cognitive function in Does a Drink of Water Make Children Smarter?, but current findings suggest that our mood states may also be positively influenced by water consumption.

The effects of dehydration in real life have not been not well documented. It wasn't until 2013 that the first study to investigate the effects of mild dehydration on a variety of feelings was published. What did the researchers find? The most important effects of fluid deprivation were increased sleepiness and fatigue, lower levels of vigor and alertness, and increased confusion. But as soon as they gave the subjects some water, the deleterious effects on alertness, happiness, and confusion were immediately reversed.

Water absorption actually happens very rapidly, within 5 minutes from mouth to bloodstream, peaking around minute 20. Interestingly, the temperature of the water appears to affect this speed. Which do you think is absorbed more rapidly--cold water or warm, body temperature water? It turns out cold water gets sucked in about 20% faster!

How can we tell if we're dehydrated or not? Well, why don't we ask our bodies? If we chug down some water and then turn around and just pee it all out, presumably that would be our body's way of saying, "I'm good, all topped off." But if we drink a bunch of water and our body keeps most of it, then presumably our tank was low. Researchers from the University of Connecticut formalized the technique. You empty your bladder, chug down 11 milliliters per kilogram of body weight (about 3 three cups of water for an average-sized person) and then an hour later see how much you pee. Basically, if you drink 3 cups and pee out less than 1, there's a good chance you were dehydrated. You can see the findings of this chug-and-pee test around minute 3 in my Can Dehydration Affect Our Mood? video.


For more on water, see my How Many Glasses of Water Should We Drink a Day?, Does a Drink Of Water Make Children Smarter?, and Treating Dry Eyes with Diet: Just Add Water?

Other healthy beverages include hibiscus tea (Hibiscus Tea vs. Plant-Based Diets for Hypertension) and green tea (Dietary Brain Wave Alteration and Benefits of Green Tea for Boosting Antiviral Immune Function).

What else can affect our mood?

What about the omega-3s in fish? That's the subject of another video: Fish Consumption and Suicide.

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

Can Dehydration Affect Our Mood?

Sept 7 Dehydration copy.jpeg

Water is by far the number-one nutrient in our diet. Studies have suggested that proper hydration may lower our risk of heart disease and cancer, and may even make us better kissers. Brushing artificial skin against the lips of young women, researchers found that hydrated lips showed greater sensitivity to light touch.

Although it is well known that water is essential for human survival, it's only recently that we have begun to understand its role in the maintenance of brain function. It makes sense. Our brain is 75% water. When we get dehydrated, our brain actually shrinks. Even mild dehydration, which can be caused by simply exercising on a hot day, has been shown to change brain function.

I've talked about the role of hydration for cognitive function in Does a Drink of Water Make Children Smarter?, but current findings suggest that our mood states may also be positively influenced by water consumption.

The effects of dehydration in real life have not been not well documented. It wasn't until 2013 that the first study to investigate the effects of mild dehydration on a variety of feelings was published. What did the researchers find? The most important effects of fluid deprivation were increased sleepiness and fatigue, lower levels of vigor and alertness, and increased confusion. But as soon as they gave the subjects some water, the deleterious effects on alertness, happiness, and confusion were immediately reversed.

Water absorption actually happens very rapidly, within 5 minutes from mouth to bloodstream, peaking around minute 20. Interestingly, the temperature of the water appears to affect this speed. Which do you think is absorbed more rapidly--cold water or warm, body temperature water? It turns out cold water gets sucked in about 20% faster!

How can we tell if we're dehydrated or not? Well, why don't we ask our bodies? If we chug down some water and then turn around and just pee it all out, presumably that would be our body's way of saying, "I'm good, all topped off." But if we drink a bunch of water and our body keeps most of it, then presumably our tank was low. Researchers from the University of Connecticut formalized the technique. You empty your bladder, chug down 11 milliliters per kilogram of body weight (about 3 three cups of water for an average-sized person) and then an hour later see how much you pee. Basically, if you drink 3 cups and pee out less than 1, there's a good chance you were dehydrated. You can see the findings of this chug-and-pee test around minute 3 in my Can Dehydration Affect Our Mood? video.


For more on water, see my How Many Glasses of Water Should We Drink a Day?, Does a Drink Of Water Make Children Smarter?, and Treating Dry Eyes with Diet: Just Add Water?

Other healthy beverages include hibiscus tea (Hibiscus Tea vs. Plant-Based Diets for Hypertension) and green tea (Dietary Brain Wave Alteration and Benefits of Green Tea for Boosting Antiviral Immune Function).

What else can affect our mood?

What about the omega-3s in fish? That's the subject of another video: Fish Consumption and Suicide.

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

Can Dehydration Affect Our Mood?

Sept 7 Dehydration copy.jpeg

Water is by far the number-one nutrient in our diet. Studies have suggested that proper hydration may lower our risk of heart disease and cancer, and may even make us better kissers. Brushing artificial skin against the lips of young women, researchers found that hydrated lips showed greater sensitivity to light touch.

Although it is well known that water is essential for human survival, it's only recently that we have begun to understand its role in the maintenance of brain function. It makes sense. Our brain is 75% water. When we get dehydrated, our brain actually shrinks. Even mild dehydration, which can be caused by simply exercising on a hot day, has been shown to change brain function.

I've talked about the role of hydration for cognitive function in Does a Drink of Water Make Children Smarter?, but current findings suggest that our mood states may also be positively influenced by water consumption.

The effects of dehydration in real life have not been not well documented. It wasn't until 2013 that the first study to investigate the effects of mild dehydration on a variety of feelings was published. What did the researchers find? The most important effects of fluid deprivation were increased sleepiness and fatigue, lower levels of vigor and alertness, and increased confusion. But as soon as they gave the subjects some water, the deleterious effects on alertness, happiness, and confusion were immediately reversed.

Water absorption actually happens very rapidly, within 5 minutes from mouth to bloodstream, peaking around minute 20. Interestingly, the temperature of the water appears to affect this speed. Which do you think is absorbed more rapidly--cold water or warm, body temperature water? It turns out cold water gets sucked in about 20% faster!

How can we tell if we're dehydrated or not? Well, why don't we ask our bodies? If we chug down some water and then turn around and just pee it all out, presumably that would be our body's way of saying, "I'm good, all topped off." But if we drink a bunch of water and our body keeps most of it, then presumably our tank was low. Researchers from the University of Connecticut formalized the technique. You empty your bladder, chug down 11 milliliters per kilogram of body weight (about 3 three cups of water for an average-sized person) and then an hour later see how much you pee. Basically, if you drink 3 cups and pee out less than 1, there's a good chance you were dehydrated. You can see the findings of this chug-and-pee test around minute 3 in my Can Dehydration Affect Our Mood? video.


For more on water, see my How Many Glasses of Water Should We Drink a Day?, Does a Drink Of Water Make Children Smarter?, and Treating Dry Eyes with Diet: Just Add Water?

Other healthy beverages include hibiscus tea (Hibiscus Tea vs. Plant-Based Diets for Hypertension) and green tea (Dietary Brain Wave Alteration and Benefits of Green Tea for Boosting Antiviral Immune Function).

What else can affect our mood?

What about the omega-3s in fish? That's the subject of another video: Fish Consumption and Suicide.

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

Heart of Gold: Turmeric vs. Exercise

Sept 5 Heart of Gold copy.jpeg

The endothelium is the inner lining of our blood vessels. Laid end-to-end, endothelial cells from a single human would wrap more than four times around the world. And it's not just an inert layer; it's highly metabolically active. I've talked before about how sensitive our endothelium is to oxidation (The Power of NO) and inflammation (The Leaky Gut Theory). If we don't take care of it, endothelial dysfunction may set us up for heart disease or a stroke. Are we ready to heed our endothelium's early warning signal?

If it's all about oxidation and inflammation, then fruits and vegetables should help. And indeed it appears they do. Each daily serving of fruits or vegetables was associated with a 6% improvement in endothelial function. These fruit- and vegetable-associated improvements in endothelial function are in contrast to several negative vitamin C pill studies that failed to show a benefit. It can be concluded that the positive findings of the fruit and vegetable study are not just because of any one nutrient in fruits and veggies. Rather than searching for the single magic bullet micronutrient, a more practical approach is likely to consider whole foods. Increasing fruit and vegetable consumption is likely to have numerous benefits due to synergistic effects of the plethora of wonderful nutrients in plants.

Exercise helps our endothelial cells, too, but what type of exercise helps best? Patients were randomized into four groups: aerobic exercise (cycling for an hour a day), resistance training (using weights and elastic bands), both, or neither. The aerobic group kicked butt. The resistance group kicked butt. The aerobic and resistance group kicked butt, too. The only group who didn't kick butt was the group who sat on their butts. Our endothelium doesn't care if we're on a bike or lifting weights, as long as we're getting physical activity regularly. If we stop exercising, our endothelial function plummets.

Antioxidant pills don't help, but drug companies aren't going to give up that easy. They're currently looking into anti-inflammatory pills. After all, there's only so much you can make selling salad. For those who prefer plants to pills, one of the most anti-inflammatory foods is the spice turmeric. Researchers in Japan recently compared the endothelial benefits of exercise to that of curcumin, the yellow pigment in turmeric and curry powder. About a teaspoon a day's worth of turmeric for eight weeks was compared to 30 to 60 minutes of aerobic exercise a day.

Which group improved their endothelial function more? The group who did neither experienced no benefit, but both the exercise and the curcumin groups significantly boosted endothelial function. The researchers reported: "The magnitude of the improvement achieved by curcumin treatment was comparable to that obtained with exercise. Therefore, regular ingestion of curcumin could be a preventive measure against cardiovascular disease" at least in postmenopausal women, who were the subjects of this study. "Furthermore, [their] results suggest that curcumin may be a potential alternative treatment for patients who are unable to exercise."

Ideally, we'd both eat curcumin and exercise. One study looked at central arterial hemodynamics. Basically, if our endothelium is impaired, our arteries stiffen, making it harder for our heart to pump. Compared to placebo, we can drop down the pressure with turmeric curcumin or exercise. However, if we combine both, then we really start rocking and rolling, as you can see in the chart about 4 minutes into my video Heart of Gold: Turmeric vs. Exercise. The researchers conclude that these findings suggest that regular endurance exercise combined with daily curcumin ingestion may reduce the pressure against which our hearts have to figh. We want both healthy eating and exertion for our endothelium.


This entry is a follow-up to Turmeric Curcumin vs. Exercise for Artery Function.

Endothelial dysfunction is at the heart (pun intended) of many of our deadliest diseases. Pledge to save your endothelial cells and check out some of these other videos about the effects of food on our endothelial function:

For more on the concept of nutrient synergy, see Garden Variety Anti-Inflammation and Cranberries vs. Cancer.

Regardless what you do or don't eat, exercise is critical:

I must have dozens of turmeric videos by now, but here are a few to get you started:

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

Heart of Gold: Turmeric vs. Exercise

Sept 5 Heart of Gold copy.jpeg

The endothelium is the inner lining of our blood vessels. Laid end-to-end, endothelial cells from a single human would wrap more than four times around the world. And it's not just an inert layer; it's highly metabolically active. I've talked before about how sensitive our endothelium is to oxidation (The Power of NO) and inflammation (The Leaky Gut Theory). If we don't take care of it, endothelial dysfunction may set us up for heart disease or a stroke. Are we ready to heed our endothelium's early warning signal?

If it's all about oxidation and inflammation, then fruits and vegetables should help. And indeed it appears they do. Each daily serving of fruits or vegetables was associated with a 6% improvement in endothelial function. These fruit- and vegetable-associated improvements in endothelial function are in contrast to several negative vitamin C pill studies that failed to show a benefit. It can be concluded that the positive findings of the fruit and vegetable study are not just because of any one nutrient in fruits and veggies. Rather than searching for the single magic bullet micronutrient, a more practical approach is likely to consider whole foods. Increasing fruit and vegetable consumption is likely to have numerous benefits due to synergistic effects of the plethora of wonderful nutrients in plants.

Exercise helps our endothelial cells, too, but what type of exercise helps best? Patients were randomized into four groups: aerobic exercise (cycling for an hour a day), resistance training (using weights and elastic bands), both, or neither. The aerobic group kicked butt. The resistance group kicked butt. The aerobic and resistance group kicked butt, too. The only group who didn't kick butt was the group who sat on their butts. Our endothelium doesn't care if we're on a bike or lifting weights, as long as we're getting physical activity regularly. If we stop exercising, our endothelial function plummets.

Antioxidant pills don't help, but drug companies aren't going to give up that easy. They're currently looking into anti-inflammatory pills. After all, there's only so much you can make selling salad. For those who prefer plants to pills, one of the most anti-inflammatory foods is the spice turmeric. Researchers in Japan recently compared the endothelial benefits of exercise to that of curcumin, the yellow pigment in turmeric and curry powder. About a teaspoon a day's worth of turmeric for eight weeks was compared to 30 to 60 minutes of aerobic exercise a day.

Which group improved their endothelial function more? The group who did neither experienced no benefit, but both the exercise and the curcumin groups significantly boosted endothelial function. The researchers reported: "The magnitude of the improvement achieved by curcumin treatment was comparable to that obtained with exercise. Therefore, regular ingestion of curcumin could be a preventive measure against cardiovascular disease" at least in postmenopausal women, who were the subjects of this study. "Furthermore, [their] results suggest that curcumin may be a potential alternative treatment for patients who are unable to exercise."

Ideally, we'd both eat curcumin and exercise. One study looked at central arterial hemodynamics. Basically, if our endothelium is impaired, our arteries stiffen, making it harder for our heart to pump. Compared to placebo, we can drop down the pressure with turmeric curcumin or exercise. However, if we combine both, then we really start rocking and rolling, as you can see in the chart about 4 minutes into my video Heart of Gold: Turmeric vs. Exercise. The researchers conclude that these findings suggest that regular endurance exercise combined with daily curcumin ingestion may reduce the pressure against which our hearts have to figh. We want both healthy eating and exertion for our endothelium.


This entry is a follow-up to Turmeric Curcumin vs. Exercise for Artery Function.

Endothelial dysfunction is at the heart (pun intended) of many of our deadliest diseases. Pledge to save your endothelial cells and check out some of these other videos about the effects of food on our endothelial function:

For more on the concept of nutrient synergy, see Garden Variety Anti-Inflammation and Cranberries vs. Cancer.

Regardless what you do or don't eat, exercise is critical:

I must have dozens of turmeric videos by now, but here are a few to get you started:

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

Reversing Diabetic Blindness with Diet

Reversing Diabetic Blindness with Diet.jpeg

Though many reported feeling better on Dr. Walter Kempner's rice and fruit diet, he refused to accept such anecdotal evidence as proof of success. He wanted objective measurements. The most famous were his "eyegrounds photographs," taken with a special camera that allowed one to visualize the back of the eye. In doing so, he proved diet can arrest the bleeding, oozing, and swelling you see in the back of the eye in people with severe kidney, hypertensive, or heart disease. Even more than that, he proved that diet could actually reverse it, something never thought possible.

In my video, Can Diabetic Retinopathy Be Reversed?, you can see before and after images of the back of patients' eyes. He found reversal to such a degree that even those who could no longer distinguish large objects were able to once again read fine print. Dr. Kempner had shown a reversal of blindness with diet.

The results were so dramatic that the head of the department of ophthalmology at Duke, where Kempner worked, was questioned as to whether they were somehow faked. He assured them they were not. In fact, he wrote in one person's chart, "This patient's eyegrounds are improved to an unbelievable degree." Not only had he never seen anything like it, he couldn't remember ever seeing a patient with such advanced disease even being alive 15 months later.

The magnitude of the improvements Kempner got--reversal of end-stage heart and kidney failure--was surprising, simply beyond belief. But as Kempner said as his closing sentence of a presentation before the American College of Physicians, "The important result is not that the change in the course of the disease has been achieved by the rice diet but that the course of the disease can be changed."

Now that we have high blood pressure drugs, we see less hypertensive retinopathy, but we still see a lot of diabetic retinopathy, now the leading cause of blindness in American adults. Even with intensive diabetes treatment--at least three insulin injections a day with the best modern technology has to offer--the best we can offer is usually just a slowing of the progression of the disease.

So, in the 21st century, we slow down your blindness. Yet a half century ago, Kempner proved we could reverse it. Kempner started out using his plant-based rice diet ultra-low in sodium, fat, cholesterol, and protein to reverse kidney and heart failure; he actually assumed the diet would make diabetes worse. He expected a 90% carbohydrate diet would increase insulin requirements, however, the opposite proved to be true. He took the next 100 patients with diabetes who walked through his door who went on the rice diet for at least three months and found their fasting blood sugars dropped despite a drop in the insulin they were taking. What really blew people away was this: Forty-four of the patients had diabetic retinopathy, and, in 30% of the cases, their eyes improved. That's not supposed to happen; diabetic retinopathy had been considered "a sign of irreversible destruction." What does this change mean in real life? Patients went from unable to even read headlines to normal vision.

The remarkable success Dr. Kempner had reversing some of the most dreaded complications of diabetes with his rice and fruit diet was not because of weight loss. The improvements occurred even in those patients who did not lose significant weight, so it must have been something specific about the diet. Maybe it was his total elimination of animal protein, animal fat, and cholesterol? Or perhaps it was his radical reduction in sodium, fat, and protein in general? We don't know.

How do we treat diabetic retinopathy these days? With steroids and other drugs injected straight into the eyeball. If that doesn't work, there's always pan-retinal laser photocoagulation, in which laser burns are etched over nearly the entire retina. Surgeons literally burn out the back of your eye. Why would they do that? The theory is that by killing off most of the retina, the little pieces you leave behind may get more blood flow.

When I see that, along with Kempner's work, I can't help but feel like history has been reversed. It seems as though it should have gone like, "Can you believe 50 years ago the best we had was this barbaric, burn-out-your-socket surgery? Thank goodness we've since learned that through dietary means alone, we can reverse the blindness." But instead of learning, medicine seems to have forgotten.

I documented the extraordinary Kempner story previously in Kempner Rice Diet: Whipping Us Into Shape and Drugs and the Demise of the Rice Diet. The reason I keep coming back to this is not to suggest people should go on such a diet (it is too extreme and potentially dangerous to do without strict medical supervision), but to show the power of dietary change to yield tremendous healing effects.

The best way to prevent diabetic blindness is to prevent or reverse diabetes in the first place. See, for example:

Why wouldn't a diet of white rice make diabetes worse? See If White Rice Is Linked to Diabetes, What About China?

For more on the nitty gritty on what is the actual cause of type 2 diabetes, see:

In health,

Michael Greger, M.D.

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

Image Credit: Community Eye Health / Flickr. This image has been modified.

Original Link

Reversing Diabetic Blindness with Diet

Reversing Diabetic Blindness with Diet.jpeg

Though many reported feeling better on Dr. Walter Kempner's rice and fruit diet, he refused to accept such anecdotal evidence as proof of success. He wanted objective measurements. The most famous were his "eyegrounds photographs," taken with a special camera that allowed one to visualize the back of the eye. In doing so, he proved diet can arrest the bleeding, oozing, and swelling you see in the back of the eye in people with severe kidney, hypertensive, or heart disease. Even more than that, he proved that diet could actually reverse it, something never thought possible.

In my video, Can Diabetic Retinopathy Be Reversed?, you can see before and after images of the back of patients' eyes. He found reversal to such a degree that even those who could no longer distinguish large objects were able to once again read fine print. Dr. Kempner had shown a reversal of blindness with diet.

The results were so dramatic that the head of the department of ophthalmology at Duke, where Kempner worked, was questioned as to whether they were somehow faked. He assured them they were not. In fact, he wrote in one person's chart, "This patient's eyegrounds are improved to an unbelievable degree." Not only had he never seen anything like it, he couldn't remember ever seeing a patient with such advanced disease even being alive 15 months later.

The magnitude of the improvements Kempner got--reversal of end-stage heart and kidney failure--was surprising, simply beyond belief. But as Kempner said as his closing sentence of a presentation before the American College of Physicians, "The important result is not that the change in the course of the disease has been achieved by the rice diet but that the course of the disease can be changed."

Now that we have high blood pressure drugs, we see less hypertensive retinopathy, but we still see a lot of diabetic retinopathy, now the leading cause of blindness in American adults. Even with intensive diabetes treatment--at least three insulin injections a day with the best modern technology has to offer--the best we can offer is usually just a slowing of the progression of the disease.

So, in the 21st century, we slow down your blindness. Yet a half century ago, Kempner proved we could reverse it. Kempner started out using his plant-based rice diet ultra-low in sodium, fat, cholesterol, and protein to reverse kidney and heart failure; he actually assumed the diet would make diabetes worse. He expected a 90% carbohydrate diet would increase insulin requirements, however, the opposite proved to be true. He took the next 100 patients with diabetes who walked through his door who went on the rice diet for at least three months and found their fasting blood sugars dropped despite a drop in the insulin they were taking. What really blew people away was this: Forty-four of the patients had diabetic retinopathy, and, in 30% of the cases, their eyes improved. That's not supposed to happen; diabetic retinopathy had been considered "a sign of irreversible destruction." What does this change mean in real life? Patients went from unable to even read headlines to normal vision.

The remarkable success Dr. Kempner had reversing some of the most dreaded complications of diabetes with his rice and fruit diet was not because of weight loss. The improvements occurred even in those patients who did not lose significant weight, so it must have been something specific about the diet. Maybe it was his total elimination of animal protein, animal fat, and cholesterol? Or perhaps it was his radical reduction in sodium, fat, and protein in general? We don't know.

How do we treat diabetic retinopathy these days? With steroids and other drugs injected straight into the eyeball. If that doesn't work, there's always pan-retinal laser photocoagulation, in which laser burns are etched over nearly the entire retina. Surgeons literally burn out the back of your eye. Why would they do that? The theory is that by killing off most of the retina, the little pieces you leave behind may get more blood flow.

When I see that, along with Kempner's work, I can't help but feel like history has been reversed. It seems as though it should have gone like, "Can you believe 50 years ago the best we had was this barbaric, burn-out-your-socket surgery? Thank goodness we've since learned that through dietary means alone, we can reverse the blindness." But instead of learning, medicine seems to have forgotten.

I documented the extraordinary Kempner story previously in Kempner Rice Diet: Whipping Us Into Shape and Drugs and the Demise of the Rice Diet. The reason I keep coming back to this is not to suggest people should go on such a diet (it is too extreme and potentially dangerous to do without strict medical supervision), but to show the power of dietary change to yield tremendous healing effects.

The best way to prevent diabetic blindness is to prevent or reverse diabetes in the first place. See, for example:

Why wouldn't a diet of white rice make diabetes worse? See If White Rice Is Linked to Diabetes, What About China?

For more on the nitty gritty on what is the actual cause of type 2 diabetes, see:

In health,

Michael Greger, M.D.

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

Image Credit: Community Eye Health / Flickr. This image has been modified.

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Optimal Bowel Movement Frequency

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Lasting for 3,000 years, ancient Egypt was one of the greatest ancient civilizations--with a vastly underestimated knowledge of medicine. They even had medical subspecialties. The pharaohs, for example, had access to dedicated physicians to be "guardian[s] of the royal bowel movement," a title alternately translated from the hieroglyphics to mean "Shepherd of the Anus." How's that for a resume builder?

Today, the primacy of the bowel movement's importance continues. Some have called for bowel habits to be considered a vital sign on how the body is functioning, along with heart rate, blood pressure, and breathing rate. Medical professionals may not particularly relish hearing all about their patients' bowel movements, but it is a vital function that nurses and doctors need to assess.

Surprisingly, the colon has remained relatively unexplored territory, one of the body's final frontiers. For example, current concepts of what "normal" stools are emanated primarily from the records of 12 consecutive bowel movements in 27 healthy subjects from the United Kingdom, who boldly went where no one had gone before. Those must have been some really detailed records.

It's important to define what's normal. When it comes to frequency, for example, we can't define concepts like constipation or diarrhea unless we know what's normal. Standard physiology textbooks may not be helpful in this regard. One text implies that anything from one bowel movement every few weeks or months to 24 in just one day can be regarded as normal. Once every few months is normal?

Out of all of our bodily functions, we may know the least about defecation. Can't we just ask people? It turns out people tend to exaggerate. There's a discrepancy between what people report and what researchers find when they record bowel habits directly. It wasn't until 2010 when we got the first serious look. In my video, How Many Bowel Movement's Should You Have Everyday? you'll see the study that found that normal stool frequency was between three per week and three per day, based on the fact that that's where 98% of people tended to fall. But normal doesn't necessarily mean optimal.

Having a "normal" salt intake can lead to a "normal" blood pressure, which can help us to die from all the "normal" causes like heart attacks and strokes. Having a normal cholesterol level in a society where it's normal to drop dead of heart disease--our number-one killer--is not necessarily a good thing. Indeed, significant proportions of people with "normal bowel function" reported urgency, straining, and incomplete defecation, leading the researchers of the 2010 study to conclude that these kinds of things must be normal. Normal, maybe, if we're eating a fiber-deficient diet, but not normal for our species. Defecation should not be a painful exercise. This is readily demonstrable. For example, the majority of rural Africans eating their traditional fiber-rich, plant-based diets can usually pass without straining a stool specimen on demand. The rectum may need to accumulate 4 or 5 ounces of fecal matter before the defecation reflex is fully initiated, so if we don't even build up that much over the day, we'd have to strain to prime the rectal pump.

Hippocrates thought bowel movements should ideally be two or three times a day, which is what we see in populations on traditional plant-based diets. These traditional diets have the kind of fiber intakes we see in our fellow Great Apes and may be more representative of the type of diets we evolved eating for millions of years. It seems somewhat optimistic, though, to expect the average American to adopt a rural African diet. We can, however, eat more plant-based and bulk up enough to take the Hippocratic oath to go two or three times a day.

There's no need to obsess about it. In fact, there's actually a "bowel obsession syndrome" characterized in part by "ideational rambling over bowel habits." But three times a day makes sense. We have what's called a gastrocolic reflex, which consists of a prompt activation of muscular waves in our colon within 1 to 3 minutes of the ingestion of the first mouthfuls of food to make room for the meal. Even just talking about food can cause our brains to increase colon activity. This suggests the body figured that one meal should be about enough to fill us up down there. So maybe we should eat enough unprocessed plant foods to get up to three a day--a movement for every meal.

I know people are suckers for poop videos--I'm so excited to finally be getting these up! There actually is a recent one--Diet and Hiatal Hernia--that talks about the consequences of straining on stool. Hernias are better than Bed Pan Death Syndrome, though, which is what I talk about in in my video, Should You Sit, Squat, or Lean During a Bowel Movement?

Here are some older videos on bowel health:

For more on this concept of how having "normal" health parameters in a society where it's normal to drop dead of heart attacks and other such preventable fates, see my video When Low Risk Means High Risk.

In health,

Michael Greger, M.D.

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

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

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