What Not to Add to White Rice, Potatoes, or Pasta

What Not to Add to White Rice, Potatoes, or Pasta.jpeg

Rice currently feeds almost half the human population, making it the single most important staple food in the world, but a meta-analysis of seven cohort studies following 350,000 people for up to 20 years found that higher consumption of white rice was associated with a significantly increased risk of type 2 diabetes, especially in Asian populations. They estimated each serving per day of white rice was associated with an 11% increase in risk of diabetes. This could explain why China has almost the same diabetes rates as we do.

Diabetes rates in China are at about 10%; we're at about 11%, despite seven times less obesity in China. Japan has eight times less obesity than we do, yet may have a higher incidence of newly diagnosed diabetes cases than we do--nine per a thousand compared to our eight. They're skinnier and still may have more diabetes. Maybe it's because of all the white rice they eat.

Eating whole fruit is associated with lower risk of diabetes, whereas eating fruit processed into juice may not just be neutral, but actually increases diabetes risk. In the same way, eating whole grains, like whole wheat bread or brown rice is associated with lower risk of diabetes, whereas eating white rice, a processed grain, may not just be neutral, but actually increase diabetes risk.

White rice consumption does not appear to be associated with increased risk of heart attack or stroke, though, which is a relief after an earlier study in China suggested a connection with stroke. But do we want to eat a food that's just neutral regarding some of our leading causes of death, when we can eat whole foods that are associated with lower risk of diabetes, heart attack, stroke, and weight gain?

If the modern diabetes epidemic in China and Japan has been linked to white rice consumption, how can we reconcile that with low diabetes rates just a few decades ago when they ate even more rice? If you look at the Cornell-Oxford-China Project, rural plant-based diets centered around rice were associated with relatively low risk of the so-called diseases of affluence, which includes diabetes. Maybe Asians just genetically don't get the same blood sugar spike when they eat white rice? This is not the case; if anything people of Chinese ethnicity get higher blood sugar spikes.

The rise in these diseases of affluence in China over the last half century has been blamed in part on the tripling of the consumption of animal source foods. The upsurge in diabetes has been most dramatic, and it's mostly just happened over the last decade. That crazy 9.7% diabetes prevalence figure that rivals ours is new--they appeared to have one of the lowest diabetes rates in the world in the year 2000.

So what happened to their diets in the last 20 years or so? Oil consumption went up 20%, pork consumption went up 40%, and rice consumption dropped about 30%. As diabetes rates were skyrocketing, rice consumption was going down, so maybe it's the animal products and junk food that are the problem. Yes, brown rice is better than white rice, but to stop the mounting Asian epidemic, maybe we should focus on removing the cause--the toxic Western diet. That would be consistent with data showing animal protein and fat consumption associated with increased diabetes risk.

But that doesn't explain why the biggest recent studies in Japan and China associate white rice intake with diabetes. One possibility is that animal protein is making the rice worse. If you feed people mashed white potatoes, a high glycemic food like white rice, you can see in my video If White Rice is Linked to Diabetes, What About China? the level of insulin your pancreas has to pump out to keep your blood sugars in check. But what if you added some tuna fish? Tuna doesn't have any carbs, sugar, or starch so it shouldn't make a difference. Or maybe it would even lower the mashed potato spike by lowering the glycemic load of the whole meal? Instead you get twice the insulin spike. This also happens with white flour spaghetti versus white flour spaghetti with meat. The addition of animal protein makes the pancreas work twice as hard.

You can do it with straight sugar water too. If you do a glucose challenge test to test for diabetes, where you drink a certain amount of sugar and add some meat, you get a much bigger spike than without meat. And the more meat you add, the worse it gets. Just adding a little meat to carbs doesn't seem to do much, but once you get up to around a third of a chicken breast's worth, you can elicit a significantly increased surge of insulin. This may help explain why those eating plant-based have such low diabetes rates, because animal protein can markedly potentiate the insulin secretion triggered by carbohydrate ingestion.

The protein exacerbation of the effect of refined carbs could help explain the remarkable results achieved by Dr. Kempner with a don't-try-this-at-home diet composed of mostly white rice and sugar. See my video, Kempner Rice Diet: Whipping Us Into Shape.

Refined grains may also not be good for our blood pressure (see Whole Grains May Work As Well As Drugs).

What should we be eating to best decrease our risk of diabetes? See:

And check out my summary video, 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:

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

Original Link

What Not to Add to White Rice, Potatoes, or Pasta

What Not to Add to White Rice, Potatoes, or Pasta.jpeg

Rice currently feeds almost half the human population, making it the single most important staple food in the world, but a meta-analysis of seven cohort studies following 350,000 people for up to 20 years found that higher consumption of white rice was associated with a significantly increased risk of type 2 diabetes, especially in Asian populations. They estimated each serving per day of white rice was associated with an 11% increase in risk of diabetes. This could explain why China has almost the same diabetes rates as we do.

Diabetes rates in China are at about 10%; we're at about 11%, despite seven times less obesity in China. Japan has eight times less obesity than we do, yet may have a higher incidence of newly diagnosed diabetes cases than we do--nine per a thousand compared to our eight. They're skinnier and still may have more diabetes. Maybe it's because of all the white rice they eat.

Eating whole fruit is associated with lower risk of diabetes, whereas eating fruit processed into juice may not just be neutral, but actually increases diabetes risk. In the same way, eating whole grains, like whole wheat bread or brown rice is associated with lower risk of diabetes, whereas eating white rice, a processed grain, may not just be neutral, but actually increase diabetes risk.

White rice consumption does not appear to be associated with increased risk of heart attack or stroke, though, which is a relief after an earlier study in China suggested a connection with stroke. But do we want to eat a food that's just neutral regarding some of our leading causes of death, when we can eat whole foods that are associated with lower risk of diabetes, heart attack, stroke, and weight gain?

If the modern diabetes epidemic in China and Japan has been linked to white rice consumption, how can we reconcile that with low diabetes rates just a few decades ago when they ate even more rice? If you look at the Cornell-Oxford-China Project, rural plant-based diets centered around rice were associated with relatively low risk of the so-called diseases of affluence, which includes diabetes. Maybe Asians just genetically don't get the same blood sugar spike when they eat white rice? This is not the case; if anything people of Chinese ethnicity get higher blood sugar spikes.

The rise in these diseases of affluence in China over the last half century has been blamed in part on the tripling of the consumption of animal source foods. The upsurge in diabetes has been most dramatic, and it's mostly just happened over the last decade. That crazy 9.7% diabetes prevalence figure that rivals ours is new--they appeared to have one of the lowest diabetes rates in the world in the year 2000.

So what happened to their diets in the last 20 years or so? Oil consumption went up 20%, pork consumption went up 40%, and rice consumption dropped about 30%. As diabetes rates were skyrocketing, rice consumption was going down, so maybe it's the animal products and junk food that are the problem. Yes, brown rice is better than white rice, but to stop the mounting Asian epidemic, maybe we should focus on removing the cause--the toxic Western diet. That would be consistent with data showing animal protein and fat consumption associated with increased diabetes risk.

But that doesn't explain why the biggest recent studies in Japan and China associate white rice intake with diabetes. One possibility is that animal protein is making the rice worse. If you feed people mashed white potatoes, a high glycemic food like white rice, you can see in my video If White Rice is Linked to Diabetes, What About China? the level of insulin your pancreas has to pump out to keep your blood sugars in check. But what if you added some tuna fish? Tuna doesn't have any carbs, sugar, or starch so it shouldn't make a difference. Or maybe it would even lower the mashed potato spike by lowering the glycemic load of the whole meal? Instead you get twice the insulin spike. This also happens with white flour spaghetti versus white flour spaghetti with meat. The addition of animal protein makes the pancreas work twice as hard.

You can do it with straight sugar water too. If you do a glucose challenge test to test for diabetes, where you drink a certain amount of sugar and add some meat, you get a much bigger spike than without meat. And the more meat you add, the worse it gets. Just adding a little meat to carbs doesn't seem to do much, but once you get up to around a third of a chicken breast's worth, you can elicit a significantly increased surge of insulin. This may help explain why those eating plant-based have such low diabetes rates, because animal protein can markedly potentiate the insulin secretion triggered by carbohydrate ingestion.

The protein exacerbation of the effect of refined carbs could help explain the remarkable results achieved by Dr. Kempner with a don't-try-this-at-home diet composed of mostly white rice and sugar. See my video, Kempner Rice Diet: Whipping Us Into Shape.

Refined grains may also not be good for our blood pressure (see Whole Grains May Work As Well As Drugs).

What should we be eating to best decrease our risk of diabetes? See:

And check out my summary video, 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:

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

Original Link

How to Prevent Ulcerative Colitis with Diet

Preventing Ulcerative Colitis with Diet.jpg

What has driven the dramatic increase in prevalence of the inflammatory bowel disease Crohn's disease in societies that rapidly westernized--a disease practically unknown just a century ago? What has changed in our internal and external environment that has led to the appearance of this horrible disease?

Japan suffered one of the most dramatic increases, and out of all the changing dietary components, animal protein appeared to be the strongest factor. There was an exponential increase in newly diagnosed Crohn's patients and daily animal protein intake, whereas the greater the vegetable protein, the fewer the cases of Crohn's, which is consistent with data showing a more plant-based diet may be successful in both preventing and treating Crohn's disease (See Preventing Crohn's Disease With Diet and Dietary Treatment of Crohn's Disease). But what about other inflammatory bowel diseases?

In the largest study of its kind, shown in my video Preventing Ulcerative Colitis with Diet, 60,000 people were followed for more than a decade. Researchers found that high total protein intake--specifically animal protein--was associated with a significantly increased risk of the other big inflammatory bowel disease, ulcerative colitis. It wasn't just protein in general, but the "association between high protein intake and inflammatory bowel disease risk was restricted to animal protein."Since World War II, animal protein intake has increased not only in Japan but also in all developed countries. This increase in animal protein consumption is thought to explain some of the increased incidence of inflammatory bowel disease in the second half of the 20th century.

Other studies found this as well, but why? What's the difference between animal protein and plant protein? Animal proteins tend to have more sulfur containing amino acids like methionine, which bacteria in our gut can turn into the toxic rotten egg smell gas, hydrogen sulfide. Emerging evidence suggests that sulfur compounds may play a role in the development of ulcerative colitis, a chronic inflammatory disease of the colon and rectum characterized by bloody diarrhea.

The first hint as to the importance of our gut flora was in the 1970's when "analysis of stools showed that their bulk was made up of mostly bacteria, not undigested material." We're pushing out trillions of bacteria a day and they just keep multiplying and multiplying. They do wonderful things for us like create the protective compound, butyrate, from the fiber we eat, but unfortunately, the bacteria may also elaborate toxic products from food residues such as hydrogen sulfide "in response to a high-meat diet."

Hydrogen sulfide is a bacterially derived cell poison that has been implicated in ulcerative colitis. We had always assumed that sulfide generation in the colon is driven by dietary components such as sulfur-containing amino acids, but we didn't know for sure until a study from Cambridge was published. Researchers had folks eat five different diets each with escalating meat contents from vegetarian all the way up to a steak each day. They found that the more meat one ate, the more sulfide; ten times more meat meant ten times more sulfide. They concluded that "dietary protein from meat is an important substrate for sulfide generation by bacteria in the human large intestine."

Hydrogen sulfide can then act as a free radical and damage our DNA at concentrations way below what our poor colon lining is exposed to on a routine basis, which may help explain why diets higher in meat and lower in fiber may produce so-called "fecal water" that causes about twice as much DNA damage. Fecal water is like when researchers make a tea from someone's stool.

The biology of sulfur in the human gut has escaped serious attention until recently. Previously it was just thought of as the rotten egg smell in malodorous gas, but the increase in sulfur compounds in response to a supplement of animal protein is not only of interest in the field of flatology--that is, the formal study of farts--but may also be of importance in the development of ulcerative colitis.

I have several videos on our microbiome, including:

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: illustrator © 123RF.com. This image has been modified.

Original Link

How to Prevent Ulcerative Colitis with Diet

Preventing Ulcerative Colitis with Diet.jpg

What has driven the dramatic increase in prevalence of the inflammatory bowel disease Crohn's disease in societies that rapidly westernized--a disease practically unknown just a century ago? What has changed in our internal and external environment that has led to the appearance of this horrible disease?

Japan suffered one of the most dramatic increases, and out of all the changing dietary components, animal protein appeared to be the strongest factor. There was an exponential increase in newly diagnosed Crohn's patients and daily animal protein intake, whereas the greater the vegetable protein, the fewer the cases of Crohn's, which is consistent with data showing a more plant-based diet may be successful in both preventing and treating Crohn's disease (See Preventing Crohn's Disease With Diet and Dietary Treatment of Crohn's Disease). But what about other inflammatory bowel diseases?

In the largest study of its kind, shown in my video Preventing Ulcerative Colitis with Diet, 60,000 people were followed for more than a decade. Researchers found that high total protein intake--specifically animal protein--was associated with a significantly increased risk of the other big inflammatory bowel disease, ulcerative colitis. It wasn't just protein in general, but the "association between high protein intake and inflammatory bowel disease risk was restricted to animal protein."Since World War II, animal protein intake has increased not only in Japan but also in all developed countries. This increase in animal protein consumption is thought to explain some of the increased incidence of inflammatory bowel disease in the second half of the 20th century.

Other studies found this as well, but why? What's the difference between animal protein and plant protein? Animal proteins tend to have more sulfur containing amino acids like methionine, which bacteria in our gut can turn into the toxic rotten egg smell gas, hydrogen sulfide. Emerging evidence suggests that sulfur compounds may play a role in the development of ulcerative colitis, a chronic inflammatory disease of the colon and rectum characterized by bloody diarrhea.

The first hint as to the importance of our gut flora was in the 1970's when "analysis of stools showed that their bulk was made up of mostly bacteria, not undigested material." We're pushing out trillions of bacteria a day and they just keep multiplying and multiplying. They do wonderful things for us like create the protective compound, butyrate, from the fiber we eat, but unfortunately, the bacteria may also elaborate toxic products from food residues such as hydrogen sulfide "in response to a high-meat diet."

Hydrogen sulfide is a bacterially derived cell poison that has been implicated in ulcerative colitis. We had always assumed that sulfide generation in the colon is driven by dietary components such as sulfur-containing amino acids, but we didn't know for sure until a study from Cambridge was published. Researchers had folks eat five different diets each with escalating meat contents from vegetarian all the way up to a steak each day. They found that the more meat one ate, the more sulfide; ten times more meat meant ten times more sulfide. They concluded that "dietary protein from meat is an important substrate for sulfide generation by bacteria in the human large intestine."

Hydrogen sulfide can then act as a free radical and damage our DNA at concentrations way below what our poor colon lining is exposed to on a routine basis, which may help explain why diets higher in meat and lower in fiber may produce so-called "fecal water" that causes about twice as much DNA damage. Fecal water is like when researchers make a tea from someone's stool.

The biology of sulfur in the human gut has escaped serious attention until recently. Previously it was just thought of as the rotten egg smell in malodorous gas, but the increase in sulfur compounds in response to a supplement of animal protein is not only of interest in the field of flatology--that is, the formal study of farts--but may also be of importance in the development of ulcerative colitis.

I have several videos on our microbiome, including:

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: illustrator © 123RF.com. This image has been modified.

Original Link

Reversal of Chronic Disease Risk Even Late in Life

NF-Oct18 Never too Late to Start Eating Healthier.jpeg

A hundred years ago, the New York Times reported on a rather sophisticated study for the time: 4,600 cases of cancer appearing over a seven year period, suggesting that the increased consumption of animal foods was to blame. A century later, the latest review on the subjects concluded that mortality from all causes put together, ischemic heart disease, circulatory, and cerebrovascular diseases was significantly lower in those eating meat-free diets, in addition to less cancer and diabetes.

I'm surprised they found such significant results given that people in these studies typically didn't stop eating meat until late in life. For example, in the largest study done up until recently, up to a third of subjects ate vegetarian for less than five years, yet they still ended up with lower rates of heart disease whether they were under 60 or over 60, normal weight or overweight, used to smoke or never smoked; those that had stopped eating meat had lower risk, suggesting that decades of higher risk dietary behavior could be reversed within just years of eating healthier.

If you look at countries that switched from eating traditional, more plant-based diets to more Westernized diets, it may take 20 years for cancer rates to shoot up. It takes decades for most tumors to grow. For example, if you look at Asia, their dietary shift was accompanied by a remarkable increase in mortality rates of breast, colon, and prostate cancers. The same thing can be shown with migration studies. Men moving from rural China to the U.S. experience a dramatic increase in cancer risk, but tumors take time to grow.

So it's remarkable to me that after most of a lifetime eating the standard Western diet, one can turn it around and reverse chronic disease risk with a healthier diet, even late in the game... as discussed in my video, Never Too Late to Start Eating Healthier.

So, "should we all start eating vegetarian?" asked an editorial that accompanied the results from the largest study ever published on Americans eating plant-based diets, which found vegetarian diets to be associated with lower all-cause mortality, meaning those who started eating vegetarian live, on average, longer lives. This analysis included so-called semi-vegetarians, who ate meat at least once a month (but no more than once a week), so it's not yet clear how harmful eating meat a few times a month is. What we can all agree on, though, is that we should limit our intake of junk food and animal fat, and eat more fruits and vegetables. Most authorities will also agree that diets should include whole grains, beans, and nuts. Instead of fighting over whose diet is the best, it's time to acknowledge these common features of diets associated with less disease, and instead focus our attention on helping patients avoid the intense commercial pressures to eat otherwise.

How amazing the human body is if we just treat it right! For more on lifestyle medicine, see:

So please don't allow the perfect to become the enemy of the good. Any movement we can make towards improving our diet can help. Though the earlier the better: See Heart Disease Starts in Childhood and Back in Circulation: Sciatica and Cholesterol.

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations--2013: Uprooting the Leading Causes of Death, More Than an Apple a Day, 2014: From Table to Able: Combating Disabling Diseases with Food, 2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet, and my latest, 2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers.

Image Credit: victorpr / 123RF

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The Dietary Link Between Acne and Cancer

NF-Jan7 Saving Lives By Treating Acne With Diet.jpg

Acne is an epidemic skin disease of industrialized countries, reaching prevalence rates of over 85 percent of teenagers. In nearly half of American men and women, acne even continues after adolescence and into the third decade of life.

Acne is considered a disease of Western civilization, as in places like Okinawa, Japan, acne is rare or even nonexistent. So acne is not some "physiological" phenomenon of puberty, but may represent "a visible risk indicator pointing to aberrant nutrient signaling promoting chronic epidemic diseases of civilization," according to a group of German researchers (See Saving Lives By Treating Acne With Diet). What they mean is that the dairy, junk foods, meat, and egg proteins in Western diets all conspire to raise the activity of the enzyme TOR, contributing to acne and obesity. Therefore, using diet to suppress TOR may not only improve acne, but may also prevent the march to more serious chronic TOR-driven diseases of civilization. The excessive TOR stimulation induced by the standard American diet may initially manifest as premature puberty and acne, but then may later contribute to obesity, diabetes, cancer and Alzheimer's.

A lot of this research is relatively new. Until recently, for example, only a weak association had been accepted for the role of milk and dairy products in acne formation. However, there is now substantial evidence supporting the effects of milk and dairy products as enhancers of acne aggravation. Milk is not just food, but appears to represent a most sophisticated hormone signaling system activating TOR, which is of critical concern given that TOR is recognized as the fundamental driving force for a number of serious chronic diseases.

If milk is naturally supposed to stimulate TOR, why the problem? Because we're drinking milk from the wrong species. Cow's milk is designed for calves. Baby cows grow nearly 40 times faster than human infants. Cow's milk has three times more leucine, the primary activator of TOR, than breast milk, so cow's milk may over-stimulate TOR when consumed by humans. It's like giving donkey milk to rats--it doesn't make sense. Furthermore, milk is for babies, so the continued consumption of any kind of milk during adolescence and adulthood is something that never really happened naturally and may have long-term adverse effects on human health.

In this regard, it's kind of frightening to realize that more than 85 percent of teens in Western countries exhibit acne; it implies that the "majority of our population is living with over-activated TOR signaling, a major disease-causing factor, which may pave the way for the development of other more serious diseases." A history of acne has been associated with breast cancer risk in women, for example, and prostate cancer in men.

So early dietary counseling of teenage acne patients is thus a great opportunity for dermatologists, who will not only help to improve acne but may reduce the long-term adverse effects of Western diet on more serious TOR-driven diseases. So just like urologists use erectile dysfunction as an opportunity to save lives by putting people on heart-healthy diets, dermatologists can use acne as a way to save lives by putting people on a cancer prevention diet.

How do you turn acne on and off via dietary manipulation of TOR? A "comprehensive dietary strategy to treat acne can only be achieved by higher consumption of vegetables and fruit and reduction of animal-derived food" given preliminary evidence for the effectiveness of natural plant-derived TOR inhibitors in the treatment of acne.

TOR is considered the engine-of-aging enzyme detailed in Why Do We Age? and Caloric Restriction vs. Animal Protein Restriction, as well as my video Prevent Cancer From Going on TOR.

I've touched on this topic before in Acne and Cancer and covered acne and dairy in:

Urologists saving the lives of men is detailed in Survival of the Firmest: Erectile Dysfunction and Death and 50 Shades of Greens.

What else are Okinawans doing right? See The Okinawa Diet: Living to 100.

-Michael Greger, M.D.

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

Image Credit: coniferconfier / Flickr

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Treating Asthma With Plants vs. Pills

NF-July7 Treating Asthma with Plants vs. Supplements.jpg

In my video Treating Asthma With Fruits and Vegetables, I highlighted a landmark study on manipulating antioxidant intake in asthma. The study found that just a few extra fruits and vegetables a day can powerfully reduce asthma exacerbation rates. If the antioxidants in the plants are ameliorating asthma, then why can't we take antioxidant pills instead? Because antioxidant pills don't appear to work.

Studies using antioxidant supplements on respiratory or allergic diseases have mostly shown no beneficial effects. This discrepancy between data relating to fruit and vegetable intake compared with those using antioxidant supplements may indicate the importance of the whole food, rather than individual components. For example, in the Harvard Nurse's Health Study, women who got the most vitamin E from their diet appeared to be at half the risk for asthma, (which may help explain why nut consumption is associated with significantly lower rates of wheezing), but vitamin E supplements did not appear to help.

Men who eat a lot of apples appear to have superior lung function, as do kids who eat fresh fruit every day, as measured by FEV1 (basically how much air you can forcibly blow out in one second). The more fruit, salad, and green vegetables kids ate, the greater their lung function appeared.

Researchers are "cautious about concluding which nutrient might be responsible." There's vitamin C in fruits, salads, and green vegetables, but there are lots of other antioxidants, such as "vitamin P," a term used to describe polyphenol phytonutrients found in grapes, flax seeds, beans, berries, broccoli, apples, citrus, herbs, tea, and soy. Polyphenol phytonutrients can directly bind to allergenic proteins and render them hypoallergenic, allowing them to slip under our body's radar. If this first line of defense fails, polyphenols can also inhibit the activation of the allergic response and prevent the ensuing inflammation, and so may not only work for prevention, but for treatment as well.

Most of the available evidence is weak, though, in terms of using supplements containing isolated phytonutrients to treat allergic diseases. We could just give people fruits and vegetables to eat, but then we couldn't perform a double-blind study to see if they work better than placebo. Some researchers decided to use pills containing plant food extracts. Plant extracts are kind of a middle ground. They are better than isolated plant chemicals, but are not as complete as whole foods. Still, since we can put whole foods in a capsule, we can compare the extracts to fake sugar pills that look and feel the same to see if they have an effect.

The first trial involved giving people extracts of apple skins. I've talked about the Japan's big cedar allergy problem before (See Alkylphenol Endocrine Disruptors and Allergies), so apple extract pills were given every day for a few months starting right before pollen season started. The results were pretty disappointing. They found maybe a little less sneezing, but the extract didn't seem to help their stuffy noses or itchy eyes.

What about a tomato extract? A randomized, double-blind, placebo-controlled eight-week trial was performed on perennial allergic rhinitis, this time not for seasonal pollen, but for year-round allergies to things like dust-mites. There are lots of drugs out there, but you may have to take them every day year-round, so how about some tomato pills instead? After oral administration of tomato extract for eight weeks, there was a significant improvement of total nasal symptom scores, combined sneezing, runny nose and nasal obstruction, with no apparent adverse effects.

Would whole tomatoes work even better? If only researchers would design an experiment directly comparing phytonutrient supplements to actual fruits and vegetables head-to-head against asthma, but such a study had never been done... until now. The same amazing study, highlighted in my video, Treating Asthma with Plants vs. Supplements?, that compared the seven-fruit-and-vegetables-a-day diet to the three-fruit-and-vegetables-a-day diet, after completion of its first phase, commenced a parallel, randomized, controlled supplementation trial with capsules of tomato extract, which boosted the power of five tomatoes in one little pill, and the study subjects were given three pills a day.

Who did better, the group that ate seven servings of actual fruits and vegetables a day, or the group that ate three servings a day but also took 15 supposed serving equivalents in pill form? The pills didn't help at all. Improvements in lung function and asthma control were evident only after increased fruit and vegetable intake, which suggests that whole-food interventions are most effective. Both the supplements and increased fruit and vegetable intake were effective methods for increasing carotenoid concentrations in the bloodstream, but who cares? Clinical improvements--getting better from disease--were evident only as a result of an increase in plant, not pill, consumption. The results provide further evidence that whole-food approaches should be used to achieve maximum efficacy of antioxidant interventions.

And if this is what a few more plants can do, what might a whole diet composed of plants accomplish? See Treating Asthma and Eczema with Plant-Based Diets.

I also dealt with preventing asthma in the first place: Preventing Asthma With Fruits and Vegetables.

The theme of whole foods being more efficacious than supplements seems to come up over and over again. See for example:

More on "vitamin P" in How to Slow Brain Aging by Two Years.

The anti-inflammatory effects of nuts may explain the Harvard Nurse's Health Study finding: Fighting Inflammation in a Nut Shell.

-Michael Greger, M.D.

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

Image Credit: Mike Mozart / Flickr

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Living Longer by Reducing Leucine Intake

NF-June16 How What We Eat (And Don't Eat) Impacts How We Age.jpg

Many studies have shown that calorie restriction, without malnutrition, can increase lifespan and lower the risk of age-related diseases, such as cancer.

However, for many people, calorie restriction clearly has its drawbacks. In the classic Minnesota Starvation Study, many of the volunteers suffered a preoccupation with food, constant hunger, binge eating, and lots of emotional and psychological issues. Even researchers who study caloric restriction rarely practice it. There's got to be a better way to suppress the aging engine enzyme, TOR (see Why Do We Age? for more on TOR).

That's why researchers were so excited about rapamycin, a drug that inhibits TOR, thinking it could be caloric restriction in a pill. But like any drug, it a long list of potentially serious side effects. There's got to be a better way.

The breakthrough came when scientists discovered that the benefits of dietary restriction may be coming not from restricting calories, but from restricting protein intake (See my video Caloric Restriction vs. Animal Protein Restriction). If we look at the first comprehensive, comparative meta-analysis of dietary restriction, "the proportion of protein intake was more important for life extension than the degree of caloric restriction." In fact, just "reducing protein without any changes in calorie level have been shown to have similar effects as caloric restriction."

That's good news. Protein restriction is much less difficult to maintain than dietary restriction, and it may even be more powerful because it suppresses both TOR and IGF-1, the two pathways thought responsible for the dramatic longevity and health benefits of caloric restriction.

Some proteins are worse than others. One amino acid in particular, leucine, appears to exert the greatest effect on TOR. In fact, just cutting down on leucine may be nearly as effective as cutting down on all protein. Where is leucine found? Predominantly animal foods: eggs, dairy, and meat (including chicken and fish). Plant foods, such as fruits, vegetables, grains, and beans, have much less.

"In 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 nine pounds of cabbage--about four big heads--or 100 apples. These calculations exemplify the extreme differences in leucine amounts provided by a conventional diet in comparison to a plant-based diet. The functional role of leucine in regulating TOR activity may help explain the extraordinary results reported in the Cornell-Oxford-China Study, "since quasi-vegan diets of modest protein content tend to be relatively low in leucine."

This may also help explain the longevity of populations like the Okinawa Japanese, who have about half our mortality rate. The traditional Okinawan diet is only about 10% protein, and practically no cholesterol, because they ate almost exclusively plants. Less than one percent of their diet was fish, meat, eggs, and dairy - the equivalent of one serving of meat a month and one egg every two months. Their longevity is surpassed only by vegetarian Adventists in California, who have perhaps the highest life expectancy of any formally studied population in history.

This reminds of the study I profiled in The Benefits of Caloric Restriction Without the Actual Restricting.

Methionine is another amino acid that may be associated with aging. See Methionine Restriction as a Life Extension Strategy to find out which foods to avoid in that case. Both leucine and methionine content may be additional reasons why Plant Protein is Preferable.

Other reasons why those eating plant-based diets may live longer:

This all may help explain the results of Harvard's Meat and Mortality Studies.

-Michael Greger, M.D.

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

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How to Reduce Exposure to Alkylphenols Through Your Diet

NF-Apr28 Dietary Sources of Alkylphenol Endocrine Disruptors.jpg

Alkylphenols are industrial chemicals that are found in hair products, spermicides, cleaning products and detergents. They are considered endocrine disruptors. For more information on alkylphenols, check out my video Alkylphenol Endocrine Disruptors and Allergies.

Concern about alkylphenols first surfaced decades ago when a group at Tufts observed an excessive proliferation of human breast cancer cells in certain types of plastic containers, something that would normally only be seen if the cells were exposed to some type of estrogen. They identified an alkylphenol leaching from the plastic as the culprit, having "estrogen-like properties when tested in the human breast tumor cells." Excessive proliferation of human breast cancer cells is never good, so countries in Europe started banning and restricting the use of these chemicals. However, the U.S. EPA has been slow to respond.

A half million tons of alkylphenols continue to spew out into the environment every year, so much so that now that they come down in the rain and then accumulate up the food chain.

One study, highlighted in my video, Dietary Sources of Alkylphenol Endocrine Disruptors, examined the Japanese food supply to find out which foods had these potentially allergy-exacerbating endocrine disruptors. The researchers found that chicken and fish had the highest levels. Water animals and birds concentrate these compounds to levels several thousands of times greater than those in the environment because these are fat-soluble chemicals. "Therefore, they can easily contaminate foods of animal origin, which are thought to represent the most important source of human exposure to many organic pollutants," not just the alkylphenols. Another research group also found that fish was the worst.

Which kind of fish? Anchovies, mackerel, salmon and cod seem to have the highest levels. In fact, salmon was the only food found contaminated with nonylphenol diethoxylate, which is even more potent than regular nonylphenol. The levels of contamination in fish were at the concentrations that start to make breast cancer cells go crazy in vitro.

These findings are consistent with the fact that seafood consumption has been associated with severe asthma, current and severe rhinoconjunctivitis, (seasonal pollen allergies), and current and severe eczema (an allergic-type disease of the skin) in adolescent populations around the globe.

If these synthetic xenoestrogens are playing a role, what about natural phytoestrogens, such as those found in soy foods? It turns out that in patients with asthma, consumption of a diet with moderate to high amounts of soy phytoestrogens is associated with better lung function and better asthma control. If anything then, it's these chemical pollutants, which come down in the rain, contaminate the soil, the plants, and then concentrate up the food chain in the fat of animals. We're now the animals at the top of the food chain, like the polar bear or bald eagle, building up higher levels of these synthetic xenoestrogens.

Thankfully, there aren't many cannibals around anymore. However, there is one group that continues to feed off human tissues--babies (See The Wrong Way to Detox). Alkylphenols have been found to concentrate in human breast milk, particularly in women who eat fish. The highest levels of these endocrine-disrupting pollutants were recorded in milk samples from mothers who said they ate fish at least twice a week, consistent with the fact that seafood consumption represents an important source of alkylphenol intake. Even these "slightly elevated levels of endocrine disruptors in the milk of mothers with a seafood-rich diet may be associated with adverse effects on neurological development, fetal and postnatal growth, and memory functions on breastfed infants, because these contaminants may interfere with the endocrine [hormonal] system."

Since these toxins concentrate in fat, the highest concentrations may be found in straight animal fat, such as chicken fat, lard, tallow, or fish oil. Consumption of fish oil capsules and processed fish products has been associated with alkylphenol concentration in mothers' milk, again due to bioaccumulation up the food chain. And then we recycle the leftover remains of farm animals into farm animal feed, so the levels can get higher and higher in animal products.

As one commentator noted, while these pollutants do contaminate human milk, they also contaminate cow's milk--humans and cows live in the same polluted world. In fact, infant formula was found to be over five times more contaminated, so breast is still best, absolutely. But these kinds of studies are important in order to provide good suggestions for food choices to nursing mothers to prevent excess exposure to these pollutants in their infants.

We can kind of cut out the middlefish and move lower down the food chain in hopes of decreasing our exposure to industrial toxins.

Endocrine disruptors have also been linked to conditions such as male infertility (Male Fertility and Diet and Xenoestrogens and Sperm Counts) and early onset of puberty (Protein, Puberty, and Pollutants and Xenoestrogens and Early Puberty).

What other industrial pollutants build up in the aquatic fish chain? See, for example:

Farmed Fish vs. Wild Caught. Which is worse?

How Long to Detox from Fish Before Pregnancy? If it's too late, How Fast Can Children Detoxify from PCBs?

-Michael Greger, M.D.

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

Image Credit: Andrea Pokrzywinski / Flickr

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Alkylphenol Endocrine Disruptors and Allergies

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In my video Preventing Childhood Allergies, I noted a study in Japan that found higher maternal intake of meat during pregnancy was significantly associated with about three times the odds of both suspected and physician-diagnosed eczema. The researchers suggest that certain components of meat may affect the fetal immune system. But what about the moms, themselves? A plant-based diet may also help alleviate allergies in adults. See Say No to Drugs by Saying Yes to More Plants and Preventing Allergies in Adulthood.

Seasonal allergies have exploded in Japan in the past few decades, starting with the first reported case in 1964 and now affecting millions every year. We've seen a rising prevalence of allergic diseases around the industrialized world in past decades, but perhaps nothing quite this dramatic.

Some have suggested that profound changes in the Japanese diet may have played a role. Over the latter half of the century total meat, fish, and milk intake rose hundreds of percent in Japan, so researchers decided to look into dietary meat and fat intake and the prevalence of these seasonal pollen allergies. No association with overall fat, but "higher meat intake was significantly associated with an increased prevalence."

Saturated fat wasn't associated with increased prevalence either, so what other constituents in meat may be to blame? The researchers considered the cooked meat carcinogens, the heterocyclic amines, the polycyclic aromatic hydrocarbons, and the nitrosamines.

A new review, highlighted in my video, Alkylphenol Endocrine Disruptors and Allergies, however, raised an intriguing possibility. There's a class of industrial pollutants called alkylphenols, recognized as common toxic endocrine disrupting chemicals that tend to accumulate in the human body and may be associated with allergic diseases. A variety of studies have shown how they may exacerbate allergen-induced inflammation, "suggesting that alkylphenol exposure may influence the onset, progression, and severity of allergic diseases." These toxic xenoestrogens can be found in human breast milk, in our body fat, in our urine, in our bloodstream, and even in the umbilical cord blood going to our babies. How did it get there? Through contaminated food.

It all goes back to a famous study about the reduction of penis size and testosterone levels in alligators living in a contaminated environment. I don't know what you do for a day job, but these researchers observed that a population of juvenile alligators living on one lake in Florida exhibited a "significantly smaller penis size" and lower blood concentrations of testosterone compared to animals on some different lake. The most important difference between the two lakes was that Lake Stubby was fed by relatively polluted waters. They attributed the "short penis phenomenon" to estrogen-mimicking (xenoestrogenic) environmental metabolites of DDT that still pollute our Earth. This seminal work introduced the concept of endocrine disruptors. Environmental xenoestrogens might result in feminization of exposed male animals. And that's just the shriveled tip of the iceberg.

Since then, endocrine-disrupting chemicals have been implicated in the dramatic rise over the last 50 years of diseases like breast cancer, prostate cancer, testicular cancer, diabetes, obesity, and fertility (such as dropping normal sperm counts), genital birth defects such as penile malformations, preterm birth, neurobehavioral disorders in children linked to thyroid disruption, and earlier breast development in young girls. Because genes do not change fast enough to explain these increases, environmental causes must be involved. Since our greatest exposure to the environment is through our gut, it's no surprise that our greatest exposure to these endocrine-disrupting chemicals is through diet.

To find out which foods may contain these alkylphenol endocrine disruptors, check out my video Dietary Sources of Alkylphenol Endocrine Disruptors.

More on endocrine disruptors in:

A different class of chemicals has been found to be associated with smaller penis size in humans. See Chicken Consumption and the Feminization of Male Genitalia.

-Michael Greger, M.D.

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

Image Credit: Mark Freeth / Flickr

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