Fish Consumption and Suicide

Sept 12 Fish Consumption copy.jpeg

Depression is a serious and common mental disorder responsible for the majority of suicides. As I've covered in Antioxidants & Depression, intake of fruits, vegetables, and naturally occurring antioxidants have been found to be protectively associated with depression. Therefore, researchers have considered that "it may be possible to prevent depression or to lessen its negative effects through dietary intervention."

But not so fast. Cross-sectional studies are snapshots in time, so we don't know "whether a poor dietary pattern precedes the development of depression or if depression causes poor dietary intake." Depression and even treatments for depression can affect appetite and dietary intake. Maybe people who feel crappier just eat crappier, instead of the other way around.

What we need is a prospective study (a study performed over time) where we start out with people who are not depressed and follow them for several years. In 2012, we got just such a study, which ran over six years. As you'll see in my video Fish Consumption and Suicide, those with higher carotenoid levels in their bloodstream, which is considered a good indicator of fruit and vegetable intake, had a 28% lower risk of becoming depressed within that time. The researchers conclude that having low blood levels of those healthy phytonutrients may predict the development of new depressive symptoms. What about suicide?

Worldwide, a million people kill themselves every year. Of all European countries, Greece appears to have the lowest rates of suicide. It may be the balmy weather, but it may also have something to do with their diet. Ten thousand people were followed for years, and those following a more Mediterranean diet pattern were less likely to be diagnosed with depression. What was it about the diet that was protective? It wasn't the red wine or fish; it was the fruit, nuts, beans, and effectively higher plant to animal fat ratio that appeared protective. Conversely, significant adverse trends were observed for dairy and meat consumption.

A similar protective dietary pattern was found in Japan. A high intake of vegetables, fruits, mushrooms, and soy products was associated with a decreased prevalence of depressive symptoms. The healthy dietary pattern was not characterized by a high intake of seafood. Similar results were found in a study of 100,000 Japanese men and women followed for up to 10 years. There was no evidence of a protective role of higher fish consumption or the long-chain omega 3s EPA and DHA against suicide. In fact, they found a significantly increased risk of suicide among male nondrinkers with high seafood omega 3 intake. This may have been by chance, but a similar result was found in the Mediterranean. High baseline fish consumption with an increase in consumption were associated with an increased risk of mental disorders.

One possible explanation could be the mercury content of fish. Could an accumulation of mercury compounds in the body increase the risk of depression? We know that mercury in fish can cause neurological damage, associated with increased risk of Alzheimer's disease, memory loss, and autism, but also depression. Therefore, "the increased risk of suicide among persons with a high fish intake might also be attributable to the harmful effects of mercury in fish."

Large Harvard University cohort studies found similar results. Hundreds of thousands were followed for up to 20 years, and no evidence was found that taking fish oil or eating fish lowered risk of suicide. There was even a trend towards higher suicide mortality.

What about fish consumption for the treatment of depression? When we put together all the trials done to date, neither the EPA nor DHA long-chain omega-3s appears more effective than sugar pills. We used to think omega-3 supplementation was useful, but several recent studies have tipped the balance the other way. It seems that "[n]early all of the treatment efficacy observed in the published literature may be attributable to publication bias," meaning the trials that showed no benefit tended not to get published at all. So, all doctors saw were a bunch of positive studies, but only because a bunch of the negative ones were buried.

This reminds me of my Is Fish Oil Just Snake Oil? video. Just like we thought omega-3 supplementation could help with mood, we also thought it could help with heart health, but the balance of evidence has decidedly shifted. I still recommend the consumption of pollutant-free sources of preformed long-chain omega 3s for cognitive health and explain my rationale in Should We Take DHA Supplements to Boost Brain Function? and Should Vegans Take DHA to Preserve Brain Function?


For more on the neurotoxic nature of mercury-contaminated seafood, see:

What can we do to help our mood? See:

What about antidepressant drugs? Sometimes they can be absolutely life-saving, but other times they may actually do more harm than good. See my controversial video Do Antidepressant Drugs Really Work?.

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

Fish Consumption and Suicide

Sept 12 Fish Consumption copy.jpeg

Depression is a serious and common mental disorder responsible for the majority of suicides. As I've covered in Antioxidants & Depression, intake of fruits, vegetables, and naturally occurring antioxidants have been found to be protectively associated with depression. Therefore, researchers have considered that "it may be possible to prevent depression or to lessen its negative effects through dietary intervention."

But not so fast. Cross-sectional studies are snapshots in time, so we don't know "whether a poor dietary pattern precedes the development of depression or if depression causes poor dietary intake." Depression and even treatments for depression can affect appetite and dietary intake. Maybe people who feel crappier just eat crappier, instead of the other way around.

What we need is a prospective study (a study performed over time) where we start out with people who are not depressed and follow them for several years. In 2012, we got just such a study, which ran over six years. As you'll see in my video Fish Consumption and Suicide, those with higher carotenoid levels in their bloodstream, which is considered a good indicator of fruit and vegetable intake, had a 28% lower risk of becoming depressed within that time. The researchers conclude that having low blood levels of those healthy phytonutrients may predict the development of new depressive symptoms. What about suicide?

Worldwide, a million people kill themselves every year. Of all European countries, Greece appears to have the lowest rates of suicide. It may be the balmy weather, but it may also have something to do with their diet. Ten thousand people were followed for years, and those following a more Mediterranean diet pattern were less likely to be diagnosed with depression. What was it about the diet that was protective? It wasn't the red wine or fish; it was the fruit, nuts, beans, and effectively higher plant to animal fat ratio that appeared protective. Conversely, significant adverse trends were observed for dairy and meat consumption.

A similar protective dietary pattern was found in Japan. A high intake of vegetables, fruits, mushrooms, and soy products was associated with a decreased prevalence of depressive symptoms. The healthy dietary pattern was not characterized by a high intake of seafood. Similar results were found in a study of 100,000 Japanese men and women followed for up to 10 years. There was no evidence of a protective role of higher fish consumption or the long-chain omega 3s EPA and DHA against suicide. In fact, they found a significantly increased risk of suicide among male nondrinkers with high seafood omega 3 intake. This may have been by chance, but a similar result was found in the Mediterranean. High baseline fish consumption with an increase in consumption were associated with an increased risk of mental disorders.

One possible explanation could be the mercury content of fish. Could an accumulation of mercury compounds in the body increase the risk of depression? We know that mercury in fish can cause neurological damage, associated with increased risk of Alzheimer's disease, memory loss, and autism, but also depression. Therefore, "the increased risk of suicide among persons with a high fish intake might also be attributable to the harmful effects of mercury in fish."

Large Harvard University cohort studies found similar results. Hundreds of thousands were followed for up to 20 years, and no evidence was found that taking fish oil or eating fish lowered risk of suicide. There was even a trend towards higher suicide mortality.

What about fish consumption for the treatment of depression? When we put together all the trials done to date, neither the EPA nor DHA long-chain omega-3s appears more effective than sugar pills. We used to think omega-3 supplementation was useful, but several recent studies have tipped the balance the other way. It seems that "[n]early all of the treatment efficacy observed in the published literature may be attributable to publication bias," meaning the trials that showed no benefit tended not to get published at all. So, all doctors saw were a bunch of positive studies, but only because a bunch of the negative ones were buried.

This reminds me of my Is Fish Oil Just Snake Oil? video. Just like we thought omega-3 supplementation could help with mood, we also thought it could help with heart health, but the balance of evidence has decidedly shifted. I still recommend the consumption of pollutant-free sources of preformed long-chain omega 3s for cognitive health and explain my rationale in Should We Take DHA Supplements to Boost Brain Function? and Should Vegans Take DHA to Preserve Brain Function?


For more on the neurotoxic nature of mercury-contaminated seafood, see:

What can we do to help our mood? See:

What about antidepressant drugs? Sometimes they can be absolutely life-saving, but other times they may actually do more harm than good. See my controversial video Do Antidepressant Drugs Really Work?.

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

Fish Consumption and Suicide

Sept 12 Fish Consumption copy.jpeg

Depression is a serious and common mental disorder responsible for the majority of suicides. As I've covered in Antioxidants & Depression, intake of fruits, vegetables, and naturally occurring antioxidants have been found to be protectively associated with depression. Therefore, researchers have considered that "it may be possible to prevent depression or to lessen its negative effects through dietary intervention."

But not so fast. Cross-sectional studies are snapshots in time, so we don't know "whether a poor dietary pattern precedes the development of depression or if depression causes poor dietary intake." Depression and even treatments for depression can affect appetite and dietary intake. Maybe people who feel crappier just eat crappier, instead of the other way around.

What we need is a prospective study (a study performed over time) where we start out with people who are not depressed and follow them for several years. In 2012, we got just such a study, which ran over six years. As you'll see in my video Fish Consumption and Suicide, those with higher carotenoid levels in their bloodstream, which is considered a good indicator of fruit and vegetable intake, had a 28% lower risk of becoming depressed within that time. The researchers conclude that having low blood levels of those healthy phytonutrients may predict the development of new depressive symptoms. What about suicide?

Worldwide, a million people kill themselves every year. Of all European countries, Greece appears to have the lowest rates of suicide. It may be the balmy weather, but it may also have something to do with their diet. Ten thousand people were followed for years, and those following a more Mediterranean diet pattern were less likely to be diagnosed with depression. What was it about the diet that was protective? It wasn't the red wine or fish; it was the fruit, nuts, beans, and effectively higher plant to animal fat ratio that appeared protective. Conversely, significant adverse trends were observed for dairy and meat consumption.

A similar protective dietary pattern was found in Japan. A high intake of vegetables, fruits, mushrooms, and soy products was associated with a decreased prevalence of depressive symptoms. The healthy dietary pattern was not characterized by a high intake of seafood. Similar results were found in a study of 100,000 Japanese men and women followed for up to 10 years. There was no evidence of a protective role of higher fish consumption or the long-chain omega 3s EPA and DHA against suicide. In fact, they found a significantly increased risk of suicide among male nondrinkers with high seafood omega 3 intake. This may have been by chance, but a similar result was found in the Mediterranean. High baseline fish consumption with an increase in consumption were associated with an increased risk of mental disorders.

One possible explanation could be the mercury content of fish. Could an accumulation of mercury compounds in the body increase the risk of depression? We know that mercury in fish can cause neurological damage, associated with increased risk of Alzheimer's disease, memory loss, and autism, but also depression. Therefore, "the increased risk of suicide among persons with a high fish intake might also be attributable to the harmful effects of mercury in fish."

Large Harvard University cohort studies found similar results. Hundreds of thousands were followed for up to 20 years, and no evidence was found that taking fish oil or eating fish lowered risk of suicide. There was even a trend towards higher suicide mortality.

What about fish consumption for the treatment of depression? When we put together all the trials done to date, neither the EPA nor DHA long-chain omega-3s appears more effective than sugar pills. We used to think omega-3 supplementation was useful, but several recent studies have tipped the balance the other way. It seems that "[n]early all of the treatment efficacy observed in the published literature may be attributable to publication bias," meaning the trials that showed no benefit tended not to get published at all. So, all doctors saw were a bunch of positive studies, but only because a bunch of the negative ones were buried.

This reminds me of my Is Fish Oil Just Snake Oil? video. Just like we thought omega-3 supplementation could help with mood, we also thought it could help with heart health, but the balance of evidence has decidedly shifted. I still recommend the consumption of pollutant-free sources of preformed long-chain omega 3s for cognitive health and explain my rationale in Should We Take DHA Supplements to Boost Brain Function? and Should Vegans Take DHA to Preserve Brain Function?


For more on the neurotoxic nature of mercury-contaminated seafood, see:

What can we do to help our mood? See:

What about antidepressant drugs? Sometimes they can be absolutely life-saving, but other times they may actually do more harm than good. See my controversial video Do Antidepressant Drugs Really Work?.

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

Lasagna

This is very reminiscent of traditional lasagnas, but of course, without the meat, cheese, and added salt and oil. Bottom line: it’s delicious! Instead of meat, I have used zucchini and mushrooms, and a great tofu blend to take the place of the ricotta. Lasagnas are a labor of love, for sure. But they are worth...

Read More »

The post Lasagna appeared first on Straight Up Food.

Original Link

Benefits of Nutritional Yeast to Prevent the Common Cold

Benefits of Nutritional Yeast to Prevent the Common Cold.jpeg

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

In health,
Michael Greger, M.D.

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

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

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

Original Link

Benefits of Nutritional Yeast to Prevent the Common Cold

Benefits of Nutritional Yeast to Prevent the Common Cold.jpeg

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

In health,
Michael Greger, M.D.

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

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

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

Original Link

How to Treat Gout With Diet

NFOct8-Gout treatment with a cherry on top.jpg

The Washington State Fruit Commission, our largest cherry producer, can fund reviews that cherry-pick studies on the anti-inflammatory effects of cherries in a petri dish and animal models. But what we've needed are human studies. For example, if we stuff the human equivalent of up to a thousand cups of cherries down the throats of rats, it appears to have an anti-inflammatory effect, but we could never eat that many. (In fact, if we tried, it could end badly. One poor guy who ate 500 cherries whole--without spitting out the pits--ended up fatally obstructing his colon.)

A decade ago, we didn't have many human studies, but thankfully now we do. A study published in The Journal of Nutrition had men and women eat about 45 cherries a day for a month (I wouldn't mind being part of that study!). The researchers found a 25% drop in C-reactive protein levels (a marker of inflammation), as well as an inflammatory protein with an inelegant acronym RANTES ("Regulated on, Activation, Normal, T cell, Expressed and, Secreted"). Even a month after the study ended there appeared to be residual anti-inflammatory benefit from the cherry fest.

These subjects were all healthy, with low levels of inflammation to begin with, but a follow-up study, highlighted in my video, Gout Treatment with a Cherry on Top, on folks with higher levels found similar results for C-reactive protein and for a number of other markers for chronic inflammatory diseases. Do cherries then help people who actually have a chronic inflammatory disease?

Back in 1950, in an obscure Texas medical journal, "observations made by responsible physicians" suggested that in a dozen patients with gout, eating half a pound of fresh or canned cherries helped prevent flares of gout. But the issue had never seriously been tested, until recently. Gout is an excruciatingly painful inflammatory arthritis caused by the crystallization of uric acid within joints. Based on the National Health and Nutrition Examination Survey 2007-2008, the prevalence of gout in the US is estimated to be 3.9% among US adults, which translates into 8.3 million people.

Hundreds of gout sufferers were studied, and cherry intake was associated with a 35% lower risk of gout attacks, with over half the risk gone at three servings measured over a two day period (about 16 cherries a day). That's the kind of efficacy the researchers saw with a low-purine diet (uric acid is a break-down product of purines). This same research group found that purine intake of animal origin increased the odds for recurrent gout attacks by nearly five-fold. Heavy alcohol consumption isn't a good idea either.

There are some high-purine non-animal foods, like mushrooms and asparagus, but they found no significant link to plant sources of purines. So the researchers recommended eliminating meat and seafood from the diet. This may decrease risk substantially, and adding cherries on top may decrease risk of gout attacks even further. Same thing with the leading drug: allopurinol works, but adding produce appears to work even better.

Often, dietary changes and cherries may be all patients have, as doctors are hesitant to prescribe uric acid-lowering drugs like allopurinol due to rare but serious side-effects.

In addition to fighting inflammation, cherries may also lower uric acid levels. Within five hours of eating a big bowl of cherries, uric acid levels in the blood significantly drop. At the same time, antioxidant levels in the blood go up. So is it just an antioxidant effect? Would other fruit work just as well? No. Researchers tried grapes, strawberries, and kiwi fruit, and none significantly lowered uric acid levels, supporting a specific anti-gout effect of cherries.

There are some new gout drugs out now, costing up to $2,000 per dose and carry a "risk of toxicity that may be avoided by using nonpharmacologic treatments or prevention in the first place." Given the potential harms and high costs, attention ought to be directed to dietary modification, reducing alcohol and meat intake, particularly sardines and organ meats. "If life serves up a bowl of cherries (consumed on a regular basis), the risk of a recurrent gout attack may be meaningfully reduced."

More about the inflammation fighting effects of sweet cherries in my video Anti-inflammatory Life is a Bowl of Cherries.

I've previously mentioned gout and controlling uric acid levels in my videos:

Other foods that may help tamp down inflammation:

In health,
Michael Greger, M.D.

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

Image Credit: Valdemar Fishmen / Flickr

Original Link

How a Tick Bite Can Lead to Food Allergies

NF-Aug25 Alpha Gal and the Lone Star Tick.jpg

In the beginning, Aristotle defined two forms of life on planet Earth: plants and animals. Two thousand years later, the light microscope was invented and we discovered tiny, single-celled organisms like amoebas. Then, the electron microscope was invented and we discovered bacteria. Finally, in 1969, biologists recognized fungi as a separate category, and we've had at least five kingdoms of life ever since.

In my video, Higher Quality May Mean Higher Risk, I talk about the potential downsides of consuming proteins from within our own kingdom, such as the impact our fellow animal proteins can have on boosting our liver's production of a cancer-promoting hormone called IGF-1.

In Eating Outside Our Kingdom, I talked about other potential advantages of preferably dipping into the plant and mushroom kingdoms for dinner, not only from a food safety perspective (we're more likely to get infected by animal pathogens than Dutch Elm Disease), but because of the potential for cross-reactivity between animal and human proteins. Our immune system is more likely to get confused between a chicken leg and our own legs than it is with a banana, so there may be less potential to trigger an autoimmune reaction, like degenerative brain diseases or inflammatory arthritis (See Diet & Rheumatoid Arthritis). In attacking some foreign animal meat protein, some of our own similarly composed tissues may get caught in the crossfire.

It's not just proteins. If you remember the Neu5Gc story (see Inflammatory Meat Molecule Neu5GC), sialic acid in other animals may cause inflammation in our arteries (see Nonhuman Molecules Lining Our Arteries) and help breast tumors and other human cancers to grow (see How Tumors Use Meat to Grow: Xeno-Autoantibodies). Now a new twist has been added to the story.

The reason Neu5Gc triggers inflammation is because humans lost the ability to make it two million years ago, and so when our body is exposed to it through animal products, it's treated as a foreign molecule, causing inflammation. But there's also another oligosaccharide called alpha-gal that humans, chimps, and apes lost the ability to make 20 million years ago, but is still made by a variety of animals, including many animals we eat.

Anti-gal antibodies may be involved in a number of detrimental processes that may result in allergic, autoimmune, and autoimmune-like diseases, such as auto-immune thyroid disorders. We see higher levels of anti-gal antibodies in Crohn's disease victims. These antibodies even react against about half of human breast tumors, and we can find them in atherosclerotic plaques in people's necks. However, those are all mostly speculative risks. We do know that alpha-gal is a major obstacle to transplanting pig organs into people, like kidneys, because our bodies reject alpha-gal as foreign. In fact, alpha-gal is thought to be the major target for human anti-pig antibodies.

It's interesting that if we look at those that abstain from pork for whatever reason, they have fewer swine-specific immune cells in their bloodstream. Researchers speculate that oral intake of pork could ferry swine molecules into the bloodstream via gut-infiltrating lymphocytes to prime the immune response. So we can have an allergic reaction to eating pig kidneys too, but such severe meat allergies were considered rare, until an unusual report surfaced. First described in 2009, the report included details on 24 cases of meat allergies triggered by tick bites.

Within a year, it was obvious that the cases should be counted in hundreds rather than dozens. By 2012, there were thousands of cases across a large area of the southern and eastern U.S., and new cases are now popping up in several countries around the world.

The culprit, the lone star tick, so-called because females have a white spot on their back, are famous for causing Masters' disease, a disease similar to Lyme syndrome, also known as STARI (southern tick associated rash illness). But thanks to the lone star tick steadily expanding its range (even as far as Long Island, NY), it's not necessarily just so Southern any more.

What is the relevance of tick bites to the production of allergy-causing anti-meat antibodies to alpha-gal? Good question. What we know is that if you get bitten by one of these ticks, you can develop an allergy to meat (See Alpha Gal and the Lone Star Tick). This appears to be the first example of a response to an external parasite giving rise to an important form of food allergy. We don't know the exact mechanism, but it may be because there's something in the tick saliva that's cross-reacting with alpha-gal, or because the tick is injecting you with animal allergens from its last meal.

What role may these tick-bite induced allergies play in the development of chronic hives and other allergic skin reactions in children? See Tick Bites, Meat Allergies, and Chronic Urticaria.

Here's some videos unearthing the IGF-1 story:

Neu5Gc is what opened up this whole can of worms:

I wonder if alpha gal is playing a role in the improvements in arthritis and Crohn's on plant-based diets: Dietary Treatment of Crohn's Disease and Diet & Rheumatoid Arthritis.

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my videos for free by clicking here and watch my full 2012 - 2015 presentations Uprooting the Leading Causes of Death, More than an Apple a Day, From Table to Able, and Food as Medicine.

Image Credit: USGS Bee Inventory and Monitoring Lab / Flickr

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