Coffee for Hepatitis C

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Decades ago, researchers in Norway came upon an unexpected finding. Alcohol consumption was associated with liver inflammation (no surprise), but a protective association was found for coffee consumption. These findings were replicated in the U.S. and around the world. Those at risk for liver disease--who drank a lot of alcohol or were overweight--appeared to cut their risk in half if they drank more than two cups of coffee a day.

Liver cancer is one of the most feared complications of liver inflammation. Hepatocellular carcinoma is the third leading cause of cancer death, and the incidence has been rapidly rising in the United States and Europe, largely driven by the burden of hepatitis C infection and fatty liver disease. Putting together all the best studies done to date, those drinking the most coffee had half the risk of liver cancer compared to those that drank the least. Since the meta-analysis was published, a new study found that male smokers may be able to cut their risk of liver cancer more than 90% by drinking four or more cups of coffee a day. (Of course, they could also stop smoking!). It's similar to heavy drinkers of alcohol: drinking more coffee may decrease liver inflammation, but not as much as drinking less alcohol.

Liver cancers are among the most avoidable cancers, through hepatitis B vaccination, control of hepatitis C transmission, and reduction of alcohol drinking. These three measures could, in principle, wipe out 90% of liver cancers worldwide. It remains unclear whether coffee drinking has an additional role on top of that, but in any case such a role would be limited compared to preventing liver damage in the first place. But what if you already have hepatitis C or are among the 30% of Americans with non-alcoholic fatty liver disease due to obesity, which may quadruple one's risk of dying from liver cancer? Coffee seems to help with hepatitis C, reducing liver damage, disease activity, and mortality. It was only the lack of randomized, interventional studies on the topic that prevented us from concluding that coffee has a protective effect.

But in 2013 we got such a study, a randomized controlled trial on the effects of coffee consumption in chronic hepatitis C (highlighted in my video, Preventing Liver Cancer with Coffee). Forty patients with chronic hepatitis C were randomized into two groups: the first consumed four cups of coffee/day for 30 days, while the second remained coffee "abstinent." Then the groups switched for the second month. Two months is too soon to detect changes in cancer rates, but the researchers were able to demonstrate that coffee consumption reduces oxidative DNA damage, increases the death of virus infected cells, stabilizes chromosomes, and reduces fibrosis, all of which could explain the role coffee appears to play in reducing the risk of disease progression and of evolution to cancer.

Is it time to write a prescription for coffee for those at risk for liver disease? Some say no: "[A]lthough the results are promising, additional work is needed to identify which specific component of coffee is the contributing factor in reducing liver disease and related mortality." There are, after all, more than 1000 compounds that could be responsible for its beneficial effects. But that's such a pharmacological worldview. Why do we have to know exactly what it is in the coffee bean before we can start using them to help people? Yes, more studies are needed, but in the interim; moderate, daily, unsweetened coffee ingestion is a reasonable adjunct to therapy for people at high risk such as those with fatty liver disease.

Daily consumption of caffeinated beverages can lead to physical dependence. Caffeine withdrawal symptoms can include days of headache, fatigue, difficulty with concentration, and mood disturbances. But this dependence could be a good thing: "The tendency for coffee to promote habitual consumption may ultimately be advantageous if its myriad potential health benefits are confirmed."

More on coffee in:

Broccoli can boost the liver's detoxifying enzymes (Prolonged Liver Function Enhancement from Broccoli) but one can overdo it (Liver Toxicity Due to Broccoli Juice?).

What other foods might reduce DNA damage? See:

-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.

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Blood Type Diet Perceived as "Crass Fraud"

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It was Adolf Hitler who coined a propaganda technique he called, "The Big Lie," arguing that people may be more likely to believe colossal untruths, because they would not believe that others could have the impudence to distort the truth so infamously, so in the big lie there is always a certain force of credibility.

Dr. Peter D'Adamo's book Eat Right for Your Type makes the astounding claim that people with different blood types should eat different foods. Type O's, for example, are supposed to be like the hunter and eat a lot of meat, whereas type A's are supposed to eat less. A 2013 systematic review of the evidence supporting blood type diets was published in one of the world's most prestigious nutrition journals. The researchers didn't find any.

The researchers sifted through over a thousand papers that might shed some light on the issue, and none of the studies showed an association between blood type diets and health-related outcomes. They conclude that "there is currently no evidence that an adherence to blood type diets will provide health benefits, despite the substantial presence and perseverance of blood type diets within the health industry."

Ten years earlier, the Journal of the Norwegian Medical Association released a number of papers that came out of a day-long scientific seminar held by the Norwegian Society for Nutrition. 40,000 copies of the Eat Right for Your Type had been sold in Norway, and so the researchers sought to determine whether blood type diets were visionary science or nonsense. They also concluded that they are nonsense.

The author of the blood type diet book responded to the review on his website, saying that "there is good science behind the blood type diet, just like there was good science behind Einstein's mathematical calculations." He says that if blood type diets were just tested in the right way, like Einstein's E=MC2, he would be vindicated. The reason we don't see any studies on blood types and nutrition, he complains, is "because of little interest and available money." But he's sold more than seven million books. Why doesn't he fund his own studies? That's what the Atkins Corporation did.

In fact, he has! In 1996, he wrote, "I am beginning the eighth year of a ten year trial on reproductive cancers, using the Blood Type Diets ... By the time I release the results in another 2 years, I expect to make it scientifically demonstrable that the Blood Type Diet plays a role in cancer remission." OK, so that would be 1998. The results? Still not released, sixteen years later.

Good tactic, though, saying you're just about to publish a study and banking that nobody would actually follow up. So in his sequel, he said he was currently conducting a "twelve-week randomized, double-blind, controlled trial implementing the Blood Type Diet, to determine its effects on the outcomes of patients with rheumatoid arthritis." (See my video Blood Type Diet Debunked). That was ten years ago.

As my Norwegian colleague bemoaned, "it is difficult not to perceive the whole thing as a crass fraud."

So rarely are popular press diet books afforded such fact-checking. Kudos to these researchers. If only we had this 13 years ago when the book was on the bestseller list!

I have a few videos on popular diets, such as:

I also wrote a book about low-carb diets, which is now available free online full-text at

Unfortunately, nutrition illiteracy is not just a problem among the public, but among the medical profession:

-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 Treat Multiple Sclerosis With Diet

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Multiple sclerosis is an unpredictable and frightening degenerative autoimmune inflammatory disease of the central nervous system in which our body attacks our own nerves. It often strikes in the prime of life and can cause symptoms in the brain, such as cognitive impairment; in the eye, such as painful loss of vision; as well as tremors, weakness, loss of bladder control, pain, and fatigue.

The most frequently prescribed drug for multiple sclerosis is interferon beta, which can make one feel lousy and cost $30,000 a year. But hey, it might be worthwhile--if it actually worked. We learned recently that it doesn't seem to prevent or delay long-term disability. That leaves chemo drugs like mitoxantrone that causes irreversible heart damage in one out of every eight people who go on the drug and causes cancer (leukemia) in nearly 1% of people who take it. But MS is no walk in the park either.

If only there was a cheap, simple, safe, side-effect free solution that also just so happened to be the most effective treatment for MS ever prescribed...

Dr. Roy Swank, who we lost recently at age 99, was a distinguished neurologist whose research culminated in over 170 scientific papers. In the video, Treating Multiple Sclerosis with the Swank MS Diet, I highlight a few.

As far back as 1950, we knew there were areas in the world that had a lot of MS--North America, Europe--and other places--Africa and Asia--that hardly had any. And migration studies show that those who move from a high risk area to a low risk area significantly drop their risk, and vice versa. So it seems less genetic and more lifestyle.

Dr. Swank had an idea. As he recounts in an interview with Dr. John McDougall at the ripe young age of 84, "it seemed possible to me that this could be a matter of food, because the further north you go the less vegetarian a life is led and the more people are carnivores, you might say--they spend a lot more time eating meat."

After looking at the multiple sclerosis data from World War II in occupied countries where meat and dairy were rationed, along with his famous study in '52 that found that the frequency of MS related directly to the amount of saturated animal fat consumed daily in different areas of Norway, he concluded that it might be the animal fat that was causing the increased risk. He decided to put it to the test by restricting people's intake of saturated animal fat, most commonly coming from dairy and chicken in the U.S. (See Trans Fat, Saturated Fat, and Cholesterol: Tolerable Upper Intake of Zero).

In Treating Multiple Sclerosis with the Swank MS Diet, you can see data on his first 47 patients before cutting out about 90% of the saturated fat from their diet and after, showing a decrease in both the frequency and severity of MS attacks. Normally, we're lucky if we can get people to stick to a diet for six months, and so that's why most dietary trials last a year at the most. The first study he published reported results from the first three and a half years.

Then came the five and a half year follow-up in which he added about another 100 patients. Then the seven year follow-up, published in the Annals of Internal Medicine. Then the 20 year follow-up, and then the 34 year follow-up.

How did his patients do? If we can get to people early in their disease, when they're only mildly disabled, and restrict their saturated fat intake, Dr. Swank showed he could stop their disease in 95% of cases--no further disability 34 years later. But if they started slacking on their diet--even years in, their disease could become reactivated. They felt so great that some felt that they could cheat a little bit, since they had their disease so well under control. But eating just eight grams of saturated fat more a day was accompanied by a striking increase in disability and a near tripling of their death rate.

How about a 50 year follow-up! They were able to track down 15 of the original patients that stuck to the diet, now in their 70s and 80s, with multiple sclerosis for over 50 years, and 13 out of 15 were walking around normal in all respects. Conclusion: "This study indicated that, in all probability, MS is caused largely by consumption of saturated animal fat."

Dr. Swank thought it was the sludging of the blood caused by even a single meal of saturated fats that can clog tiny capillaries that feed our nervous system. Diets rich in saturated fat and cholesterol can thicken the blood and make our red cells sticky. A single meal of sausage and eggs can stick our blood cells together like rolls of quarters. And that kind of hyperaggregation can lead to a reduction of blood flow and oxygenation of our tissues. What's in sausage and eggs that may cause so much inflammation? See my video series on endotoxins described in my blog How Does Meat Cause Inflammation?

If we put someone's blood through a machine that sucks out about 90% of the cholesterol in their blood, we can demonstrate an immediate improvement in microcirculation in the heart muscle. But what about the brain?

The eyes are the windows... to our brain. We can visualize--in real-time--changes in blood vessel function in the retina at the back of the eye, which gives us a sense of what's happening further back in the brain. And if we lower the cholesterol level in the blood, we can immediately get a significant improvement in vasodilation--the little veins open wider and let the blood flow.

So yes, it could be the animal fat leading to clogging of our capillaries, but now we know animal fats can have all sorts of other deleterious effects such as inflammation, so who knows what the actual mechanism may be by which cutting animal fat can cut MS progression. Regardless, patients with MS that follow a diet with no more than 10 or 15 grams of saturated fat can expect to survive and thrive to a ripe old age. Of course, cutting out saturated fat completely might be better, given that heart disease is our number one killer.

The bottom line is that the results Dr. Swank published remain "the most effective treatment of multiple sclerosis ever reported in the peer reviewed medical literature." In patients with early stage MS, 95% were without progression of their disease 34 years later after adopting his low saturated fat dietary program. Even patients with initially advanced disease showed significant benefit. To date, no medication or invasive procedure has ever even come close, to demonstrating such success.

Doesn't cost $30,000 dollars; doesn't give you leukemia--and works. Better!

This all begs one big obvious question: If Dr. Swanks results are "so stunningly impressive, why haven't other physicians, neurologists, and centers adopted this method of treatment?" One reason may be that MRI machines weren't invented until the 1970s, decades after Dr. Swank's study began. MRIs are how we track the progress of MS today. We don't have to rely on patients' subjective reports or doctor's clinical judgments, we can see the disease get better or worse right there in black and white.

It's like in the 1970s when Nathan Pritikin appeared to reverse heart disease by the thousands but no one took him seriously until angiography was invented and the likes of Ornish and Esselstyn (see Our Number One Killer Can Be Stopped) could hold up angiographic images, proving conclusively that a plant-based diet could help literally open up arteries.

So what we need is someone to repeat Swank's experiment today with MRI scans every step of the way. And I'm happy to report that exact experiment was just completed by Dr. John McDougall. Dr. Swank was one of Dr. McDougall's heroes, and Dr. McDougall is one of mine. Study enrollment was completed last year and we should have the full results soon.

I touched on this in my live 2013 year-in-review lecture More Than an Apple a Day, but I'm excited to be able to take a deeper dive into this extraordinary story.

Those interested in supporting Dr. McDougall's landmark study (headed by Dr. Dennis Bourdette, M.D. and under the supervision of Dr. Vijayshree Yadav) can donate to his nonprofit McDougall Research & Education Foundation (you can also donate to to help keep us bringing you similarly underreported yet life-saving science).

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live 2012 year-in-review presentation Uprooting the Leading Causes of Death.

Image Credit: Theen Moy / Flickr

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