What Causes Diabetes?

What Causes Diabetes?.jpeg

After about age 20, we may have all the insulin-producing beta cells we're ever going to get. So if we lose them, we may lose them for good. Autopsy studies show that by the time type 2 diabetes is diagnosed, we may have already killed off half of our beta cells.

You can kill pancreatic cells right in a petri dish. If you expose the insulin-producing beta cells in our pancreas to fat, they suck it up and then start dying off. Fat breakdown products can interfere with the function of these cells and ultimately lead to their death. A chronic increase in blood fat levels can be harmful to our pancreas.

It's not just any fat; it's saturated fat. As you can see in my video, What Causes Diabetes?, predominant fat in olives, nuts, and avocados gives a tiny bump in death protein 5, but saturated fat really elevates this contributor to beta cell death. Therefore, saturated fats are harmful to beta cells. Cholesterol is, too. The uptake of bad cholesterol (LDL) can cause beta cell death as a result of free radical formation.

Diets rich in saturated fats not only cause obesity and insulin resistance, but the increased levels of circulating free fats in the blood (non-esterified fatty acids, or NEFAs) may also cause beta cell death and may thus contribute to the progressive beta cell loss we see in type 2 diabetes. These findings aren't just based on test tube studies. If researchers have infused fat into people's blood streams, they can show it directly impairing pancreatic beta cell function. The same occurs when we ingest it.

Type 2 diabetes is characterized by "defects in both insulin secretion and insulin action," and saturated fat appears to impair both. Researchers showed saturated fat ingestion reduces insulin sensitivity within hours. The subjects were non-diabetics, so their pancreases should have been able to boost insulin secretion to match the drop in sensitivity. But no, "insulin secretion failed to compensate for insulin resistance in subjects who ingested [the saturated fat]." This implies saturated fat impaired beta cell function as well, again just within hours after going into our mouth. "[I]ncreased consumption of [saturated fats] has a powerful short- and long-term effect on insulin action," contributing to the dysfunction and death of pancreatic beta cells in diabetes.

Saturated fat isn't just toxic to the pancreas. The fats found predominantly in meat and dairy--chicken and cheese are the two main sources in the American diet--are considered nearly "universally toxic." In contrast, the fats found in olives, nuts, and avocados are not. Saturated fat has been found to be particularly toxic to liver cells, contributing to the formation of fatty liver disease. If you expose human liver cells to plant fat, though, nothing happens. If you expose our liver cells to animal fat, a third of them die. This may explain why higher intake of saturated fat and cholesterol are associated with non-alcoholic fatty liver disease.

By cutting down on saturated fat consumption, we may be able to help interrupt these processes. Decreasing saturated fat intake can help bring down the need for all that excess insulin. So either being fat or eating saturated fat can both cause excess insulin in the blood. The effect of reducing dietary saturated fat intake on insulin levels is substantial, regardless of how much belly fat we have. It's not just that by eating fat we may be more likely to store it as fat. Saturated fats, independently of any role they have in making us fat, "may contribute to the development of insulin resistance and its clinical consequences." After controlling for weight, alcohol, smoking, exercise, and family history, diabetes incidence was significantly associated with the proportion of saturated fat in our blood.

So what causes diabetes? The consumption of too many calories rich in saturated fats. Just like everyone who smokes doesn't develop lung cancer, everyone who eats a lot of saturated fat doesn't develop diabetes--there is a genetic component. But just like smoking can be said to cause lung cancer, high-calorie diets rich in saturated fats are currently considered the cause of type 2 diabetes.

I have a lot of videos on diabetes, including:

Preventing the disease:

And treating it:

In health,

Michael Greger, M.D.

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

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

Original Link

What Causes Diabetes?

What Causes Diabetes?.jpeg

After about age 20, we may have all the insulin-producing beta cells we're ever going to get. So if we lose them, we may lose them for good. Autopsy studies show that by the time type 2 diabetes is diagnosed, we may have already killed off half of our beta cells.

You can kill pancreatic cells right in a petri dish. If you expose the insulin-producing beta cells in our pancreas to fat, they suck it up and then start dying off. Fat breakdown products can interfere with the function of these cells and ultimately lead to their death. A chronic increase in blood fat levels can be harmful to our pancreas.

It's not just any fat; it's saturated fat. As you can see in my video, What Causes Diabetes?, predominant fat in olives, nuts, and avocados gives a tiny bump in death protein 5, but saturated fat really elevates this contributor to beta cell death. Therefore, saturated fats are harmful to beta cells. Cholesterol is, too. The uptake of bad cholesterol (LDL) can cause beta cell death as a result of free radical formation.

Diets rich in saturated fats not only cause obesity and insulin resistance, but the increased levels of circulating free fats in the blood (non-esterified fatty acids, or NEFAs) may also cause beta cell death and may thus contribute to the progressive beta cell loss we see in type 2 diabetes. These findings aren't just based on test tube studies. If researchers have infused fat into people's blood streams, they can show it directly impairing pancreatic beta cell function. The same occurs when we ingest it.

Type 2 diabetes is characterized by "defects in both insulin secretion and insulin action," and saturated fat appears to impair both. Researchers showed saturated fat ingestion reduces insulin sensitivity within hours. The subjects were non-diabetics, so their pancreases should have been able to boost insulin secretion to match the drop in sensitivity. But no, "insulin secretion failed to compensate for insulin resistance in subjects who ingested [the saturated fat]." This implies saturated fat impaired beta cell function as well, again just within hours after going into our mouth. "[I]ncreased consumption of [saturated fats] has a powerful short- and long-term effect on insulin action," contributing to the dysfunction and death of pancreatic beta cells in diabetes.

Saturated fat isn't just toxic to the pancreas. The fats found predominantly in meat and dairy--chicken and cheese are the two main sources in the American diet--are considered nearly "universally toxic." In contrast, the fats found in olives, nuts, and avocados are not. Saturated fat has been found to be particularly toxic to liver cells, contributing to the formation of fatty liver disease. If you expose human liver cells to plant fat, though, nothing happens. If you expose our liver cells to animal fat, a third of them die. This may explain why higher intake of saturated fat and cholesterol are associated with non-alcoholic fatty liver disease.

By cutting down on saturated fat consumption, we may be able to help interrupt these processes. Decreasing saturated fat intake can help bring down the need for all that excess insulin. So either being fat or eating saturated fat can both cause excess insulin in the blood. The effect of reducing dietary saturated fat intake on insulin levels is substantial, regardless of how much belly fat we have. It's not just that by eating fat we may be more likely to store it as fat. Saturated fats, independently of any role they have in making us fat, "may contribute to the development of insulin resistance and its clinical consequences." After controlling for weight, alcohol, smoking, exercise, and family history, diabetes incidence was significantly associated with the proportion of saturated fat in our blood.

So what causes diabetes? The consumption of too many calories rich in saturated fats. Just like everyone who smokes doesn't develop lung cancer, everyone who eats a lot of saturated fat doesn't develop diabetes--there is a genetic component. But just like smoking can be said to cause lung cancer, high-calorie diets rich in saturated fats are currently considered the cause of type 2 diabetes.

I have a lot of videos on diabetes, including:

Preventing the disease:

And treating it:

In health,

Michael Greger, M.D.

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

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

Original Link

Plant versus Animal Iron

Plant versus Animal Iron.jpeg

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

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

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

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

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

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

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

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

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

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

In health,

Michael Greger, M.D.

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

Image Credit: Sally Plank

Original Link

Plant versus Animal Iron

Plant versus Animal Iron.jpeg

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

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

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

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

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

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

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

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

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

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

In health,

Michael Greger, M.D.

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

Image Credit: Sally Plank

Original Link

Best Foods for Acid Reflux

Best Foods for Acid Reflux.jpeg

Gastroesophageal reflux disease (GERD) is one of the most common disorders of the digestive tract. The two most typical symptoms are heartburn and regurgitation of stomach contents into the back of the throat, but GERD is not just burning pain and a sour taste in your mouth. It causes millions of doctor visits and hospitalizations every year in the United States. The most feared complication is cancer.

You start out with a normal esophagus. If the acid keeps creeping up, your esophagus can get inflamed and result in esophagitis. Esophagitis can transform into Barrett's esophagus, a precancerous condition which can then turn into adenocarcinoma (a type of cancer). To prevent all that, we need to prevent the acid reflux in the first place.

In the last three decades, the incidence of this cancer in the US has increased six-fold, an increase greater than that of melanoma, breast, or prostate cancer. This is because acid reflux is on the rise. In the United States, we're up to about 1 in 4 people suffering at least weekly heartburn and/or acid regurgitation, compared to around 5% in Asia. This suggests that dietary factors may play a role.

In general, high fat intake is associated with increased risk, whereas high fiber foods appear to be protective. The reason fat intake may be associated with GERD symptoms and erosive esophagitis is because when we eat fatty foods, the sphincter at the top of the stomach that's supposed to keep the food down becomes relaxed, so more acid can creep up into the esophagus. In my video Diet & GERD Acid Reflux Heartburn, you can see a study in which researchers fed volunteers a high-fat meal--a McDonald's sausage and egg McMuffin--compared to a low-fat meal (McDonald's hot cakes), and there was significantly more acid squirted up in the esophagus after the high-fat meal.

In terms of later stages of disease progression, over the last twenty years 45 studies have been published in the association between diet and Barrett's esophagus and esophageal cancer. In general, they found that meat and high-fat meals appeared to increase cancer risk. Different meats were associated with cancers in different locations, thoughj. Red meat was more associated with cancer in the esophagus, whereas poultry was more associated with cancer at the top of the stomach. Plant-based sources of protein, such as beans and nuts, were associated with a significantly decreased risk of cancer.

Those eating the most antioxidant-rich foods have half the odds of esophageal cancer, while there is practically no reduction in risk among those who used antioxidant vitamin supplements, such as vitamin C or E pills. The most protective produce may be red-orange vegetables, dark green leafies, berries, apples, and citrus. The benefit may come from more than just eating plants. Eating healthy foods crowds out less healthy foods, so it may be a combination of both.

Based on a study of 3,000 people, the consumption of non-vegetarian foods (including eggs) was an independent predictor of GERD. Egg yolks cause an increase in the hormone cholecystokinin, which may overly relax the sphincter that separates the esophagus from the stomach. The same hormone is increased by meat, which may help explain why plant-based diets appear to be a protective factor for reflux esophagitis.

Researchers found that those eating meat had twice the odds of reflux-induced esophageal inflammation. Therefore, plant-based diets may offer protection, though it's uncertain whether it's attributable to the absence of meat in the diet or the increased consumption of healthy foods. Those eating vegetarian consume greater amounts of fruits and vegetables containing innumerable phytochemicals, dietary fiber, and antioxidants. They also restrict their consumption of animal sources of food, which tend to be fattier and can thus relax that sphincter and aggravate reflux.

GERD is common; its burdens are enormous. It relapses frequently and can cause bleeding, strictures, and a deadly cancer. The mainstay of treatment is proton pump inhibitor drugs, which rake in billions of dollars. We spend four billion dollars on Nexium alone, three billion on Prevacid, two billion on Protonix, one billion on Aciphex. These drugs can cause nutrient deficiencies and increase the risk for pneumonia, food poisoning, and bone fractures. Thus, it is important to find correctable risk factors and correct them. Known correctable risk factors have been things like obesity, smoking and alcohol consumption. Until recently, though, there hadn't been studies on specifically what to eat and what to avoid, but now we have other correctable factors to help prevent this disease.

For more on GERD, see: Diet & Hiatal Hernia, Coffee & Mortality, and Club Soda for Stomach Pain & Constipation.

I also have a video about esophageal cancer, detailing the extraordinary reversal of the kinds of precancerous changes that lead to the devastating condition--with nothing but strawberries: Strawberries versus Esophageal Cancer.

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: PDPics / Pixabay. Image has been modified.

Original Link

Best Foods for Acid Reflux

Best Foods for Acid Reflux.jpeg

Gastroesophageal reflux disease (GERD) is one of the most common disorders of the digestive tract. The two most typical symptoms are heartburn and regurgitation of stomach contents into the back of the throat, but GERD is not just burning pain and a sour taste in your mouth. It causes millions of doctor visits and hospitalizations every year in the United States. The most feared complication is cancer.

You start out with a normal esophagus. If the acid keeps creeping up, your esophagus can get inflamed and result in esophagitis. Esophagitis can transform into Barrett's esophagus, a precancerous condition which can then turn into adenocarcinoma (a type of cancer). To prevent all that, we need to prevent the acid reflux in the first place.

In the last three decades, the incidence of this cancer in the US has increased six-fold, an increase greater than that of melanoma, breast, or prostate cancer. This is because acid reflux is on the rise. In the United States, we're up to about 1 in 4 people suffering at least weekly heartburn and/or acid regurgitation, compared to around 5% in Asia. This suggests that dietary factors may play a role.

In general, high fat intake is associated with increased risk, whereas high fiber foods appear to be protective. The reason fat intake may be associated with GERD symptoms and erosive esophagitis is because when we eat fatty foods, the sphincter at the top of the stomach that's supposed to keep the food down becomes relaxed, so more acid can creep up into the esophagus. In my video Diet & GERD Acid Reflux Heartburn, you can see a study in which researchers fed volunteers a high-fat meal--a McDonald's sausage and egg McMuffin--compared to a low-fat meal (McDonald's hot cakes), and there was significantly more acid squirted up in the esophagus after the high-fat meal.

In terms of later stages of disease progression, over the last twenty years 45 studies have been published in the association between diet and Barrett's esophagus and esophageal cancer. In general, they found that meat and high-fat meals appeared to increase cancer risk. Different meats were associated with cancers in different locations, thoughj. Red meat was more associated with cancer in the esophagus, whereas poultry was more associated with cancer at the top of the stomach. Plant-based sources of protein, such as beans and nuts, were associated with a significantly decreased risk of cancer.

Those eating the most antioxidant-rich foods have half the odds of esophageal cancer, while there is practically no reduction in risk among those who used antioxidant vitamin supplements, such as vitamin C or E pills. The most protective produce may be red-orange vegetables, dark green leafies, berries, apples, and citrus. The benefit may come from more than just eating plants. Eating healthy foods crowds out less healthy foods, so it may be a combination of both.

Based on a study of 3,000 people, the consumption of non-vegetarian foods (including eggs) was an independent predictor of GERD. Egg yolks cause an increase in the hormone cholecystokinin, which may overly relax the sphincter that separates the esophagus from the stomach. The same hormone is increased by meat, which may help explain why plant-based diets appear to be a protective factor for reflux esophagitis.

Researchers found that those eating meat had twice the odds of reflux-induced esophageal inflammation. Therefore, plant-based diets may offer protection, though it's uncertain whether it's attributable to the absence of meat in the diet or the increased consumption of healthy foods. Those eating vegetarian consume greater amounts of fruits and vegetables containing innumerable phytochemicals, dietary fiber, and antioxidants. They also restrict their consumption of animal sources of food, which tend to be fattier and can thus relax that sphincter and aggravate reflux.

GERD is common; its burdens are enormous. It relapses frequently and can cause bleeding, strictures, and a deadly cancer. The mainstay of treatment is proton pump inhibitor drugs, which rake in billions of dollars. We spend four billion dollars on Nexium alone, three billion on Prevacid, two billion on Protonix, one billion on Aciphex. These drugs can cause nutrient deficiencies and increase the risk for pneumonia, food poisoning, and bone fractures. Thus, it is important to find correctable risk factors and correct them. Known correctable risk factors have been things like obesity, smoking and alcohol consumption. Until recently, though, there hadn't been studies on specifically what to eat and what to avoid, but now we have other correctable factors to help prevent this disease.

For more on GERD, see: Diet & Hiatal Hernia, Coffee & Mortality, and Club Soda for Stomach Pain & Constipation.

I also have a video about esophageal cancer, detailing the extraordinary reversal of the kinds of precancerous changes that lead to the devastating condition--with nothing but strawberries: Strawberries versus Esophageal Cancer.

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: PDPics / Pixabay. Image has been modified.

Original Link

High Blood Pressure: Normal but Not Natural

High Blood Pressure - Normal but Not Natural.jpeg

The most comprehensive and systematic analysis of causes of death ever undertaken allows us to answer questions like, how many lives could we save if people cut back on soda? The answer is 299,521. Soft drinks aren't just bad because they're empty calories. More than just not being a health-promoting item, soda appears to be an actively death-promoting item. Of course, it's not as deadly as processed meats such as bacon, bologna, ham, or hot dogs, which account for about 800,000 deaths every year--killing twice as many women as domestic violence and five times more people than all illegal drugs combined.

On the other hand, eating more whole grains could save 1.7 million lives. And more vegetables could save 1.8 million lives every year. If only we ate more nuts and seeds, we'd save 2 and a half million lives. But fruit is apparently what the world needs most (they didn't look at beans) with 4.9 million lives hanging in the balance every year. The cure is not drugs or vaccines; the cure is fruit. The #1 dietary risk factor for death in the world may be not eating enough fruit.

One reason why plant-based diets can save so many millions is because the #1 killer risk factor in the world is high blood pressure, laying to waste nine million people year after year. In the United States, high blood pressure affects nearly 78 million--that's one in three of us. As we age our pressures get higher and higher, such that by age 60, it strikes more than half of that population. If it affects most of us when we get older, maybe it's less a disease and more just a natural, inevitable consequence of getting older?

No.

We've known for nearly a century that high blood pressure need never occur. Researchers measured the blood pressure of a thousand people in rural Kenya. Up until age 40, the blood pressures of rural Africans were about the same as Europeans and Americans, down around 120's over 80's, but as Westerners age, our pressures creep up such that by age 60 the average person is hypertensive, exceeding 140 over 90. But the pressures of those in rural Africa improved with age; not only did they not develop hypertension, their blood pressures actually got better.

The 140/90 cut-off is arbitrary. Just like studies that show the lower our cholesterol the better--there's really no safe level above about 150--blood pressure studies also support a "lower the better" approach. Even people who start out with blood pressure under 120/80 appear to benefit from blood pressure reduction. The ideal blood pressure, the no-benefit-from-reducing-it-further blood pressure, appears to be 110/70. Is it possible to get blood pressures under 110 over 70? It's not just possible, it can be normal for those eating healthy enough diets (see How Not to Die from High Blood Pressure).

Over two years at a rural Kenyan hospital, 1,800 patients were admitted. How many cases of high blood pressure were found? Zero. Wow. They must have had low rates of heart disease. Actually, they had no rates of heart disease. Not low risk--no risk. Not a single case of arteriosclerosis was found.

Having a "normal" blood pressure may set you up for dying from "normal" causes such as heart attacks and strokes. For more on this concept, see When Low Risk Means High Risk. It's like having a normal cholesterol level (see Optimal Cholesterol Level).

It seems high blood pressure is a choice. Like cavities: Cavities and Coronaries: Our Choice.

Even end-stage malignant hypertension can be reversed with diet (thereby demonstrating it was the diet and not other lifestyle factors that protected traditional plant-based populations). See Kempner Rice Diet: Whipping Us Into Shape.

Flax seeds, hibiscus tea, whole grains, and nitrate-rich vegetables may offer additional protection:

Why not just take the drugs? See The Actual Benefit of Diet vs. Drugs and Why Prevention is Worth a Ton of Cure. And be sure to check out my summary video, How Not to Die from High Blood Pressure, as well as The Evidence that Salt Raises Blood Pressure.

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

High Blood Pressure: Normal but Not Natural

High Blood Pressure - Normal but Not Natural.jpeg

The most comprehensive and systematic analysis of causes of death ever undertaken allows us to answer questions like, how many lives could we save if people cut back on soda? The answer is 299,521. Soft drinks aren't just bad because they're empty calories. More than just not being a health-promoting item, soda appears to be an actively death-promoting item. Of course, it's not as deadly as processed meats such as bacon, bologna, ham, or hot dogs, which account for about 800,000 deaths every year--killing twice as many women as domestic violence and five times more people than all illegal drugs combined.

On the other hand, eating more whole grains could save 1.7 million lives. And more vegetables could save 1.8 million lives every year. If only we ate more nuts and seeds, we'd save 2 and a half million lives. But fruit is apparently what the world needs most (they didn't look at beans) with 4.9 million lives hanging in the balance every year. The cure is not drugs or vaccines; the cure is fruit. The #1 dietary risk factor for death in the world may be not eating enough fruit.

One reason why plant-based diets can save so many millions is because the #1 killer risk factor in the world is high blood pressure, laying to waste nine million people year after year. In the United States, high blood pressure affects nearly 78 million--that's one in three of us. As we age our pressures get higher and higher, such that by age 60, it strikes more than half of that population. If it affects most of us when we get older, maybe it's less a disease and more just a natural, inevitable consequence of getting older?

No.

We've known for nearly a century that high blood pressure need never occur. Researchers measured the blood pressure of a thousand people in rural Kenya. Up until age 40, the blood pressures of rural Africans were about the same as Europeans and Americans, down around 120's over 80's, but as Westerners age, our pressures creep up such that by age 60 the average person is hypertensive, exceeding 140 over 90. But the pressures of those in rural Africa improved with age; not only did they not develop hypertension, their blood pressures actually got better.

The 140/90 cut-off is arbitrary. Just like studies that show the lower our cholesterol the better--there's really no safe level above about 150--blood pressure studies also support a "lower the better" approach. Even people who start out with blood pressure under 120/80 appear to benefit from blood pressure reduction. The ideal blood pressure, the no-benefit-from-reducing-it-further blood pressure, appears to be 110/70. Is it possible to get blood pressures under 110 over 70? It's not just possible, it can be normal for those eating healthy enough diets (see How Not to Die from High Blood Pressure).

Over two years at a rural Kenyan hospital, 1,800 patients were admitted. How many cases of high blood pressure were found? Zero. Wow. They must have had low rates of heart disease. Actually, they had no rates of heart disease. Not low risk--no risk. Not a single case of arteriosclerosis was found.

Having a "normal" blood pressure may set you up for dying from "normal" causes such as heart attacks and strokes. For more on this concept, see When Low Risk Means High Risk. It's like having a normal cholesterol level (see Optimal Cholesterol Level).

It seems high blood pressure is a choice. Like cavities: Cavities and Coronaries: Our Choice.

Even end-stage malignant hypertension can be reversed with diet (thereby demonstrating it was the diet and not other lifestyle factors that protected traditional plant-based populations). See Kempner Rice Diet: Whipping Us Into Shape.

Flax seeds, hibiscus tea, whole grains, and nitrate-rich vegetables may offer additional protection:

Why not just take the drugs? See The Actual Benefit of Diet vs. Drugs and Why Prevention is Worth a Ton of Cure. And be sure to check out my summary video, How Not to Die from High Blood Pressure, as well as The Evidence that Salt Raises Blood Pressure.

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

The Five Most Important Dietary Tweaks

The Five Most Important Dietary Tweaks.jpeg

Generally, adherence to healthy lifestyle patterns has decreased during the last 18 years. Obesity is up, exercise is down, and the number of people eating just five servings of fruits and veggies a day dropped like a rock. And we didn't start out that great to begin with.

Only 3% of Americans at the turn of the 21st century had the following four healthy lifestyle characteristics: not smoking, not overweight, five daily servings of fruits and vegetables, and exercising a half hour a day at least five days a week. Whether people were wealthy or college-educated didn't matter; no sub-group even remotely met clinical or public health recommendations.

Where are people falling down the most? You can see in my video What Percent of Americans Lead Healthy Lifestyles?. If you look at heart disease risk factors, for example, most people don't smoke and about half are exercising. But if we look at the healthy diet score-which is based on things like drinking less than four cups of soda a week-a scale of zero to five, only about 1% of Americans score a four or five. The American Heart Association's aggressive 2020 target to improve that by 20% would bring us up to 1.2%.

Since we've known for decades that advanced coronary artery disease may be present by age 20--with atherosclerosis often even present in young children--it is particularly disturbing that healthy lifestyle choices are declining rather than improving in the U.S.

In terms of life expectancy, the U.S. is down around 27 or 28 out of the 34 OECD free-market democracies. The people of Slovenia live a year longer than citizens of the United States. Why? According to the most rigorous analysis of risk factors ever published, the number one cause of death and disability in the United States is our diet.

It's the food.

According to the Global Burden of Disease study, the worst five things about our diet are: we don't eat enough fruit, we don't eat enough nuts and seeds, we eat too much salt, too much processed meat, and not enough vegetables.

Studies that have looked at diet quality and chronic disease mortality risk found that those scoring higher (e.g. more whole plant foods), reduced the risk of dying prematurely from heart disease, cancer, and all causes of death combined. There is now an overwhelming body of clinical and epidemiological evidence illustrating the dramatic impact of a healthy lifestyle on reducing all-cause mortality and preventing chronic diseases such as coronary heart disease, stroke, diabetes, and cancer.

Why do we eat so poorly? Aren't we scared of dying from these horrible chronic diseases? It's almost as if we're eating as though our future didn't matter. And there's actually data to back that up, from a study entitled Death Row Nutrition.

The growing macabre fascination with speculating about one's ''last meal'' offers a window into one's true consumption desires when one's value of the future is discounted close to zero. In contrast to pop culture anecdotes, a group of Cornell researchers created a catalog of actual last meals-the final food requests of 247 individuals executed in the United States during a recent five-year period. Meat was the most common request. The researchers go out of their way to note that tofu never made the list, and no one asked for a vegetarian meal. In fact, if you compare the last meals to what Americans normally eat, there's not much difference.

If we continue to eat as though they were our last meals, eventually, they will be.


A few years ago I did a video called Nation's Diet in Crisis. It's sad that it doesn't seem like much has changed. How Many Meet the Simple Seven? is another video in which you can see how your own habits stack up.

For more on fruits and veggies and living longer, see Fruits and Longevity: How Many Minutes per Mouthful? Surprised that nuts made the longevity list? See Nuts May Help Prevent Death. What about legumes? See Increased Lifespan from Beans.

The reason public health professionals are so keen on measuring lifestyle characteristics is because modest improvements may have extraordinary effects. See, for example:

Didn't know the beginnings of heart disease may already be present in children? See my video Heart Disease Starts in Childhood. Think that's tragic? Check out Heart Disease May Start in the Womb. Is it too late if we've been eating poorly most of our lives? It's Never Too Late to Start Eating Healthier.

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

The Five Most Important Dietary Tweaks

The Five Most Important Dietary Tweaks.jpeg

Generally, adherence to healthy lifestyle patterns has decreased during the last 18 years. Obesity is up, exercise is down, and the number of people eating just five servings of fruits and veggies a day dropped like a rock. And we didn't start out that great to begin with.

Only 3% of Americans at the turn of the 21st century had the following four healthy lifestyle characteristics: not smoking, not overweight, five daily servings of fruits and vegetables, and exercising a half hour a day at least five days a week. Whether people were wealthy or college-educated didn't matter; no sub-group even remotely met clinical or public health recommendations.

Where are people falling down the most? You can see in my video What Percent of Americans Lead Healthy Lifestyles?. If you look at heart disease risk factors, for example, most people don't smoke and about half are exercising. But if we look at the healthy diet score-which is based on things like drinking less than four cups of soda a week-a scale of zero to five, only about 1% of Americans score a four or five. The American Heart Association's aggressive 2020 target to improve that by 20% would bring us up to 1.2%.

Since we've known for decades that advanced coronary artery disease may be present by age 20--with atherosclerosis often even present in young children--it is particularly disturbing that healthy lifestyle choices are declining rather than improving in the U.S.

In terms of life expectancy, the U.S. is down around 27 or 28 out of the 34 OECD free-market democracies. The people of Slovenia live a year longer than citizens of the United States. Why? According to the most rigorous analysis of risk factors ever published, the number one cause of death and disability in the United States is our diet.

It's the food.

According to the Global Burden of Disease study, the worst five things about our diet are: we don't eat enough fruit, we don't eat enough nuts and seeds, we eat too much salt, too much processed meat, and not enough vegetables.

Studies that have looked at diet quality and chronic disease mortality risk found that those scoring higher (e.g. more whole plant foods), reduced the risk of dying prematurely from heart disease, cancer, and all causes of death combined. There is now an overwhelming body of clinical and epidemiological evidence illustrating the dramatic impact of a healthy lifestyle on reducing all-cause mortality and preventing chronic diseases such as coronary heart disease, stroke, diabetes, and cancer.

Why do we eat so poorly? Aren't we scared of dying from these horrible chronic diseases? It's almost as if we're eating as though our future didn't matter. And there's actually data to back that up, from a study entitled Death Row Nutrition.

The growing macabre fascination with speculating about one's ''last meal'' offers a window into one's true consumption desires when one's value of the future is discounted close to zero. In contrast to pop culture anecdotes, a group of Cornell researchers created a catalog of actual last meals-the final food requests of 247 individuals executed in the United States during a recent five-year period. Meat was the most common request. The researchers go out of their way to note that tofu never made the list, and no one asked for a vegetarian meal. In fact, if you compare the last meals to what Americans normally eat, there's not much difference.

If we continue to eat as though they were our last meals, eventually, they will be.


A few years ago I did a video called Nation's Diet in Crisis. It's sad that it doesn't seem like much has changed. How Many Meet the Simple Seven? is another video in which you can see how your own habits stack up.

For more on fruits and veggies and living longer, see Fruits and Longevity: How Many Minutes per Mouthful? Surprised that nuts made the longevity list? See Nuts May Help Prevent Death. What about legumes? See Increased Lifespan from Beans.

The reason public health professionals are so keen on measuring lifestyle characteristics is because modest improvements may have extraordinary effects. See, for example:

Didn't know the beginnings of heart disease may already be present in children? See my video Heart Disease Starts in Childhood. Think that's tragic? Check out Heart Disease May Start in the Womb. Is it too late if we've been eating poorly most of our lives? It's Never Too Late to Start Eating Healthier.

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