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

Foods that Affect Testosterone Levels

Foods that Affect Testosterone Levels.jpeg

A number of studies suggest that exposure to industrial pollutants may affect sexual function, for example, loss of libido, sexual dysfunction, and impotence. This may be due to effects on testosterone levels. In a study of men who ate a lot of contaminated fish, an elevation in PCB levels in the blood was associated with a lower concentration of testosterone levels. These pollutants are found predominantly in fish, but also meat and dairy. The lowest levels are found in plants (see Dietary Pollutants May Affect Testosterone Levels).

Testosterone doesn't just play a role in the determination of secondary sex characteristics like facial hair at puberty. It also regulates normal sexual functioning and the overall physical and psychological well-being of adult men. Abnormally low levels of testosterone can lead to decreased physical endurance and memory capacity, loss of libido, drop in sperm count, loss of bone density, obesity, and depression.

Endocrine-disrupting compounds that build up in fish may be able to mimic or block hormone receptors, or alter rates of synthesis or breakdown of sex steroid hormones. In children, these pollutants may actually impair sexual development. Boys who are exposed may grow up with smaller penises (although only by about two-thirds of an inch shorter at most). Researchers have tried exposing cells from aborted fetal human penises to these kinds of dietary pollutants, and gene expression related to genital development is indeed affected at real-life exposure levels. We're not sure if the effects on penis length are due to the pro-estrogenic effects of the toxins, though, or the anti-testosterone effects.

You've heard of save the whales? Well, male reproductive organs may be at risk from environmental hazards as well.

I previously addressed how we discovered the endocrine disruptor phenomenon in Alkylphenol Endocrine Disruptors and Allergies, as well as where they're found (Dietary Sources of Alkylphenol Endocrine Disruptors).

For more on sustaining male virility, see Male Fertility and Diet, The Role of Diet in Declining Sperm Counts, and Dairy Estrogen and Male Fertility.

I've talked about the role a plastics chemical may play in male sexual functioning (BPA Plastic and Male Sexual Dysfunction). But it's not just toxins, it's the total diet (Survival of the Firmest: Erectile Dysfunction and Death), and not only in men (Cholesterol and Female Sexual Dysfunction). My latest on the topic is Best Foods to Improve Sexual Function.

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. Image has been modified.

Original Link

Foods that Affect Testosterone Levels

Foods that Affect Testosterone Levels.jpeg

A number of studies suggest that exposure to industrial pollutants may affect sexual function, for example, loss of libido, sexual dysfunction, and impotence. This may be due to effects on testosterone levels. In a study of men who ate a lot of contaminated fish, an elevation in PCB levels in the blood was associated with a lower concentration of testosterone levels. These pollutants are found predominantly in fish, but also meat and dairy. The lowest levels are found in plants (see Dietary Pollutants May Affect Testosterone Levels).

Testosterone doesn't just play a role in the determination of secondary sex characteristics like facial hair at puberty. It also regulates normal sexual functioning and the overall physical and psychological well-being of adult men. Abnormally low levels of testosterone can lead to decreased physical endurance and memory capacity, loss of libido, drop in sperm count, loss of bone density, obesity, and depression.

Endocrine-disrupting compounds that build up in fish may be able to mimic or block hormone receptors, or alter rates of synthesis or breakdown of sex steroid hormones. In children, these pollutants may actually impair sexual development. Boys who are exposed may grow up with smaller penises (although only by about two-thirds of an inch shorter at most). Researchers have tried exposing cells from aborted fetal human penises to these kinds of dietary pollutants, and gene expression related to genital development is indeed affected at real-life exposure levels. We're not sure if the effects on penis length are due to the pro-estrogenic effects of the toxins, though, or the anti-testosterone effects.

You've heard of save the whales? Well, male reproductive organs may be at risk from environmental hazards as well.

I previously addressed how we discovered the endocrine disruptor phenomenon in Alkylphenol Endocrine Disruptors and Allergies, as well as where they're found (Dietary Sources of Alkylphenol Endocrine Disruptors).

For more on sustaining male virility, see Male Fertility and Diet, The Role of Diet in Declining Sperm Counts, and Dairy Estrogen and Male Fertility.

I've talked about the role a plastics chemical may play in male sexual functioning (BPA Plastic and Male Sexual Dysfunction). But it's not just toxins, it's the total diet (Survival of the Firmest: Erectile Dysfunction and Death), and not only in men (Cholesterol and Female Sexual Dysfunction). My latest on the topic is Best Foods to Improve Sexual Function.

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. Image has been modified.

Original Link

How Milk May Contribute to Childhood Obesity

How Milk May Contribute to Childhood Obesity.jpeg

We've known that breastfed infants may be protected against obesity later in life for more than 30 years, but why? It may be the formula. Giving infants formula based on cow's milk presents an unusual situation. Cow's milk is designed to put nearly two pounds a day onto a growing calf, 40 times the growth rate of human infants (see Formula for Childhood Obesity).

The perfect food for humans, finely tuned over millions of years, is human breast milk. Remarkably, among all mammalian species, the protein content of human milk is the lowest. The excessive protein content of cow's milk-based formula is thought to be what may be what sets the child up for obesity later in life.

And then, instead of being weaned, we continue to drink milk. The question thus arises as to whether consumption of a growth-promoting substance from another species throughout childhood fundamentally alters processes of human growth and maturation. A study out of Indiana University, for example, found evidence that greater milk intake is associated with an increased risk of premature puberty; girls drinking a lot of milk started to get their periods earlier. Thus, cross-species milk consumption and ingestion into childhood may trigger unintended consequences.

Only human milk allows appropriate metabolic programming and protects against diseases of civilization in later life, whereas consumption of cow's milk and dairy products during adolescence and adulthood is an evolutionarily novel behavior that may have long-term adverse effects on human health.

Teens exposed to dairy proteins such as casein, skim milk, or whey, experienced a significant increase in BMI and waist circumference compared to a control group. In contrast, not a single study funded by the dairy industry found a result unfavorable to milk.

The head of the Obesity Prevention Center at Boston Children's Hospital and the chair of Harvard's nutrition department wrote an editorial recently to the AMA's Pediatrics journal questioning the role of cow's milk in human nutrition. They stated the obvious: humans have no requirement for other animal's milk; in fact, dairy may play a role in certain cancers due to the high levels of reproductive hormones in the U.S. milk supply.


So what's The Best Baby Formula? Click on the link and find out!

More on dairy and infancy:

And in childhood: Childhood Constipation and Cow's Milk and Treating Infant Colic by Changing Mom's Diet

In adolescence: Saving Lives By Treating Acne With Diet

Before conception: Dairy Estrogen and Male Fertility

During pregnancy: Why Do Vegan Women Have 5x Fewer Twins?

And in adulthood:

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: Sergey Novikov © 123RF.com. This image has been modified.

Original Link

How Milk May Contribute to Childhood Obesity

How Milk May Contribute to Childhood Obesity.jpeg

We've known that breastfed infants may be protected against obesity later in life for more than 30 years, but why? It may be the formula. Giving infants formula based on cow's milk presents an unusual situation. Cow's milk is designed to put nearly two pounds a day onto a growing calf, 40 times the growth rate of human infants (see Formula for Childhood Obesity).

The perfect food for humans, finely tuned over millions of years, is human breast milk. Remarkably, among all mammalian species, the protein content of human milk is the lowest. The excessive protein content of cow's milk-based formula is thought to be what may be what sets the child up for obesity later in life.

And then, instead of being weaned, we continue to drink milk. The question thus arises as to whether consumption of a growth-promoting substance from another species throughout childhood fundamentally alters processes of human growth and maturation. A study out of Indiana University, for example, found evidence that greater milk intake is associated with an increased risk of premature puberty; girls drinking a lot of milk started to get their periods earlier. Thus, cross-species milk consumption and ingestion into childhood may trigger unintended consequences.

Only human milk allows appropriate metabolic programming and protects against diseases of civilization in later life, whereas consumption of cow's milk and dairy products during adolescence and adulthood is an evolutionarily novel behavior that may have long-term adverse effects on human health.

Teens exposed to dairy proteins such as casein, skim milk, or whey, experienced a significant increase in BMI and waist circumference compared to a control group. In contrast, not a single study funded by the dairy industry found a result unfavorable to milk.

The head of the Obesity Prevention Center at Boston Children's Hospital and the chair of Harvard's nutrition department wrote an editorial recently to the AMA's Pediatrics journal questioning the role of cow's milk in human nutrition. They stated the obvious: humans have no requirement for other animal's milk; in fact, dairy may play a role in certain cancers due to the high levels of reproductive hormones in the U.S. milk supply.


So what's The Best Baby Formula? Click on the link and find out!

More on dairy and infancy:

And in childhood: Childhood Constipation and Cow's Milk and Treating Infant Colic by Changing Mom's Diet

In adolescence: Saving Lives By Treating Acne With Diet

Before conception: Dairy Estrogen and Male Fertility

During pregnancy: Why Do Vegan Women Have 5x Fewer Twins?

And in adulthood:

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: Sergey Novikov © 123RF.com. This image has been modified.

Original Link

How Much Fiber Should You Eat Every Day?

How Much Fiber Should You Eat Every Day.jpeg

High dietary fiber intake may help prevent strokes. The belief that dietary fiber intake is protectively associated with certain diseases was postulated 40 years ago and then enormously fueled and kept alive by a great body of science since. Today it is generally believed that eating lots of fiber-rich foods helps prevent obesity, diabetes, and cardiovascular diseases such as stroke.

Strokes are the second most common cause of death worldwide. Moreover, stroke is a leading cause of disability, and so preventing strokes in the first place--what's called primary prevention--should therefore, be a key public health priority (see How to Prevent a Stroke).

The best observational studies to date found that fiber appears to significantly protect against the risk of stroke. Different strokes for different folks, depending, evidently, on how much fiber they ate. Notably, increasing fiber just seven grams a day was associated with a 7% reduction in stroke risk. And seven grams is easy, that's like a serving of whole grain pasta with tomato sauce and an apple.

What's the mechanism? Maybe it's that fiber helps lower cholesterol and blood sugar levels. Or it could just be that those eating more fiber are just eating more vegetables, or fewer calories, or less meat and fat, or improving digestion, all of which may slim us down and lower our blood pressure and the amount of inflammation in our bodies. Does it really matter, though? As Dr. Burkitt commented on the biblical passage, "A man scatters seed on the land--the seed sprouts and opens--how, he does not know," the farmer doesn't wait to find out. Had the farmer postponed his sowing until he understood seed germination, he would not have lasted very long. So yes, let's keep trying to figure out why fiber is protective, but in the meanwhile, we should be increasing our intake of fiber, which is to say increasing our intake of whole plant foods.

It's never too early to start eating healthier. Strokes are one of many complications of arterial stiffness. Though our first stroke might not happen until our 50's, our arteries may have been stiffening for decades leading up to it. Hundreds of kids were followed for 24 years, from age 13 in through 36 and researchers found that lower intake of fiber during a young age was associated with stiffening of the arteries leading up to the brain. Even by age 13, they could see differences in arterial stiffness depending on diet. Fiber intake is important at any age.

Again, it doesn't take much. One extra apple a day or an extra quarter cup of broccoli might translate into meaningful differences in arterial stiffness in adulthood. If you really don't want a stroke, we should try to get 25 grams a day of soluble fiber (found concentrated in beans, oats, nuts, and berries) and 47 grams a day of insoluble fiber (concentrated in whole grains). One would have to eat an extraordinarily healthy diet to get that much, yet these cut-off values could be considered as the minimum recommended daily intake of soluble and insoluble fiber to prevent stroke. The researchers admit these are higher than those commonly and arbitrarily proposed as "adequate" levels by scientific societies, but should we care about what authorities think is practical? They should just share the best scienceand let us make up our own minds.

Someone funded by Kellogg's wrote in to complain that in practice, such fiber intakes are "unachievable" and that the message should just be the more, the better--like maybe just have a bowl of cereal or something.

The real Dr. Kellogg was actually one of our most famous physicians, credited for being one of the first to sound the alarm about smoking, and who may have been the first American physician to have recognized the field of nutrition as a science. He would be rolling in his grave today if he knew what his family's company had become.


More on preventing strokes can be found here:

More on the wonders of fiber in:

It really is never too early to start eating healthier. See, for example, Heart Disease Starts in Childhood, How to Prevent Prediabetes in Children, Heart Disease May Start in the Womb, and Should All Children Have their Cholesterol Checked?

In health,

Michael Greger, M.D.

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

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

Original Link

How Much Fiber Should You Eat Every Day?

How Much Fiber Should You Eat Every Day.jpeg

High dietary fiber intake may help prevent strokes. The belief that dietary fiber intake is protectively associated with certain diseases was postulated 40 years ago and then enormously fueled and kept alive by a great body of science since. Today it is generally believed that eating lots of fiber-rich foods helps prevent obesity, diabetes, and cardiovascular diseases such as stroke.

Strokes are the second most common cause of death worldwide. Moreover, stroke is a leading cause of disability, and so preventing strokes in the first place--what's called primary prevention--should therefore, be a key public health priority (see How to Prevent a Stroke).

The best observational studies to date found that fiber appears to significantly protect against the risk of stroke. Different strokes for different folks, depending, evidently, on how much fiber they ate. Notably, increasing fiber just seven grams a day was associated with a 7% reduction in stroke risk. And seven grams is easy, that's like a serving of whole grain pasta with tomato sauce and an apple.

What's the mechanism? Maybe it's that fiber helps lower cholesterol and blood sugar levels. Or it could just be that those eating more fiber are just eating more vegetables, or fewer calories, or less meat and fat, or improving digestion, all of which may slim us down and lower our blood pressure and the amount of inflammation in our bodies. Does it really matter, though? As Dr. Burkitt commented on the biblical passage, "A man scatters seed on the land--the seed sprouts and opens--how, he does not know," the farmer doesn't wait to find out. Had the farmer postponed his sowing until he understood seed germination, he would not have lasted very long. So yes, let's keep trying to figure out why fiber is protective, but in the meanwhile, we should be increasing our intake of fiber, which is to say increasing our intake of whole plant foods.

It's never too early to start eating healthier. Strokes are one of many complications of arterial stiffness. Though our first stroke might not happen until our 50's, our arteries may have been stiffening for decades leading up to it. Hundreds of kids were followed for 24 years, from age 13 in through 36 and researchers found that lower intake of fiber during a young age was associated with stiffening of the arteries leading up to the brain. Even by age 13, they could see differences in arterial stiffness depending on diet. Fiber intake is important at any age.

Again, it doesn't take much. One extra apple a day or an extra quarter cup of broccoli might translate into meaningful differences in arterial stiffness in adulthood. If you really don't want a stroke, we should try to get 25 grams a day of soluble fiber (found concentrated in beans, oats, nuts, and berries) and 47 grams a day of insoluble fiber (concentrated in whole grains). One would have to eat an extraordinarily healthy diet to get that much, yet these cut-off values could be considered as the minimum recommended daily intake of soluble and insoluble fiber to prevent stroke. The researchers admit these are higher than those commonly and arbitrarily proposed as "adequate" levels by scientific societies, but should we care about what authorities think is practical? They should just share the best scienceand let us make up our own minds.

Someone funded by Kellogg's wrote in to complain that in practice, such fiber intakes are "unachievable" and that the message should just be the more, the better--like maybe just have a bowl of cereal or something.

The real Dr. Kellogg was actually one of our most famous physicians, credited for being one of the first to sound the alarm about smoking, and who may have been the first American physician to have recognized the field of nutrition as a science. He would be rolling in his grave today if he knew what his family's company had become.


More on preventing strokes can be found here:

More on the wonders of fiber in:

It really is never too early to start eating healthier. See, for example, Heart Disease Starts in Childhood, How to Prevent Prediabetes in Children, Heart Disease May Start in the Womb, and Should All Children Have their Cholesterol Checked?

In health,

Michael Greger, M.D.

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

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

Original Link

How Much Fiber Should You Eat Every Day?

How Much Fiber Should You Eat Every Day.jpeg

High dietary fiber intake may help prevent strokes. The belief that dietary fiber intake is protectively associated with certain diseases was postulated 40 years ago and then enormously fueled and kept alive by a great body of science since. Today it is generally believed that eating lots of fiber-rich foods helps prevent obesity, diabetes, and cardiovascular diseases such as stroke.

Strokes are the second most common cause of death worldwide. Moreover, stroke is a leading cause of disability, and so preventing strokes in the first place--what's called primary prevention--should therefore, be a key public health priority (see How to Prevent a Stroke).

The best observational studies to date found that fiber appears to significantly protect against the risk of stroke. Different strokes for different folks, depending, evidently, on how much fiber they ate. Notably, increasing fiber just seven grams a day was associated with a 7% reduction in stroke risk. And seven grams is easy, that's like a serving of whole grain pasta with tomato sauce and an apple.

What's the mechanism? Maybe it's that fiber helps lower cholesterol and blood sugar levels. Or it could just be that those eating more fiber are just eating more vegetables, or fewer calories, or less meat and fat, or improving digestion, all of which may slim us down and lower our blood pressure and the amount of inflammation in our bodies. Does it really matter, though? As Dr. Burkitt commented on the biblical passage, "A man scatters seed on the land--the seed sprouts and opens--how, he does not know," the farmer doesn't wait to find out. Had the farmer postponed his sowing until he understood seed germination, he would not have lasted very long. So yes, let's keep trying to figure out why fiber is protective, but in the meanwhile, we should be increasing our intake of fiber, which is to say increasing our intake of whole plant foods.

It's never too early to start eating healthier. Strokes are one of many complications of arterial stiffness. Though our first stroke might not happen until our 50's, our arteries may have been stiffening for decades leading up to it. Hundreds of kids were followed for 24 years, from age 13 in through 36 and researchers found that lower intake of fiber during a young age was associated with stiffening of the arteries leading up to the brain. Even by age 13, they could see differences in arterial stiffness depending on diet. Fiber intake is important at any age.

Again, it doesn't take much. One extra apple a day or an extra quarter cup of broccoli might translate into meaningful differences in arterial stiffness in adulthood. If you really don't want a stroke, we should try to get 25 grams a day of soluble fiber (found concentrated in beans, oats, nuts, and berries) and 47 grams a day of insoluble fiber (concentrated in whole grains). One would have to eat an extraordinarily healthy diet to get that much, yet these cut-off values could be considered as the minimum recommended daily intake of soluble and insoluble fiber to prevent stroke. The researchers admit these are higher than those commonly and arbitrarily proposed as "adequate" levels by scientific societies, but should we care about what authorities think is practical? They should just share the best scienceand let us make up our own minds.

Someone funded by Kellogg's wrote in to complain that in practice, such fiber intakes are "unachievable" and that the message should just be the more, the better--like maybe just have a bowl of cereal or something.

The real Dr. Kellogg was actually one of our most famous physicians, credited for being one of the first to sound the alarm about smoking, and who may have been the first American physician to have recognized the field of nutrition as a science. He would be rolling in his grave today if he knew what his family's company had become.


More on preventing strokes can be found here:

More on the wonders of fiber in:

It really is never too early to start eating healthier. See, for example, Heart Disease Starts in Childhood, How to Prevent Prediabetes in Children, Heart Disease May Start in the Womb, and Should All Children Have their Cholesterol Checked?

In health,

Michael Greger, M.D.

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

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

Original Link

How Exactly Does Type 2 Diabetes Develop?

How Exactly Does Type 2 Diabetes Develop.jpeg

Insulin resistance is the cause of both prediabetes and type 2 diabetes. OkK, so what is the cause of insulin resistance? Insulin resistance is now accepted to be closely associated with the accumulation of fat within our muscle cells. This fat toxicity inside of our muscles is a major factor in the cause of insulin resistance and type 2 diabetes, as it interferes with the action of insulin. I've explored how fat makes our muscles insulin resistant (see What Causes Insulin Resistance?), how that fat can come from the fat we eat or the fat we wear (see The Spillover Effect Links Obesity to Diabetes), and how not all fats are the same (see Lipotoxicity: How Saturated Fat Raises Blood Sugar). It's the type of fat found predominantly in animal fats, relative to plant fats, that appears to be especially deleterious with respect to fat-induced insulin insensitivity. But this insulin resistance in our muscles starts years before diabetes is diagnosed.

In my video, Diabetes as a Disease of Fat Toxicity, you can see that insulin resistance starts over a decade before diabetes is actually diagnosed, as blood sugar levels slowly start creeping up. And then, all of the sudden, the pancreas conks out, and blood sugars skyrocket. What could underlie this relatively rapid failure of insulin secretion?

At first, the pancreas pumps out more and more insulin, trying to overcome the fat-induced insulin resistance in the muscles, and high insulin levels can lead to the accumulation of fat in the liver, called fatty liver disease. Before diagnosis of type 2 diabetes, there is a long silent scream from the liver. As fat builds up in our liver, it also becomes resistant to insulin.

Normally, the liver is constantly producing blood sugar to keep our brain alive between meals. As soon as we eat breakfast, though, the insulin released to deal with the meal normally turns off liver glucose production, which makes sense since we don't need it anymore. But when our liver is filled with fat, it becomes insulin resistant like our muscles, and doesn't respond to the breakfast signal; it keeps pumping out blood sugar all day long on top of whatever we eat. Then the pancreas pumps out even more insulin to deal with the high sugars, and our liver gets fatter and fatter. That's one of the twin vicious cycles of diabetes. Fatty muscles, in the context of too many calories, leads to a fatty liver, which leads to an even fattier liver. This is all still before we have diabetes.

Fatty liver can be deadly. The liver starts trying to offload the fat by dumping it back into the bloodstream in the form of something called VLDL, and that starts building up in the cells in the pancreas that produce the insulin in the first place. Now we know how diabetes develops: fatty muscles lead to a fatty liver, which leads to a fatty pancreas. It is now clear that type 2 diabetes is a condition of excess fat inside our organs, whether we're obese or not.

The only thing that was keeping us from diabetes-unchecked skyrocketing blood sugars-is that the pancreas was working overtime pumping out extra insulin to overcome insulin resistance. But as the so-called islet or Beta cells in the pancreas are killed off by the fatty buildup, insulin production starts to fail, and we're left with the worst of both worlds: insulin resistance combined with a failing pancreas. Unable to then overcome the resistance, blood sugar levels go up and up, and boom: type 2 diabetes.

This has implications for cancer as well. Obesity leads to insulin resistance and our blood sugars start to go up, so our pancreas starts pumping out more insulin to try to force more sugar into our muscles, and eventually the fat spills over into the pancreas, killing off the insulin-producing cells. Then we develop diabetes, in which case we may have to start injecting insulin at high levels to overcome the insulin-resistance, and these high insulin levels promote cancer. That's one of the reasons we think obese women get more breast cancer. It all traces back to fat getting into our muscle cells, causing insulin resistance: fat from our stomach (obesity) or fat going into our stomach (saturated fats in our diet).

Now it should make sense why the American Diabetes Association recommends reduced intake of dietary fat as a strategy for reducing the risk for developing diabetes.


The reason I'm going into all this detail is that I'm hoping to empower both those suffering from the disease and those treating sufferers so as to better understand dietary interventions to prevent and treat the epidemic.

Here are some videos on prevention:

And here are some on treatment:

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: Nephron. This image has been modified.

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