Four Ways to Improve on the Mediterranean Diet

Improving on the Mediterranean Diet.jpg

The traditional Mediterranean diet can be considered mainly, but not exclusively, as a plant-based diet, and certainly not a whole foods, plant-based diet. Olive oil and wine can be considered essentially fruit juices. Even if one is eating a "vegiterranean diet," an entirely plant-based version, there are a number of problematic nutritional aspects that are rarely talked about. For example, the Mediterranean diet includes lots of white bread, white pasta and not a lot of whole grains.

In an anatomy of the health effects of the Mediterranean diet, the single most important component was the high consumption of plant foods. In contrast, high cereal consumption, meaning high grain consumption, did not appear to help. This may be because most grains that modern Mediterranean dieters eat are refined, like white bread, whereas the traditional Mediterranean diet was characterized by unprocessed cereals--in other words, whole grains. And while whole grains have been associated with lower risk of diabetes, heart disease and cancer, refined grain may increase the risk of diabetes, obesity, heart disease and other chronic diseases. In the PREDIMED study, those who ate the most white bread--but not whole grain bread--gained significant weight.

Alcohol may also be a problem. As a plant-centered diet, adherence to a Mediterranean diet is associated with lower cancer risk, but does not appear to lower breast cancer risk. With all the fruits, veggies, nuts, seeds, beans and low saturated fat content, you'd assume there would be lower breast cancer risk, but alcohol is a known breast carcinogen, even in moderate amounts. When researchers created a special adapted version of the Mediterranean diet score that excluded alcohol, the diet does indeed appear to reduce breast cancer risk.

The wonderful grape phytonutrients in red wine can improve our arterial function such that if you drink nonalcoholic red wine (wine with the alcohol removed), you get a significant boost in endothelial function--the ability of our arteries to relax and dilate normally, increasing blood flow. If you drink the same red wine with alcohol, it abolishes the beneficial effect and counteracts the benefit of the grape phytonutrients. So, it would be better just to eat grapes. You can find more information about this in my video Improving on the Mediterranean Diet.

Similarly, there are components of extra virgin olive oil--the antioxidant phytonutrients, that may help endothelial function, but when consumed as oil, (even extra virgin olive oil), it may impair arterial function. So even if white bread dipped in olive oil is the very symbol of the Mediterranean diet, we can modernize it by removing oils and refined grains.

Another important, albeit frequently ignored issue in the modern Mediterranean diet is sodium intake. Despite evidence linking salt intake to high blood pressure, heart disease and strokes, dietary salt intake in the U.S. is on the rise. Right now, Americans get about seven to ten grams a day, mostly from processed foods. If we were to decrease that just by three grams every year, we could possibly save tens of thousands of people from having a heart attack, prevent tens of thousands of strokes, and tens of thousands of deaths. There is a common misperception that only certain people should reduce their salt intake and that for the vast majority of the population, salt reduction is unnecessary, but in reality, the opposite is true.

There is much we can learn from the traditional Mediterranean diet. A defining characteristic of the Mediterranean diet is an abundance of plant foods, but one thing that seems to have fallen by the wayside. No main Mediterranean meal is replete without lots of greens, a key part of not only a good Mediterranean diet, but of any good diet.

Here are some of my previous videos on the Mediterranean diet:

I touch more on whole grains in How Many Meet the Simple Seven? and Whole Grains May Work As Well As Drugs.

More on breast cancer and alcohol in Breast Cancer and Alcohol: How Much Is Safe?, Preventing Skin Cancer From the Inside Out, and Breast Cancer Risk: Red Wine v. White Wine.

I've touched on olive oil in the other videos in this Mediterranean diet series, but also have an older video Extra Virgin Olive Oil vs. Nuts and more recently, Olive Oil & Artery Function.

More on sodium in Dietary Guidelines: With a Grain of Big Salt, Big Salt - Getting to the Meat of the Matter, and Can Diet Protect Against Kidney Cancer? But what if without salt everything tastes like cardboard? Not to worry! See Changing Our Taste Buds.

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

Four Ways to Improve on the Mediterranean Diet

Improving on the Mediterranean Diet.jpg

The traditional Mediterranean diet can be considered mainly, but not exclusively, as a plant-based diet, and certainly not a whole foods, plant-based diet. Olive oil and wine can be considered essentially fruit juices. Even if one is eating a "vegiterranean diet," an entirely plant-based version, there are a number of problematic nutritional aspects that are rarely talked about. For example, the Mediterranean diet includes lots of white bread, white pasta and not a lot of whole grains.

In an anatomy of the health effects of the Mediterranean diet, the single most important component was the high consumption of plant foods. In contrast, high cereal consumption, meaning high grain consumption, did not appear to help. This may be because most grains that modern Mediterranean dieters eat are refined, like white bread, whereas the traditional Mediterranean diet was characterized by unprocessed cereals--in other words, whole grains. And while whole grains have been associated with lower risk of diabetes, heart disease and cancer, refined grain may increase the risk of diabetes, obesity, heart disease and other chronic diseases. In the PREDIMED study, those who ate the most white bread--but not whole grain bread--gained significant weight.

Alcohol may also be a problem. As a plant-centered diet, adherence to a Mediterranean diet is associated with lower cancer risk, but does not appear to lower breast cancer risk. With all the fruits, veggies, nuts, seeds, beans and low saturated fat content, you'd assume there would be lower breast cancer risk, but alcohol is a known breast carcinogen, even in moderate amounts. When researchers created a special adapted version of the Mediterranean diet score that excluded alcohol, the diet does indeed appear to reduce breast cancer risk.

The wonderful grape phytonutrients in red wine can improve our arterial function such that if you drink nonalcoholic red wine (wine with the alcohol removed), you get a significant boost in endothelial function--the ability of our arteries to relax and dilate normally, increasing blood flow. If you drink the same red wine with alcohol, it abolishes the beneficial effect and counteracts the benefit of the grape phytonutrients. So, it would be better just to eat grapes. You can find more information about this in my video Improving on the Mediterranean Diet.

Similarly, there are components of extra virgin olive oil--the antioxidant phytonutrients, that may help endothelial function, but when consumed as oil, (even extra virgin olive oil), it may impair arterial function. So even if white bread dipped in olive oil is the very symbol of the Mediterranean diet, we can modernize it by removing oils and refined grains.

Another important, albeit frequently ignored issue in the modern Mediterranean diet is sodium intake. Despite evidence linking salt intake to high blood pressure, heart disease and strokes, dietary salt intake in the U.S. is on the rise. Right now, Americans get about seven to ten grams a day, mostly from processed foods. If we were to decrease that just by three grams every year, we could possibly save tens of thousands of people from having a heart attack, prevent tens of thousands of strokes, and tens of thousands of deaths. There is a common misperception that only certain people should reduce their salt intake and that for the vast majority of the population, salt reduction is unnecessary, but in reality, the opposite is true.

There is much we can learn from the traditional Mediterranean diet. A defining characteristic of the Mediterranean diet is an abundance of plant foods, but one thing that seems to have fallen by the wayside. No main Mediterranean meal is replete without lots of greens, a key part of not only a good Mediterranean diet, but of any good diet.

Here are some of my previous videos on the Mediterranean diet:

I touch more on whole grains in How Many Meet the Simple Seven? and Whole Grains May Work As Well As Drugs.

More on breast cancer and alcohol in Breast Cancer and Alcohol: How Much Is Safe?, Preventing Skin Cancer From the Inside Out, and Breast Cancer Risk: Red Wine v. White Wine.

I've touched on olive oil in the other videos in this Mediterranean diet series, but also have an older video Extra Virgin Olive Oil vs. Nuts and more recently, Olive Oil & Artery Function.

More on sodium in Dietary Guidelines: With a Grain of Big Salt, Big Salt - Getting to the Meat of the Matter, and Can Diet Protect Against Kidney Cancer? But what if without salt everything tastes like cardboard? Not to worry! See Changing Our Taste Buds.

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

Benefits of Nuts for Stroke Prevention

PREDIMED - Does Eating Nuts Prevent Strokes.jpg

In the PREDIMED study, from the Spanish "PREvencio ́n con DIeta MEDiterranea," a whopping 7,447 patients were randomized into three groups. These were folks at high risk for a heart attack, about half were obese, diabetic and most had high blood pressure and high cholesterol, but they had not yet had their first heart attack or stroke. A third were told to eat a Mediterranean diet and given a free quart of extra virgin olive oil every week. The second group were told to eat a Mediterranean diet and given a half pound of free nuts every week, and the last third were told to follow the American Heart Association guidelines and reduce their fat intake. No portion control or exercise advice was given, and they were followed for about five years. The results were published in the New England Journal of Medicine.

The first thing you do when you look at a diet intervention trial is see what the groups actually ended up eating, which can be very different from what they were told to eat. For example, the so-called low-fat group started out at 39 percent of calories from fat, and ended up getting 37 percent of calories from fat, which is high fat even compared to the Standard American Diet which comes in at 33 percent, something the researchers plainly acknowledged. In fact, the control group didn't change much at all over the years, so can be thought of as the what-if-you-don't-do-anything group, which is still an important control group to have. Though the two Mediterranean diet groups didn't get much more Mediterranean. You can see the charts in my video PREDIMED: Does Eating Nuts Prevent Strokes?

The two Mediterranean groups were told to eat more fruits and vegetables, for example, and less meat and dairy, but didn't accomplish any of those compared to control. The biggest changes recorded were, not surprisingly, in the consumption of the freebies. The group that got a free jug of extra-virgin olive oil delivered to their home every week really did start increasing their consumption, in part by replacing some of the refined olive oil they had been using. And those that got a half pound of free nuts sent to them every week for four years straight did start eating more nuts.

Basically the researchers designed a study to test two different Mediterranean diets versus a low fat diet, but ended up studying something very different. In essence, they studied what happens when thousands of people switch from consuming about three tablespoons of olive oil a day (half virgin) to four tablespoons of all virgin, compared to thousands of people who all the sudden go from eating about a half an ounce of nuts a day to a whole ounce, compared to thousands of people who don't make much of a change at all. It may not have been what they were hoping for, but these are important research questions in and of themselves.

With no significant differences in meat and dairy intake, there were no significant differences in saturated fat or cholesterol intake, so no surprise there was no significant differences in their blood cholesterol levels, and so no difference in their subsequent number of heart attacks. In the five or so years the study ran, there were 37 heart attacks in the olive oil group, 31 in the nut group and 38 in the neither group. No significant difference. Same with dying from a heart attack or stroke or from any cause--but, those in the olive oil and especially the nut group had significantly fewer strokes. All three groups were eating stroke-promoting diets; some people in all three groups had strokes after eating these diets for years, and so ideally we'd choose diets that can stop or reverse the disease process, but the diet with added extra virgin olive oil caused about a third fewer strokes, and adding nuts seemed to cut their stroke risk nearly in half. If this worked as well in the general population, in the U.S. alone that would mean preventing 89,000 strokes a year. That's would be like ten strokes an hour around the clock prevented simply by adding half an ounce of nuts to one's daily diet.

Here are some of my previous videos on the Mediterranean diet:

The PREDIMED study got a bad rap because of how it was reported, but it's an extraordinary trial that continues to churn out useful results.

More on nuts in:

But what about nuts and weight gain? See Nuts and Obesity: The Weight of Evidence .

For videos on olive oil, see Extra Virgin Olive Oil vs. Nuts and Olive Oil & Artery 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. This image has been modified.

Original Link

Benefits of Nuts for Stroke Prevention

PREDIMED - Does Eating Nuts Prevent Strokes.jpg

In the PREDIMED study, from the Spanish "PREvencio ́n con DIeta MEDiterranea," a whopping 7,447 patients were randomized into three groups. These were folks at high risk for a heart attack, about half were obese, diabetic and most had high blood pressure and high cholesterol, but they had not yet had their first heart attack or stroke. A third were told to eat a Mediterranean diet and given a free quart of extra virgin olive oil every week. The second group were told to eat a Mediterranean diet and given a half pound of free nuts every week, and the last third were told to follow the American Heart Association guidelines and reduce their fat intake. No portion control or exercise advice was given, and they were followed for about five years. The results were published in the New England Journal of Medicine.

The first thing you do when you look at a diet intervention trial is see what the groups actually ended up eating, which can be very different from what they were told to eat. For example, the so-called low-fat group started out at 39 percent of calories from fat, and ended up getting 37 percent of calories from fat, which is high fat even compared to the Standard American Diet which comes in at 33 percent, something the researchers plainly acknowledged. In fact, the control group didn't change much at all over the years, so can be thought of as the what-if-you-don't-do-anything group, which is still an important control group to have. Though the two Mediterranean diet groups didn't get much more Mediterranean. You can see the charts in my video PREDIMED: Does Eating Nuts Prevent Strokes?

The two Mediterranean groups were told to eat more fruits and vegetables, for example, and less meat and dairy, but didn't accomplish any of those compared to control. The biggest changes recorded were, not surprisingly, in the consumption of the freebies. The group that got a free jug of extra-virgin olive oil delivered to their home every week really did start increasing their consumption, in part by replacing some of the refined olive oil they had been using. And those that got a half pound of free nuts sent to them every week for four years straight did start eating more nuts.

Basically the researchers designed a study to test two different Mediterranean diets versus a low fat diet, but ended up studying something very different. In essence, they studied what happens when thousands of people switch from consuming about three tablespoons of olive oil a day (half virgin) to four tablespoons of all virgin, compared to thousands of people who all the sudden go from eating about a half an ounce of nuts a day to a whole ounce, compared to thousands of people who don't make much of a change at all. It may not have been what they were hoping for, but these are important research questions in and of themselves.

With no significant differences in meat and dairy intake, there were no significant differences in saturated fat or cholesterol intake, so no surprise there was no significant differences in their blood cholesterol levels, and so no difference in their subsequent number of heart attacks. In the five or so years the study ran, there were 37 heart attacks in the olive oil group, 31 in the nut group and 38 in the neither group. No significant difference. Same with dying from a heart attack or stroke or from any cause--but, those in the olive oil and especially the nut group had significantly fewer strokes. All three groups were eating stroke-promoting diets; some people in all three groups had strokes after eating these diets for years, and so ideally we'd choose diets that can stop or reverse the disease process, but the diet with added extra virgin olive oil caused about a third fewer strokes, and adding nuts seemed to cut their stroke risk nearly in half. If this worked as well in the general population, in the U.S. alone that would mean preventing 89,000 strokes a year. That's would be like ten strokes an hour around the clock prevented simply by adding half an ounce of nuts to one's daily diet.

Here are some of my previous videos on the Mediterranean diet:

The PREDIMED study got a bad rap because of how it was reported, but it's an extraordinary trial that continues to churn out useful results.

More on nuts in:

But what about nuts and weight gain? See Nuts and Obesity: The Weight of Evidence .

For videos on olive oil, see Extra Virgin Olive Oil vs. Nuts and Olive Oil & Artery 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. This image has been modified.

Original Link

What’s the Optimal Cholesterol Level?

Optimal Cholesterol Level.jpg

No matter where we live, how old we are or what we look like, health researchers from the Institute of Circulatory and Respiratory Health have discovered that 90% of the chance of having a first heart attack "can be attributed to nine modifiable risk factors." The nine factors that could save our lives include: smoking, too much bad cholesterol, high blood pressure, diabetes, abdominal obesity, stress, a lack of daily fruit and veggie consumption, as well as a lack of daily exercise.

Dr. William Clifford Roberts, Executive Director of Baylor Heart and Vascular Institute and long-time Editor in Chief of the American Journal of Cardiology, is convinced, however, that atherosclerosis has a single cause--namely cholesterol--and that the other so-called atherosclerotic risk factors are only contributory at most. In other words, we could be stressed, overweight, smoking, diabetic couch potatoes, but if our cholesterol is low enough, there may just not be enough cholesterol in our blood stream to infiltrate our artery walls and trigger the disease. Thus, the only absolute prerequisite for a fatal or nonfatal atherosclerotic event like a heart attack is an elevated cholesterol level.

It was not appreciated until recently "that the average blood cholesterol level in the United States, the so-called normal level, was actually abnormal," accelerating the blockages in our arteries and putting a large fraction of the normal population at risk. That's cited as one of the reasons the cholesterol controversy lasted so long--an "unwillingness to accept the notion that a very large fraction of our population actually has an unhealthily high cholesterol level."

Normal cholesterol levels may be fatal cholesterol levels.

The optimal "bad cholesterol" (LDL) level is 50 to 70. Accumulating data from multiple lines of evidence consistently demonstrate that that's where a physiologically normal LDL level would be. That appears to be the threshold above which atherosclerosis and heart attacks develop. That's what we start out at birth with, that's what fellow primates have, and that's the level seen in populations free of the heart disease epidemic. One can also look at all the big randomized controlled cholesterol lowering trials.

In my video, Optimal Cholesterol Level, you can see graphing of the progression of atherosclerosis versus LDL cholesterol. More cholesterol means more atherosclerosis, but if we draw a line down through the points, we can estimate that the LDL level at which there is zero progression is around 70. We can do the same with the studies preventing heart attacks. Zero coronary heart disease events might be reached down around 55, and those who've already had a heart attack and are trying to prevent a second one might need to push LDL levels even lower.

Atherosclerosis is endemic in our population in part because the average person's LDL level is up around 130, approximately twice the normal physiologic level. The reason the federal government doesn't recommend everyone shoot for under 100 is that despite the lower risk accompanying more optimal cholesterol levels, the intensity of clinical intervention required to achieve such levels for everyone in the population would "financially overload the health care system. Drug usage would rise enormously." But, they're assuming drugs are the only way to get our LDL that low. Those eating really healthy plant-based diets may hit the optimal cholesterol target without even trying, naturally nailing under 70.

The reason given by the federal government for not advocating for what the science shows is best was that it might frustrate the public, "who would have difficulty maintaining a lower level," but maybe the public's greatest frustration would come from not being informed of the optimal diet for health.


It's imperative for everyone to understand Dr. Rose's sick population concept, which I introduced in When Low Risk Means High Risk.

What about large fluffy LDL cholesterol versus small and dense? See Does Cholesterol Size Matter?

More from the Framingham Heart Study can be found in Barriers to Heart Disease Prevention and Everything in Moderation? Even Heart Disease?.

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

Original Link

What’s the Optimal Cholesterol Level?

Optimal Cholesterol Level.jpg

No matter where we live, how old we are or what we look like, health researchers from the Institute of Circulatory and Respiratory Health have discovered that 90% of the chance of having a first heart attack "can be attributed to nine modifiable risk factors." The nine factors that could save our lives include: smoking, too much bad cholesterol, high blood pressure, diabetes, abdominal obesity, stress, a lack of daily fruit and veggie consumption, as well as a lack of daily exercise.

Dr. William Clifford Roberts, Executive Director of Baylor Heart and Vascular Institute and long-time Editor in Chief of the American Journal of Cardiology, is convinced, however, that atherosclerosis has a single cause--namely cholesterol--and that the other so-called atherosclerotic risk factors are only contributory at most. In other words, we could be stressed, overweight, smoking, diabetic couch potatoes, but if our cholesterol is low enough, there may just not be enough cholesterol in our blood stream to infiltrate our artery walls and trigger the disease. Thus, the only absolute prerequisite for a fatal or nonfatal atherosclerotic event like a heart attack is an elevated cholesterol level.

It was not appreciated until recently "that the average blood cholesterol level in the United States, the so-called normal level, was actually abnormal," accelerating the blockages in our arteries and putting a large fraction of the normal population at risk. That's cited as one of the reasons the cholesterol controversy lasted so long--an "unwillingness to accept the notion that a very large fraction of our population actually has an unhealthily high cholesterol level."

Normal cholesterol levels may be fatal cholesterol levels.

The optimal "bad cholesterol" (LDL) level is 50 to 70. Accumulating data from multiple lines of evidence consistently demonstrate that that's where a physiologically normal LDL level would be. That appears to be the threshold above which atherosclerosis and heart attacks develop. That's what we start out at birth with, that's what fellow primates have, and that's the level seen in populations free of the heart disease epidemic. One can also look at all the big randomized controlled cholesterol lowering trials.

In my video, Optimal Cholesterol Level, you can see graphing of the progression of atherosclerosis versus LDL cholesterol. More cholesterol means more atherosclerosis, but if we draw a line down through the points, we can estimate that the LDL level at which there is zero progression is around 70. We can do the same with the studies preventing heart attacks. Zero coronary heart disease events might be reached down around 55, and those who've already had a heart attack and are trying to prevent a second one might need to push LDL levels even lower.

Atherosclerosis is endemic in our population in part because the average person's LDL level is up around 130, approximately twice the normal physiologic level. The reason the federal government doesn't recommend everyone shoot for under 100 is that despite the lower risk accompanying more optimal cholesterol levels, the intensity of clinical intervention required to achieve such levels for everyone in the population would "financially overload the health care system. Drug usage would rise enormously." But, they're assuming drugs are the only way to get our LDL that low. Those eating really healthy plant-based diets may hit the optimal cholesterol target without even trying, naturally nailing under 70.

The reason given by the federal government for not advocating for what the science shows is best was that it might frustrate the public, "who would have difficulty maintaining a lower level," but maybe the public's greatest frustration would come from not being informed of the optimal diet for health.


It's imperative for everyone to understand Dr. Rose's sick population concept, which I introduced in When Low Risk Means High Risk.

What about large fluffy LDL cholesterol versus small and dense? See Does Cholesterol Size Matter?

More from the Framingham Heart Study can be found in Barriers to Heart Disease Prevention and Everything in Moderation? Even Heart Disease?.

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

Original Link

Improving Employee Diets Could Save Companies Millions

Plant-Based Workplace Intervention.jpg

The food, alcohol, and tobacco industries have been blamed for "manufacturing epidemics" of chronic disease, but they're just trying to sell more product like everyone else. And so if that means distorting science, creating front groups, compromising scientists, blocking public health policies... they're just trying to protect their business.

It's not about customer satisfaction, but shareholder satisfaction. How else could we have tobacco companies, for example, "continuing to produce products that kill one in two of their most loyal customers?"

Civil society organizations concerned with public health have earned a reputation for being "anti-industry," but the issue is not industry, but that sector of industry whose products are harmful to public health. We like the broccoli industry. In fact, the corporate world might end up leading the lifestyle medicine revolution.

As shown in my video, Plant-Based Workplace Intervention, the annual cost attributable to obesity alone among full-time employees is estimated at 70 billion dollars, primarily because obese employees are not as productive on the job. Having healthy employees is good for the bottom-line. Every dollar spent on wellness programs may offer a $3 return on investment. And if you track the market performance of companies that strive to nurture a culture of health, they appear to outperform their competition.

That's why companies like GEICO are exploring workplace dietary interventions (see my video, Slimming the Gecko). The remarkable success at GEICO headquarters led to an expansion of the program at corporate offices across the country, with test sites from San Diego to Macon, Georgia. Given that previous workplace studies have found that workers who ate a lot of animal protein had nearly five times the odds of obesity, whereas those that ate mostly plant protein appeared protected, obese and diabetic employees were asked to follow a plant-based diet of whole grains, vegetables, beans, and fruit while avoiding meat, dairy, and eggs. Compliance wasn't great. Fewer than half really got their animal product consumption down, but there were definitely improvements such as significant reductions in saturated fat, an increase in protective nutrients, and even noted weight loss, lower blood cholesterol levers, and better blood sugar control in diabetics.

And this was with no calorie counting, no portion control, and no exercise component. The weight reduction appears to result from feeling fuller earlier, due to higher dietary fiber intake. The difference in weight loss could also be the result of an increase in the thermic effect of food, allowing a small extra edge for weight loss in the vegan group. Those eating plant-based diets tend to burn off more calories in heat.

Eating plants appears to boost metabolism. This may be due to increased insulin sensitivity in cells, allowing cells to metabolize carbohydrates more quickly rather than storing them as body fat. "As a result, vegan diets have been shown to increase postprandial calorie burn by about 16%, up to three hours after consuming a meal."

Imagine how much money companies that self-insure their employees could save! See, for example:

Find out more on some of the potential downsides of corporate influence in videos like

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: Ryan McGuire / Pixabay. This image has been modified.

Original Link

Improving Employee Diets Could Save Companies Millions

Plant-Based Workplace Intervention.jpg

The food, alcohol, and tobacco industries have been blamed for "manufacturing epidemics" of chronic disease, but they're just trying to sell more product like everyone else. And so if that means distorting science, creating front groups, compromising scientists, blocking public health policies... they're just trying to protect their business.

It's not about customer satisfaction, but shareholder satisfaction. How else could we have tobacco companies, for example, "continuing to produce products that kill one in two of their most loyal customers?"

Civil society organizations concerned with public health have earned a reputation for being "anti-industry," but the issue is not industry, but that sector of industry whose products are harmful to public health. We like the broccoli industry. In fact, the corporate world might end up leading the lifestyle medicine revolution.

As shown in my video, Plant-Based Workplace Intervention, the annual cost attributable to obesity alone among full-time employees is estimated at 70 billion dollars, primarily because obese employees are not as productive on the job. Having healthy employees is good for the bottom-line. Every dollar spent on wellness programs may offer a $3 return on investment. And if you track the market performance of companies that strive to nurture a culture of health, they appear to outperform their competition.

That's why companies like GEICO are exploring workplace dietary interventions (see my video, Slimming the Gecko). The remarkable success at GEICO headquarters led to an expansion of the program at corporate offices across the country, with test sites from San Diego to Macon, Georgia. Given that previous workplace studies have found that workers who ate a lot of animal protein had nearly five times the odds of obesity, whereas those that ate mostly plant protein appeared protected, obese and diabetic employees were asked to follow a plant-based diet of whole grains, vegetables, beans, and fruit while avoiding meat, dairy, and eggs. Compliance wasn't great. Fewer than half really got their animal product consumption down, but there were definitely improvements such as significant reductions in saturated fat, an increase in protective nutrients, and even noted weight loss, lower blood cholesterol levers, and better blood sugar control in diabetics.

And this was with no calorie counting, no portion control, and no exercise component. The weight reduction appears to result from feeling fuller earlier, due to higher dietary fiber intake. The difference in weight loss could also be the result of an increase in the thermic effect of food, allowing a small extra edge for weight loss in the vegan group. Those eating plant-based diets tend to burn off more calories in heat.

Eating plants appears to boost metabolism. This may be due to increased insulin sensitivity in cells, allowing cells to metabolize carbohydrates more quickly rather than storing them as body fat. "As a result, vegan diets have been shown to increase postprandial calorie burn by about 16%, up to three hours after consuming a meal."

Imagine how much money companies that self-insure their employees could save! See, for example:

Find out more on some of the potential downsides of corporate influence in videos like

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: Ryan McGuire / Pixabay. This image has been modified.

Original Link

How a Low-Carb Diet is Metabolically Like Being Obese

NF-Nov22 The Spillover Effect copy.jpg

Free fatty acids (meaning fat circulating in the bloodstream not packaged into triglycerides) result in inflammation, toxic fat breakdown products, and oxidative stress, which can gum up the insulin receptor pathway and lead to insulin resistance in our muscles. Insulin resistance is what causes prediabetes and type 2 diabetes. I explain the process in my video What Causes Insulin Resistance? As the level of fat in the blood rises, the body's ability to clear sugar from the blood drops dramatically.

Where does this fat in our blood that's wreaking all this havoc come from? It comes from the fat that we eat and from the fat that we wear.

The number of fat cells we have stays constant in adulthood. The way researchers figured that out is by measuring the amount of radioactive carbon still trapped in our DNA from all the nuclear bomb tests. After massive weight loss, our fat cells shrink as they offload fat, but the number stays the same. Conversely, when we gain weight, our fat cells stretch as we pack more and more into each individual fat cell. So, when our belly, butt, or thighs get big, we're not adding more fat cells, we're just cramming more fat into each cell. At a certain point, our cells become so bloated that they spill fat back into the bloodstream.

This is called the spillover effect. Not only does an obese person have more fat, but they're constantly spilling that fat into their bloodstream. So that could be the link between obesity and diabetes. Fat is spilling out from our fat cells and gets lodged in our muscle cells, leading to the insulin resistance that promotes the onset of type 2 diabetes. I show this in my video The Spillover Effect Links Obesity to Diabetes.

The fat can also enter our bloodstream through our mouth. If you put people on a low carb diet, fat builds up in their muscle within two hours and insulin sensitivity drops. And the more fat found in the muscle, the lower the ability to clear sugar from the blood. It doesn't take years for this to happen, just hours after fatty foods go into our mouths. A fat-rich diet can increase fat in the blood and this increase is accompanied by a decrease in insulin sensitivity.

Studies clearly demonstrate that fat in the blood directly inhibit glucose transport and usage in our muscles, which is responsible for clearing about 85% of the glucose out of blood. These findings indicate that fat consumption can play an important role in the development of insulin resistance.

Normally we only have 10 to 50 micromoles of free fat floating around in our blood stream at any one time, but those who are obese have between 60 to 80. But, we can reach 80 just eating a high fat diet. So a skinny person eating a low-carb diet can have the same level of fat in their blood that obese people do. Similarly, being obese is like eating some horrible bacon and butter diet all day, because obese persons are constantly spilling fat into their bloodstream, no matter what goes in their mouth.

Are all types of fat the same? Find out the answer in my video Lipotoxicity: How Saturated Fat Raises Blood Sugar.

The fat leaking into our bloodstream may also contain fat-soluble pollutants that accumulated from our diet: Pollutants in Salmon and Our Own Fat.

The spillover effect may also help explain the increased heart disease risk associated with obesity: Low Carb Diets and Coronary Blood Flow.

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: [Eugene Bochkarev] © 123RF.com

Original Link

How a Low-Carb Diet is Metabolically Like Being Obese

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Free fatty acids (meaning fat circulating in the bloodstream not packaged into triglycerides) result in inflammation, toxic fat breakdown products, and oxidative stress, which can gum up the insulin receptor pathway and lead to insulin resistance in our muscles. Insulin resistance is what causes prediabetes and type 2 diabetes. I explain the process in my video What Causes Insulin Resistance? As the level of fat in the blood rises, the body's ability to clear sugar from the blood drops dramatically.

Where does this fat in our blood that's wreaking all this havoc come from? It comes from the fat that we eat and from the fat that we wear.

The number of fat cells we have stays constant in adulthood. The way researchers figured that out is by measuring the amount of radioactive carbon still trapped in our DNA from all the nuclear bomb tests. After massive weight loss, our fat cells shrink as they offload fat, but the number stays the same. Conversely, when we gain weight, our fat cells stretch as we pack more and more into each individual fat cell. So, when our belly, butt, or thighs get big, we're not adding more fat cells, we're just cramming more fat into each cell. At a certain point, our cells become so bloated that they spill fat back into the bloodstream.

This is called the spillover effect. Not only does an obese person have more fat, but they're constantly spilling that fat into their bloodstream. So that could be the link between obesity and diabetes. Fat is spilling out from our fat cells and gets lodged in our muscle cells, leading to the insulin resistance that promotes the onset of type 2 diabetes. I show this in my video The Spillover Effect Links Obesity to Diabetes.

The fat can also enter our bloodstream through our mouth. If you put people on a low carb diet, fat builds up in their muscle within two hours and insulin sensitivity drops. And the more fat found in the muscle, the lower the ability to clear sugar from the blood. It doesn't take years for this to happen, just hours after fatty foods go into our mouths. A fat-rich diet can increase fat in the blood and this increase is accompanied by a decrease in insulin sensitivity.

Studies clearly demonstrate that fat in the blood directly inhibit glucose transport and usage in our muscles, which is responsible for clearing about 85% of the glucose out of blood. These findings indicate that fat consumption can play an important role in the development of insulin resistance.

Normally we only have 10 to 50 micromoles of free fat floating around in our blood stream at any one time, but those who are obese have between 60 to 80. But, we can reach 80 just eating a high fat diet. So a skinny person eating a low-carb diet can have the same level of fat in their blood that obese people do. Similarly, being obese is like eating some horrible bacon and butter diet all day, because obese persons are constantly spilling fat into their bloodstream, no matter what goes in their mouth.

Are all types of fat the same? Find out the answer in my video Lipotoxicity: How Saturated Fat Raises Blood Sugar.

The fat leaking into our bloodstream may also contain fat-soluble pollutants that accumulated from our diet: Pollutants in Salmon and Our Own Fat.

The spillover effect may also help explain the increased heart disease risk associated with obesity: Low Carb Diets and Coronary Blood Flow.

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: [Eugene Bochkarev] © 123RF.com

Original Link