How to Treat High Blood Pressure with Diet

How to Treat High Blood Pressure with Diet.jpeg

High blood pressure ranks as the number-one risk factor for death and disability in the world. In my video, How to Prevent High Blood Pressure with Diet, I showed how a plant-based diet may prevent high blood pressure. But what do we do if we already have it? That's the topic of How to Treat High Blood Pressure with Diet.

The American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention recommend lifestyle modification as the first-line treatment. If that doesn't work, patients may be prescribed a thiazide diuretic (commonly known as a water pill) before getting even more meds until their blood pressure is forced down. Commonly, people will end up on three drugs, though researchers are experimenting with four at a time. Some patients even end up on five different meds.

What's wrong with skipping the lifestyle modification step and jumping straight to the drugs? Because drugs don't treat the underlying cause of high blood pressure yet can cause side effects. Less than half of patients stick with even the first-line drugs, perhaps due to such adverse effects as erectile dysfunction, fatigue, and muscle cramps.

What are the recommended lifestyle changes? The AHA, ACC, and CDC recommend controlling one's weight, salt, and alcohol intake, engaging in regular exercise, and adopting a DASH eating plan.

The DASH diet has been described as a lactovegetarian diet, but it's not. It emphasizes fruits, vegetables, and low-fat dairy, but only a reduction in meat consumption. Why not vegetarian? We've known for decades that animal products are significantly associated with blood pressure. In fact, if we take vegetarians and give them meat (and pay them enough to eat it!), we can watch their blood pressures go right up.

I've talked about the benefits to getting blood pressure down as low as 110 over 70. But who can get that low? Populations centering their diets around whole plant foods. Rural Chinese have been recorded with blood pressures averaging around 110 over 70 their whole lives. In rural Africa, the elderly have perfect blood pressure as opposed to hypertension. What both diets share in common is that they're plant-based day-to-day, with meat only eaten on special occasion.

How do we know it's the plant-based nature of their diets that was so protective? Because in the Western world, as the American Heart Association has pointed out, the only folks getting down that low were those eating strictly plant-based diets, coming out about 110 over 65.

So were the creators of the DASH diet just not aware of this landmark research done by Harvard's Frank Sacks? No, they were aware. The Chair of the Design Committee that came up with the DASH diet was Dr. Sacks himself. In fact, the DASH diet was explicitly designed with the number-one goal of capturing the blood pressure-lowering benefits of a vegetarian diet, yet including enough animal products to make it "palatable" to the general public.

You can see what they were thinking. Just like drugs never work--unless you actually take them. Diet never work--unless you actually eat them. So what's the point of telling people to eat strictly plant-based if few people will do it? So by soft-peddling the truth and coming up with a compromise diet you can imagine how they were thinking that on a population clae they might be doing more good. Ok, but tell that to the thousand U.S. families a day that lose a loved one to high blood pressure. Maybe it's time to start telling the American public the truth.

Sacks himself found that the more dairy the lactovegetarians ate, the higher their blood pressures. But they had to make the diet acceptable. Research has since shown that it's the added plant foods--not the changes in oil, sweets, or dairy--that appears to the critical component of the DASH diet. So why not eat a diet composed entirely of plant foods?

A recent meta-analysis showed vegetarian diets are good, but strictly plant-based diets may be better. In general, vegetarian diets provide protection against cardiovascular diseases, some cancers, and even death. But completely plant-based diets seem to offer additional protection against obesity, hypertension, type-2 diabetes, and heart disease mortality. Based on a study of more than 89,000 people, those eating meat-free diets appear to cut their risk of high blood pressure in half. But those eating meat-free, egg-free, and dairy-free may have 75% lower risk.

What if we're already eating a whole food, plant-based diet, no processed foods, no table salt, yet still not hitting 110 over 70? Here are some foods recently found to offer additional protection: Just a few tablespoons of ground flaxseeds a day was 2 to 3 times more potent than instituting an aerobic endurance exercise program and induced one of the most powerful, antihypertensive effects ever achieved by a diet-related intervention. Watermelon also appears to be extraordinary, but you'd have to eat around 2 pounds a day. Sounds like my kind of medicine, but it's hard to get year-round (at least in my neck of the woods). Red wine may help, but only if the alcohol has been taken out. Raw vegetables or cooked? The answer is both, though raw may work better. Beans, split peas, chickpeas, and lentils may also help a bit.

Kiwifruits don't seem to work at all, even though the study was funded by a kiwifruit company. Maybe they should have taken direction from the California Raisin Marketing Board, which came out with a study showing raisins can reduce blood pressure, but only, apparently, compared to fudge cookies, Cheez-Its, and Chips Ahoy.

The DASH diet is one of the best studied, and it consistently ranks as US News & World Report's #1 diet. It's one of the few diets that medical students are taught about in medical school. I was so fascinated to learn of its origins as a compromise between practicality and efficacy.

I've talked about the patronizing attitude many doctors have that patients can't handle the truth in:

What would hearing the truth from your physician sound like? See Fully Consensual Heart Disease Treatment and The Actual Benefit of Diet vs. Drugs.

For more on what plants can do for high blood pressure, see:

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

How to Treat High Blood Pressure with Diet

How to Treat High Blood Pressure with Diet.jpeg

High blood pressure ranks as the number-one risk factor for death and disability in the world. In my video, How to Prevent High Blood Pressure with Diet, I showed how a plant-based diet may prevent high blood pressure. But what do we do if we already have it? That's the topic of How to Treat High Blood Pressure with Diet.

The American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention recommend lifestyle modification as the first-line treatment. If that doesn't work, patients may be prescribed a thiazide diuretic (commonly known as a water pill) before getting even more meds until their blood pressure is forced down. Commonly, people will end up on three drugs, though researchers are experimenting with four at a time. Some patients even end up on five different meds.

What's wrong with skipping the lifestyle modification step and jumping straight to the drugs? Because drugs don't treat the underlying cause of high blood pressure yet can cause side effects. Less than half of patients stick with even the first-line drugs, perhaps due to such adverse effects as erectile dysfunction, fatigue, and muscle cramps.

What are the recommended lifestyle changes? The AHA, ACC, and CDC recommend controlling one's weight, salt, and alcohol intake, engaging in regular exercise, and adopting a DASH eating plan.

The DASH diet has been described as a lactovegetarian diet, but it's not. It emphasizes fruits, vegetables, and low-fat dairy, but only a reduction in meat consumption. Why not vegetarian? We've known for decades that animal products are significantly associated with blood pressure. In fact, if we take vegetarians and give them meat (and pay them enough to eat it!), we can watch their blood pressures go right up.

I've talked about the benefits to getting blood pressure down as low as 110 over 70. But who can get that low? Populations centering their diets around whole plant foods. Rural Chinese have been recorded with blood pressures averaging around 110 over 70 their whole lives. In rural Africa, the elderly have perfect blood pressure as opposed to hypertension. What both diets share in common is that they're plant-based day-to-day, with meat only eaten on special occasion.

How do we know it's the plant-based nature of their diets that was so protective? Because in the Western world, as the American Heart Association has pointed out, the only folks getting down that low were those eating strictly plant-based diets, coming out about 110 over 65.

So were the creators of the DASH diet just not aware of this landmark research done by Harvard's Frank Sacks? No, they were aware. The Chair of the Design Committee that came up with the DASH diet was Dr. Sacks himself. In fact, the DASH diet was explicitly designed with the number-one goal of capturing the blood pressure-lowering benefits of a vegetarian diet, yet including enough animal products to make it "palatable" to the general public.

You can see what they were thinking. Just like drugs never work--unless you actually take them. Diet never work--unless you actually eat them. So what's the point of telling people to eat strictly plant-based if few people will do it? So by soft-peddling the truth and coming up with a compromise diet you can imagine how they were thinking that on a population clae they might be doing more good. Ok, but tell that to the thousand U.S. families a day that lose a loved one to high blood pressure. Maybe it's time to start telling the American public the truth.

Sacks himself found that the more dairy the lactovegetarians ate, the higher their blood pressures. But they had to make the diet acceptable. Research has since shown that it's the added plant foods--not the changes in oil, sweets, or dairy--that appears to the critical component of the DASH diet. So why not eat a diet composed entirely of plant foods?

A recent meta-analysis showed vegetarian diets are good, but strictly plant-based diets may be better. In general, vegetarian diets provide protection against cardiovascular diseases, some cancers, and even death. But completely plant-based diets seem to offer additional protection against obesity, hypertension, type-2 diabetes, and heart disease mortality. Based on a study of more than 89,000 people, those eating meat-free diets appear to cut their risk of high blood pressure in half. But those eating meat-free, egg-free, and dairy-free may have 75% lower risk.

What if we're already eating a whole food, plant-based diet, no processed foods, no table salt, yet still not hitting 110 over 70? Here are some foods recently found to offer additional protection: Just a few tablespoons of ground flaxseeds a day was 2 to 3 times more potent than instituting an aerobic endurance exercise program and induced one of the most powerful, antihypertensive effects ever achieved by a diet-related intervention. Watermelon also appears to be extraordinary, but you'd have to eat around 2 pounds a day. Sounds like my kind of medicine, but it's hard to get year-round (at least in my neck of the woods). Red wine may help, but only if the alcohol has been taken out. Raw vegetables or cooked? The answer is both, though raw may work better. Beans, split peas, chickpeas, and lentils may also help a bit.

Kiwifruits don't seem to work at all, even though the study was funded by a kiwifruit company. Maybe they should have taken direction from the California Raisin Marketing Board, which came out with a study showing raisins can reduce blood pressure, but only, apparently, compared to fudge cookies, Cheez-Its, and Chips Ahoy.

The DASH diet is one of the best studied, and it consistently ranks as US News & World Report's #1 diet. It's one of the few diets that medical students are taught about in medical school. I was so fascinated to learn of its origins as a compromise between practicality and efficacy.

I've talked about the patronizing attitude many doctors have that patients can't handle the truth in:

What would hearing the truth from your physician sound like? See Fully Consensual Heart Disease Treatment and The Actual Benefit of Diet vs. Drugs.

For more on what plants can do for high blood pressure, see:

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 Not to Add to White Rice, Potatoes, or Pasta

What Not to Add to White Rice, Potatoes, or Pasta.jpeg

Rice currently feeds almost half the human population, making it the single most important staple food in the world, but a meta-analysis of seven cohort studies following 350,000 people for up to 20 years found that higher consumption of white rice was associated with a significantly increased risk of type 2 diabetes, especially in Asian populations. They estimated each serving per day of white rice was associated with an 11% increase in risk of diabetes. This could explain why China has almost the same diabetes rates as we do.

Diabetes rates in China are at about 10%; we're at about 11%, despite seven times less obesity in China. Japan has eight times less obesity than we do, yet may have a higher incidence of newly diagnosed diabetes cases than we do--nine per a thousand compared to our eight. They're skinnier and still may have more diabetes. Maybe it's because of all the white rice they eat.

Eating whole fruit is associated with lower risk of diabetes, whereas eating fruit processed into juice may not just be neutral, but actually increases diabetes risk. In the same way, eating whole grains, like whole wheat bread or brown rice is associated with lower risk of diabetes, whereas eating white rice, a processed grain, may not just be neutral, but actually increase diabetes risk.

White rice consumption does not appear to be associated with increased risk of heart attack or stroke, though, which is a relief after an earlier study in China suggested a connection with stroke. But do we want to eat a food that's just neutral regarding some of our leading causes of death, when we can eat whole foods that are associated with lower risk of diabetes, heart attack, stroke, and weight gain?

If the modern diabetes epidemic in China and Japan has been linked to white rice consumption, how can we reconcile that with low diabetes rates just a few decades ago when they ate even more rice? If you look at the Cornell-Oxford-China Project, rural plant-based diets centered around rice were associated with relatively low risk of the so-called diseases of affluence, which includes diabetes. Maybe Asians just genetically don't get the same blood sugar spike when they eat white rice? This is not the case; if anything people of Chinese ethnicity get higher blood sugar spikes.

The rise in these diseases of affluence in China over the last half century has been blamed in part on the tripling of the consumption of animal source foods. The upsurge in diabetes has been most dramatic, and it's mostly just happened over the last decade. That crazy 9.7% diabetes prevalence figure that rivals ours is new--they appeared to have one of the lowest diabetes rates in the world in the year 2000.

So what happened to their diets in the last 20 years or so? Oil consumption went up 20%, pork consumption went up 40%, and rice consumption dropped about 30%. As diabetes rates were skyrocketing, rice consumption was going down, so maybe it's the animal products and junk food that are the problem. Yes, brown rice is better than white rice, but to stop the mounting Asian epidemic, maybe we should focus on removing the cause--the toxic Western diet. That would be consistent with data showing animal protein and fat consumption associated with increased diabetes risk.

But that doesn't explain why the biggest recent studies in Japan and China associate white rice intake with diabetes. One possibility is that animal protein is making the rice worse. If you feed people mashed white potatoes, a high glycemic food like white rice, you can see in my video If White Rice is Linked to Diabetes, What About China? the level of insulin your pancreas has to pump out to keep your blood sugars in check. But what if you added some tuna fish? Tuna doesn't have any carbs, sugar, or starch so it shouldn't make a difference. Or maybe it would even lower the mashed potato spike by lowering the glycemic load of the whole meal? Instead you get twice the insulin spike. This also happens with white flour spaghetti versus white flour spaghetti with meat. The addition of animal protein makes the pancreas work twice as hard.

You can do it with straight sugar water too. If you do a glucose challenge test to test for diabetes, where you drink a certain amount of sugar and add some meat, you get a much bigger spike than without meat. And the more meat you add, the worse it gets. Just adding a little meat to carbs doesn't seem to do much, but once you get up to around a third of a chicken breast's worth, you can elicit a significantly increased surge of insulin. This may help explain why those eating plant-based have such low diabetes rates, because animal protein can markedly potentiate the insulin secretion triggered by carbohydrate ingestion.

The protein exacerbation of the effect of refined carbs could help explain the remarkable results achieved by Dr. Kempner with a don't-try-this-at-home diet composed of mostly white rice and sugar. See my video, Kempner Rice Diet: Whipping Us Into Shape.

Refined grains may also not be good for our blood pressure (see Whole Grains May Work As Well As Drugs).

What should we be eating to best decrease our risk of diabetes? See:

And check out my summary video, How Not to Die from Diabetes.

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 Not to Add to White Rice, Potatoes, or Pasta

What Not to Add to White Rice, Potatoes, or Pasta.jpeg

Rice currently feeds almost half the human population, making it the single most important staple food in the world, but a meta-analysis of seven cohort studies following 350,000 people for up to 20 years found that higher consumption of white rice was associated with a significantly increased risk of type 2 diabetes, especially in Asian populations. They estimated each serving per day of white rice was associated with an 11% increase in risk of diabetes. This could explain why China has almost the same diabetes rates as we do.

Diabetes rates in China are at about 10%; we're at about 11%, despite seven times less obesity in China. Japan has eight times less obesity than we do, yet may have a higher incidence of newly diagnosed diabetes cases than we do--nine per a thousand compared to our eight. They're skinnier and still may have more diabetes. Maybe it's because of all the white rice they eat.

Eating whole fruit is associated with lower risk of diabetes, whereas eating fruit processed into juice may not just be neutral, but actually increases diabetes risk. In the same way, eating whole grains, like whole wheat bread or brown rice is associated with lower risk of diabetes, whereas eating white rice, a processed grain, may not just be neutral, but actually increase diabetes risk.

White rice consumption does not appear to be associated with increased risk of heart attack or stroke, though, which is a relief after an earlier study in China suggested a connection with stroke. But do we want to eat a food that's just neutral regarding some of our leading causes of death, when we can eat whole foods that are associated with lower risk of diabetes, heart attack, stroke, and weight gain?

If the modern diabetes epidemic in China and Japan has been linked to white rice consumption, how can we reconcile that with low diabetes rates just a few decades ago when they ate even more rice? If you look at the Cornell-Oxford-China Project, rural plant-based diets centered around rice were associated with relatively low risk of the so-called diseases of affluence, which includes diabetes. Maybe Asians just genetically don't get the same blood sugar spike when they eat white rice? This is not the case; if anything people of Chinese ethnicity get higher blood sugar spikes.

The rise in these diseases of affluence in China over the last half century has been blamed in part on the tripling of the consumption of animal source foods. The upsurge in diabetes has been most dramatic, and it's mostly just happened over the last decade. That crazy 9.7% diabetes prevalence figure that rivals ours is new--they appeared to have one of the lowest diabetes rates in the world in the year 2000.

So what happened to their diets in the last 20 years or so? Oil consumption went up 20%, pork consumption went up 40%, and rice consumption dropped about 30%. As diabetes rates were skyrocketing, rice consumption was going down, so maybe it's the animal products and junk food that are the problem. Yes, brown rice is better than white rice, but to stop the mounting Asian epidemic, maybe we should focus on removing the cause--the toxic Western diet. That would be consistent with data showing animal protein and fat consumption associated with increased diabetes risk.

But that doesn't explain why the biggest recent studies in Japan and China associate white rice intake with diabetes. One possibility is that animal protein is making the rice worse. If you feed people mashed white potatoes, a high glycemic food like white rice, you can see in my video If White Rice is Linked to Diabetes, What About China? the level of insulin your pancreas has to pump out to keep your blood sugars in check. But what if you added some tuna fish? Tuna doesn't have any carbs, sugar, or starch so it shouldn't make a difference. Or maybe it would even lower the mashed potato spike by lowering the glycemic load of the whole meal? Instead you get twice the insulin spike. This also happens with white flour spaghetti versus white flour spaghetti with meat. The addition of animal protein makes the pancreas work twice as hard.

You can do it with straight sugar water too. If you do a glucose challenge test to test for diabetes, where you drink a certain amount of sugar and add some meat, you get a much bigger spike than without meat. And the more meat you add, the worse it gets. Just adding a little meat to carbs doesn't seem to do much, but once you get up to around a third of a chicken breast's worth, you can elicit a significantly increased surge of insulin. This may help explain why those eating plant-based have such low diabetes rates, because animal protein can markedly potentiate the insulin secretion triggered by carbohydrate ingestion.

The protein exacerbation of the effect of refined carbs could help explain the remarkable results achieved by Dr. Kempner with a don't-try-this-at-home diet composed of mostly white rice and sugar. See my video, Kempner Rice Diet: Whipping Us Into Shape.

Refined grains may also not be good for our blood pressure (see Whole Grains May Work As Well As Drugs).

What should we be eating to best decrease our risk of diabetes? See:

And check out my summary video, How Not to Die from Diabetes.

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

Eating Garlic and Raisins May Help Prevent Preterm Birth

NF-Apr7 Garlic and Raisins to Prevent Premature Birth.jpeg

The United States has one of the worst premature birth rates in the world, now ranking 131st worldwide. Even worse, over the last few decades, the rate of preterm birth in the U.S. has been going up.

We've known that preterm delivery is associated with significant problems during infancy, and almost three quarters of all infant deaths. Unfortunately even preemies who survive past infancy may carry a legacy of health issues, such as behavioral problems, moderate to severe neurodevelopmental disabilities and psychiatric disorders in half of those born extremely preterm by the time they reach school-age. There's even evidence now that adults born very prematurely are at increased risk for things like heart disease and diabetes. And babies don't even have to be born that premature to suffer long-term effects. Even so-called near-term births at 36 or 37 weeks are now thought to be related to subtle developmental problems. So what can pregnant women do to decrease this risk?

66,000 pregnant women were studied to examine whether an association exists between maternal dietary patterns and risk of preterm delivery. Researchers compared a so-called "prudent," which was more plant-based versus a Western or traditional Scandinavian diet (vegetables, fruits, oils, water as beverage, whole grain cereals, fiber rich bread) versus the "Western" (salty and sweet snacks, white bread, desserts, processed meat products), and found that the "prudent" pattern was associated with significantly reduced risk of preterm delivery.

Inflammation is thought to play a role in triggering delivery, so a diet characterized by high intakes of vegetables, fruit and berries can reduce both systemic and local inflammation, and the lower saturated fat levels would also be associated with reduced inflammation. Any foods in particular?

A significant percentage of preterm deliveries are thought to be related to infections and inflammatory conditions in the genital tract. Garlic is well-known for its antimicrobial properties, and also has probiotic dietary fibers that feed our good bacteria. Dried fruit is also packed with fiber and has antimicrobial activities against some of the bacteria suspected to play a role in preterm delivery.

Researchers (highlighted in my video, Garlic and Raisins to Prevent Premature Birth) studied the garlic, onion and dried fruit intake of nearly 19,000 pregnant women, and indeed, they observed a reduced risk of spontaneous preterm delivery related to groups of garlic and onion family vegetables and dried fruits. In particular, garlic stood out for the vegetables and raisins stood out for the dried fruit. Both were associated with a reduced risk of both preterm delivery and preterm pre-labor rupture of membranes, which means your water breaking prematurely (before 37 weeks). And it didn't seem to take much. The so-called "high" garlic intake associated with the lowest risk was just about one clove a week or more, and "high" raisin intake was defined as just one of those mini snack boxes of raisins a month.

Here's the video on aspartame (NutraSweet) and diet soda during pregnancy: Diet Soda and Preterm Birth.

Some other popular pregnancy videos include:

More on garlic in #1 Anti-Cancer Vegetable and Cancer, Interrupted: Garlic and Flavenoids.

Videos on dried fruit include:

In health,
Michael Greger, M.D.

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

Image Credit: Isabel Eyre / Flickr

Original Link

Dr. Greger’s 2015 Live Year-in-Review Presentation

Food as Medicine

View my new live presentation here: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet

Every year I scour the world's scholarly literature on clinical nutrition, pulling together what I find to be the most interesting, practical, and groundbreaking science on how to best feed ourselves and our families. I start with the thousands of papers published annually on nutrition (27,000 this year--a new record!) and, thanks to a crack team of volunteers (and now staff!), I'm able to whittle those down (to a mere 8,000 this year). They are then downloaded, categorized, read, analyzed, and churned into the few hundred short videos. This allows me to post new videos and articles every day, year-round, to NutritionFacts.org. This certainly makes the site unique. There's no other science-based source for free daily updates on the latest discoveries in nutrition. The problem is that the amount of information can be overwhelming.

Currently I have more than a thousand videos covering 1,931 nutrition topics. Where do you even begin? Many have expressed their appreciation for the breadth of material, but asked that I try to distill it into a coherent summary of how best to use diet to prevent and treat chronic disease. I took this feedback to heart and in 2012 developed Uprooting the Leading Causes of Death, which explored the role diet may play in preventing, arresting, and even reversing our top 15 killers. Not only did it rise to become one of the Top 10 Most Popular Videos of 2012, it remains my single most viewed video to date, watched over a million times (NutritionFacts.org is now up to more than 1.5 million hits a month!).

In 2013 I developed the sequel, More Than an Apple a Day, in which I explored the role diet could play in treating some of our most common conditions. I presented it around the country and it ended up #1 on our Top 10 Most Popular Videos of 2013. Then in 2014 I premiered the sequel-sequel, From Table to Able, in which I explored the role diet could play in treating some of our most disabling diseases, landing #1 on our Top 10 Most Popular Videos of 2014.

Every year I wonder how I'm going to top the year before. Knowing how popular these live presentations can be and hearing all the stories from folks about what a powerful impact they can have on people's lives, I put my all into this new 2015 one. I spent more time putting together this presentation than any other in my life. It took me an entire month, and when you see it I think you'll appreciate why.

This year, I'm honored to bring you Food as Medicine, in which I go through our most dreaded diseases--but that's not even the best part! I'm really proud of what I put together for the ending. I spend the last 20 minutes or so (starting at 56:22) going through a thought experiment that I'm hoping everyone will find compelling. I think it may be my best presentation ever. You be the judge.

You can watch it at no cost online, but it is also available on DVD through my website or on Amazon. If you want to share copies with others, I have a five for $40 special (enter coupon code 5FOR40FAM). All proceeds from the sales of all my books, DVDs, downloads, and presentations go to the 501c3 nonprofit charity that keeps NutritionFacts.org free for all, for all time. If you want to support this initiative to educate millions about eradicating dietary diseases, please consider making a donation.

After you've watched the new presentation, make sure you're subscribed to get my video updates daily, weekly, or monthly to stay on top of all the latest.

-Michael Greger

Original Link

Why Deep Fried Foods May Cause Cancer

NF-Jul21 Cancer Risk from French fries.jpg

In the latest study on dietary patterns and breast cancer risk among women, healthier eating was associated with eliminating three-quarters of the odds of breast cancer, whereas less healthy eating was associated with up to nearly eight times the odds. Included in the unhealthy eating pattern was the consumption of deep-fried foods, which have previously been linked to breast cancer, pancreatic cancer, lung cancer, oral and throat cancers, esophageal cancer, and cancer of the voicebox. No deep fried foods? What's a Southern belle to do? Instead of deep fried foods, how about the traditional Southern diet, characterized by high intakes of cooked greens, beans, legumes, cabbage, sweet potatoes and cornbread, which may reduce the risk of invasive breast cancer significantly.

What about the consumption of deep-fried foods and risk of prostate cancer? Researchers at the Fred Hutchinson Cancer Research Center and the University of Washington found that eating French fries, fried chicken, fried fish, and doughnuts was associated with about a third greater odds of prostate cancer. After stratifying for tumor aggressiveness, they found slightly stronger associations with more aggressive disease, suggesting that regular intake of deep-fried foods may contribute to the progression of prostate cancer as well.

What in deep fried foods is so bad for us? Just heating oil that hot can generate potentially carcinogenic compounds, and then known carcinogens such as heterocyclic amines and polycyclic aromatic hydrocarbons form when the muscles of chickens and fish are cooked at that temperature. Deep-fried plants, on the other hand, can form acrylamide.

I did a video about acrylamide back in 2008, suggesting it's a probable human carcinogen (See Acrylamide in French Fries). Since then, studies have suggested pregnant women may want to cut back on French fries to protect the growth of their baby's body and brain. Based on a study (highlighted in my video, Cancer Risk from French Fries) feeding people a little bag of potato chips every day for a month, it now seems acrylamide may also cause inflammation as well, which could explain its purported role in cancer progression.

Acrylamide intake has been associated with endometrial cancer, ovarian cancer, lung cancer, kidney cancer, and esophageal cancer. How much cancer risk are we talking about? Taiwanese researchers examined lifetime cancer risk and French fry consumption. The researchers picked on French fries because they comprise by far the greatest percentage contribution of acrylamide to the diets of children. They estimated that, at most, one or two boys and girls out of every ten thousand would develop cancer eating French fries that they would otherwise not have developed if they hadn't eaten French fries. So it's not as bad as eating something like fried fish, or fried chicken, but how much is that saying?

The level of cancer risk in both boys and girls associated with French fries depends on how long and hot they're fried. In Europe, the food industry swore that they'd self-regulate and control fry times to decrease acrylamide levels, but we've yet to see any subsequent change in acrylamide levels in French fries.

Researchers continue to urge that the cooking temperature should be as low as possible and the cooking time should be as short as possible, "while still maintaining a tasty quality" of course. We wouldn't want to reduce cancer risk too much--they might not taste as good!

Blanching the potatoes first reduces acrylamide formation, but potato chip companies complain that, not only would it muck with the flavor, but it would reduce the nutritional properties by leaching away some of the vitamin C. But if we're relying on potato chips to get our vitamin C, acrylamide is probably the least of our worries.

More on heterocyclic amines:

There are some things we can do to counteract the effects of these carcinogens, though:

I touch on polycyclic aromatic hydrocarbons in Meat Fumes: Dietary Secondhand Smoke and Is Liquid Smoke Flavoring Carcinogenic?
Certain fats may play a role in breast cancer survival as well: Breast Cancer Survival, Butterfat, and Chicken and Breast Cancer Survival and Trans Fat.

-Michael Greger, M.D.

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

Image Credit: Kim Love / Flickr

Original Link

The Reversal on Fish Oil

NF-Feb26 Is Fish Oil Just Snake Oil?.jpg

Are the purported benefits of fish oil supplementation for the prevention and treatment of heart disease just a "fish tale"? Thanks to recommendations from organizations such as the American Heart Association that individuals at high risk for heart disease ask their physicians about fish oil supplementation, fish oil has grown into a multibillion dollar industry. We now consume over 100,000 tons of fish oil every year.

But what does the science say? A systematic review and meta-analysis published in the Journal of the American Medical Association, highlighted in my video Is Fish Oil Just Snake Oil? looked at all the best "randomized clinical trials evaluating the effects of omega-3's on lifespan, cardiac death, sudden death, heart attack, and stroke." The studies told the subjects to either eat more oily fish or to take fish oil capsules. What did the study find? Overall, the researchers found no protective benefit for all-cause mortality, heart disease mortality, sudden cardiac death, heart attack, or stroke.

What about for those who already had a heart attack and are trying to prevent another? Still no benefit. Where did we even get this idea that omega 3's were good for the heart? If we look at some of the older studies, the results seemed promising. For example, there was the famous DART trial back in the 80s involving 2,000 men. Those advised to eat fatty fish had a 29% reduction in mortality. Pretty impressive--no wonder it got a lot of attention. But people seemed to have forgotten the sequel, the DART-2 trial. The same group of researchers, and an even bigger study (3,000 men). In DART-2 "those advised to eat oily fish and particularly those supplied with fish oil capsules had a higher risk of cardiac death."

Put all the studies together, and there's no justification for the use of omega 3s as a structured intervention in everyday clinical practice or for guidelines supporting more dietary omega-3's. So what should doctors say when their patients follow the American Heart Association advice to ask them about fish oil supplements? Given this and other negative meta-analyses, "our job as doctors should be to stop highly marketed fish oil supplementation in all of our patients."

I've previously discussed fish oil supplements in the context of risks versus purported cardiovascular benefits:

But if the benefits aren't there, then all one is left with are concerns over the industrial pollutants that concentrate in the fish fat (even in distilled fish oil, see Is Distilled Fish Oil Toxin-Free?).

These same contaminants are found in the fish themselves. This raises concern for adults (Fish Fog), children (Nerves of Mercury), and pregnant moms:

-Michael Greger, M.D.

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

Image Credit: Jo Christian Oterhals / Flickr

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How "Healthy Fats" Hurt You

Extracted Oils Are the Most Dangerous

The government, the food industry, even doctors may all bombard you with advice to eat so-called "healthy fats," in the form of:

  • olive oil (for monounsaturated fats)
  • other vegetable oils (for polyunsaturated fats)
  • fish oil (for long-chain omega-3 polyunsaturated fats)

But when you start looking closely, you will be faced with an unpleasant surprise. These extracted oils are dangerous in olive oil in cruet_opt.jpgthree major ways.

WHAT ARE EXTRACTED OILS?

No whole food is entirely fat. Instead, fat is mixed in with the thousands of other components of the food, including proteins, carbohydrates, vitamins, minerals, and (if it's a plant) protective phytochemicals that work as antioxidants.

Extracted oils are fats that are forced out of this whole food matrix and put into a capsule, bottle, or tub. Liquid vegetable oils, margarine, and fish oil are all examples of extracted oils.

WHAT FATS DO YOU NEED?

There are two kinds of fats you do need to get from your diet. These are the "short-chain" omega-3 and omega-6 fatty acids (which are polyunsaturated fats). Your daily need is low, only about 3% of your total calories. Extracted oils are not necessary to meet this requirement if you are eating a wide range of whole plant foods.

Given an adequate supply of calories from any source (including carbohydrates and proteins), your body can handily make other kinds of fats you use, including saturated and monounsaturated fat, and can construct long-chain omega-3 and omega-6's from their short-chain precursors.

HOW EXTRACTED OILS HURT YOU

CLICK HERE TO READ THE THREE WAYS THAT EXTRACTED OILS HARM YOU

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Foods for Glaucoma

NF-Dec30 Which Foods Fight Glaucoma?.jpg

Glaucoma is the second leading cause of legal blindness in white women, and the number one cause of blindness in African-American women. In a study I profile in the video Greens vs. Glaucoma, researchers chose a population of African-American women to study the effects of fruit and vegetable consumption on glaucoma risk because they were specifically interested in studying the effect of foods with the highest concentration of those eye-protecting phytonutrients like zeaxanthin. Zeaxanthin is found primarily in plants such as kale and collard greens. (It is also found in eggs--find out how much in Egg Industry Blind Spot). However, we'd be lucky if we could find one in ten white people eating even a single serving of these dark green leafy vegetables a month, whereas nearly nine out of ten African-American women in the study consumed this amount.

What did the researchers find? Well, as I've stressed over the years, all fruits and vegetables are not the same (see for example, How to Reach the Antioxidant "RDA"). Whether the participants hardly ever ate bananas or had one or more every day didn't seem to matter much in terms of the risk of glaucoma. However, eating only a couple oranges every week was associated with dramatically lower risk. Orange juice was not associated with a lower risk, though, even if drunk every day. A similar finding was found for peaches: fresh peaches seemed to help, but canned peaches didn't.

Similarly the intake of vegetables in general as a catch-all term didn't seem to matter. For example, whether subjects ate a green salad twice a week, once a week, or zero times a week didn't seem to matter when it came to reducing glaucoma risk, but most people's salads are pretty pitiful. It was a different story for kale and collard greens: just two or three servings a month was associated with half the risk of glaucoma compared to once a month or less.

It may be especially important for white people to consume kale and collard greens. The lighter our eye color, the more greens we need to eat. Blue eyes let 100 times more light through, so people with blue or gray eyes appear significantly more vulnerable to damage compared to brown or black. Green and hazel fall somewhere in the middle.

This is interesting: carrots appeared to be less protective in black women compared to white women. They suggest it could be a difference in food preparation methods. Perhaps the African-American subjects tended to eat carrots raw, limiting the absorption of certain nutrients, while they chopped and prepared their collard greens with oil, making the nutrients more bioavailable because the absorption of carotenoid phytonutrients depends on the presence of fat. This is why I encourage people to eat nuts or seeds with the greens--such as a little tahini sauce or something.

Why not just take a zeaxanthin pill? We don't know what exactly it is in these wonderful foods that's working their wonders, so it's probably better to just eat our greens rather than supplements. In fact, people that take calcium or iron supplements may even be doubling, quadrupling, or septupling their odds of glaucoma. It's better to get most of our nutrients from produce, not pills.

I wish there were more studies on under-represented populations. I've covered a few, such as Preventing Breast Cancer By Any Greens Necessary, but I am constantly on the lookout for more.

My other videos on glaucoma include Prevent Glaucoma and See 27 Miles Farther and Dietary Treatment of Glaucoma. For more on eye health check out my video, Dietary Prevention of Age-Related Macular Degeneration.

-Michael Greger, M.D.

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

Image Credit: bruno garciact / Flickr

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