The Best Diet for Rheumatoid Arthritis

The Best Diet for Rheumatoid Arthritis.jpeg

Rheumatoid arthritis is a chronic systemic autoimmune disease affecting millions. It is characterized by persistent pain, stiffness, and progressive joint destruction leading to crippling deformities, particularly in the hands and feet. What can we do to prevent and treat it?

In my video Why Do Plant-Based Diets Help Rheumatoid Arthritis?, I show a famous 13-month randomized controlled trial of plant-based diets for rheumatoid arthritis where patients were put on a vegan diet for three and a half months and then switched to an egg-free lactovegetarian diet for the remainder of the study. Compared to the control group (who didn't change their diet at all), the plant-based group experienced significant improvements starting within weeks. Their morning stiffness improved within the first month, cutting the number of hours they suffered from joint stiffness in half. Their pain level dropped from 5 out of 10 down to less than 3 out of 10. Disability levels dropped, and subjects reported feeling better; they had greater grip strength, fewer tender joints, less tenderness per joint, and less swelling. They also had a drop in inflammatory markers in their blood, such as sedimentation rate, C-reactive protein, and white blood cell count. As a bonus, they lost about 13 pounds and kept most of that weight off throughout the year.

What does diet have to do with joint disease?

Rheumatoid arthritis is an autoimmune disease, in which our own body attacks the lining of our joints. There's also a different autoimmune disease called rheumatic fever, in which our body attacks our heart. Why would it do that? It appears to be a matter of friendly fire.

Rheumatic fever is caused by strep throat, which is itself caused by a bacterium that has a protein that looks an awful lot like a protein in our heart. When our immune system attacks the strep bacteria, it also attacks our heart valves, triggering an autoimmune attack by "molecular mimicry." The protein on the strep bacteria is mimicking a protein in our heart, so our body gets confused and attacks both. That's why it's critical to treat strep throat early to prevent our heart from getting caught in the crossfire.

Researchers figured that rheumatoid arthritis might be triggered by an infection as well. A clue to where to start looking was the fact that women seem to get it three times more frequently than men. What type of infection do women get more than men? Urinary tract infections (UTIs). So researchers started testing the urine of rheumatoid arthritis sufferers and, lo and behold, found a bacterium called Proteus mirabilis. Not enough to cause symptoms of a UTI, but enough to trigger an immune response. And indeed, there's a molecule in the bacterium that looks an awful lot like one of the molecules in our joints.

The theory is that anti-Proteus antibodies against the bacterial molecule may inadvertently damage our own joint tissues, leading eventually to joint destruction. Therefore, interventions to remove this bacteria from the bodies of patients, with consequent reduction of antibodies against the organism, should lead to a decrease in inflammation.

As we saw in my video Avoiding Chicken to Avoid Bladder Infections, urinary tract infections originate from the fecal flora. The bacteria crawl up from the rectum into the bladder. How might we change the bugs in our colons? By changing our diet.

Some of the first studies published more than 20 years ago to fundamentally shift people's gut flora were done using raw vegan diets, figuring that's about as fundamental a shift from the standard Western diet as possible. Indeed, within days researchers could significantly change subjects' gut flora. When researchers put rheumatoid arthritis sufferers on that kind of diet, they experienced relief, and the greatest improvements were linked to greatest changes in gut flora. The diet was considered so intolerable, though, that half the patients couldn't take it and dropped out, perhaps because they were trying to feed people things like "buckwheat-beetroot cutlets" buttered with a spread made out of almonds and fermented cucumber juice.

Thankfully, regular vegetarian and vegan diets work too, changing the intestinal flora and improving rheumatoid arthritis. However, we didn't specifically have confirmation that plant-based diets brought down anti-Proteus antibodies until 2014. Subjects that responded to the plant-based diet showed a significant drop in anti-Proteus mirabilis antibodies compared to the control group. Maybe it just dropped immune responses across the board? No, antibody levels against other bugs remained the same, so the assumption is that the plant-based diet reduced urinary or gut levels of the bacteria.

A shift from an omnivorous to a vegetarian diet has a profound influence on the composition of urine as well. For example, those eating plant-based had higher levels of lignans in their urine. Up until now, it was thought that they only protected people from getting cancer, but we now know lignans can also have antimicrobial properties. Perhaps they help clear Proteus mirabilis from the system. Either way, these data suggest a new type of therapy for the management of rheumatoid arthritis: anti-Proteus measures including plant-based diets.


I have to admit I had never even heard of Proteus mirabilis. That's why I love doing work--I learn as much as you do!

I explored another unconventional theory as to why plant-based diets are so successful in treating inflammatory arthritis in Potassium and Autoimmune Disease.

There's another foodborne bacteria implicated in human disease, the EXPEC in chicken leading to urinary tract infections--another game-changer: Avoiding Chicken To Avoid Bladder Infections.

I have a bunch of videos on gut flora--the microbiome. They 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:

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

Original Link

The Best Diet for Rheumatoid Arthritis

The Best Diet for Rheumatoid Arthritis.jpeg

Rheumatoid arthritis is a chronic systemic autoimmune disease affecting millions. It is characterized by persistent pain, stiffness, and progressive joint destruction leading to crippling deformities, particularly in the hands and feet. What can we do to prevent and treat it?

In my video Why Do Plant-Based Diets Help Rheumatoid Arthritis?, I show a famous 13-month randomized controlled trial of plant-based diets for rheumatoid arthritis where patients were put on a vegan diet for three and a half months and then switched to an egg-free lactovegetarian diet for the remainder of the study. Compared to the control group (who didn't change their diet at all), the plant-based group experienced significant improvements starting within weeks. Their morning stiffness improved within the first month, cutting the number of hours they suffered from joint stiffness in half. Their pain level dropped from 5 out of 10 down to less than 3 out of 10. Disability levels dropped, and subjects reported feeling better; they had greater grip strength, fewer tender joints, less tenderness per joint, and less swelling. They also had a drop in inflammatory markers in their blood, such as sedimentation rate, C-reactive protein, and white blood cell count. As a bonus, they lost about 13 pounds and kept most of that weight off throughout the year.

What does diet have to do with joint disease?

Rheumatoid arthritis is an autoimmune disease, in which our own body attacks the lining of our joints. There's also a different autoimmune disease called rheumatic fever, in which our body attacks our heart. Why would it do that? It appears to be a matter of friendly fire.

Rheumatic fever is caused by strep throat, which is itself caused by a bacterium that has a protein that looks an awful lot like a protein in our heart. When our immune system attacks the strep bacteria, it also attacks our heart valves, triggering an autoimmune attack by "molecular mimicry." The protein on the strep bacteria is mimicking a protein in our heart, so our body gets confused and attacks both. That's why it's critical to treat strep throat early to prevent our heart from getting caught in the crossfire.

Researchers figured that rheumatoid arthritis might be triggered by an infection as well. A clue to where to start looking was the fact that women seem to get it three times more frequently than men. What type of infection do women get more than men? Urinary tract infections (UTIs). So researchers started testing the urine of rheumatoid arthritis sufferers and, lo and behold, found a bacterium called Proteus mirabilis. Not enough to cause symptoms of a UTI, but enough to trigger an immune response. And indeed, there's a molecule in the bacterium that looks an awful lot like one of the molecules in our joints.

The theory is that anti-Proteus antibodies against the bacterial molecule may inadvertently damage our own joint tissues, leading eventually to joint destruction. Therefore, interventions to remove this bacteria from the bodies of patients, with consequent reduction of antibodies against the organism, should lead to a decrease in inflammation.

As we saw in my video Avoiding Chicken to Avoid Bladder Infections, urinary tract infections originate from the fecal flora. The bacteria crawl up from the rectum into the bladder. How might we change the bugs in our colons? By changing our diet.

Some of the first studies published more than 20 years ago to fundamentally shift people's gut flora were done using raw vegan diets, figuring that's about as fundamental a shift from the standard Western diet as possible. Indeed, within days researchers could significantly change subjects' gut flora. When researchers put rheumatoid arthritis sufferers on that kind of diet, they experienced relief, and the greatest improvements were linked to greatest changes in gut flora. The diet was considered so intolerable, though, that half the patients couldn't take it and dropped out, perhaps because they were trying to feed people things like "buckwheat-beetroot cutlets" buttered with a spread made out of almonds and fermented cucumber juice.

Thankfully, regular vegetarian and vegan diets work too, changing the intestinal flora and improving rheumatoid arthritis. However, we didn't specifically have confirmation that plant-based diets brought down anti-Proteus antibodies until 2014. Subjects that responded to the plant-based diet showed a significant drop in anti-Proteus mirabilis antibodies compared to the control group. Maybe it just dropped immune responses across the board? No, antibody levels against other bugs remained the same, so the assumption is that the plant-based diet reduced urinary or gut levels of the bacteria.

A shift from an omnivorous to a vegetarian diet has a profound influence on the composition of urine as well. For example, those eating plant-based had higher levels of lignans in their urine. Up until now, it was thought that they only protected people from getting cancer, but we now know lignans can also have antimicrobial properties. Perhaps they help clear Proteus mirabilis from the system. Either way, these data suggest a new type of therapy for the management of rheumatoid arthritis: anti-Proteus measures including plant-based diets.


I have to admit I had never even heard of Proteus mirabilis. That's why I love doing work--I learn as much as you do!

I explored another unconventional theory as to why plant-based diets are so successful in treating inflammatory arthritis in Potassium and Autoimmune Disease.

There's another foodborne bacteria implicated in human disease, the EXPEC in chicken leading to urinary tract infections--another game-changer: Avoiding Chicken To Avoid Bladder Infections.

I have a bunch of videos on gut flora--the microbiome. They 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:

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

Original Link

Confessions from a Former Big Pharma Rep – Vanessa’s Journey from Pill Pusher to Plant-Based Healer

It's not everyday you meet an NFL cheerleader, unless you're a professional football player. It's even more rare that you meet an NFL cheerleader turned Big Pharma rep, unless maybe you're a doctor or pharmacist. And it's almost unheard of that you meet a former NFL cheerleader and Big Pharma rep who gave up the American lifestyle that people only dream of in order to heal patients using plants over pills.

Meet Vanessa Sardi - Former New Orleans Saint's cheerleader and Big Pharma rep who said goodbye to a cushy, six-figure salary to help those in need end their battle with chronic disease(s). Vanessa does this using a grocery list, NOT a prescription list.

I was fortunate enough to meet Vanessa recently and asked her if she'd be willing to share her life-transforming story from pill pusher to plant-based healer. She graciously accepted, and so follows...

Read Interview Here.

Original Link

Confessions from a Former Big Pharma Rep – Vanessa’s Journey from Pill Pusher to Plant-Based Healer

It's not everyday you meet an NFL cheerleader, unless you're a professional football player. It's even more rare that you meet an NFL cheerleader turned Big Pharma rep, unless maybe you're a doctor or pharmacist. And it's almost unheard of that you meet a former NFL cheerleader and Big Pharma rep who gave up the American lifestyle that people only dream of in order to heal patients using plants over pills.

Meet Vanessa Sardi - Former New Orleans Saint's cheerleader and Big Pharma rep who said goodbye to a cushy, six-figure salary to help those in need end their battle with chronic disease(s). Vanessa does this using a grocery list, NOT a prescription list.

I was fortunate enough to meet Vanessa recently and asked her if she'd be willing to share her life-transforming story from pill pusher to plant-based healer. She graciously accepted, and so follows...

Read Interview Here.

Original Link

Five Dangers of Eating Poultry

Chicken and Turkey Are Health Risks All Year Long

Turkeys are the routine centerpiece of many holiday meals, while chickens are a common "main course" for everyday dinners. Yet when you look closely at poultry, the health dangers may surprise you, and guide you to make life-affirming choices instead. Here are five hazards you should know about if you think that chicken and turkey are "health foods."

POULTRY INCREASES YOUR RISK OF WEIGHT GAIN

Chicken and turkey are portrayed as smart choices if you are trying to lose weight. Reality proves this is false advertising. A study in Europe followed 373,803 participants for an average of five years to see what foods were linked to weight gain over time. The strongest association was found for poultry.

The researchers point out that all meat is calorie-dense. According to the USDA, three ounces of light meat, roasted chicken (one "serving") contains 147 calories, while an equivalent amount of light meat, roasted turkey has 125 calories.chicken 1 resized smaller.jpg This might not sound like much, until you realize that a "serving" is about the size of a deck of cards, while your stomach is about the size of a liter bottle. How many poultry servings would it take to fill that bottle? Lots of calories, and with zero associated fiber in the birds to make you feel full.

If you want to stop or reverse weight gain, try a whole foods, animal-free diet. Numerous studies consistently show that people who choose a plant-based lifestyle are leaner than those who eat animal foods, including poultry.

A SIDE OF CANCER WITH THAT BIRD

Several studies indicate that eating poultry and exposure to chickens and turkey over prolonged periods of time raise the risk of various kinds of cancer.

  • A study in Shanghai and another in the US found eating more poultry boosted breast cancer risk. In the American study, Caucasian women who ate the most poultry had a 42% high likelihood of developing breast cancer.
  • A European study of more than 477,000 people found that each additional 1.76 ounces of poultry eaten per day raised pancreatic cancer risk by 72%.

Researchers have tested the idea that viruses in chickens and turkeys that cause cancer may infect people, greatly increasing cancer likelihood. The easiest way to study this is in poultry workers, who have been found to have alarmingly higher incidence of liver, pancreatic, and brain cancer. Those who grow up on a poultry farm have an especially high incidence of blood cancers.

Does this mean that if you are not in one of these groups, you don't have to worry?

Click here to read more about the health dangers of eating poultry

Original Link

Seeing Red

The best advice I ever received was perhaps in the 9th grade. I told my English teacher I wanted to be a writer. She gave me a puzzling frown and replied, "Don't study to be a writer, do something with your life and write about it. The best writing comes when you write what you know."

Twenty years later, I am a physiciphoto (1).JPGan. My undergraduate degree was in communication studies and deep down, all I ever wanted to do was write. Little did I know that between medical education, a marriage, and three children, I wouldn't find many spare moments in my day to write.

I addition to practicing obstetrics and gynecology, I also practice a plant based died. The journey to health through nutrition has been mostly self-taught, so I was absolutely delighted when I was approached to share my perspectives on Vegsource.com as a blogger. But with contemporaries like Drs. Greger, Klaper, and Popper...I was curious what angle I could possibly bring to the picture.

And then today, just days after receiving my blog access, I was delivered to the very best setting to begin to share my insights as a plant based physician. And of all places, it was the American Heart Association Go Red For Women luncheon. Last I checked it wasn't exactly a secret heart disease kills more American women than all cancers combined. But shall we start from the beginning?

A few months ago I was flattered to be invited join a local philanthropic women's group composed of thought leaders who desired to use their influence to spread the word about heart health. Of all the anticipatory guidance and preventive screening I provide in my practice, heart health is certainly something I discus, so the group seemed like a perfect fit. I could share what I know about diet and lifestyle changes to prevent and reverse heart disease, and due to the group's ties to the American Heart Association, I could gain access to more resources to share with my patients.

The group has met for several social and educational events and I was even asked to share tips for making changes towards a heart-healthy diet. Without an overt vegan agenda, I shared how some of the very best data we have on heart disease came from the human subjects in the Framingham Heart Study--and that nutrition status is a crucial and modifiable risk factor. I briefly reviewed how a high fiber, low fat diet will lower cholesterol, etc. And after my presentation was complete, the group proceeded with a "heart healthy" cooking class where duck breast, salmon, and fat-laden Caesar salad was prepared. I drove home heavy-hearted, feeling as though I had not done enough to point out the forest from the trees.

Today I found myself at the biggest event of the year, the Go Red For Women Luncheon. Following a silent auction of themed purses and gift baskets, over 400 attendees were seated in a beautifully decorated dining room for lunch. As a side note, I had contributed to the auction by enthusiastically donating a vegan tote bag stuffed with materials from the Physicians Committee for Responsible Medicine and Prevent and Reverse Heart Disease by Dr. Caldwell Esselstyn.

I had not, however, taken any trouble to request a meal free of animal products. I can usually get away with being a "low profile vegan," and I was fully expecting to be served some standard banquet vegetarian plate of steamed potatoes and green beans. I truly did not expect what was awaiting me at the table. And I quote from the menu--

Sliced tenderloin of beef over wild rice salad

Baby spinach, Roasted red pepper, Kalamata olive, toasted pine nuts and sherry vinaigrette

Drizzled with watercress pesto

Flourless chocolate cake with white chocolate mikado,

Dark chocolate ganache, white chocolate drizzle, and chocolate fudge sauce

It was my choice to come and also my choice whether or not I wanted to eat. I wasn't going to starve (and was already thinking of the fresh fruit I keep on hand back at my office), so as the presentation began, I settled in for heartwarming stories from survivors and local celebrities, and politely sipped my ice water.

Then it happened. After the blessing, the emcee invited us to enjoy our "heart healthy lunch."

Whoa! Back up a second.

I can accept banquet food. And I can accept that not all venues cater to all dietary preferences, especially when I had not asked in advance. But if I donated a 4-figure sum to attend this fundraiser, I expect to not be lied to or have my intelligence insulted at the suggestion of a "heart healthy lunch."

The presentations were lovely and I unfortunately had to leave before the end in order to resume my afternoon clinical responsibilities. As I drove back to the hospital from downtown, I felt so empty. Sure, my stomach was empty, but I felt more bereft by the missed opportunity I had witnessed. Somehow a brilliant committee of very passionate and dedicated women had managed to get hundreds of women to pay to attend this luncheon, had dozens more sponsor the event financially, and even more than that donate purses for the auction.

Yet, when the fork hit the plate, no one in the room was any wiser about the absolutely most important, crucial, and yet simple way to decrease their risk of heart disease.

By serving a meal that represented just about every misconception of the standard American diet, not to mention touting it as "heart-healthy," every attendee's current nutrition beliefs were only reinforced.

While researching for this post, I went to the American Heart Association website to check some statistics. Today, on the front page was a link to a Huffington Post blog by American Heart Assocation CEO Nancy Brown discussing Dr. Ancel Keys' data about how limiting saturated fat helps your heart. She specifically quotes the November 2013 lifestyle guidelines released by the American Heart Association and American College of Cardiology, which recommended, "limiting saturated fats to about 5 or 6 percent of daily calories to lower blood pressure and "bad" cholesterol (LDL)."

So, with that in mind, let's recap an overview of the nutrition information from today's lunch. I'm not much of an app person, but I do love My Fitness Pal. I utilized this database to plug-in my kind estimations of the food items presented to me today. For 6 oz of beef tenderloin, ½ cup of rice (not accounting for the glistening oil or animal fat I could see it had been bathed in), ¼ cup spinach, and flourless chocolate cake with dollop of whipped cream, it estimated the meal to be 717 calories, with 25% from carbohydrates, 46% from fat, and 29% from protein. Of the 40 grams of fat, 21 were estimated to be saturated fat. Ok, tenderloin is leaner than a pork chop, spinach is green, and chocolate has antioxidants, but no matter how you slice this, I was not served a heart-healthy meal.

Suppose I could overlook the meal. The theme of high fat, low fiber recommendations pervaded the recipes included in the program. The broccoli salad called for mayonnaise, sour cream, and bacon. The nutrition information indicated that 40% of the calories per serving came from fat. Again, the opportunity to share a truly heart-healthy recipe was missed.

Do you need to eat a vegan diet to be healthy? Not necessarily. Has a vegan diet been proven again and again to prevent and reverse heart disease in literally millions of subjects? Yes. Was the topic of a plant based diet even briefly mentioned as an option at this event? No.

Per the American Heart Association website, "Most vegetarian diets are low in or devoid of animal products. They're also usually lower than nonvegetarian diets in total fat, saturated fat and cholesterol. Many studies have shown that vegetarians seem to have a lower risk of obesity, coronary heart disease (which causes heart attack), high blood pressure, diabetes mellitus and some forms of cancer."

How hard would it have been to throw that information in the line-up today? And how many lives could we save if we spent less time trying to raise money and more time trying to really educate people on simple changes such as diet?

The one activity most Americans make time to do every day is eat (ok, and sleep). When we eat we make choices. If you are reading this, you are somewhere on your own journey to wellness through nutrition. Whoever you are and wherever you came from, I welcome you on the path. And until we meet here again, I want to leave you with the slogan the American Heart Associated printed on the donation cards at each seat today -- "Speak Red." In the case of my lunch, the language of Red appeared to be red meat. That had me "Seeing Red." I had the choice to leave the luncheon disappointed and unchanged, but instead I decided to Speak to all of you about how I feel we are still in the Red with our efforts to adequately educate this nation about heart disease.

Let's keep this conversation going. Let's commend the Go Red For Women organization for having over 1.6 million sponsors and raising over $36 million towards education and research. But let's also, as citizens, donors, physicians, and women, insist that the right messages be sent with this money. Let's continue to work with these organizations to provide the whole story, especially when it comes to educating women about all the ways of decreasing their risk of dying of heart disease.

P.S. When I arrived home this evening, I found an invitation to an upcoming American Heart Association event entitled "Advocacy Afterhours", to review key heart disease and stroke priorities with key volunteers.

Despite the events of today, I'm more motivated than ever to assist in educating people about heart disease.

But next time, I'll eat before I go.

Original Link

Male Fertility and Dietary Pollutants

 

 

 

 

 

 

 

 

Male Fertility and Diet

Infertility affects 10–15 percent of couples attempting to conceive, and in about half the cases the problem is in the man. A recent Harvard study found that increasing saturated fat intake just 5 percent was associated with a 38 percent lower sperm count, but why? It may be because of endocrine-disrupting industrial pollutants that build up in animal fat, particularly fish, as I describe in my video Xenoestrogens & Sperm Counts, but male fertility is not just about the number of sperm, but also how well they work.

A recent study, featured in my 5-min video Male Fertility and Diet, found that successful pregnancy and fertilized egg implantation outcomes are decreased in patients reporting a more frequent intake of meat. The researchers blame industrial pollutants and steroids present in animal products. They conclude that couples having trouble conceiving must be advised about the dramatic effects diet may play on treatment success for both men and women, consistent with previous findings that “frequent intake of fat-laden foods like meat products or milk may negatively affect semen quality in humans, whereas some fruits or vegetables may maintain or improve semen quality.” Vegetable consumption was also found protective in this new study, which may be because of the antioxidant and nutrient content.

The reason why maternal beef consumption may alter a man’s testicular development and adversely affect his future reproductive capacity is thought to be due to the anabolic steroids implanted into the animals. However, as an accompanying editorial to a study exploring this phenomenon pointed out, the steroids could also be interacting with other xenobiotics—industrial chemicals present in meat—such as pesticides and dioxin-like pollutants, and even chemicals that may be present in the plastic wrap (see Dioxins in the Food Supply). For more on the hormones used in meat production, see my video Anabolic Steroids in Meat.

Heavy metals may also play a role. Lead and cadmium exposure, as measured by levels in the bloodstream, were associated with a significantly longer time to conceive. Where might exposure be coming from? Common types of seafood from fish markets and supermarkets were sampled. The highest cadmium levels were found in tuna; highest lead levels in scallops and shrimp. The greatest risk from different metals resided in different fish. Thus, the risk information given to the public (mainly about mercury) does not present a complete picture. There are other toxic metals in fish as well.

For more on heavy metal exposure (dietary as opposed to auditory), see:

The only beverage associated with infertility in women was soft drinks, though this may be from an indirect route, since soda is linked to obesity and obesity is then linked to reduced fertilization rates. However, Harvard researchers conducted a study on one really direct route: “The Effectiveness of Coca Cola As a Spermicidal Agent in Vaginal Douching.” Diet coke apparently had the strongest effect. What about Coke versus Pepsi? Tax-payer money hard at work for this head-to-head test. Neither of them really worked—Coke nor Pepsi—though they explain their methods for preparing the "sperm-cola mixtures" differed from the Harvard group. Bottom line: soda probably isn’t good for you going into any orifice.

For more on both male and female infertility, see my videos Soy Hormones & Male Infertility and Meat Hormones & Female Infertility.

-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 and More Than an Apple a Day.

Image credit: Jug Jones/ Flickr

Original Link

Trans Fat in Animal Fat

 

 

 

 

 

 

 

 

Trans Fat in Meat and Dairy

Trans fats are bad. They may increase one’s risks of heart disease, sudden death, diabetes—and perhaps even aggression. Trans fat intake has been associated with overt aggressive behavior, impatience, and irritability.

Trans fats are basically found in only one place in nature: animal fat. The food industry, however, found a way to synthetically create these toxic fats by hardening vegetable oil in a process called hydrogenation, which rearranges their atoms to make them behave more like animal fats.

Although most of America’s trans fat intake has traditionally come from processed foods containing partially-hydrogenated oils, a fifth of the trans fats in the American diet used to come from animal products—1.2 grams out of the 5.8 total consumed daily. Now that trans fat labeling has been mandated, however, and places like New York City have banned the use of partially hydrogenated oils, the intake of industrial-produced trans fat is down to about 1.3, so about 50 percent of America’s trans fats come now from animal products.

Which foods naturally have significant amounts of trans fat? According to the official USDA nutrient database, cheese, milk, yogurt, burgers, chicken fat, turkey meat, bologna, and hot dogs contain about 1 to 5 percent trans fats (see the USDA chart in Trans Fat In Meat And Dairy). There are also tiny amounts of trans fats in non-hydrogenated vegetable oils due to steam deodorization or stripping during the refining process.

Is getting a few percent trans fats a problem, though? The most prestigious scientific body in the United States, the National Academies of Science (NAS), concluded that the only safe intake of trans fats is zero. In their report condemning trans fats, they couldn’t even assign a Tolerable Upper Daily Limit of intake because “any incremental increase in trans fatty acid intake increases coronary heart disease risk.” There may also be no safe intake of dietary cholesterol, which underscores the importance of reducing animal product consumption. See my video Trans Fat, Saturated Fat, and Cholesterol: Tolerable Upper Intake of Zero.

There’s been controversy, though, as to whether the trans fats naturally found in animal products are as bad as the synthetic fats in partially hydrogenated junk food. The latest study supports the notion that trans fat intake, irrespective of source—animal or industrial—increases cardiovascular disease risk, especially, it appears, in women.

“Because trans fats are unavoidable on ordinary, non-vegan diets, getting down to zero percent trans fats would require significant changes in patterns of dietary intake,” reads the NAS report. One of the authors, the Director of Harvard’s Cardiovascular Epidemiology Program, famously explained why—despite this—they didn’t recommend a vegan diet: “We can’t tell people to stop eating all meat and all dairy products,” he said. “Well, we could tell people to become vegetarians,” he added. “If we were truly basing this only on science, we would, but it is a bit extreme.”  

Wouldn’t want scientists basing anything on science now would we?

“Nevertheless,” the report concludes, “it is recommended that trans fatty acid consumption be as low as possible while consuming a nutritionally adequate diet.”

Even if you eat vegan, though, there’s a loophole in labeling regulations that allows foods with a trans fats content of less than 0.5 grams per serving to be listed as having—you guessed it—zero grams of trans fat. This labeling is misguiding the public by allowing foods to be labeled as ”trans fat free” when they are, in fact, not. So to avoid all trans fats, avoid meat and dairy, refined oils, and anything that says partially hydrogenated in the ingredients list, regardless of what it says on the Nutrition Facts label.

More on trans fat can be found in my videos Blocking the First Step of Heart Disease and Breast Cancer Survival and Trans Fat.

While unrefined oils such as extra virgin olive should not contain trans fats, to boost the absorption of carotenoids in your salad why not add olives themselves or whole food sources of fat such as nuts or seeds? Other videos on oils include:

-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 and More Than an Apple a Day.

Image credit: PKMousie / Flickr

Original Link

My Testimony Before the 2015 Dietary Guidelines Committee

 

 

 

 

 

 

 

 

My Testimony Before the 2015 Dietary Guidelines Committee

This week I had the honor of speaking before the 2015 Dietary Guidelines Advisory Committee, which is responsible for making evidence-based recommendations on the next round of federal nutrition advice. Normally such meetings devolve into a platform for moneyed interests to lobby on behalf of their corporate clients, but if you watch the video, I think you'll be as surprised as I at the number of presenters pushing sane, healthy choices. For example, four out of the first five speakers promoted a plant-based diet. Kathy Freston closed out the morning session (min. 1:55:52) and actress Marilu Henner shares a heartfelt appeal at 2:23:10.

The entire video is worth watching if just for the political education value. Big Sugar and Big Meat were on hand. You (almost) feel bad for the representative from the National Confectioner's (candy) Association. A good sign was how defensive the industry lobbyists sounded, encapsulated in press releases such as "Keep Dairy in the American Diet, National Milk Producers Federation Urges."

The morning's highlight can be seen at 1:31:05. Dr. Mona Sigal had just gotten through condemning the USDA for their cheese-pushing scandal at the behest of the dairy lobby, decrying the inordinate role Big Dairy has played in manipulating the dietary guidelines. The audience broke out into laughter as the next speaker was introduced: Jill Nicholls from the National Dairy Council.

Here's a transcript of my comments (min. 17:18):

In the Permanente Journal last year, the official peer-reviewed publication of our nations largest managed care organization, a “Nutrition Update for Physicians” was published, which concluded that “Healthy eating maybe best achieved with a plant-based diet,” which they defined as a diet that encourages whole plant-based foods and discourages meat, dairy products, and eggs as well as empty calorie junk. To quote their conclusion: "Research shows that plant-based diets are cost-effective, low-risk interventions that may lower body mass index, blood pressure, HbA1C, and cholesterol levels. They may also reduce the number of medications needed to treat chronic diseases and lower ischemic heart disease mortality rates. Physicians should consider recommending a plant-based diet to all their patients, especially those with high blood pressure, diabetes, cardiovascular disease, or obesity," which of course describes a bulk of our population.

This sentiment was echoed last summer by the American Institute for Cancer Research—probably the most preeminent institution on diet and cancer risk—when they explicitly endorsed a diet revolving around whole plant foods: vegetables, whole grains, fruits and beans.

I’ve personally been eating a plant-rich diet since 1990, when Dr. Dean Ornish published his Lifestyle Heart Trial in The Lancet, angiographically proving that heart disease could be reversed with the help of a plant-based diet, opening up arteries without drugs, without surgery. If that’s all a plant-based diet could do, reverse our number one killer of men and women, then shouldn’t that be our default dietary recommendation until proven otherwise? And the fact that plant-based diets can also be effective in preventing, treating, and arresting other leading killers, such as type 2 diabetes and hypertension, would seem to make the case for plant-based eating overwhelming.

Now to the last Guideline Committee’s great credit, the 2010 guidelines were a leap in the right direction, recognizing food as a package deal. Yes there’s calcium in dairy, protein in pork, iron in beef, but because of the baggage that comes along (like the saturated fat and cholesterol), plant sources are preferable, because then the “baggage’ we get is the fiber, the folate, the phytonutrients, etc.

I would like to see the committee be more explicit, though. When “eat-more” recommendations are issued, the messaging is clear—for example, “Increase vegetable and fruit intake.” But when there’s a conflict between USDA’s dual role to protect the public while at the same time promoting agricultural products, recommendations often resort to speaking in cryptic biochemical components, such as “Reduce intake of solid fats (major sources of saturated and trans fatty acids).” How about instead, eat less cheese. Or messages like drink less soda.  Eat less meat, particularly processed meat. The American Institute for Cancer Research just comes out and says it: “Processed meat like bacon, sausage, and cold cuts should be avoided.” Period. They don’t need to sell food; they just want to prevent cancer.

I am not here today on behalf of the broccoli lobby (though I'd be honored to represent big broccoli). I am not here representing any financial interest. I am here as a physician, representing the interests of the hundreds of thousands of Americans that continue to suffer and die every year from chronic disease. And you can help them by recommending a more plant-based diet.

For those interested in my thoughts about the last round of federal dietary guidelines I've compiled them into a 14 part video series:

  1. Nation’s Diet in Crisis
  2. Dietary Guidelines: Corporate Guidance
  3. Dietary Guidelines: With a Grain of Big Salt
  4. Dietary Guidelines: USDA Conflicts of Interest
  5. Dietary Guidelines: Just Say No
  6. Dietary Guidelines: The First 25 Years
  7. Dietary Guidelines: From Dairies to Berries
  8. Dietary Guidelines: It’s All Greek to the USDA
  9. Plant Protein Preferable
  10. Dietary Guidelines: Science Versus Corporate Interests
  11. Dietary Guidelines: Advisory Committee Conflicts of Interest
  12. New Dietary Guidelines for Americans
  13. Dietary Guidelines: Progressing From Pyramid to Plate
  14. Dietary Guidelines: Pushback From the Sugar, Salt, and Meat Industries

-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 and More Than an Apple a Day.

Image credit: tfengreen / Flickr

Original Link

How Probiotics Affect Mental Health

 

 

 

 

 

 

 

 

 How Probiotics Affect Mental Health

Before Thorazine was invented in 1950, mental illness was often treated surgically. In fact, in 1949 the inventor of the lobotomy was awarded the Nobel Prize. Before tens of thousands were lobotomized, however, colectomy was all the rage. There was a theory that bad bacteria in the gut­ was the cause of mental illness. So the cure was to surgically remove the colon. Yes, the surgery killed about one in three–but when they didn’t die, surgeons claimed positive results. Some, for example, bragged that when they resected the colons of schoolchildren as a preventive measure there was a cessation of “abnormal sex practices” like masturbation (which was viewed at the time as a precursor for mental illness later in life). Reminds me of the mastectomies they used to perform for menstrual breast pain (Plant-Based Diets For Breast Pain).

Others, though, suggested a less drastic approach, proposing that one could instead treat this "intestinal putrefaction" by changing the intestinal flora. Indeed, over a century ago there were reports of successfully treating psychiatric illnesses like depression with a dietary regimen that included probiotics. Doctors perceived a connection between depression and “feces deficient in quantity and moisture and very offensive in odor.” Reportedly, after the probiotic regimen not only did people feel better psychologically, but they had their “feces increase in quantity, become softer, and of regular consistency, and the offensive smell diminish….” Concurrent with the probiotics, however, all patients were started on a vegetarian diet—so it may not have been the probiotics at all.

Why might the vegetarian diet alone have improved mood? Check out my videos Plant-Based Diet & Mood and the follow-up Improving Mood Through Diet as well as my serotonin series starting with Human Neurotransmitters in Plants.

This entire field of inquiry remained dormant for about a hundred years, but a new discipline has recently emerged known as enteric (meaning intestinal) neuroscience. Our enteric nervous system—the collection of nerves in our gut—has been referred to as a “second brain” given its size, complexity, and similarity. We have as many nerves in our gut as we do in our spinal cord! The size and complexity of our gut brain is not surprising when considering the challenges posed by the interface. We have a hundred times more contact with the outside world through our gut than through our skin. We also have to deal with our 100 trillion little friends down there. That takes a lot of processing power.

Anyone who’s had butterflies in their stomach knows that our mental state can affect our gut. Studies show that every day stresses can actually affect gut flora populations. An innovative study out of Australia looked at feces scraped from toilet paper used by undergrads during exam week. If you check out my 5-min video Gut Feelings: Probiotics and Mental Health, you can see how many bacteria the undergrads had in their feces before and after the exam. You’ll notice the effect lasted the whole week. Their findings show that our mental state can indeed affect our gut, but can our gut affect our mental state? We didn’t know until recently.

Many suffering from chronic fatigue syndrome complain of gut dysfunction, so researchers tried giving sufferers probiotics to see if their mental and emotional state could be improved and it did appear to help. You can learn more about treating chronic fatigue syndrome in:

What about for healthy people, though? A study entitled “Assessment of the Psychotropic Properties of Probiotics” marked a turning point in our thinking. Researchers found that one month of probiotics appeared to significantly decrease symptoms of anxiety, depression, anger and hostility. Until that study was published, the idea that probiotic bacteria administered to the intestine could influence the brain seemed almost surreal–like science-fiction. Well, science yes, but maybe not fiction. 

Might people suffering from certain forms of mental health problems benefit from a fecal transplant from someone with more happy-go-lucky bacteria? We don’t know, but this apparent ability of probiotics to affect brain processes is one of the most exciting recent developments in probiotic research.

Gut Feelings: Probiotics and Mental Health closes out my 4-part video series on the latest in probiotic science. I started with the two most established indications for their use in Preventing and Treating Diarrhea with Probiotics, then moved onto a more speculative use in Preventing the Common Cold with Probiotics?, and then offered practical advice on how to best take probiotic supplements in Should Probiotics Be Taken Before, During, or After Meals?

What else might our good bacteria be doing for us? They may help with weight control (Fawning Over Flora and Gut Flora & Obesity) and serve up anti-cancer compounds! (Flax and Fecal Flora and Sometimes the Enzyme Myth Is True).

-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 and More Than an Apple a Day.

Image credit: Ana_Cotta / Flickr

Original Link