What Happened to the Rice Diet?

What Happened to the Rice Diet?.jpeg

During his career at Duke, Dr. Walter Kempner treated more than 18,000 patients with his rice diet. The diet was originally designed as a treatment for kidney failure and out-of-control high blood pressure at a time when these diagnoses were essentially a death sentence. Patients who would have died in all other hospitals had a reasonable chance for survival if they came under Kempner's care.

The results were so dramatic that many experienced physicians suspected him of falsifying data, because he was essentially reversing terminal diseases with rice and fruit, diseases understood to be incurable by the best of modern medicine at the time. Intensive investigations into his clinic vindicated his work, however, which other researchers were then able to replicate and validate.

Kempner was criticized for his lack of controls, meaning that when patients came to him he didn't randomly allocate half to his rice treatment and put the other half on conventional therapy. Kempner argued that the patients each acted as their own controls. For example, one patient, after the medical profession threw everything they had at him, still had blood pressure as high as 220 over 160. A normal blood pressure is considered to be around 120 over 80--which is where Kempner's rice diet took him. Had the patient not been given the rice diet, his pressures might have been even lower, though: zero over zero, because he'd likely be dead. The "control group" in Kempner's day had a survival expectancy estimated at 6 months. To randomize patients to conventional care would be to randomize them to their deaths.

We can also compare those who stuck to the diet to those who didn't. In one study, of those who started the rice diet but then stopped it within a year, 80% died. For those who made it a year but then gave up the diet, instead of an 80% chance of dying, they had about a 50% chance, a flip of the coin. Of those that stuck with the program, 90% lived to tell the tale.

Beginning in the late 1950's, drugs became available that effectively reduced blood pressure and hypertension, leading to a decreased demand for the rice diet. What conclusions can we draw from this all-but-forgotten therapy for hypertension? Not only was it the first effective therapy for high blood pressure, it may be equal to or more effective than our current multi-drug treatments. See Drugs & the Demise of the Rice Diet.

This causes one to speculate on the current practice of placing patients on one drug, then another, and perhaps a third until the blood pressure is controlled, with lip-service advocacy of a moderate reduction in dietary sodium, fat, and protein intake. At the same time, the impressive effectiveness of the rice-fruit diet, which is able to quickly stop the leakage from our arteries, lower increased intracranial pressure, reduce heart size, reverse the ECG changes, reverse heart failure, reduce weight, and markedly improve diabetes, is ignored.

Should we return to the Kempner protocol of starting with the most effective therapy, saving drugs for patients who fail to respond or who are unable or unwilling to restrict their diet? Today many people follow a plant-based diet as a choice, which is similar to what Kempner was often able to transition people to. After their high blood pressure was cured by the rice diet, patients were often able to gradually transition to a less strenuous dietary regime without adding medications and with no return of the elevated blood pressure.

If the Kempner sequence of a strictest of strict plant-based diets to a saner plant-based type diet offers the quickest and best approach to effective therapy, why isn't it still in greater use? The powerful role of the pharmaceutical industry in steering medical care away from dietary treatment to medications should be noted. Who profits from dietary treatment? Who provides the support for investigation and the funds for clinical trials? There is more to overcome than just the patient's reluctance to change their diet.

What Kempner wrote to a patient in 1954 is as true now as it was 60 years ago:

"[D]rugs can be very useful if properly employed and used in conjunction with intensive dietary treatment. However, the real difficulty is that Hypertensive Vascular Disease with all its possible complications--heart disease, kidney disease, stroke, blindness--is still treated very casually, a striking contrast to the attitude toward cancer. Since patients, physicians, and the chemical industry prefer the taking, prescribing, and selling of drugs to a treatment inconvenient to patient and physician and of no benefit to the pharmaceutical industry, the mortality figures for these diseases are still rather appalling."

Despite hundreds of drugs on the market now, high blood pressure remains the #1 cause of death and disability in the world, killing off 9 million people a year. A whole food plant-based diet treats the underlying cause. As Dr. Kempner explained to a patient, "If you should find a heap of manure on your living room floor, I do not recommend that you go buy some Air-Wick [an air freshener] and perfume. I recommend that you get a bucket and shovel and a strong scrubbing brush. Then, when your living room floor is clean again, why, you may certainly apply some Air-Wick if you wish."

As the great physician Maimonides said about 800 years ago, any illness that can be treated by diet alone should be treated by no other means.

For background on this amazing story, see Kempner Rice Diet: Whipping Us Into Shape. He would be proud that there is a whole medical specialty now: Lifestyle Medicine: Treating the Causes of Disease.

This reminds me of the role statin cholesterol-lowering drugs have played in seducing people into the magic bullet approach, but as with all magic it appears to mostly be misdirection:

Check out a couple of my recent overview videos for more on this topic: How Not to Die from Heart Disease and Taking Personal Responsibility for Your Health.

In this day and age, What Diet Should Physician's Recommend?

In health,

Michael Greger, M.D.

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

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

Original Link

What Happened to the Rice Diet?

What Happened to the Rice Diet?.jpeg

During his career at Duke, Dr. Walter Kempner treated more than 18,000 patients with his rice diet. The diet was originally designed as a treatment for kidney failure and out-of-control high blood pressure at a time when these diagnoses were essentially a death sentence. Patients who would have died in all other hospitals had a reasonable chance for survival if they came under Kempner's care.

The results were so dramatic that many experienced physicians suspected him of falsifying data, because he was essentially reversing terminal diseases with rice and fruit, diseases understood to be incurable by the best of modern medicine at the time. Intensive investigations into his clinic vindicated his work, however, which other researchers were then able to replicate and validate.

Kempner was criticized for his lack of controls, meaning that when patients came to him he didn't randomly allocate half to his rice treatment and put the other half on conventional therapy. Kempner argued that the patients each acted as their own controls. For example, one patient, after the medical profession threw everything they had at him, still had blood pressure as high as 220 over 160. A normal blood pressure is considered to be around 120 over 80--which is where Kempner's rice diet took him. Had the patient not been given the rice diet, his pressures might have been even lower, though: zero over zero, because he'd likely be dead. The "control group" in Kempner's day had a survival expectancy estimated at 6 months. To randomize patients to conventional care would be to randomize them to their deaths.

We can also compare those who stuck to the diet to those who didn't. In one study, of those who started the rice diet but then stopped it within a year, 80% died. For those who made it a year but then gave up the diet, instead of an 80% chance of dying, they had about a 50% chance, a flip of the coin. Of those that stuck with the program, 90% lived to tell the tale.

Beginning in the late 1950's, drugs became available that effectively reduced blood pressure and hypertension, leading to a decreased demand for the rice diet. What conclusions can we draw from this all-but-forgotten therapy for hypertension? Not only was it the first effective therapy for high blood pressure, it may be equal to or more effective than our current multi-drug treatments. See Drugs & the Demise of the Rice Diet.

This causes one to speculate on the current practice of placing patients on one drug, then another, and perhaps a third until the blood pressure is controlled, with lip-service advocacy of a moderate reduction in dietary sodium, fat, and protein intake. At the same time, the impressive effectiveness of the rice-fruit diet, which is able to quickly stop the leakage from our arteries, lower increased intracranial pressure, reduce heart size, reverse the ECG changes, reverse heart failure, reduce weight, and markedly improve diabetes, is ignored.

Should we return to the Kempner protocol of starting with the most effective therapy, saving drugs for patients who fail to respond or who are unable or unwilling to restrict their diet? Today many people follow a plant-based diet as a choice, which is similar to what Kempner was often able to transition people to. After their high blood pressure was cured by the rice diet, patients were often able to gradually transition to a less strenuous dietary regime without adding medications and with no return of the elevated blood pressure.

If the Kempner sequence of a strictest of strict plant-based diets to a saner plant-based type diet offers the quickest and best approach to effective therapy, why isn't it still in greater use? The powerful role of the pharmaceutical industry in steering medical care away from dietary treatment to medications should be noted. Who profits from dietary treatment? Who provides the support for investigation and the funds for clinical trials? There is more to overcome than just the patient's reluctance to change their diet.

What Kempner wrote to a patient in 1954 is as true now as it was 60 years ago:

"[D]rugs can be very useful if properly employed and used in conjunction with intensive dietary treatment. However, the real difficulty is that Hypertensive Vascular Disease with all its possible complications--heart disease, kidney disease, stroke, blindness--is still treated very casually, a striking contrast to the attitude toward cancer. Since patients, physicians, and the chemical industry prefer the taking, prescribing, and selling of drugs to a treatment inconvenient to patient and physician and of no benefit to the pharmaceutical industry, the mortality figures for these diseases are still rather appalling."

Despite hundreds of drugs on the market now, high blood pressure remains the #1 cause of death and disability in the world, killing off 9 million people a year. A whole food plant-based diet treats the underlying cause. As Dr. Kempner explained to a patient, "If you should find a heap of manure on your living room floor, I do not recommend that you go buy some Air-Wick [an air freshener] and perfume. I recommend that you get a bucket and shovel and a strong scrubbing brush. Then, when your living room floor is clean again, why, you may certainly apply some Air-Wick if you wish."

As the great physician Maimonides said about 800 years ago, any illness that can be treated by diet alone should be treated by no other means.

For background on this amazing story, see Kempner Rice Diet: Whipping Us Into Shape. He would be proud that there is a whole medical specialty now: Lifestyle Medicine: Treating the Causes of Disease.

This reminds me of the role statin cholesterol-lowering drugs have played in seducing people into the magic bullet approach, but as with all magic it appears to mostly be misdirection:

Check out a couple of my recent overview videos for more on this topic: How Not to Die from Heart Disease and Taking Personal Responsibility for Your Health.

In this day and age, What Diet Should Physician's Recommend?

In health,

Michael Greger, M.D.

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

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

Original Link

The Best Diet to Prevent Kidney Stones

The Best Diet to Prevent Kidney Stones.jpeg

In my video How to Prevent Kidney Stones With Diet you can see what the jagged surface of a kidney stone looks like under a microscope. Imagine one of those scraping down your urinary canal! Kidney stones affect approximately 1 in 11 people in the United States. Twenty years ago it was only 1 in 20, representing a dramatic increase in the prevalence of the disease that started rising after World War II. Our first clue as to why was a study published in the 70's, which found a striking relationship between stone incidence and the consumption of animal protein. This was a population study, though, so it couldn't prove cause and effect.

That study inspired researchers in Britain to do an interventional study, adding animal protein to subjects' diets, such as an extra can of tuna fish a day, and measuring stone-forming risk factors in their urine. Participants' overall probability of forming stones increased 250% during those days they were eating that extra fish. And the so-called "high animal protein diet" was just enough to bring intake up to that of the average American. So Americans' intake of meat appears to markedly increase the risk of kidney stones.

What about consuming no meat at all? By the late 70's we knew that the only dietary factor consistently associated with kidney stones was animal protein. The higher the intake of animal protein, the more likely the individual was to not only get their first kidney stone, but to then suffer from subsequent multiple stones. This effect was not found for high protein intake in general, but specifically high animal protein intake. Conversely, a diet low in animal protein may dramatically reduce the overall probability of forming stones. This may explain the apparently low incidence of stones in vegetarian societies, so researchers advocated "a more vegetarian form of diet" as a means of reducing the risk.

It wasn't until 2014 that vegetarian kidney stone risk was studied in detail, though. Using hospital admissions data, researchers found that vegetarians were indeed at a lower risk of being hospitalized for kidney stones. It's not all or nothing, though. Among meat-eaters, increasing meat intake is associated with a higher risk of developing kidney stones, whereas a high intake of fresh fruit, fiber, and magnesium may reduce the risk.

Which animal protein is the worst? People who form kidney stones are commonly advised to restrict the intake of red meat to decrease stone risk, but what about chicken and fish? Despite compelling evidence that excessive animal protein consumption enhances the risk of stone formation, the effect of different sources of animal protein had not been explored until another study in 2014. Researchers compared the effects of salmon and cod, chicken breast meat, and burger and steak. In terms of uric acid production, they found that gram for gram fish may actually be worse. However, the overall effects were complex. Basically, stone formers should be counseled to limit the intake of all animal proteins, and not by just a little bit. Only those who markedly decrease their animal protein intake may expect to benefit.

Making our urine more alkaline can also help prevent the formation of kidney stones (and even dissolve and cure uric acid stones). How can you tell the pH of your urine? See my video Testing Your Diet with Pee & Purple Cabbage.

For more on kidney stones, see How to Treat Kidney Stones with Diet and Do Vitamin C Supplements Prevent Colds but Cause Kidney Stones?. And check out my overview of kidney health in How Not to Die from Kidney Disease.

Uric acid can also crystallize in our joints, but the good news is that there are natural treatments. See Gout Treatment with a Cherry on Top and Treating Gout with Cherry Juice.

Kidney stones are just one more reason that Plant Protein is Preferable.

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 to Prevent Kidney Stones

The Best Diet to Prevent Kidney Stones.jpeg

In my video How to Prevent Kidney Stones With Diet you can see what the jagged surface of a kidney stone looks like under a microscope. Imagine one of those scraping down your urinary canal! Kidney stones affect approximately 1 in 11 people in the United States. Twenty years ago it was only 1 in 20, representing a dramatic increase in the prevalence of the disease that started rising after World War II. Our first clue as to why was a study published in the 70's, which found a striking relationship between stone incidence and the consumption of animal protein. This was a population study, though, so it couldn't prove cause and effect.

That study inspired researchers in Britain to do an interventional study, adding animal protein to subjects' diets, such as an extra can of tuna fish a day, and measuring stone-forming risk factors in their urine. Participants' overall probability of forming stones increased 250% during those days they were eating that extra fish. And the so-called "high animal protein diet" was just enough to bring intake up to that of the average American. So Americans' intake of meat appears to markedly increase the risk of kidney stones.

What about consuming no meat at all? By the late 70's we knew that the only dietary factor consistently associated with kidney stones was animal protein. The higher the intake of animal protein, the more likely the individual was to not only get their first kidney stone, but to then suffer from subsequent multiple stones. This effect was not found for high protein intake in general, but specifically high animal protein intake. Conversely, a diet low in animal protein may dramatically reduce the overall probability of forming stones. This may explain the apparently low incidence of stones in vegetarian societies, so researchers advocated "a more vegetarian form of diet" as a means of reducing the risk.

It wasn't until 2014 that vegetarian kidney stone risk was studied in detail, though. Using hospital admissions data, researchers found that vegetarians were indeed at a lower risk of being hospitalized for kidney stones. It's not all or nothing, though. Among meat-eaters, increasing meat intake is associated with a higher risk of developing kidney stones, whereas a high intake of fresh fruit, fiber, and magnesium may reduce the risk.

Which animal protein is the worst? People who form kidney stones are commonly advised to restrict the intake of red meat to decrease stone risk, but what about chicken and fish? Despite compelling evidence that excessive animal protein consumption enhances the risk of stone formation, the effect of different sources of animal protein had not been explored until another study in 2014. Researchers compared the effects of salmon and cod, chicken breast meat, and burger and steak. In terms of uric acid production, they found that gram for gram fish may actually be worse. However, the overall effects were complex. Basically, stone formers should be counseled to limit the intake of all animal proteins, and not by just a little bit. Only those who markedly decrease their animal protein intake may expect to benefit.

Making our urine more alkaline can also help prevent the formation of kidney stones (and even dissolve and cure uric acid stones). How can you tell the pH of your urine? See my video Testing Your Diet with Pee & Purple Cabbage.

For more on kidney stones, see How to Treat Kidney Stones with Diet and Do Vitamin C Supplements Prevent Colds but Cause Kidney Stones?. And check out my overview of kidney health in How Not to Die from Kidney Disease.

Uric acid can also crystallize in our joints, but the good news is that there are natural treatments. See Gout Treatment with a Cherry on Top and Treating Gout with Cherry Juice.

Kidney stones are just one more reason that Plant Protein is Preferable.

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 Animal Protein Does in Your Colon

What Animal Protein Does in Your Colon.jpeg

There's a take-off of the industry slogan, "Beef: It's What's For Dinner" - "Beef: It's What's Rotting in Your Colon." I saw this on a shirt once with some friends and I was such the party pooper--no pun intended--explaining to everyone that meat is fully digested in the small intestine, and never makes it down into the colon. It's no fun hanging out with biology geeks.

But I was wrong!

It's been estimated that with a typical Western diet, up to 12 grams of protein can escape digestion, and when it reaches the colon, it can be turned into toxic substances like ammonia. This degradation of undigested protein in the colon is called putrefaction, so a little meat can actually end up putrefying in our colon. The problem is that some of the by-products of this putrefaction process can be toxic.

It's generally accepted that carbohydrate fermentation--the fiber and resistant starches that reach our colon--results in beneficial effects because of the generation of short-chain fatty acids like butyrate, whereas protein fermentation is considered detrimental. Protein fermentation mainly occurs in the lower end of colon and results in the production of potentially toxic metabolites. That may be why colorectal cancer and ulcerative colitis tends to happen lower down--because that's where the protein is putrefying.

Probably the simplest strategy to reduce the potential harm of protein fermentation is to reduce dietary protein intake. But the accumulation of these toxic byproducts of protein metabolism may be attenuated by the fermentation of undigested plant matter. In my video, Bowel Wars: Hydrogen Sulfide vs. Butyrate, you can see a study out of Australia showed that if you give people foods containing resistant starch you can block the accumulation of potentially harmful byproducts of protein metabolism. Resistant starch is resistant to small intestine digestion and so it makes it down to our colon where it can feed our good bacteria. Resistant starch is found in cooked beans, split peas, chickpeas, lentils, raw oatmeal, and cooled cooked pasta (like macaroni salad). Apparently, the more starch that ends up in the colon, the less ammonia that is produced.

Of course, there's protein in plants too. The difference is that animal proteins tend to have more sulfur-containing amino acids like methionine, which can be turned into hydrogen sulfide in our colon. Hydrogen sulfide is the rotten egg gas that may play a role in the development of the inflammatory bowel disease, ulcerative colitis (see Preventing Ulcerative Colitis with Diet).

The toxic effects of hydrogen sulfide appear to be a result of blocking the ability of the cells lining our colon from utilizing butyrate, which is what our good bacteria make from the fiber and resistant starch we eat. It's like this constant battle in our colon between the bad metabolites of protein, hydrogen sulfide, and the good metabolites of carbohydrates, butyrate. Using human colon samples, researchers were able to show that the adverse effects of sulfide could be reversed by butyrate. So we can either cut down on meat, eat more plants, or both.

There are two ways hydrogen sulfide can be produced, though. It's mainly present in our large intestine as a result of the breakdown of sulfur-containing proteins, but the rotten egg gas can also be generated from inorganic sulfur preservatives like sulfites and sulfur dioxide.

Sulfur dioxide is used as a preservative in dried fruit, and sulfites are added to wines. We can avoid sulfur additives by reading labels or by just choosing organic, since they're forbidden from organic fruits and beverages by law.

More than 35 years ago, studies started implicating sulfur dioxide preservatives in the exacerbation of asthma. This so-called "sulfite-sensitivity" seems to affect only about 1 in 2,000 people, so I recommended those with asthma avoid it, but otherwise I considered the preservative harmless. I am now not so sure, and advise people to avoid it when possible.

Cabbage family vegetables naturally have some sulfur compounds, but thankfully, after following more than a hundred thousand women for over 25 years, researchers concluded cruciferous vegetables were not associated with elevated colitis risk.

Because of animal protein and processed food intake, the standard American diet may contain five or six times more sulfur than a diet centered around unprocessed plant foods. This may help explain the rarity of inflammatory bowel disease among those eating traditional whole food, plant-based diets.

How could companies just add things like sulfur dioxide to foods without adequate safety testing? See Who Determines if Food Additives are Safe? For other additives that may be a problem, see Titanium Dioxide & Inflammatory Bowel Disease and Is Carrageenan Safe?

More on this epic fermentation battle in our gut in Stool pH and Colon Cancer.

Does the sulfur-containing amino acid methionine sound familiar? You may remember it from such hits as Starving Cancer with Methionine Restriction and Methionine Restriction as a Life Extension Strategy.

These short-chain fatty acids released by our good bacteria when we eat fiber and resistant starches are what may be behind the second meal effect: Beans and the Second Meal Effect.

I mentioned ulcerative colitis. What about the other inflammatory bowel disease Crohn's? See Preventing Crohn's Disease With Diet and Dietary Treatment of Crohn's 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: Sally Plank / Flickr. This image has been modified.

Original Link

What Animal Protein Does in Your Colon

What Animal Protein Does in Your Colon.jpeg

There's a take-off of the industry slogan, "Beef: It's What's For Dinner" - "Beef: It's What's Rotting in Your Colon." I saw this on a shirt once with some friends and I was such the party pooper--no pun intended--explaining to everyone that meat is fully digested in the small intestine, and never makes it down into the colon. It's no fun hanging out with biology geeks.

But I was wrong!

It's been estimated that with a typical Western diet, up to 12 grams of protein can escape digestion, and when it reaches the colon, it can be turned into toxic substances like ammonia. This degradation of undigested protein in the colon is called putrefaction, so a little meat can actually end up putrefying in our colon. The problem is that some of the by-products of this putrefaction process can be toxic.

It's generally accepted that carbohydrate fermentation--the fiber and resistant starches that reach our colon--results in beneficial effects because of the generation of short-chain fatty acids like butyrate, whereas protein fermentation is considered detrimental. Protein fermentation mainly occurs in the lower end of colon and results in the production of potentially toxic metabolites. That may be why colorectal cancer and ulcerative colitis tends to happen lower down--because that's where the protein is putrefying.

Probably the simplest strategy to reduce the potential harm of protein fermentation is to reduce dietary protein intake. But the accumulation of these toxic byproducts of protein metabolism may be attenuated by the fermentation of undigested plant matter. In my video, Bowel Wars: Hydrogen Sulfide vs. Butyrate, you can see a study out of Australia showed that if you give people foods containing resistant starch you can block the accumulation of potentially harmful byproducts of protein metabolism. Resistant starch is resistant to small intestine digestion and so it makes it down to our colon where it can feed our good bacteria. Resistant starch is found in cooked beans, split peas, chickpeas, lentils, raw oatmeal, and cooled cooked pasta (like macaroni salad). Apparently, the more starch that ends up in the colon, the less ammonia that is produced.

Of course, there's protein in plants too. The difference is that animal proteins tend to have more sulfur-containing amino acids like methionine, which can be turned into hydrogen sulfide in our colon. Hydrogen sulfide is the rotten egg gas that may play a role in the development of the inflammatory bowel disease, ulcerative colitis (see Preventing Ulcerative Colitis with Diet).

The toxic effects of hydrogen sulfide appear to be a result of blocking the ability of the cells lining our colon from utilizing butyrate, which is what our good bacteria make from the fiber and resistant starch we eat. It's like this constant battle in our colon between the bad metabolites of protein, hydrogen sulfide, and the good metabolites of carbohydrates, butyrate. Using human colon samples, researchers were able to show that the adverse effects of sulfide could be reversed by butyrate. So we can either cut down on meat, eat more plants, or both.

There are two ways hydrogen sulfide can be produced, though. It's mainly present in our large intestine as a result of the breakdown of sulfur-containing proteins, but the rotten egg gas can also be generated from inorganic sulfur preservatives like sulfites and sulfur dioxide.

Sulfur dioxide is used as a preservative in dried fruit, and sulfites are added to wines. We can avoid sulfur additives by reading labels or by just choosing organic, since they're forbidden from organic fruits and beverages by law.

More than 35 years ago, studies started implicating sulfur dioxide preservatives in the exacerbation of asthma. This so-called "sulfite-sensitivity" seems to affect only about 1 in 2,000 people, so I recommended those with asthma avoid it, but otherwise I considered the preservative harmless. I am now not so sure, and advise people to avoid it when possible.

Cabbage family vegetables naturally have some sulfur compounds, but thankfully, after following more than a hundred thousand women for over 25 years, researchers concluded cruciferous vegetables were not associated with elevated colitis risk.

Because of animal protein and processed food intake, the standard American diet may contain five or six times more sulfur than a diet centered around unprocessed plant foods. This may help explain the rarity of inflammatory bowel disease among those eating traditional whole food, plant-based diets.

How could companies just add things like sulfur dioxide to foods without adequate safety testing? See Who Determines if Food Additives are Safe? For other additives that may be a problem, see Titanium Dioxide & Inflammatory Bowel Disease and Is Carrageenan Safe?

More on this epic fermentation battle in our gut in Stool pH and Colon Cancer.

Does the sulfur-containing amino acid methionine sound familiar? You may remember it from such hits as Starving Cancer with Methionine Restriction and Methionine Restriction as a Life Extension Strategy.

These short-chain fatty acids released by our good bacteria when we eat fiber and resistant starches are what may be behind the second meal effect: Beans and the Second Meal Effect.

I mentioned ulcerative colitis. What about the other inflammatory bowel disease Crohn's? See Preventing Crohn's Disease With Diet and Dietary Treatment of Crohn's 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: Sally Plank / Flickr. This image has been modified.

Original Link

High Blood Pressure: Normal but Not Natural

High Blood Pressure - Normal but Not Natural.jpeg

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

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

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

No.

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

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

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

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

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

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

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

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

In health,

Michael Greger, M.D.

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

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

Original Link

High Blood Pressure: Normal but Not Natural

High Blood Pressure - Normal but Not Natural.jpeg

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

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

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

No.

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

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

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

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

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

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

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

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

In health,

Michael Greger, M.D.

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

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

Original Link

The Five Most Important Dietary Tweaks

The Five Most Important Dietary Tweaks.jpeg

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

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

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

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

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

It's the food.

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

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

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

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

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


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

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

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

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

In health,

Michael Greger, M.D.

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

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

Original Link

The Five Most Important Dietary Tweaks

The Five Most Important Dietary Tweaks.jpeg

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

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

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

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

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

It's the food.

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

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

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

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

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


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

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

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

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

In health,

Michael Greger, M.D.

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

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

Original Link