How to Treat Dry Eye Disease Naturally with Diet

Oct 31 Dry Eyes copy.jpeg

One of the most common eye disorders, dry eye disease, causes irritation or discomfort, and can decrease functional vision, sometimes causing a dramatic deterioration in the quality of life. About five million Americans over age 50 suffer from moderate-to-severe dry eyes, and tens of millions more have mild or episodic manifestations of the disease, at a cost of more than $50 billion.

In terms of treatment, there are several drops and drugs that can help. We spend hundreds of millions of dollars on things like artificial tears, but currently there is no therapy available to actually fix the problem. If drugs don't work, doctors can try plugging up the outflow tear ducts, but that can cause complications, such as plugs migrating and eroding into the face, requiring surgical removal. Alternatively, surgeons can just cauterize or stitch up the ducts in the first place.

There has to be a better way.

What about prevention? Dry eyes can be caused by LASIK surgery, affecting about 20-40% of patients six months after the operation. With a million LASIK procedures performed annually, that's a lot of people, and sometimes the long-term symptoms can be severe and disabling.

There's a long list of drugs that can cause it, including antihistamines, decongestants, nearly all the antidepressants, anticonvulsants, antipsychotics, anti-Parkinson's drugs, beta-blockers, and hormone replacement therapy, as well as a few herbal preparations.

In the developing world, vitamin A deficiency can start out as dry eyes and then progress to becoming the leading cause of preventable childhood blindness. Vitamin A deficiency is almost never seen in the developed world, unless you do it intentionally. There was a report in the 1960s of a guy who deliberately ate a vitamin A-deficient diet, living off of bread and lime juice for five years, and his eyes developed vascularization and ulceration of the cornea, which you can see (if you dare) in my Treating Dry Eye Disease with Diet: Just Add Water? video. That was better than what happened to an unfortunate woman who was the member of a cult and tried to live off of brown rice and herbal tea: Her eyes literally melted and collapsed.

There are also a couple case reports of autistic children who refused to eat anything but French fries or menus exclusively comprised of bacon, blueberry muffins, and Kool-Aid, and became vitamin A deficient. A case in the Bronx was written up as vegan diet and vitamin A deficiency, but it had nothing to do with his vegan diet--the kid refused to eat vegetables, consuming only potato chips, puffed rice cereal with non-fortified soymilk, and juice drinks. "His parents lacked particular skill in overcoming the child's tendency to avoid fruits and vegetables."

A plant-based diet may actually be the best thing for patients with dry eye disease, those who wear contact lenses, and those who wish to maximize their tear secretions. People with dry eyes should be advised to lower protein, total fat, and cholesterol intake, and do the following:

  • increase complex carbohydrates;
  • increase vitamin A content (by eating red, orange, yellow, and dark green leafy vegetables);
  • increase zinc and folate intake (by eating whole grains, beans, and raw vegetables, especially spinach);
  • ensure sufficient vitamin B6 and potassium intake (by eating nuts, bananas, and beans);
  • ensure sufficient vitamin C intake (by eating citrus);
  • eliminate alcohol and caffeine;
  • reduce sugar and salt intake; and
  • consume six to eight glasses of water per day.

We know dehydration can cause a dry mouth, but could dehydration cause dry eyes? It may seem kind of obvious, but evidently it was never studied until recently. Is the answer to just drink more water? We know that those suffering from dry eye are comparatively dehydrated, so researchers figured that tear secretion decreases with progressive dehydration just like saliva secretion decreases and gives us a dry mouth. And indeed, as one gets more and more dehydrated, their urine concentrates and so does the tear fluid. But one can reverse that with rehydration, raising the exciting prospect that improving whole-body hydration by getting people to drink more water might bring relief for those with dry eyes. The researchers recommend eight cups of water a day for women and ten cups a day for men.


Find more on the importance of proper hydration in my How Many Glasses of Water Should We Drink a Day?, Does a Drink Of Water Make Children Smarter?, and Can Dehydration Affect Our Mood? videos.

To learn more on other topics related to eye health, check out:

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:

Original Link

How to Treat Dry Eye Disease Naturally with Diet

Oct 31 Dry Eyes copy.jpeg

One of the most common eye disorders, dry eye disease, causes irritation or discomfort, and can decrease functional vision, sometimes causing a dramatic deterioration in the quality of life. About five million Americans over age 50 suffer from moderate-to-severe dry eyes, and tens of millions more have mild or episodic manifestations of the disease, at a cost of more than $50 billion.

In terms of treatment, there are several drops and drugs that can help. We spend hundreds of millions of dollars on things like artificial tears, but currently there is no therapy available to actually fix the problem. If drugs don't work, doctors can try plugging up the outflow tear ducts, but that can cause complications, such as plugs migrating and eroding into the face, requiring surgical removal. Alternatively, surgeons can just cauterize or stitch up the ducts in the first place.

There has to be a better way.

What about prevention? Dry eyes can be caused by LASIK surgery, affecting about 20-40% of patients six months after the operation. With a million LASIK procedures performed annually, that's a lot of people, and sometimes the long-term symptoms can be severe and disabling.

There's a long list of drugs that can cause it, including antihistamines, decongestants, nearly all the antidepressants, anticonvulsants, antipsychotics, anti-Parkinson's drugs, beta-blockers, and hormone replacement therapy, as well as a few herbal preparations.

In the developing world, vitamin A deficiency can start out as dry eyes and then progress to becoming the leading cause of preventable childhood blindness. Vitamin A deficiency is almost never seen in the developed world, unless you do it intentionally. There was a report in the 1960s of a guy who deliberately ate a vitamin A-deficient diet, living off of bread and lime juice for five years, and his eyes developed vascularization and ulceration of the cornea, which you can see (if you dare) in my Treating Dry Eye Disease with Diet: Just Add Water? video. That was better than what happened to an unfortunate woman who was the member of a cult and tried to live off of brown rice and herbal tea: Her eyes literally melted and collapsed.

There are also a couple case reports of autistic children who refused to eat anything but French fries or menus exclusively comprised of bacon, blueberry muffins, and Kool-Aid, and became vitamin A deficient. A case in the Bronx was written up as vegan diet and vitamin A deficiency, but it had nothing to do with his vegan diet--the kid refused to eat vegetables, consuming only potato chips, puffed rice cereal with non-fortified soymilk, and juice drinks. "His parents lacked particular skill in overcoming the child's tendency to avoid fruits and vegetables."

A plant-based diet may actually be the best thing for patients with dry eye disease, those who wear contact lenses, and those who wish to maximize their tear secretions. People with dry eyes should be advised to lower protein, total fat, and cholesterol intake, and do the following:

  • increase complex carbohydrates;
  • increase vitamin A content (by eating red, orange, yellow, and dark green leafy vegetables);
  • increase zinc and folate intake (by eating whole grains, beans, and raw vegetables, especially spinach);
  • ensure sufficient vitamin B6 and potassium intake (by eating nuts, bananas, and beans);
  • ensure sufficient vitamin C intake (by eating citrus);
  • eliminate alcohol and caffeine;
  • reduce sugar and salt intake; and
  • consume six to eight glasses of water per day.

We know dehydration can cause a dry mouth, but could dehydration cause dry eyes? It may seem kind of obvious, but evidently it was never studied until recently. Is the answer to just drink more water? We know that those suffering from dry eye are comparatively dehydrated, so researchers figured that tear secretion decreases with progressive dehydration just like saliva secretion decreases and gives us a dry mouth. And indeed, as one gets more and more dehydrated, their urine concentrates and so does the tear fluid. But one can reverse that with rehydration, raising the exciting prospect that improving whole-body hydration by getting people to drink more water might bring relief for those with dry eyes. The researchers recommend eight cups of water a day for women and ten cups a day for men.


Find more on the importance of proper hydration in my How Many Glasses of Water Should We Drink a Day?, Does a Drink Of Water Make Children Smarter?, and Can Dehydration Affect Our Mood? videos.

To learn more on other topics related to eye health, check out:

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:

Original Link

Best Food for MGUS to Prevent Multiple Myeloma

Best Food for MGUS to Prevent Multiple Myeloma.jpeg

Multiple myeloma is one of our most dreaded cancers. It's a cancer of our antibody-producing plasma cells, and is considered one of our most intractable blood diseases. The precursor disease is called monoclonal gammopathy of undetermined significance (MGUS). When it was named, it's significance was undetermined, but now we know that multiple myeloma is almost always preceded by MGUS. This makes MGUS one of the most common premalignant disorders, with a prevalence of about 3% in the older white general population, and about 2 to 3 times that in African-American populations.

MGUS itself is asymptomatic, you don't even know you have it until your doctor finds it incidentally doing routine bloodwork. But should it progress to multiple myeloma, you only have about four years to live. So we need to find ways to treat MGUS early, before it turns into cancer. Unfortunately, no such treatment exists. Rather, patients are just placed in a kind of holding pattern with frequent check-ups. If all we're going to do is watch and wait, researchers figured to might as well try some dietary changes.

One such dietary change is adding curcumin, the yellow pigment in the spice turmeric. Why curcumin? It's relatively safe, considering that it has been consumed as a dietary spice for centuries. And it kills multiple myeloma cells. In my video Turmeric Curcumin, MGUS, & Multiple Myeloma, you can see the unimpeded growth of four different cell lines of multiple myeloma. We start out with about 5000 cancer cells at the beginning of the week, which then that doubles, triples, and quadruples in a matter of days. If we add a little bit of curcumin, growth is stunted. If we add a lot of curcumin, growth is stopped. This was in a petri dish, but it is exciting enough to justify trying curcumin in a clinical trial. And six years later, researchers did.

We can measure the progression of the disease by the rise in blood levels of paraprotein, which is what's made by MGUS and myeloma cells. About 1 in 3 of the patients responded to the curcumin with dropping paraprotein levels, whereas there were no responses in the placebo group. These positive findings prompted researchers to commence a double-blind, randomized, controlled trial. The same kind of positive biomarker response was seen in both MGUS patients as well as those with so-called "smoldering" multiple myeloma, an early stage of the cancer. These findings suggest that curcumin might have the potential to slow the disease process in patients, delaying or preventing the progression of MGUS to multiple myeloma. However, we won't know for sure until longer larger studies are done.

The best way to deal with multiple myeloma is to not get it in the first place. In my 2010 video Meat & Multiple Myeloma, I profiled a study suggesting that vegetarians have just a quarter the risk of multiple myeloma compared to meat-eaters. Even just working with chicken meat may double one's risk of multiple myeloma, the thinking being that cancers like leukemias, lymphomas, and myelomas may be induced by so-called zoonotic (animal-to-human) cancer-causing viruses found in both cattle and chickens. Beef, however, was not associated with multiple myeloma.

There are, however, some vegetarian foods we may want to avoid. Harvard researchers reported a controversial link between diet soda and multiple myeloma, implicating aspartame. Studies suggest french fries and potato chips should not be the way we get our vegetables, nor should we probably pickle them. While the intake of shallots, garlic, soy foods, and green tea was significantly associated with a reduced risk of multiple myeloma, intake of pickled vegetables three times a week or more was associated with increased risk.

For dietary links to other blood cancers, see EPIC Findings on Lymphoma.

The turmeric story just never seems to end. I recommend a quarter teaspoon a day:

Why might garlic and tea help? See Cancer, Interrupted: Garlic & Flavonoids and Cancer Interrupted, Green Tea.

More on the effects of NutraSweet in Aspartame and the Brain and acrylamide in Cancer Risk From French Fries.

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

Best Food for MGUS to Prevent Multiple Myeloma

Best Food for MGUS to Prevent Multiple Myeloma.jpeg

Multiple myeloma is one of our most dreaded cancers. It's a cancer of our antibody-producing plasma cells, and is considered one of our most intractable blood diseases. The precursor disease is called monoclonal gammopathy of undetermined significance (MGUS). When it was named, it's significance was undetermined, but now we know that multiple myeloma is almost always preceded by MGUS. This makes MGUS one of the most common premalignant disorders, with a prevalence of about 3% in the older white general population, and about 2 to 3 times that in African-American populations.

MGUS itself is asymptomatic, you don't even know you have it until your doctor finds it incidentally doing routine bloodwork. But should it progress to multiple myeloma, you only have about four years to live. So we need to find ways to treat MGUS early, before it turns into cancer. Unfortunately, no such treatment exists. Rather, patients are just placed in a kind of holding pattern with frequent check-ups. If all we're going to do is watch and wait, researchers figured to might as well try some dietary changes.

One such dietary change is adding curcumin, the yellow pigment in the spice turmeric. Why curcumin? It's relatively safe, considering that it has been consumed as a dietary spice for centuries. And it kills multiple myeloma cells. In my video Turmeric Curcumin, MGUS, & Multiple Myeloma, you can see the unimpeded growth of four different cell lines of multiple myeloma. We start out with about 5000 cancer cells at the beginning of the week, which then that doubles, triples, and quadruples in a matter of days. If we add a little bit of curcumin, growth is stunted. If we add a lot of curcumin, growth is stopped. This was in a petri dish, but it is exciting enough to justify trying curcumin in a clinical trial. And six years later, researchers did.

We can measure the progression of the disease by the rise in blood levels of paraprotein, which is what's made by MGUS and myeloma cells. About 1 in 3 of the patients responded to the curcumin with dropping paraprotein levels, whereas there were no responses in the placebo group. These positive findings prompted researchers to commence a double-blind, randomized, controlled trial. The same kind of positive biomarker response was seen in both MGUS patients as well as those with so-called "smoldering" multiple myeloma, an early stage of the cancer. These findings suggest that curcumin might have the potential to slow the disease process in patients, delaying or preventing the progression of MGUS to multiple myeloma. However, we won't know for sure until longer larger studies are done.

The best way to deal with multiple myeloma is to not get it in the first place. In my 2010 video Meat & Multiple Myeloma, I profiled a study suggesting that vegetarians have just a quarter the risk of multiple myeloma compared to meat-eaters. Even just working with chicken meat may double one's risk of multiple myeloma, the thinking being that cancers like leukemias, lymphomas, and myelomas may be induced by so-called zoonotic (animal-to-human) cancer-causing viruses found in both cattle and chickens. Beef, however, was not associated with multiple myeloma.

There are, however, some vegetarian foods we may want to avoid. Harvard researchers reported a controversial link between diet soda and multiple myeloma, implicating aspartame. Studies suggest french fries and potato chips should not be the way we get our vegetables, nor should we probably pickle them. While the intake of shallots, garlic, soy foods, and green tea was significantly associated with a reduced risk of multiple myeloma, intake of pickled vegetables three times a week or more was associated with increased risk.

For dietary links to other blood cancers, see EPIC Findings on Lymphoma.

The turmeric story just never seems to end. I recommend a quarter teaspoon a day:

Why might garlic and tea help? See Cancer, Interrupted: Garlic & Flavonoids and Cancer Interrupted, Green Tea.

More on the effects of NutraSweet in Aspartame and the Brain and acrylamide in Cancer Risk From French Fries.

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

Are the Benefits of Organic Food Underrated or Overrated?

Vegsource.jpeg

Pesticides have been classified as probable carcinogens for 25 years. Different pesticides have been associated with different cancers through a variety of mechanisms, including genetic damage--direct hits to our DNA or chromosomes--and epigenetic modification, changes in the way our genes are expressed. These effects have been documented in workers who are spraying the pesticides, but exposure to pesticide residues that remain on food is much smaller.

More recently, higher cancer rates have also been noted in people who live in areas where pesticides are heavily sprayed, but what about the food we buy at the store? Organic fruits and vegetables have fewer pesticides, but even the levels on conventional produce are generally well below acceptable limits. There is still scientific controversy about the safety of some pesticides even under the regulatory limits, however, given the possible additive effects of the mixture of pesticides to which we're exposed. The pesticide approval process also doesn't take into account toxic breakdown products such as dioxins that can form once pesticides are released into the environment.

Cadmium is another issue. In the largest review to date, involving hundreds of studies, not only did organic foods have more antioxidant phytonutrients, but lower concentrations of cadmium. Cadmium is one of three highly toxic heavy metals (along with lead and mercury) found in the food supply. Cadmium accumulates in the body, so we should try to keep intake as low as possible. Organic crops only have about half the cadmium, which is thought to come from the phosphate fertilizers that are added to conventional crops.

Of course, not all organic foods are healthy. The organic food industry is now worth tens of billions of dollars, and they didn't get that way just selling carrots. We can now buy pesticide-free potato chips and organic jelly beans. Organic foods can be even worse because, for example, people falsely judge organic Oreo cookies to have fewer calories than conventional Oreos, and so may eat more. Forgoing exercise was deemed more acceptable when the person had just chosen an organic dessert rather than a conventional one. In fact, leniency toward forgoing exercise was slightly greater after choosing an organic dessert than after eating no dessert at all--organic cookies were effectively viewed as having negative calories! Organic junk food is still junk food.

Not only do people tend to overestimate the nutritional benefits of organic foods, they also overestimate the risks of pesticides. People think that as many people die from pesticide residues on conventional food as die in motor vehicle accidents in the United States. Surveys have found organic food buyers may think eating conventional produce is almost as bad as smoking a pack of cigarettes. That kind of thinking is dangerous because it could potentially lead to a decrease in overall fruit and vegetable consumption.

If just half of the U.S. population were to increase fruit and vegetable consumption by a single serving a day, an estimated 20,000 cancer cases might be avoided each year. That's how powerful produce may be. But, because the model was using conventional fruits and veggies, the pesticide burden from those extra fruits and vegetables might result in 10 additional cancer cases. So overall, if half of us ate one more serving, we'd just prevent 19,990 cases of cancer a year.

Now that was a paper written by scientists-for-hire paid for by the Alliance for Food and Farming, which is a bunch of conventional produce growers, so they probably exaggerated the benefits and minimized the risks, but I think the bottom line is sound. We get a tremendous benefit from eating conventional fruits and vegetables that far outweighs whatever tiny bump in risk we may get from the pesticides. Why not reap the benefits without the risk and choose organic? Great! But we should never let concern about pesticides stop us from stuffing our face with as many fruits and vegetables as possible.

My video, Are the Benefits of Organic Food Underrated or Overrated?, was the final installment of a 5-part series on organics. The first four videos are:

I've covered the issue of cadmium in our diet before in Cadmium and Cancer: Plant vs. Animal Foods and Male Fertility and Diet. Heavy metals are found concentrated in seafood and organ meats, but can also be found in certain supplements and protein powders.

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

Are the Benefits of Organic Food Underrated or Overrated?

Vegsource.jpeg

Pesticides have been classified as probable carcinogens for 25 years. Different pesticides have been associated with different cancers through a variety of mechanisms, including genetic damage--direct hits to our DNA or chromosomes--and epigenetic modification, changes in the way our genes are expressed. These effects have been documented in workers who are spraying the pesticides, but exposure to pesticide residues that remain on food is much smaller.

More recently, higher cancer rates have also been noted in people who live in areas where pesticides are heavily sprayed, but what about the food we buy at the store? Organic fruits and vegetables have fewer pesticides, but even the levels on conventional produce are generally well below acceptable limits. There is still scientific controversy about the safety of some pesticides even under the regulatory limits, however, given the possible additive effects of the mixture of pesticides to which we're exposed. The pesticide approval process also doesn't take into account toxic breakdown products such as dioxins that can form once pesticides are released into the environment.

Cadmium is another issue. In the largest review to date, involving hundreds of studies, not only did organic foods have more antioxidant phytonutrients, but lower concentrations of cadmium. Cadmium is one of three highly toxic heavy metals (along with lead and mercury) found in the food supply. Cadmium accumulates in the body, so we should try to keep intake as low as possible. Organic crops only have about half the cadmium, which is thought to come from the phosphate fertilizers that are added to conventional crops.

Of course, not all organic foods are healthy. The organic food industry is now worth tens of billions of dollars, and they didn't get that way just selling carrots. We can now buy pesticide-free potato chips and organic jelly beans. Organic foods can be even worse because, for example, people falsely judge organic Oreo cookies to have fewer calories than conventional Oreos, and so may eat more. Forgoing exercise was deemed more acceptable when the person had just chosen an organic dessert rather than a conventional one. In fact, leniency toward forgoing exercise was slightly greater after choosing an organic dessert than after eating no dessert at all--organic cookies were effectively viewed as having negative calories! Organic junk food is still junk food.

Not only do people tend to overestimate the nutritional benefits of organic foods, they also overestimate the risks of pesticides. People think that as many people die from pesticide residues on conventional food as die in motor vehicle accidents in the United States. Surveys have found organic food buyers may think eating conventional produce is almost as bad as smoking a pack of cigarettes. That kind of thinking is dangerous because it could potentially lead to a decrease in overall fruit and vegetable consumption.

If just half of the U.S. population were to increase fruit and vegetable consumption by a single serving a day, an estimated 20,000 cancer cases might be avoided each year. That's how powerful produce may be. But, because the model was using conventional fruits and veggies, the pesticide burden from those extra fruits and vegetables might result in 10 additional cancer cases. So overall, if half of us ate one more serving, we'd just prevent 19,990 cases of cancer a year.

Now that was a paper written by scientists-for-hire paid for by the Alliance for Food and Farming, which is a bunch of conventional produce growers, so they probably exaggerated the benefits and minimized the risks, but I think the bottom line is sound. We get a tremendous benefit from eating conventional fruits and vegetables that far outweighs whatever tiny bump in risk we may get from the pesticides. Why not reap the benefits without the risk and choose organic? Great! But we should never let concern about pesticides stop us from stuffing our face with as many fruits and vegetables as possible.

My video, Are the Benefits of Organic Food Underrated or Overrated?, was the final installment of a 5-part series on organics. The first four videos are:

I've covered the issue of cadmium in our diet before in Cadmium and Cancer: Plant vs. Animal Foods and Male Fertility and Diet. Heavy metals are found concentrated in seafood and organ meats, but can also be found in certain supplements and protein powders.

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 Do All the Blue Zones Have in Common?

Do Flexitarians Live Longer.jpg

What accounts for the benefits of a Mediterranean-style diet? An anatomy of health effects was published, and the single most important component was the high consumption of plant foods. In contrast, fish and seafood consumption, the only animal foods promoted in the Mediterranean diet, did not seem to help.

If you look at four of the major dietary quality scoring systems, which have all been associated with extending lifespan and lowering heart disease and cancer mortality, they all share only four things in common: more fruit, more vegetables, more whole grains and more nuts and beans. They are all built on a common core of a diet rich in plant foods, whereas opposite food patterns, rich in animal foods and poor in plant-based foods (in other words, the Western diet), is associated with higher risks. So we need to optimize the food environment to support whole grains, vegetables, fruit and plant-based proteins.

That's one of the things all the so-called Blue Zones have in common: the longest living populations have not only social support and engagement and daily exercise, but nutritionally they all center their diets around plant foods, reserving meat mostly for special occasions. In fact, the population with perhaps the highest life-expectancy in the world, the California Adventist vegetarians, doesn't eat any meat at all.

So if the primary benefits of the Mediterranean diet are due to all the whole plant foods, what if you went back to the famous PREDIMED study and created a "provegetarian" scoring system? We know vegetarians live longer, but because a pure vegetarian diet might not easily be embraced by many individuals, maybe it would be easier to swallow if we just tell people more plant-based foods and less animal-based foods. But would just moving along the spectrum towards more plants actually enable people to live longer? Researchers thought of this food pattern as a "gentle approach" to vegetarianism, figuring that if it improved survival it would be an easily understandable message for health promotion: more plant foods, less animal foods.

On this scoring system, you get points for eating fruit, vegetables, nuts, grains, beans, olive oil and potatoes, but get docked points for any animal fats, eggs, fish, dairy or any type of meat or meat products. Of course that means you get a higher score the more potato chips and French fries you eat. That's why I prefer the term "whole-food, plant-based diet" since it's defined by what you eat, not by what you don't eat. When I taught at Cornell I had "vegan" students who apparently were trying to live off French fries and beer; vegan does not necessarily mean health-promoting.

But did the provegetarian scoring system work? Regardless of healthy versus unhealthy, if you give points to people for any kind of plant food, processed or not, and detract points for any kind of animal product consumption, people with higher scores live longer. The maximum provegetarian score is 60, but even just scoring 40 or more was associated with a 40 percent drop in mortality. In fact, there were so few deaths in the highest category of adherence to the provegetarian diet, they had to merge the two upper categories for their analysis. This is evidence that simple advice to increase the consumption of plant-derived foods with reductions in the consumption of foods from animal sources confers a survival advantage. You can view the graph in my video Do Flexitarians Live Longer?

The researchers conclude, "this modest change is realistic, affordable, and achievable because a sizable proportion of their population was already eating that way. So one can get significant survival benefit without a radical shift to the exclusive consumption of plant foods, a more gradual and gentle approach which is more easily translatable into public policy." A 41 percent drop in mortality rates in the United States would mean saving the lives of hundreds of thousands of Americans every year.

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

I've done a few videos on the health of so-called semi-vegetarians or flexitarians ("flexible" vegetarians). See how they rate in:

The Provegetarian Score reminds me of the animal to vegetable protein ratio in Prostate Cancer Survival: The A/V Ratio. My favorite dietary quality index is the one in Calculate Your Healthy Eating Score. How do you rate? Even the healthiest among us may be able to continue to push the envelope.

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 Do All the Blue Zones Have in Common?

Do Flexitarians Live Longer.jpg

What accounts for the benefits of a Mediterranean-style diet? An anatomy of health effects was published, and the single most important component was the high consumption of plant foods. In contrast, fish and seafood consumption, the only animal foods promoted in the Mediterranean diet, did not seem to help.

If you look at four of the major dietary quality scoring systems, which have all been associated with extending lifespan and lowering heart disease and cancer mortality, they all share only four things in common: more fruit, more vegetables, more whole grains and more nuts and beans. They are all built on a common core of a diet rich in plant foods, whereas opposite food patterns, rich in animal foods and poor in plant-based foods (in other words, the Western diet), is associated with higher risks. So we need to optimize the food environment to support whole grains, vegetables, fruit and plant-based proteins.

That's one of the things all the so-called Blue Zones have in common: the longest living populations have not only social support and engagement and daily exercise, but nutritionally they all center their diets around plant foods, reserving meat mostly for special occasions. In fact, the population with perhaps the highest life-expectancy in the world, the California Adventist vegetarians, doesn't eat any meat at all.

So if the primary benefits of the Mediterranean diet are due to all the whole plant foods, what if you went back to the famous PREDIMED study and created a "provegetarian" scoring system? We know vegetarians live longer, but because a pure vegetarian diet might not easily be embraced by many individuals, maybe it would be easier to swallow if we just tell people more plant-based foods and less animal-based foods. But would just moving along the spectrum towards more plants actually enable people to live longer? Researchers thought of this food pattern as a "gentle approach" to vegetarianism, figuring that if it improved survival it would be an easily understandable message for health promotion: more plant foods, less animal foods.

On this scoring system, you get points for eating fruit, vegetables, nuts, grains, beans, olive oil and potatoes, but get docked points for any animal fats, eggs, fish, dairy or any type of meat or meat products. Of course that means you get a higher score the more potato chips and French fries you eat. That's why I prefer the term "whole-food, plant-based diet" since it's defined by what you eat, not by what you don't eat. When I taught at Cornell I had "vegan" students who apparently were trying to live off French fries and beer; vegan does not necessarily mean health-promoting.

But did the provegetarian scoring system work? Regardless of healthy versus unhealthy, if you give points to people for any kind of plant food, processed or not, and detract points for any kind of animal product consumption, people with higher scores live longer. The maximum provegetarian score is 60, but even just scoring 40 or more was associated with a 40 percent drop in mortality. In fact, there were so few deaths in the highest category of adherence to the provegetarian diet, they had to merge the two upper categories for their analysis. This is evidence that simple advice to increase the consumption of plant-derived foods with reductions in the consumption of foods from animal sources confers a survival advantage. You can view the graph in my video Do Flexitarians Live Longer?

The researchers conclude, "this modest change is realistic, affordable, and achievable because a sizable proportion of their population was already eating that way. So one can get significant survival benefit without a radical shift to the exclusive consumption of plant foods, a more gradual and gentle approach which is more easily translatable into public policy." A 41 percent drop in mortality rates in the United States would mean saving the lives of hundreds of thousands of Americans every year.

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

I've done a few videos on the health of so-called semi-vegetarians or flexitarians ("flexible" vegetarians). See how they rate in:

The Provegetarian Score reminds me of the animal to vegetable protein ratio in Prostate Cancer Survival: The A/V Ratio. My favorite dietary quality index is the one in Calculate Your Healthy Eating Score. How do you rate? Even the healthiest among us may be able to continue to push the envelope.

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

Are Raisins a Good Snack Choice?

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Raisins, like all fruits, have a variety of health benefits, but dried fruit is higher in calories per serving than fresh, so might they contribute to weight gain? A study done by the University of Connecticut helped set people's minds at ease. Men and women were assigned to consume a cup of raisins a day for six weeks and were able to successfully offset the consumption of other foods in their diets such that they experienced no significant change in weight or waist circumference. What about in kids? I explore that in the video, Are Raisins Good Snacks for Kids?.

Leave it to the California Raisin Marketing Board to dream up a study titled, "An after-school snack of raisins lowers cumulative food intake in young children." Sounds good, right? They compared raisins to potato chips and chocolate chip cookies. They gave kids raisins, grapes, chips or cookies and said they could eat as much as they wanted and surprise surprise kids ate less fruit and more junk, but I guess naming the paper "Kids Prefer Cookies" would not have garnered the same kind of sponsor approval.

This reminds me of another study they did showing that regular consumption of raisins may reduce blood sugar levels... compared to fudge cookies and Oreos. Another study showed raisins caused less of a blood sugar spike than Coca-cola and candy bars. Though you can tell it was not funded by Big Raisin by their conclusion, "whether the general public should be advised to snack on fruit rather than on candy bars requires further debate and investigation."

Comparing raisins to chips and cookies was similarly unhelpful. Luckily, a less biased study was published by researchers at the University of Toronto. Nine to eleven year old boys and girls were told to eat all the grapes or raisins they wanted 30 minutes before a meal in which they could eat all the pizza they wanted. If you just gave them the meal, no snack, they ate 837 calories worth of pizza. If you gave them all-you-can-eat grapes before the meal, they ate 128 calories of grapes, but that seemed to fill them up a bit, so they ended up eating less pizza. But because they ate the snack and the meal they ended up getting more calories over all. Still, grape calories are better than pizza calories, but when given raisins instead, they ate even more snack calories, but the raisins were evidently so satiating that they ate so much less pizza that they ate fewer calories over all.

Now I know as parents there's a concern that if our kids eat snacks it might spoil their dinner, but when the snacks are fruit and the meal is a pepperoni and three cheese pizza, the more we can ruin their appetite, the better.

Raisin marketers aren't the only one's trying game the scientific method. Check out:

How to help get our kids to eat their fruits and veggies:

More dried fruit studies (my fave is dried mango):

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--2013: Uprooting the Leading Causes of Death, More Than an Apple a Day, 2014: From Table to Able: Combating Disabling Diseases with Food, 2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet, and my latest, 2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers.

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How Big Food Twists the Science

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Just like mosquitos are the vectors of spread for malaria, a landmark article published last year in one of the most prestigious medical journals, Lancet, described large food corporations as the vectors of spread for chronic disease. Unlike "infectious disease epidemics, however, these corporate disease vectors implement sophisticated campaigns to undermine public health interventions." Most mosquitoes don't have as good PR firms.

A key message was that "alcohol and ultra-processed food and drink industries use similar strategies as the tobacco industry to undermine effective public health policies and programs." What they mean by ultra-processed is things like burgers, frozen meals, chicken nuggets, fish sticks, potato chips, doughnuts and soda pop.

But how is the food industry like the tobacco industry? The "first strategy is to bias research findings." For example, Philip Morris implemented the Whitecoat project to hire doctors to publish ghost-written studies purporting to negate links between secondhand smoke and harm, publishing biased cherry-picked scientific reports to deny harm and suppress health information. In my video Food Industry-Funded Research Bias, you can see the actual industry memo describing the Whitecoat Project, designed to reverse the scientific "misconception" that secondhand smoke is harmful.

Similarly, funding from these large food corporations biases research. Studies show systematic bias from industry funding, so we get the same kind of tactics--supplying misinformation, use of supposedly conflicting evidence and hiding negative data.

The same scientists-for-hire that downplayed the risks of secondhand smoke are the same hired by the likes of the National Confectioner's Association to say candy cigarettes are A-OK as well. Of course, they declared "no conflict of interest."

The similarities between strategies used by the tobacco, alcohol, and food and drink corporations are unsurprising in view of the flow of people, funds and activities across these industries, which also have histories of joint ownership--like Philip Morris owned both Kraft and Miller Brewing.

So what's their strategy? As a former FDA commissioner described:

"The tobacco industry's strategy was embodied in a script written by the lawyers. Every tobacco company executive in the public eye was told to learn the script backwards and forwards, no deviation was allowed. The basic premise was simple-- smoking had not been proven to cause cancer. Not proven, not proven, not proven--this would be stated insistently and repeatedly. Inject a thin wedge of doubt, create controversy, never deviate from the prepared line. It was a simple plan and it worked."

Internal industry memos make this explicit, stating "doubt is our product, since it is the best means of competing with the body of fact that exists in the mind of the general public." The internal industry memos list objective number one as "to set aside in the minds of millions the false conviction that cigarette smoking causes lung cancer and other diseases; a conviction based on fanatical assumptions, fallacious rumors, unsupported claims and the unscientific statements and conjectures of publicity-seeking opportunists... [We need] to lift the cigarette from the cancer identification as quickly as possible, and to establish--once and for all--that no scientific evidence has ever been produced, presented or submitted to prove conclusively that cigarette smoking causes cancer," similar to what's now coming out from the food industry, from the same folks that brought us smoke and candy.

This is part of a series of "political" blogs which includes my video, Collaboration with the New Vectors of Disease. Why don't I just "stick to the science"? When there are billions of dollars at stake, the body of evidence can be skewed and manipulated. Funders can determine which studies are performed, how they're performed and whether or not they get published at all. That's why I think it's important to take a broader view to account for the ways the scientific method can be perverted for profit.

Here are some examples:

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--2013: Uprooting the Leading Causes of Death, More Than an Apple a Day, 2014: From Table to Able: Combating Disabling Diseases with Food, 2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet, and my latest, 2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers.

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