What to Eat to Protect Against Kidney Cancer

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58,000 Americans are diagnosed with kidney cancer every year, and 13,000 die. And the numbers have been going up. Approximately 4 percent of cases are hereditary, but what about the other 96 percent? The only accepted risk factor has been tobacco use, but cigarette smoking has been declining.

Nitrosamines are one of the most potent carcinogens in cigarette smoke. One hot dog has as many nitrosamines and nitrosamides as five cigarettes. And these carcinogens are also found in fresh meat as well: beef, chicken and pork. So even though smoking rates have dropped, perhaps the rise in kidney cancer over the last few decades may have something to do with meat consumption. But would kidney cancer just be related to the processed meats like bacon, sausage, hot dogs and cold cuts that have nitrate and nitrite additives, or fresh meat as well?

The NIH-AARP study featured in my video Can Diet Protect Against Kidney Cancer? is the largest prospective study on diet and health ever performed--about 500,000 followed for nine years. In addition to examining nitrate and nitrite intake from processed meat, they also looked at intake from other sources such as fresh meat, eggs and dairy. Nitrite from animal sources, not just processed meats, was associated with an increased risk of kidney cancer, and total intake of nitrate and nitrite from processed meat sources was also associated with kidney cancer risk. The researchers found no associations with nitrate or nitrite intake from plant sources, but nitrates from processed meat was associated with cancer.

When meat producers advertise their bacon or lunch meat as "uncured," this means no nitrites or nitrates added. But if you look at the small print you'll see something like, "except for celery juice." That's just a sneaky way to add nitrites. Processed meat producers ferment the nitrates in celery to create nitrites, then add it to the meat; a practice even the industry admits "may be viewed as incorrect at best or deceptive at worst."

But that same fermentation of nitrates to nitrites can happen thanks to bacteria on our tongue when we eat vegetables. So why are nitrates and nitrites from vegetables on our tongue harmless, but nitrates and nitrites from vegetables in meat linked to cancer? The actual carcinogens are not nitrites, but nitrosamines and nitrosamides. In our stomach, to turn nitrites into nitros-amines, and nitros-amides we need amines and amides, which are concentrated in animal products. And vitamin C and other antioxidants in plant foods block the formation of these carcinogens in our stomach. That's why we can safely benefit from the nitrates in vegetables without the cancer risk. In fact some of the highest nitrate vegetables like arugula, kale, and collards are associated with decreased risk of kidney cancer. The more plants, it appears, the better.

Plant-based diets and fiber-rich diets are recommended to prevent cancer directly, as well as chronic conditions associated with kidney cancer, such as obesity, high blood pressure and diabetes. It's similar to sodium intake and kidney cancer. Sodium intake increases kidney disease risk, but that's not just because sodium intake increases blood pressure. It appears the salt is associated with increased cancer risk even independently of hypertension. What about plant-based diets? Turns out the protective association remains even in people who are not obese and have normal blood pressure. So overall, plant-based and fiber-rich diets appear to do both: decrease cancer risk directly and indirectly.

I briefly address kidney health in Preventing Kidney Failure Through Diet and Treating Kidney Failure Through Diet, but have a whole series of more in-depth videos dealing with various kidney issues.

More on the fascinating nitrate/nitrite story in my 17-part series about improving athletic performance with nitrate-rich vegetables such as beets and arugula. Here are a few short highlights:

More on carcinogens caused by cooking meat in videos like:

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations--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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The Effects of Dietary Cholesterol on Blood Cholesterol

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Blood cholesterol levels are clearly increased by eating dietary cholesterol. In other words, putting cholesterol in our mouth means putting cholesterol in our blood, and it may also potentiate the harmful effects of saturated fats, meaning when we eat sausage and eggs, the eggs may make the effects of the sausage even worse. If you eat the saturated fat and cholesterol found in two sausages and egg McMuffins every day for two weeks, your cholesterol would shoot up nearly 30 points. If you ate about the same saturated fat without the cholesterol, some kind of cholesterol-free sausage McMuffins without the egg, what would happen? Now the egg would have saturated fat too, so to even it out we have to add three strips of bacon to the comparison. Same saturated fat, but two-eggs-worth less cholesterol, would only bump us up only around five points. So, saturated fat may increase fasting cholesterol levels more than dietary cholesterol, but especially in the presence of dietary cholesterol.

And this is measuring fasting cholesterol, meaning the baseline from which all our meal-related cholesterol spikes would then shoot. Heart disease has been described as a postprandial phenomenon, meaning an after-meal phenomenon. Milky little droplets of fat and cholesterol straight from a meal called chylomicrons can build up in atherosclerotic plaques just like LDL cholesterol. So what happens after a meal that includes eggs?

In my video How the Egg Board Designs Misleading Studies, you can see what happens to the level of fat and cholesterol in our blood stream for the seven hours after eating a meal with no-fat, no-cholesterol. There are hardly changes at all. But when you eat a meal with fat and more and more egg, triglycerides and blood cholesterol shoot up.

That's the kind of data that's bad for egg sales, so how could you design a study to hide this fact?

What if you only measured fasting cholesterol levels in the morning, seven hours after supper? You wouldn't see a big difference between those that ate eggs the night before and those that didn't. As the lead investigator of a study which compared the cardiovascular health effects of smoking versus eating eggs pointed out, measuring fasting cholesterol is appropriate for measuring the effects of drugs suppressing our liver's cholesterol production, but not appropriate for measuring the effects of dietary cholesterol. After a cholesterol-laden supper, our arteries are being pummeled all night long. Then think about what's happening during the day. There may be only four hours between breakfast and lunch. So if we had eggs for breakfast we'd get that big spike and by lunch start the whole cycle of fat and cholesterol in our arteries all over again. So most of our lives are lived in a postprandial state, in an after-meal state, and the graph I show in the video shows that the amount of egg in our meals makes a big difference when it really matters--after we've eaten, which is where we spend most of our lives. So that's why when the Egg Board funds a study, they only measure fasting cholesterol levels of the next day.

Doctors are so used to testing fasting cholesterol levels to monitor the effects of drugs, they too often fall for these egg industry tactics hook, line, and sinker. Please share the video with anyone who tries to downplay the risks of eggs or dietary cholesterol in general.

The smoking study I mentioned can be found here: Eggs vs. Cigarettes in Atherosclerosis.

For more videos on eggs for those who just desperately cling to egg industry propaganda, please see a few of my latest:

For another jaw-dropper as to the gall of corporate interests to use the veneer of science to downplay the risks of their products, check out BOLD Indeed: Beef Lowers Cholesterol?

In health,
Michael Greger, M.D.

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

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What Do Eggs Do To Our Arteries?

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In reaction to the study that found a similar exponential increase in artery clogging plaque in both smokers and egg eaters, one critic countered that eggs have beneficial effects on vascular endothelium, the inner lining of our arteries, citing a 2005 study on egg consumption and endothelial function, funded by the American Egg Board (highlighted in my video, Eggs and Arterial Function).

The study was done on a group of men and women eating the standard American diet, were overweight, had "normal" cholesterol, (which is to say extremely high cholesterol--LDL levels twice as high as could be considered optimal). As the authors of a paper published in the Journal of the American College of Cardiology note, it's often not appreciated "that the average blood cholesterol level in the United States, the so-called normal level, was actually too high," accelerating heart disease and "putting a large fraction of the so-called normal population at a higher risk" for coronary heart disease, our number one killer.

If we threw a lit match into a flaming pool of gasoline and saw no real difference in the height of the flames, we can't conclude that throwing lit matches into gasoline is not a fire hazard. But that is exactly what the Egg Board study concluded. When the addition of eggs didn't make the arterial function worse than it already was, they concluded that "short-term egg consumption does not adversely affect endothelial function in healthy adults."

The egg board paid for a follow-up study using folks who were even worse off, with a mean total cholesterol of 244. They reported that egg consumption had no effect on endothelial function... as compared to sausage and cheese. Yet instead of sounding the alarm that eating eggs is as bad for arterial function as a McDonald's Sausage McMuffin (!), the researchers concluded that egg consumption was found to be non-detrimental to endothelial function and cholesterol levels. The subjects started out with life-threatening cholesterol, and ended up with life-threatening cholesterol.

Why don't endothelial function and cholesterol levels get even worse? Because there's a plateau effect. We can basically max out on our cholesterol absorption. After a certain level of intake, it's just another match to the fire. If we're already consuming the standard American diet averaging 400mg of cholesterol daily, even adding two jumbo eggs to our diet may not have a sizeable impact. But to people trying to eat healthy, those two eggs could shoot their cholesterol up 20 points.

However, a fat-free, cholesterol-free egg substitute was found to be beneficial. That is, not eating eggs lowers cholesterol levels and improves endothelial function--and that's what these people needed. Their arteries were already hurting, they needed something to bring the fire down, not more matches. The subjects were apparently eating so unhealthy that adding eggs couldn't make things much worse, but eating oatmeal instead of eggs made things better, helping to quench the fire. So even the Egg Board-funded studies said that not eating eggs is better for our arteries, yet these are the same studies that pro-egg folks cite to claim beneficial vascular effects.

More on the reaction to the Eggs vs. Cigarettes in Atherosclerosis study in my video, Debunking Egg Industry Myths, as well as further discussion of the effects of the cholesterol in eggs on the cholesterol levels in the blood of egg consumers. More on that in:

I previously featured a food that actually does benefit vascular function. See Walnuts and Artery Function. Though the nut industry did try a similar tactic, see my video Nuts and Bolts of Cholesterol Lowering. The beef, soda, and dairy industries may also be guilty of experimental manipulation. See BOLD Indeed: Beef Lowers Cholesterol and Food Industry "Funding Effect".

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my videos for free by clicking here and watch my full 2012 - 2015 presentations Uprooting the Leading Causes of Death, More than an Apple a Day, From Table to Able, and Food as Medicine.

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How to Treat Multiple Sclerosis With Diet

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Multiple sclerosis is an unpredictable and frightening degenerative autoimmune inflammatory disease of the central nervous system in which our body attacks our own nerves. It often strikes in the prime of life and can cause symptoms in the brain, such as cognitive impairment; in the eye, such as painful loss of vision; as well as tremors, weakness, loss of bladder control, pain, and fatigue.

The most frequently prescribed drug for multiple sclerosis is interferon beta, which can make one feel lousy and cost $30,000 a year. But hey, it might be worthwhile--if it actually worked. We learned recently that it doesn't seem to prevent or delay long-term disability. That leaves chemo drugs like mitoxantrone that causes irreversible heart damage in one out of every eight people who go on the drug and causes cancer (leukemia) in nearly 1% of people who take it. But MS is no walk in the park either.

If only there was a cheap, simple, safe, side-effect free solution that also just so happened to be the most effective treatment for MS ever prescribed...

Dr. Roy Swank, who we lost recently at age 99, was a distinguished neurologist whose research culminated in over 170 scientific papers. In the video, Treating Multiple Sclerosis with the Swank MS Diet, I highlight a few.

As far back as 1950, we knew there were areas in the world that had a lot of MS--North America, Europe--and other places--Africa and Asia--that hardly had any. And migration studies show that those who move from a high risk area to a low risk area significantly drop their risk, and vice versa. So it seems less genetic and more lifestyle.

Dr. Swank had an idea. As he recounts in an interview with Dr. John McDougall at the ripe young age of 84, "it seemed possible to me that this could be a matter of food, because the further north you go the less vegetarian a life is led and the more people are carnivores, you might say--they spend a lot more time eating meat."

After looking at the multiple sclerosis data from World War II in occupied countries where meat and dairy were rationed, along with his famous study in '52 that found that the frequency of MS related directly to the amount of saturated animal fat consumed daily in different areas of Norway, he concluded that it might be the animal fat that was causing the increased risk. He decided to put it to the test by restricting people's intake of saturated animal fat, most commonly coming from dairy and chicken in the U.S. (See Trans Fat, Saturated Fat, and Cholesterol: Tolerable Upper Intake of Zero).

In Treating Multiple Sclerosis with the Swank MS Diet, you can see data on his first 47 patients before cutting out about 90% of the saturated fat from their diet and after, showing a decrease in both the frequency and severity of MS attacks. Normally, we're lucky if we can get people to stick to a diet for six months, and so that's why most dietary trials last a year at the most. The first study he published reported results from the first three and a half years.

Then came the five and a half year follow-up in which he added about another 100 patients. Then the seven year follow-up, published in the Annals of Internal Medicine. Then the 20 year follow-up, and then the 34 year follow-up.

How did his patients do? If we can get to people early in their disease, when they're only mildly disabled, and restrict their saturated fat intake, Dr. Swank showed he could stop their disease in 95% of cases--no further disability 34 years later. But if they started slacking on their diet--even years in, their disease could become reactivated. They felt so great that some felt that they could cheat a little bit, since they had their disease so well under control. But eating just eight grams of saturated fat more a day was accompanied by a striking increase in disability and a near tripling of their death rate.

How about a 50 year follow-up! They were able to track down 15 of the original patients that stuck to the diet, now in their 70s and 80s, with multiple sclerosis for over 50 years, and 13 out of 15 were walking around normal in all respects. Conclusion: "This study indicated that, in all probability, MS is caused largely by consumption of saturated animal fat."

Dr. Swank thought it was the sludging of the blood caused by even a single meal of saturated fats that can clog tiny capillaries that feed our nervous system. Diets rich in saturated fat and cholesterol can thicken the blood and make our red cells sticky. A single meal of sausage and eggs can stick our blood cells together like rolls of quarters. And that kind of hyperaggregation can lead to a reduction of blood flow and oxygenation of our tissues. What's in sausage and eggs that may cause so much inflammation? See my video series on endotoxins described in my blog How Does Meat Cause Inflammation?

If we put someone's blood through a machine that sucks out about 90% of the cholesterol in their blood, we can demonstrate an immediate improvement in microcirculation in the heart muscle. But what about the brain?

The eyes are the windows... to our brain. We can visualize--in real-time--changes in blood vessel function in the retina at the back of the eye, which gives us a sense of what's happening further back in the brain. And if we lower the cholesterol level in the blood, we can immediately get a significant improvement in vasodilation--the little veins open wider and let the blood flow.

So yes, it could be the animal fat leading to clogging of our capillaries, but now we know animal fats can have all sorts of other deleterious effects such as inflammation, so who knows what the actual mechanism may be by which cutting animal fat can cut MS progression. Regardless, patients with MS that follow a diet with no more than 10 or 15 grams of saturated fat can expect to survive and thrive to a ripe old age. Of course, cutting out saturated fat completely might be better, given that heart disease is our number one killer.

The bottom line is that the results Dr. Swank published remain "the most effective treatment of multiple sclerosis ever reported in the peer reviewed medical literature." In patients with early stage MS, 95% were without progression of their disease 34 years later after adopting his low saturated fat dietary program. Even patients with initially advanced disease showed significant benefit. To date, no medication or invasive procedure has ever even come close, to demonstrating such success.

Doesn't cost $30,000 dollars; doesn't give you leukemia--and works. Better!

This all begs one big obvious question: If Dr. Swanks results are "so stunningly impressive, why haven't other physicians, neurologists, and centers adopted this method of treatment?" One reason may be that MRI machines weren't invented until the 1970s, decades after Dr. Swank's study began. MRIs are how we track the progress of MS today. We don't have to rely on patients' subjective reports or doctor's clinical judgments, we can see the disease get better or worse right there in black and white.

It's like in the 1970s when Nathan Pritikin appeared to reverse heart disease by the thousands but no one took him seriously until angiography was invented and the likes of Ornish and Esselstyn (see Our Number One Killer Can Be Stopped) could hold up angiographic images, proving conclusively that a plant-based diet could help literally open up arteries.

So what we need is someone to repeat Swank's experiment today with MRI scans every step of the way. And I'm happy to report that exact experiment was just completed by Dr. John McDougall. Dr. Swank was one of Dr. McDougall's heroes, and Dr. McDougall is one of mine. Study enrollment was completed last year and we should have the full results soon.

I touched on this in my live 2013 year-in-review lecture More Than an Apple a Day, but I'm excited to be able to take a deeper dive into this extraordinary story.

Those interested in supporting Dr. McDougall's landmark study (headed by Dr. Dennis Bourdette, M.D. and under the supervision of Dr. Vijayshree Yadav) can donate to his nonprofit McDougall Research & Education Foundation (you can also donate to NutritionFacts.org to help keep us bringing you similarly underreported yet life-saving science).

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live 2012 year-in-review presentation Uprooting the Leading Causes of Death.

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