Who Should Avoid Coffee?

Oct 19 Coffee copy.jpeg

Do coffee drinkers live longer than non-coffee drinkers? Is it "wake up and smell the coffee" or don't wake up at all? I discuss these questions in my video, Coffee and Mortality.

The largest study ever conducted on diet and health put that question to the test, examining the association between coffee drinking and subsequent mortality among hundreds of thousands of older men and women in the United States. Coffee drinkers won, though the effect was modest, a 10-15% lower risk of death for those drinking six or more cups a day. This was due specifically to lower risk of dying from heart disease, respiratory disease, stroke, injuries and accidents, diabetes, and infections.

However, another study that amount of coffee was found to increase the death rate of younger people under age 55. It may be appropriate, then, to recommend that you avoid drinking more than four cups a day. But if you review all the studies, the bottom line is that coffee consumption is associated with no change or a small reduction in mortality starting around one or two cups a day, for both men and women. The risk of dying was 3% lower for each cup of coffee consumed daily, which provides reassurance for the concern that coffee drinking might adversely affect health, or at least longevity.

A recent population study found no link between coffee consumption and symptoms of GERD, reflux diseases such as heartburn and regurgitation. If you actually stick a tube down people's throats and measure pH, though, coffee induces significant acid reflux, whereas tea does not. Is this just because tea has less caffeine? No. If you reduce the caffeine content of the coffee down to that of tea, coffee still causes significantly more acid reflux. Decaf causes even less, so GERD patients might want to choose decaffeinated coffee or, even better, opt for tea.

Coffee intake is also associated with urinary incontinence, so a decrease in caffeine intake should be discussed with patients who have the condition. About two cups of coffee a day worth of caffeine may worsen urinary leakage.

A 2014 meta-analysis suggested that daily coffee consumption was associated with a slightly increased risk of bone fractures in women, but a decreased risk of fractures in men. However, no significant association was found between coffee consumption and the risk of hip fracture specifically. Tea consumption may actually protect against hip fracture, though it appears to have no apparent relationship with fracture risk in general.

Certain populations, in particular, may want to stay away from caffeine, including those with glaucoma or a family history of glaucoma, individuals with epilepsy, and, not surprisingly, people who have trouble sleeping. Even a single cup at night can cause a significant deterioration in sleep quality.

We used to think caffeine might increase the risk of an irregular heart rhythm called atrial fibrillation, but that was based on anecdotal case reports like one of a young woman who suffered atrial fibrillation after "chocolate intake abuse." These cases invariably involved the acute ingestion of very large quantities of caffeine. As a result, the notion that caffeine ingestion may trigger abnormal heart rhythms had become "common knowledge," and this assumption led to changes in medical practice.

We now have evidence that caffeine does not increase the risk of atrial fibrillation. Low-dose caffeine--defined as less than about five cups of coffee a day--may even have a protective effect. Tea consumption also appears to lower cardiovascular disease risk, especially when it comes to stroke. But given the proliferation of energy drinks that contain massive quantities of caffeine, one might temper any message that suggests that caffeine is beneficial. Indeed, 12 highly caffeinated energy drinks within a few hours could be lethal.


To learn more about various health aspects of coffee, see my videos Coffee and Cancer, What About the Caffeine?, Preventing Liver Cancer with Coffee?, and Coffee and Artery Function.

What else can we consume to live longer? Check out Nuts May Help Prevent Death, Increased Lifespan from Beans, Fruits and Longevity: How Many Minutes per Mouthful?, and Finger on the Pulse of Longevity.

And, for more on controlling acid reflux, see Diet and GERD Acid Reflux Heartburn and Diet and Hiatal Hernia.

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

Who Should Avoid Coffee?

Oct 19 Coffee copy.jpeg

Do coffee drinkers live longer than non-coffee drinkers? Is it "wake up and smell the coffee" or don't wake up at all? I discuss these questions in my video, Coffee and Mortality.

The largest study ever conducted on diet and health put that question to the test, examining the association between coffee drinking and subsequent mortality among hundreds of thousands of older men and women in the United States. Coffee drinkers won, though the effect was modest, a 10-15% lower risk of death for those drinking six or more cups a day. This was due specifically to lower risk of dying from heart disease, respiratory disease, stroke, injuries and accidents, diabetes, and infections.

However, another study that amount of coffee was found to increase the death rate of younger people under age 55. It may be appropriate, then, to recommend that you avoid drinking more than four cups a day. But if you review all the studies, the bottom line is that coffee consumption is associated with no change or a small reduction in mortality starting around one or two cups a day, for both men and women. The risk of dying was 3% lower for each cup of coffee consumed daily, which provides reassurance for the concern that coffee drinking might adversely affect health, or at least longevity.

A recent population study found no link between coffee consumption and symptoms of GERD, reflux diseases such as heartburn and regurgitation. If you actually stick a tube down people's throats and measure pH, though, coffee induces significant acid reflux, whereas tea does not. Is this just because tea has less caffeine? No. If you reduce the caffeine content of the coffee down to that of tea, coffee still causes significantly more acid reflux. Decaf causes even less, so GERD patients might want to choose decaffeinated coffee or, even better, opt for tea.

Coffee intake is also associated with urinary incontinence, so a decrease in caffeine intake should be discussed with patients who have the condition. About two cups of coffee a day worth of caffeine may worsen urinary leakage.

A 2014 meta-analysis suggested that daily coffee consumption was associated with a slightly increased risk of bone fractures in women, but a decreased risk of fractures in men. However, no significant association was found between coffee consumption and the risk of hip fracture specifically. Tea consumption may actually protect against hip fracture, though it appears to have no apparent relationship with fracture risk in general.

Certain populations, in particular, may want to stay away from caffeine, including those with glaucoma or a family history of glaucoma, individuals with epilepsy, and, not surprisingly, people who have trouble sleeping. Even a single cup at night can cause a significant deterioration in sleep quality.

We used to think caffeine might increase the risk of an irregular heart rhythm called atrial fibrillation, but that was based on anecdotal case reports like one of a young woman who suffered atrial fibrillation after "chocolate intake abuse." These cases invariably involved the acute ingestion of very large quantities of caffeine. As a result, the notion that caffeine ingestion may trigger abnormal heart rhythms had become "common knowledge," and this assumption led to changes in medical practice.

We now have evidence that caffeine does not increase the risk of atrial fibrillation. Low-dose caffeine--defined as less than about five cups of coffee a day--may even have a protective effect. Tea consumption also appears to lower cardiovascular disease risk, especially when it comes to stroke. But given the proliferation of energy drinks that contain massive quantities of caffeine, one might temper any message that suggests that caffeine is beneficial. Indeed, 12 highly caffeinated energy drinks within a few hours could be lethal.


To learn more about various health aspects of coffee, see my videos Coffee and Cancer, What About the Caffeine?, Preventing Liver Cancer with Coffee?, and Coffee and Artery Function.

What else can we consume to live longer? Check out Nuts May Help Prevent Death, Increased Lifespan from Beans, Fruits and Longevity: How Many Minutes per Mouthful?, and Finger on the Pulse of Longevity.

And, for more on controlling acid reflux, see Diet and GERD Acid Reflux Heartburn and Diet and Hiatal Hernia.

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

Side-Effects of Aspartame on the Brain

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The National Institutes of Health AARP study of hundreds of thousands of Americans followed for years found that frequent consumption of sweetened beverages, especially diet drinks, may increase depression risk among older adults. Whether soda, fruit-flavored drinks, or iced tea, those artificially sweetened drinks appeared to carry higher risk. There was a benefit in coffee drinkers compared to non-drinkers, but if they added sugar, much of the benefits appeared to disappear, and if they added Equal or Sweet-and-Low, the risk appeared to go up.

Various effects of artificial sweeteners, including neurological effects, have been suspected. For example, aspartame--the chemical in Equal and Nutrasweet--may modulate brain neurotransmitters such as dopamine and serotonin, although data have been controversial and inconsistent. Scientific opinions range from "safe under all conditions" to "unsafe at any dose." The controversy started in the 80's soon after aspartame was approved. Researchers at the Mass College of Pharmacy and MIT noted:

"given the very large number of Americans routinely exposed, if only 1% of the 100,000,000 Americans thought to consume aspartame ever exceed the sweetener's acceptable daily intake, and if only 1% of this group happen coincidentally to have an underlying disease that makes their brains vulnerable to the effects, then the number of people who might manifest adverse brain reactions attributable to aspartame could still be about 10,000, a number on the same order as the number of brain and nerve-related consumer complaints already registered with the FDA before they stopped accepting further reports on adverse reactions to the sweetener."

Those with a history of depression might be especially vulnerable. Researchers at Case Western designed a study I highlighted in my video Aspartame and the Brain to ascertain whether individuals with mood disorders are particularly vulnerable to adverse effects of aspartame. Although they had planned on recruiting 40 patients with depression and 40 controls, the project was halted early by the Institutional Review Board for safety reasons because of the severity of reactions to aspartame within the group of patients with a history of depression.

It was decided that it was unethical to continue to expose people to the stuff.

Normally when we study a drug or a food, the company donates the product to the researchers because they're proud of the benefits or safety of their product. But the Nutrasweet company refused to even sell it to these researchers. The researchers managed to get their hands on some, and within a week there were significantly more adverse effects reported in the aspartame group than in the placebo group. They concluded that individuals with mood disorders may be particularly sensitive to aspartame, and therefore its use in this population should be discouraged.

In a review of the direct and indirect cellular effects of aspartame on the brain, it was noted that there are reports of aspartame causing neurological and behavioral disturbances in sensitive individuals, such as headaches, insomnia and seizures. The researchers go even further and propose that excessive aspartame ingestion might be involved in the development of certain mental disorders and also in compromised learning and emotional functioning. They conclude that "due to all the adverse effects caused by aspartame, it is suggested that serious further testing and research be undertaken to eliminate any and all controversies," to which someone responded in the journal that "there really is no controversy," arguing that aspartame was conclusively toxic.

But what do they mean by excessive ingestion? The latest study on the neuro-behavioral effects of aspartame consumption put people on a high aspartame diet compared to a low aspartame diet. But even the high dose at 25 mg/kg was only half the adequate daily intake set by the FDA. The FDA says one can safely consume 50mg a day, but after just eight days on half of that, participants had more irritable mood, exhibited more depression, and performed worse on certain brain function tests. And these weren't people with a pre-existing history of mental illness; these were just regular people. The researchers concluded that "given that the higher intake level tested here was well below the maximum acceptable daily intake level [40mg in Europe, 50mg here] careful consideration is warranted when consuming food products that may affect neurobehavioral health."

Easier said than done, since it's found in more than 6,000 foods, apparently making artificial sweeteners "impossible to completely eradicate from daily exposure." While that may be true for the great majority of Americans, it's only because they elect to eat processed foods. If we stick to whole foods, we don't even have to read the ingredients lists, because the healthiest foods in the supermarket are label-free, they don't even have ingredients lists--produce!

I've previously touched on artificial sweeteners before:

The healthiest caloric sweeteners are blackstrap molasses and date sugar (whole dried powdered dates). The least toxic low-calorie sweetener is probably erythritol (Erythritol May Be a Sweet Antioxidant).

Coffee may decrease suicide and cancer risk (Preventing Liver Cancer with Coffee? and Coffee and Cancer) but may impair blood flow to the heart (Coffee and Artery Function).

Other ways to improve mood include:

In health,
Michael Greger, M.D.

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

Image Credit: Mike Mozart / Flickr

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How Animal Proteins May Trigger Autoimmune Disease

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Although slaughterhouse workers with the most poultry exposure appear to suffer the greatest excess mortality (see Poultry Exposure Tied to Liver and Pancreatic Cancer), increased risk of death from cancer is also found in other slaughterplant workers. This research goes back decades and shows higher cancer rates in butchers, slaughterhouse workers, meat cutters, and those working in meat processing plants.

The increased risk for meat industry workers in developing and dying from cancer "may be due to animal-to-human viruses or antigenic stimulation through chronic exposure to animal protein." Cancer-causing virus exposure could also help explain why those who eat meat have higher cancer rates. There's even a retrovirus associated with cancerous fish tumors, which has been speculated as the cause for increased cancer rates in American seafood workers.

Growing up on a livestock farm is associated with higher rates of blood-borne cancer, lymphomas and leukemia. Worst, though, is growing up on a poultry farm, which is consistent with chicken consumption being most closely tied to these cancers. Eating a quarter of a chicken breast daily is associated with a doubling or tripling of risk for these cancers (see EPIC Findings on Lymphoma). Growing up on a farm raising only plant crops, however, is not associated with blood-borne cancers.

What about growing up with dogs and cats? See Pets & Human Lymphoma and Are Cats or Dogs More Protective for Children's Health? You still probably shouldn't eat them, though (see Foodborne Rabies).

Researchers are finally able to start connecting the dots. High levels of antibodies to avian leucosis/sarcoma viruses and reticuloendotheliosis viruses in poultry workers provide evidence of infectious exposure to these cancer-causing poultry viruses. The highest levels were found not in the eviscerators, or gut-pullers, or those that hang the live birds, but among the line workers that just cut up the final product.

In an attempt to narrow down which diseases were associated with which meat, researchers tried separating out those in pig slaughtering and pork processing. "One of the primary sources of concern in using pig organs and tissues as transplants in humans is the fear of introducing zoonotic infections" from animals. We're concerned about what's called PERV transmission, the pig-to-human transmission of porcine endogenous retroviruses, raising theoretical concerns about cancer, immunological, and neurological disorders. However, we don't need to get a pig transplant to be exposed. PERVs are also found in blood, so people exposed to pig blood may be exposed to the virus.

The main finding unique to the pork study (profiled in my video Eating Outside Our Kingdom), which was not found in beef and sheep processing, was the significant excess of deaths "from senile conditions such as Alzheimer's disease." It reminds me of all those poor pork brain extraction workers. You think your job is bad? How would you like to work at the "head-table"? Well, that doesn't sound so bad until you learn it's where, through the "unbridled use of compressed air in the pursuit of maximum yield of soft tissue," they remove the brains of severed swine heads.

In one study, researchers noted that as the line speeds increased, "the workers reported being unable to place the skulls completely on the brain removal device before triggering the compressed air, causing greater splatter of brain material." The aerosolized "mist of brain" is suspected to be the cause of dozens of cases of inflammatory neurological disease in workers who started with symptoms as mild as pain, tingling, and difficulty walking, and ended up so bad that doctors had to put them in a coma for six weeks because of unrelenting seizures.

At first researchers thought it was a brain parasite, but now it's known to be an auto-immune attack triggered by the exposure to aerosolized brain. A similar mechanism has been blamed for meat proteins triggering inflammatory arthritis in people eating meat. By eating fellow animals, we are exposed not only to fellow animal diseases, but to animal tissues that our body may mistake as our own. This may be one advantage to eating a more plant-based diet. By eating outside of the animal kingdom--dipping into the plant or mushroom kingdoms for supper--not only do we not have to worry about getting something like Dutch elm disease, but we can be reassured by the fact that never has an "auto-immune polyradiculoneuropathy" been blamed on a head... of lettuce.

For more on foodborne illnesses one can contract from fellow animals, see, for example:

Probably the strangest example of this whole concept is the Neu5Gc story. A 7-part video series worth checking out:

  1. Cancer as an Autoimmune Disease
  2. Clonal Selection Theory of Immunity
  3. Clonal Deletion Theory of Immunity
  4. The Inflammatory Meat Molecule Neu5Gc
  5. How Tumors Use Meat to Grow: Xeno-Autoantibodies
  6. Nonhuman Molecules Lining Our Arteries
  7. Meat May Exceed Daily Allowance of Irony

-Michael Greger, M.D.

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

Image Credit: vgm8383 / Flickr

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Toxin Contamination of Spirulina Supplements

 

 

 

 

 

 

 

 

Toxin Contamination of Spirulina Supplements

On his first day of life, an infant was hospitalized with seizures. Researchers concluded that his mother’s daily spirulina use starting in the fourth month of pregnancy was likely to blame. I’ve talked previously about the liver and nerve toxins present in many spirulina supplements, but the supplement companies swear up and down that spirulina doesn’t produce those toxins, and they may be right (See my video Infant Seizures Linked to Mother's Spirulina Use).

But if spirulina doesn’t produce toxins, how is it that toxins are found in spirulina supplements on store shelves? It appears to be contamination of spirulina with toxin-producing blue-green algae.

For example, if we look at the new U.S. Pharmacopeia safety evaluation of spirulina, researchers conclude that “the available evidence does not indicate a serious risk to health or other public health concern when spirulina is properly identified, formulated, and used.” Ah, but that’s the catch. Spirulina is often grown and collected in open lakes and we have no idea what other algae are going to crop up.

The researchers reported a range of adverse reactions of people taking spirulina products, ­­but they attribute these issues to non-spirulina algae toxin contaminants within spirulina supplements. So unless there’s third-party testing of each batch (which no company could presumably afford to do), I continue to encourage people to avoid spirulina (and blue-green algae) products.

If one still wants something green to sprinkle on their popcorn, I’d recommend chlorella instead (Is Chlorella Good for You?).

I’ve previously addressed green powders in:

Pregnancy is a very vulnerable time and requires an even higher level of dietary vigilance:

Some supplements may be risky for everyone though. See, for example Safety of Noni and Mangosteen Juice.

-Michael Greger, M.D.

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

Image credit: SurFeRGirl30 / Flickr

Original Link

Is Noni or Mangosteen Juice Safe?

 

 

 

 

 

 

 

 

Is Noni or Mangosteen Juice Safe?

There is now another case report of acute toxicity linked to noni juice ingestion, this time in a 14 year old. At least his liver didn’t fail completely like in two of the earlier cases. What do we expect from a product also known as “vomit fruit”? The multi-level marketing company that sells noni products blamed the aloe vera juice that the boy had also consumed, which is indeed something else I’d encourage folks not to drink. But what about all the scientific studies promoting these types of products bandied about on commercial websites?

Recently, a public health researcher published a review on the “Science in Liquid Dietary Supplement Promotion,” evidently a $23 billion dollar market. The review describes how “Central to the marketing of many such products is the citation of ’scientific studies’ supporting the product’s health claims. While these studies seem deliberately created for marketing purposes, their findings and quality are generally presented in a manner that appears designed to mislead potential consumers.”

The researcher uses the case of mangosteen juice—another product I’ve warned about in the past—as an "example of how widely marketed and consumed liquid dietary supplements use exaggeration and pseudoscience to bolster their web promotions of product effectiveness and safety."

The multilevel marketing company that sells mangosteen cited a study they paid for to support its assertion that their product is “shown to be safe at all dosages tested” and indeed “safe for everyone.” The study, profiled in my video, Safety of Noni and Mangosteen Juice, involved exposing just 30 people to their product, with another ten given placebo. With so few people exposed, the stuff could kill 1 or 2% of people and you’d never even know.

For more on these two liquid supplements, check out my videos Is Noni Juice Good for You? and Is Mangosteen Juice Good for You?

Noni and mangosteen juice aren’t the only supplements “proven safe” by dubious research. A study of the multi-level marketing supplement Metabolife had 35 people on the stuff and they seemed to do just fine.  Later, though, it had to be withdrawn from the market after being linked to 18 heart attacks, 26 strokes, 43 seizures and five deaths. Oops.

Hydroxycut was studied on 40 people. No serious adverse effects in the study, but later the same thing: withdrawn after dozens of cases of organ damage including massive hepatic necrosis requiring liver transplants and death.

And often times, in the multilevel marketing study researchers don’t disclose their funding sources, pretending to be objective scientists, but a little detective work exposed a whole web of financial conflicts of interest, “at best reducing the face-validity of findings, and at worst [they] represent deception.”

Other beverages that might be good to avoid include alcohol (Breast Cancer and Alcohol: How Much Is Safe?), soft drinks (Is Sodium Benzoate Harmful?), yerba maté (Update on Yerba Maté), and kombucha (Is Kombucha Tea Good for You?).

I prefer water (Does a Drink of Water Make Children Smarter?), white tea (Antimutagenic Activity of Green Versus White Tea), and hibiscus tea (Better Than Green Tea?).

Other cautionary tales about supplements can be found in:

-Michael Greger, M.D.

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

Image credit: shankar s. / Flickr

Original Link