Stomach Stapling Kids

Stomach Stapling Kids.jpeg

Weight loss surgery for children and adolescents is becoming widespread and is being performed in children as young as five years old. Roux-en-Y gastric bypass is the most common type of procedure, in which surgeons cut out nearly the entire stomach, as you can see in my video, Stomach Stapling Kids. Bariatric surgery in pediatric patients does result in weight loss, but also has the potential for serious complications. These include pulmonary embolism, shock, intestinal obstruction, postoperative bleeding, leaking along the staple line, severe malnutrition, and even death at a rate of 0.5%. This means that 1 in 200 kids who go under the knife may die. Infection is identified as the leading cause of death and is most often associated with leaking of intestinal contents into the abdominal cavity.

Sometimes the surgery doesn't work, and you have to go in and do another procedure. If that doesn't work either, you can always try implanting electrodes into patients' brains, a "novel antiobesity strategy" reported in the Journal of Neurosurgery. The concept of deep brain stimulation "since its inception has been that placing an electrode somewhere in the brain could make people eat less." You drill two little holes in the patient's skull, snake in some electrodes a few inches, and then tunnel the wires under the scalp into a pulse generator implanted under the skin on the chest. You evidently can't crank it up past 5 volts because it induces anxiety and nausea. But even without the nausea, people with electrodes stuck in their brains lost an average of about 10 pounds a year.

The childhood obesity epidemic is so tragic. It pains me to see insult piled on injury. Too often, medical treatments can be worse than the disease. See my video, Why Prevention Is Worth a Ton of Cure.

Speaking of prevention, what might be the best diet for our young ones? See:

There are complications associated with gastric bypass in adults, too. See my video The Dangers of Broccoli?.

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: ReSurge International / Flickr. This image has been modified.

Original Link

Stomach Stapling Kids

Stomach Stapling Kids.jpeg

Weight loss surgery for children and adolescents is becoming widespread and is being performed in children as young as five years old. Roux-en-Y gastric bypass is the most common type of procedure, in which surgeons cut out nearly the entire stomach, as you can see in my video, Stomach Stapling Kids. Bariatric surgery in pediatric patients does result in weight loss, but also has the potential for serious complications. These include pulmonary embolism, shock, intestinal obstruction, postoperative bleeding, leaking along the staple line, severe malnutrition, and even death at a rate of 0.5%. This means that 1 in 200 kids who go under the knife may die. Infection is identified as the leading cause of death and is most often associated with leaking of intestinal contents into the abdominal cavity.

Sometimes the surgery doesn't work, and you have to go in and do another procedure. If that doesn't work either, you can always try implanting electrodes into patients' brains, a "novel antiobesity strategy" reported in the Journal of Neurosurgery. The concept of deep brain stimulation "since its inception has been that placing an electrode somewhere in the brain could make people eat less." You drill two little holes in the patient's skull, snake in some electrodes a few inches, and then tunnel the wires under the scalp into a pulse generator implanted under the skin on the chest. You evidently can't crank it up past 5 volts because it induces anxiety and nausea. But even without the nausea, people with electrodes stuck in their brains lost an average of about 10 pounds a year.

The childhood obesity epidemic is so tragic. It pains me to see insult piled on injury. Too often, medical treatments can be worse than the disease. See my video, Why Prevention Is Worth a Ton of Cure.

Speaking of prevention, what might be the best diet for our young ones? See:

There are complications associated with gastric bypass in adults, too. See my video The Dangers of Broccoli?.

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: ReSurge International / Flickr. This image has been modified.

Original Link

Music as Medicine

Music as Medicine.jpeg

We've been playing music since the Paleolithic Era, 40,000 years ago. Music as therapy has been documented since at least biblical times. The first music therapy experiment was published in the Journal of the American Medical Association in 1914. As to why he placed a phonograph in the operating room as his patients lay fully conscious and awake during surgery, the surgeon explained it was "a means of calming and distracting my patients from the horror of the situation."

Now that we have anesthesia, music is used to calm nerves before surgery. Normally we use Valium-type drugs like midazolam (sold as Versed), but they can have a variety of side effects, including sometimes even making people more agitated. A study from Sweden sought to determine if relaxing music has a greater anxiety-reducing effect than a standard dose of midazolam. Researchers whipped out some Kenny G, and the music worked significantly better than the drug. Those listening to Mr. G had lower anxiety scores, heart rates, and blood pressures. This is perhaps the first report of any anti-anxiety therapy working not only as good as, but even better than, benzodiazepine drugs. The difference in side effects of relaxing music compared to the drug is obvious: There were none. Soft jazz causes no post-operative hangover. The researchers suggest we should start using music instead of midazolam.

Music may also reduce anxiety and pain in children undergoing minor medical and dental procedures, helping with blood draws and shots. It may even reduce the pain of spinal taps. However, Mozart is evidently powerless against the pain of circumcision.

It doesn't take a randomized controlled trial to demonstrate that listening to music can be relaxing. Tell me something I don't know. Well, if you take someone with a latex allergy and inject their skin with latex, they get a big, red, angry bump. But if you repeat the test after they've been listening to Mozart for 30 minutes, they develop a much smaller bump (as you can see in my video, Music as Medicine). That is, they have less of an allergic reaction. If you think that's wild, get ready for this: Beethoven didn't work. The subjects had the same reaction before and after listening to his music! Schubert, Hayden, and Brahms didn't work either, as all failed to reduce the allergic skin response. The reducing effect on allergic responses may be specific to Mozart.

So Mozart's looking pretty good, but what if he could be suppressing our immune systems in general? That would not be good. The same researchers also injected a chemical that causes reactions in everyone, not just in allergic people. Mozart had no effect. It seems Mozart suppresses only the pathological allergic reaction. If that isn't crazy enough for you, the researchers drew subjects' blood after the music, stuck their white blood cells in a petri dish with a little latex, and measured the allergic antibody response. The white blood cells from those exposed to Mozart had less of an allergic response even outside the body compared to cells taken from Beethoven blood. How cool is that?

Music may even impact our metabolism. This inquiry started with a 2012 study published in the journal Pediatrics, which found the resting energy expenditure (the number of calories burned when just lying around) was lower in preterm infants when researchers piped in Mozart. This may explain why infants exposed to music put on weight faster, so much so they are able to go home earlier.

Gaining weight faster is great for premature babies, but not necessarily for adults. Could listening to music slow our metabolism and contribute to weight gain? Well, one study found no effect on adults. But the researchers used Bach, not Mozart. Bach doesn't cause a drop in energy expenditure in babies either. These data suggest there may be "more a 'Mozart effect' than a universal 'music effect'."

What if we just listen to music of our choice? Does that affect our metabolism? We didn't know... until now. It turns out that listening to music appears to actually increase our metabolic rate, such that we burn an average of 27.6 more calories a day just lying in bed. That's only like six M&M's worth, though, so it's better to use music to get up and start dancing or exercising. Music can not only improve exercise enjoyment but also performance--a way to improve athletic performance that's legal.

Male bodybuilders may be less enthused music's effects. After listening to music for just 30 minutes, testosterone levels drop 14% in young men and go up 21% in young women. Do all kinds of music have this effect or just some types? Thirty minutes of silence had no effect on testosterone levels at all, while a half-hour of Mozart, jazz, pop, or Gregorian chants (no relation :) all suppressed testosterone. What about a half-hour of people's personal favorites? Testosterone levels were cut in half! Testosterone decreased in males under all music conditions, whereas testosterone increased in females. What is going on? Well, in men, testosterone is related to libido, dominance, and aggressiveness, whereas women get a bigger boost in testosterone from cuddling than from sex. So maybe we evolved using music as a way to ensure we all got along, like a melodious cold shower to keep everyone chill.

Is that crazy or what? I'm fascinated by the whole topic. For more, see Music for Anxiety: Mozart vs. Metal.

Sounds are the only sensory-stimulators that can have an effect on us--so can scents! See:

Exposure to industrial pollutants may also affect both allergic diseases and testosterone levels:

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. This image has been modified.

Original Link

Music as Medicine

Music as Medicine.jpeg

We've been playing music since the Paleolithic Era, 40,000 years ago. Music as therapy has been documented since at least biblical times. The first music therapy experiment was published in the Journal of the American Medical Association in 1914. As to why he placed a phonograph in the operating room as his patients lay fully conscious and awake during surgery, the surgeon explained it was "a means of calming and distracting my patients from the horror of the situation."

Now that we have anesthesia, music is used to calm nerves before surgery. Normally we use Valium-type drugs like midazolam (sold as Versed), but they can have a variety of side effects, including sometimes even making people more agitated. A study from Sweden sought to determine if relaxing music has a greater anxiety-reducing effect than a standard dose of midazolam. Researchers whipped out some Kenny G, and the music worked significantly better than the drug. Those listening to Mr. G had lower anxiety scores, heart rates, and blood pressures. This is perhaps the first report of any anti-anxiety therapy working not only as good as, but even better than, benzodiazepine drugs. The difference in side effects of relaxing music compared to the drug is obvious: There were none. Soft jazz causes no post-operative hangover. The researchers suggest we should start using music instead of midazolam.

Music may also reduce anxiety and pain in children undergoing minor medical and dental procedures, helping with blood draws and shots. It may even reduce the pain of spinal taps. However, Mozart is evidently powerless against the pain of circumcision.

It doesn't take a randomized controlled trial to demonstrate that listening to music can be relaxing. Tell me something I don't know. Well, if you take someone with a latex allergy and inject their skin with latex, they get a big, red, angry bump. But if you repeat the test after they've been listening to Mozart for 30 minutes, they develop a much smaller bump (as you can see in my video, Music as Medicine). That is, they have less of an allergic reaction. If you think that's wild, get ready for this: Beethoven didn't work. The subjects had the same reaction before and after listening to his music! Schubert, Hayden, and Brahms didn't work either, as all failed to reduce the allergic skin response. The reducing effect on allergic responses may be specific to Mozart.

So Mozart's looking pretty good, but what if he could be suppressing our immune systems in general? That would not be good. The same researchers also injected a chemical that causes reactions in everyone, not just in allergic people. Mozart had no effect. It seems Mozart suppresses only the pathological allergic reaction. If that isn't crazy enough for you, the researchers drew subjects' blood after the music, stuck their white blood cells in a petri dish with a little latex, and measured the allergic antibody response. The white blood cells from those exposed to Mozart had less of an allergic response even outside the body compared to cells taken from Beethoven blood. How cool is that?

Music may even impact our metabolism. This inquiry started with a 2012 study published in the journal Pediatrics, which found the resting energy expenditure (the number of calories burned when just lying around) was lower in preterm infants when researchers piped in Mozart. This may explain why infants exposed to music put on weight faster, so much so they are able to go home earlier.

Gaining weight faster is great for premature babies, but not necessarily for adults. Could listening to music slow our metabolism and contribute to weight gain? Well, one study found no effect on adults. But the researchers used Bach, not Mozart. Bach doesn't cause a drop in energy expenditure in babies either. These data suggest there may be "more a 'Mozart effect' than a universal 'music effect'."

What if we just listen to music of our choice? Does that affect our metabolism? We didn't know... until now. It turns out that listening to music appears to actually increase our metabolic rate, such that we burn an average of 27.6 more calories a day just lying in bed. That's only like six M&M's worth, though, so it's better to use music to get up and start dancing or exercising. Music can not only improve exercise enjoyment but also performance--a way to improve athletic performance that's legal.

Male bodybuilders may be less enthused music's effects. After listening to music for just 30 minutes, testosterone levels drop 14% in young men and go up 21% in young women. Do all kinds of music have this effect or just some types? Thirty minutes of silence had no effect on testosterone levels at all, while a half-hour of Mozart, jazz, pop, or Gregorian chants (no relation :) all suppressed testosterone. What about a half-hour of people's personal favorites? Testosterone levels were cut in half! Testosterone decreased in males under all music conditions, whereas testosterone increased in females. What is going on? Well, in men, testosterone is related to libido, dominance, and aggressiveness, whereas women get a bigger boost in testosterone from cuddling than from sex. So maybe we evolved using music as a way to ensure we all got along, like a melodious cold shower to keep everyone chill.

Is that crazy or what? I'm fascinated by the whole topic. For more, see Music for Anxiety: Mozart vs. Metal.

Sounds are the only sensory-stimulators that can have an effect on us--so can scents! See:

Exposure to industrial pollutants may also affect both allergic diseases and testosterone levels:

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. This image has been modified.

Original Link

Ginger Root for Migraines

Ginger Root for Migraines.jpeg

Many successful herbal treatments start like this: Some doctor learns that some plant has been used in some ancient medical tradition, like ginger for headaches. Well, the physician has patients with headaches and so tries advising one with migraines to give it a try since it's just some safe, common spice. At the first sign of a migraine coming on, the patient mixed a quarter teaspoon of powdered ginger in some water, drank it down, and poof! Within a half-hour, the migraine went away. It worked every time for them with no side effects. That's what's called a case report.

In my video, Ginger for Migraines, I show the remarkable case report, but case reports are really just glorified anecdotes. Case reports have played an important role in the history of medicine, though. AIDS was first discovered as a series of case reports. Some young guy walks into a clinic in Los Angeles with a bad case of thrush, and the rest is history. Reports of an unusual side effect of a failed chest pain drug led to the billion-dollar blockbuster, Viagra. Case reports may represent the weakest level of evidence, but they are often the first line of evidence, where everything starts. The ginger and migraine report isn't helpful in itself, but it can inspire researchers to put the treatment to the test.

The problem is, who's going to fund it? The market for migraine drugs is worth billions of dollars. A quarter teaspoon of powdered ginger costs about a penny. Who would fund a study pitting ginger versus the leading migraine drug?

No one... that is, until now. A double-blinded, randomized, controlled, clinical trial compared the efficacy of ginger to sumatriptan, also known as Imitrex, one of the top-selling billion-dollar drugs in the world in the treatment of migraine headaches. Researchers tried using only one-eighth of a teaspoon of powdered ginger versus a good dose of the drug.

They both worked just as well and just as fast.

Most patients started out in moderate or severe pain but, after taking the ginger or the drug, ended up in mild pain or completely pain-free. The same proportion of migraine sufferers reported satisfaction with the results either way. As far as I'm concerned, ginger won--not only because it's a few billion dollars cheaper than the drug, but because there were significantly fewer side effects in the ginger group. People taking sumatriptan reported dizziness, a sedative effect, vertigo, and heartburn. The only thing reported for ginger was an upset tummy in about 1 out of 25 people. (As a note of caution, taking a whole tablespoon of ginger powder at one time on an empty stomach could irritate anyone's stomach.)

An eighth of a teaspoon of ginger is not only up to 3000-times cheaper than the drug, but you're also less likely to end up as a case report yourself of someone who had a heart attack or died after taking the drug--tragedies that have occurred due to sumatriptan.

These are my favorite kinds of posts to do because I can offer something that is immediately practical, cheap, safe, and effective to reduce suffering. If this kind of information helps you or someone you love, I hope you'll consider making a tax-deductible donation to support the nonprofit organization that runs NutritionFacts.org. We have a growing staff and server costs to cover, and any help you could give would be much appreciated (and there are perks!).

For more on ginger root:

Avoiding aspartame (Aspartame and the Brain) and using lavender may also help (Lavender for Migraine Headaches). If you have cluster headaches, ask your physician about capsaicin (Hot Sauce in the Nose for Cluster Headaches?).

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

Original Link

Ginger Root for Migraines

Ginger Root for Migraines.jpeg

Many successful herbal treatments start like this: Some doctor learns that some plant has been used in some ancient medical tradition, like ginger for headaches. Well, the physician has patients with headaches and so tries advising one with migraines to give it a try since it's just some safe, common spice. At the first sign of a migraine coming on, the patient mixed a quarter teaspoon of powdered ginger in some water, drank it down, and poof! Within a half-hour, the migraine went away. It worked every time for them with no side effects. That's what's called a case report.

In my video, Ginger for Migraines, I show the remarkable case report, but case reports are really just glorified anecdotes. Case reports have played an important role in the history of medicine, though. AIDS was first discovered as a series of case reports. Some young guy walks into a clinic in Los Angeles with a bad case of thrush, and the rest is history. Reports of an unusual side effect of a failed chest pain drug led to the billion-dollar blockbuster, Viagra. Case reports may represent the weakest level of evidence, but they are often the first line of evidence, where everything starts. The ginger and migraine report isn't helpful in itself, but it can inspire researchers to put the treatment to the test.

The problem is, who's going to fund it? The market for migraine drugs is worth billions of dollars. A quarter teaspoon of powdered ginger costs about a penny. Who would fund a study pitting ginger versus the leading migraine drug?

No one... that is, until now. A double-blinded, randomized, controlled, clinical trial compared the efficacy of ginger to sumatriptan, also known as Imitrex, one of the top-selling billion-dollar drugs in the world in the treatment of migraine headaches. Researchers tried using only one-eighth of a teaspoon of powdered ginger versus a good dose of the drug.

They both worked just as well and just as fast.

Most patients started out in moderate or severe pain but, after taking the ginger or the drug, ended up in mild pain or completely pain-free. The same proportion of migraine sufferers reported satisfaction with the results either way. As far as I'm concerned, ginger won--not only because it's a few billion dollars cheaper than the drug, but because there were significantly fewer side effects in the ginger group. People taking sumatriptan reported dizziness, a sedative effect, vertigo, and heartburn. The only thing reported for ginger was an upset tummy in about 1 out of 25 people. (As a note of caution, taking a whole tablespoon of ginger powder at one time on an empty stomach could irritate anyone's stomach.)

An eighth of a teaspoon of ginger is not only up to 3000-times cheaper than the drug, but you're also less likely to end up as a case report yourself of someone who had a heart attack or died after taking the drug--tragedies that have occurred due to sumatriptan.

These are my favorite kinds of posts to do because I can offer something that is immediately practical, cheap, safe, and effective to reduce suffering. If this kind of information helps you or someone you love, I hope you'll consider making a tax-deductible donation to support the nonprofit organization that runs NutritionFacts.org. We have a growing staff and server costs to cover, and any help you could give would be much appreciated (and there are perks!).

For more on ginger root:

Avoiding aspartame (Aspartame and the Brain) and using lavender may also help (Lavender for Migraine Headaches). If you have cluster headaches, ask your physician about capsaicin (Hot Sauce in the Nose for Cluster Headaches?).

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

Original Link

Should Cancer Patients Avoid Raw Fruits and Vegetables?

Should Cancer Patients Avoid Raw Fruits and Vegetables?.jpeg

Back in the 1960s, a patient isolator unit was developed for cancer patients undergoing chemotherapy. Because our immune system cells were often caught in the friendly fire, up to 50% of cancer patients died of infections before they could even complete the chemo because their immune systems had become so compromised. So, a bubble boy-like contraption was developed. The patient was shaved, dipped in disinfectant, rinsed off with alcohol, rubbed with antibiotic ointment into every orifice, and placed on a rotating regimen of a dozen of the most powerful antibiotics they had. Procedures were performed through plastic sleeves on the sides of the unit, and everything in and out had to be sterilized and passed through airlocks. So, the patient wasn't allowed any fresh fruits or vegetables.

People went crazy cooped up in these bubble-like units, with 38% even experiencing hallucinations. Fifteen years later the results were in: it simply didn't work. People were still dying at the same rate, so the whole thing was scrapped--except the diet. The airlocks and alcohol baths were abandoned, but they continued to make sure no one got to eat a salad.

Neutrophils are white blood cells that serve as our front line of defense. When we're immunocompromised and don't have enough neutrophils, we're called "neutropenic." So, the chemotherapy patients were put on a so-called neutropenic diet without any fresh fruits and vegetables. The problem is there's a glaring lack of evidence that such a neutropenic diet actually helps (see my video Is a Neutropenic Diet Necessary for Cancer Patients?).

Ironically, the neutropenic diet is the one remaining component of those patient isolator unit protocols that's still practiced, yet it has the least evidence supporting its use. Why? The rationale is: there are bacteria in salads, bacteria cause infections, immunocompromised patients are at increased risk for infections, and therefore, no salad. What's more, they were actually glad there aren't any studies on this because it could be way too risky to give a cancer patient an apple or something. So, its continued use seems to be based on a ''better safe than sorry'' philosophy.

The problem is that kids diagnosed with cancer are already low in dietary antioxidants, so the last thing we should do is tell them they can't have any fresh fruit or veggies. In addition to the lack of clinical evidence for this neutropenic diet, there may be some drawbacks. Restricting fruits and vegetables may even increase the risk of infection and compromise their nutritional status.

So, are neutropenic diets for cancer patients "reasonable prudence" or "clinical superstition"? Starting in the 1990s, there was a resurgence of research when greater importance was placed on the need to "support clinical practice with evidence."

What a concept!

Three randomized controlled trials were published, and not one supported the neutropenic diet. In the biggest study, an all-cooked diet was compared to one that allowed raw fruits and veggies, and there was no difference in infection and death rates. As a result of the study, the principal investigator at the MD Anderson Cancer Center described how their practice has changed and now everyone is allowed to eat their vegetables--a far cry from "please don't eat the salads" 31 years earlier.

Today, neither the Food and Drug Administration, the Centers for Disease Control and Prevention, nor the American Cancer Society support the neutropenic diet. The real danger comes from pathogenic food-poisoning bacteria like Campylobacter, Salmonella, and E. coli. So we still have to keep patients away from risky foods like undercooked eggs, meat, dairy, and sprouts. At this point, though, there really shouldn't be a debate about whether cancer patients should be on a neutropenic diet. Nevertheless, many institutions still tell cancer patients they shouldn't eat fresh fruits and veggies. According to the latest survey, more than half of pediatric cancer doctors continue to prescribe these diets, though it's quite variable even among those at the same institution.

Why are doctors still reluctant to move away from the neutropenic diet? There are several reasons why physicians may be hesitant to incorporate evidence-based medicine into their practices. They may have limited time to review the literature. They'd like to dig deep into studies, but simply don't have the time to look at the evidence. Hmm, if only there was a website... :)

Bone marrow transplants are the final frontier. Sometimes it's our immune system itself that is cancerous, such as in leukemia or lymphoma. In these cases, the immune system is wiped out on purpose to rebuild it from scratch. So, inherent in the procedure is a profound immunodeficiency for which a neutropenic diet is often recommended. This has also had never been tested--until now.

Not only did it not work, a strict neutropenic diet was actually associated with an increased risk for infection, maybe because you don't get the good bugs from fruits and vegetables crowding out the bad guys in the gut. So not only was the neutropenic diet found to be unbeneficial; there was a suggestion that it has the potential to be harmful. This wouldn't be the first time an intervention strategy made good sense theoretically, but, when put to the test, was ultimately ineffective.

Unfortunately, there's an inertia in medicine that can result in medical practice that is at odds with the available evidence. Sometimes this disconnect can have devastating consequences. See, for example, Evidence-Based Medicine or Evidence-Biased? and The Tomato Effect.

The reason it is so important to straighten out the neutropenic diet myth is that fruits and vegetables may actually improve cancer survival:

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

Original Link

Should Cancer Patients Avoid Raw Fruits and Vegetables?

Should Cancer Patients Avoid Raw Fruits and Vegetables?.jpeg

Back in the 1960s, a patient isolator unit was developed for cancer patients undergoing chemotherapy. Because our immune system cells were often caught in the friendly fire, up to 50% of cancer patients died of infections before they could even complete the chemo because their immune systems had become so compromised. So, a bubble boy-like contraption was developed. The patient was shaved, dipped in disinfectant, rinsed off with alcohol, rubbed with antibiotic ointment into every orifice, and placed on a rotating regimen of a dozen of the most powerful antibiotics they had. Procedures were performed through plastic sleeves on the sides of the unit, and everything in and out had to be sterilized and passed through airlocks. So, the patient wasn't allowed any fresh fruits or vegetables.

People went crazy cooped up in these bubble-like units, with 38% even experiencing hallucinations. Fifteen years later the results were in: it simply didn't work. People were still dying at the same rate, so the whole thing was scrapped--except the diet. The airlocks and alcohol baths were abandoned, but they continued to make sure no one got to eat a salad.

Neutrophils are white blood cells that serve as our front line of defense. When we're immunocompromised and don't have enough neutrophils, we're called "neutropenic." So, the chemotherapy patients were put on a so-called neutropenic diet without any fresh fruits and vegetables. The problem is there's a glaring lack of evidence that such a neutropenic diet actually helps (see my video Is a Neutropenic Diet Necessary for Cancer Patients?).

Ironically, the neutropenic diet is the one remaining component of those patient isolator unit protocols that's still practiced, yet it has the least evidence supporting its use. Why? The rationale is: there are bacteria in salads, bacteria cause infections, immunocompromised patients are at increased risk for infections, and therefore, no salad. What's more, they were actually glad there aren't any studies on this because it could be way too risky to give a cancer patient an apple or something. So, its continued use seems to be based on a ''better safe than sorry'' philosophy.

The problem is that kids diagnosed with cancer are already low in dietary antioxidants, so the last thing we should do is tell them they can't have any fresh fruit or veggies. In addition to the lack of clinical evidence for this neutropenic diet, there may be some drawbacks. Restricting fruits and vegetables may even increase the risk of infection and compromise their nutritional status.

So, are neutropenic diets for cancer patients "reasonable prudence" or "clinical superstition"? Starting in the 1990s, there was a resurgence of research when greater importance was placed on the need to "support clinical practice with evidence."

What a concept!

Three randomized controlled trials were published, and not one supported the neutropenic diet. In the biggest study, an all-cooked diet was compared to one that allowed raw fruits and veggies, and there was no difference in infection and death rates. As a result of the study, the principal investigator at the MD Anderson Cancer Center described how their practice has changed and now everyone is allowed to eat their vegetables--a far cry from "please don't eat the salads" 31 years earlier.

Today, neither the Food and Drug Administration, the Centers for Disease Control and Prevention, nor the American Cancer Society support the neutropenic diet. The real danger comes from pathogenic food-poisoning bacteria like Campylobacter, Salmonella, and E. coli. So we still have to keep patients away from risky foods like undercooked eggs, meat, dairy, and sprouts. At this point, though, there really shouldn't be a debate about whether cancer patients should be on a neutropenic diet. Nevertheless, many institutions still tell cancer patients they shouldn't eat fresh fruits and veggies. According to the latest survey, more than half of pediatric cancer doctors continue to prescribe these diets, though it's quite variable even among those at the same institution.

Why are doctors still reluctant to move away from the neutropenic diet? There are several reasons why physicians may be hesitant to incorporate evidence-based medicine into their practices. They may have limited time to review the literature. They'd like to dig deep into studies, but simply don't have the time to look at the evidence. Hmm, if only there was a website... :)

Bone marrow transplants are the final frontier. Sometimes it's our immune system itself that is cancerous, such as in leukemia or lymphoma. In these cases, the immune system is wiped out on purpose to rebuild it from scratch. So, inherent in the procedure is a profound immunodeficiency for which a neutropenic diet is often recommended. This has also had never been tested--until now.

Not only did it not work, a strict neutropenic diet was actually associated with an increased risk for infection, maybe because you don't get the good bugs from fruits and vegetables crowding out the bad guys in the gut. So not only was the neutropenic diet found to be unbeneficial; there was a suggestion that it has the potential to be harmful. This wouldn't be the first time an intervention strategy made good sense theoretically, but, when put to the test, was ultimately ineffective.

Unfortunately, there's an inertia in medicine that can result in medical practice that is at odds with the available evidence. Sometimes this disconnect can have devastating consequences. See, for example, Evidence-Based Medicine or Evidence-Biased? and The Tomato Effect.

The reason it is so important to straighten out the neutropenic diet myth is that fruits and vegetables may actually improve cancer survival:

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

Original Link

Benefits of Nutritional Yeast to Prevent the Common Cold

Benefits of Nutritional Yeast to Prevent the Common Cold.jpeg

Natural immunomodulators that can help regulate our immune system without side-effects have been sought for centuries, and all the while they've been sitting in the produce aisle. Plants produce thousand of active compounds, many of which modulate our immune system, but we can't forget the fungi (see Boosting Immunity While Reducing Inflammation).

Mushrooms have used for centuries as folk remedies, and for good reason. Some have been shown to boost immune function, so much so that a type of fiber found in shiitake mushrooms is approved for use as adjunct chemotherapy, injected intravenously to help treat a variety of cancers by rallying our immune defenses.

More than 6,000 papers have been published on these so-called beta glucans, but almost all of the data about preventing infections had come from petri dish or lab animal studies, until a few years ago when a series of experiments on athletes showed beneficial effects in marathon runners (see Preserving Immune Function in Athletes With Nutritional Yeast). What about the rest of us? We didn't know... until now.

As I explore in my video, Nutritional Yeast to Prevent the Common Cold, beta glucan fiber found in baker's, brewer's and nutritional yeast helps to maintain our body's defense against pathogens even in nonathletes, according to a double-blind, randomized, placebo-controlled trial. The recurrence of infections with the common cold was reduced by 25% in those that ate the equivalent of about a spoonful of nutritional yeast a day, and had fewer cold-related sleeping difficulties when they did get sick.

What about half a spoonful a day? Still worked! Subjects experienced a big drop in common cold incidence and a reduction in symptoms as well. Why is this? This study found that not only were upper respiratory infection symptoms diminished, but that mood states appeared to improve, for example a significant boost in feelings of "vigor." So the researchers suggest that maybe the yeast fiber is able to counteract the negative effects of stress on the immune system.

In terms of side-effects, two folks reported stomachaches, but they were both in the placebo group.

Unlike antibiotics and antivirals, which are designed to kill the pathogen directly, these yeast compounds instead appear to work by stimulating our immune defenses, and as such don't share the same antibiotic side effects. They stimulate our immune defenses presumably because our body recognizes them as foreign. But if it's treated like an invader, might it trigger an inflammatory response? Turns out these fiber compounds may actually have an anti-inflammatory effect, suggesting nutritional yeast may offer the best of both worlds, boosting the infection fighting side of the immune system while suppressing inflammatory components.

Yeast is high in purines, so those with gout, uric acid kidney stones, and new organ transplant recipients may want to keep their intake to less than a teaspoon a day. But is there any downside for everyone else? In California some packages of nutritional yeast are slapped with prop 65 warning stickers, suggesting there's something in it exceeding cancer or birth defect safety limits. I called around to the companies and it turns out the problem is lead. California state law says a product cannot contain more than half of a microgram of lead per daily serving, so I contacted the six brands I knew about and asked them how much lead was in their products.

KAL originally said "<5 ppm," but when we called back they said "<3 ppm." Even if it's 3, that translates into less than 45 micrograms per serving, nearly a 100 times more than the California limit. But perhaps that's better than Bob's Red Mill or Frontier Coop, who evidently don't test at all. But at least they got back to me. Redstar brand failed to respond to multiple attempts to contact them. Now Foods said they test for lead and claim that at least their recent batches meet the less than a half a microgram California standard. Unfortunately, despite repeated requests they would not provide me with documentation to substantiate their numbers. My favorite response was from Bragg's who sent me the analysis certificate from the lab showing less than 0.01 ppm, which means at most less than half the California standard, which I believe is the most stringent in the world. To put the numbers in context, in determining how much lead manufacturers can put into candy likely to be frequently consumed by small children, the Food and Drug Administration would allow about 2 micrograms a day in the form of lollipops, but as far as I'm concerned the less lead the better.

I was so frustrated by the lack of transparency I decided to test them for lead myself. NutritionFacts.org hired an independent lab to conduct our own tests for lead and shipped out 8 samples of nutritional yeast in their original package. The lab used standard practices for lead testing known as Official Methods of Analysis set by AOAC International. Lab technicians determined the lead values based on California Prop 65 standards. Here are the results from the brands we tested:

Bob's Red Mill - Test report shows no detectable lead (<0.01 ppm).

Bragg - Test report shows no detectable lead (< 0.01 ppm).

Dr. Fuhrman - Test report shows no detectable lead (< 0.01 ppm).

Frontier Coop - Test report shows lead levels at 0.021 ppm. It would take six tablespoons a day (based on the manufacture's listed density) to exceed the California Office of Environmental Health Hazard Assessment Maximum Allowable Dose Level (MADL) for chemicals causing reproductive toxicity.*

KAL - Test report shows lead levels at 0.011 ppm. It would take seven tablespoons a day to exceed the MADL.*

NOW Foods - Test report shows no detectable lead (< 0.01 ppm).

Red Star - Test report shows no detectable lead (< 0.01 ppm).

Whole Foods - Test report shows lead levels at 0.012 ppm. It would take six tablespoons a day to exceed the MADL.*

So what do all those numbers mean? None of the brands tested exceeded California prop 65 standards. No matter what brand, consuming a typical serving (2 tablespoons) per day is still well within safe limits.

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:

* The Maximum Allowable Dose Level for lead as a developmental toxin is 0.5 micrograms a day. How are MADL's calculated? Basically scientists figure out what the "no observable effect level" is, the level at which no birth defects or reproductive toxicity can be found, and then introduce a 1000-fold safety buffer. So for example, let's say there's some chemical that causes birth defects if expectant moms are exposed to two drops of the chemical a day, but there's no evidence that one drop a day is harmful. Do they set the Maximum Allowable Dose Level at one drop? No, they set it at 1/1000th of a drop to account for scientific uncertainty and to err on the side of caution. So by saying six tablespoons a day of nutritional yeast may exceed the MADL is in effect saying that the level of lead found in 6,000 tablespoons of nutritional yeast may cause birth defects. Like mercury, though, as far as I'm concerned the less lead exposure the better. I hope this will inspire companies to do further testing to see if the levels we found were just flukes.

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

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Benefits of Nutritional Yeast to Prevent the Common Cold

Benefits of Nutritional Yeast to Prevent the Common Cold.jpeg

Natural immunomodulators that can help regulate our immune system without side-effects have been sought for centuries, and all the while they've been sitting in the produce aisle. Plants produce thousand of active compounds, many of which modulate our immune system, but we can't forget the fungi (see Boosting Immunity While Reducing Inflammation).

Mushrooms have used for centuries as folk remedies, and for good reason. Some have been shown to boost immune function, so much so that a type of fiber found in shiitake mushrooms is approved for use as adjunct chemotherapy, injected intravenously to help treat a variety of cancers by rallying our immune defenses.

More than 6,000 papers have been published on these so-called beta glucans, but almost all of the data about preventing infections had come from petri dish or lab animal studies, until a few years ago when a series of experiments on athletes showed beneficial effects in marathon runners (see Preserving Immune Function in Athletes With Nutritional Yeast). What about the rest of us? We didn't know... until now.

As I explore in my video, Nutritional Yeast to Prevent the Common Cold, beta glucan fiber found in baker's, brewer's and nutritional yeast helps to maintain our body's defense against pathogens even in nonathletes, according to a double-blind, randomized, placebo-controlled trial. The recurrence of infections with the common cold was reduced by 25% in those that ate the equivalent of about a spoonful of nutritional yeast a day, and had fewer cold-related sleeping difficulties when they did get sick.

What about half a spoonful a day? Still worked! Subjects experienced a big drop in common cold incidence and a reduction in symptoms as well. Why is this? This study found that not only were upper respiratory infection symptoms diminished, but that mood states appeared to improve, for example a significant boost in feelings of "vigor." So the researchers suggest that maybe the yeast fiber is able to counteract the negative effects of stress on the immune system.

In terms of side-effects, two folks reported stomachaches, but they were both in the placebo group.

Unlike antibiotics and antivirals, which are designed to kill the pathogen directly, these yeast compounds instead appear to work by stimulating our immune defenses, and as such don't share the same antibiotic side effects. They stimulate our immune defenses presumably because our body recognizes them as foreign. But if it's treated like an invader, might it trigger an inflammatory response? Turns out these fiber compounds may actually have an anti-inflammatory effect, suggesting nutritional yeast may offer the best of both worlds, boosting the infection fighting side of the immune system while suppressing inflammatory components.

Yeast is high in purines, so those with gout, uric acid kidney stones, and new organ transplant recipients may want to keep their intake to less than a teaspoon a day. But is there any downside for everyone else? In California some packages of nutritional yeast are slapped with prop 65 warning stickers, suggesting there's something in it exceeding cancer or birth defect safety limits. I called around to the companies and it turns out the problem is lead. California state law says a product cannot contain more than half of a microgram of lead per daily serving, so I contacted the six brands I knew about and asked them how much lead was in their products.

KAL originally said "<5 ppm," but when we called back they said "<3 ppm." Even if it's 3, that translates into less than 45 micrograms per serving, nearly a 100 times more than the California limit. But perhaps that's better than Bob's Red Mill or Frontier Coop, who evidently don't test at all. But at least they got back to me. Redstar brand failed to respond to multiple attempts to contact them. Now Foods said they test for lead and claim that at least their recent batches meet the less than a half a microgram California standard. Unfortunately, despite repeated requests they would not provide me with documentation to substantiate their numbers. My favorite response was from Bragg's who sent me the analysis certificate from the lab showing less than 0.01 ppm, which means at most less than half the California standard, which I believe is the most stringent in the world. To put the numbers in context, in determining how much lead manufacturers can put into candy likely to be frequently consumed by small children, the Food and Drug Administration would allow about 2 micrograms a day in the form of lollipops, but as far as I'm concerned the less lead the better.

I was so frustrated by the lack of transparency I decided to test them for lead myself. NutritionFacts.org hired an independent lab to conduct our own tests for lead and shipped out 8 samples of nutritional yeast in their original package. The lab used standard practices for lead testing known as Official Methods of Analysis set by AOAC International. Lab technicians determined the lead values based on California Prop 65 standards. Here are the results from the brands we tested:

Bob's Red Mill - Test report shows no detectable lead (<0.01 ppm).

Bragg - Test report shows no detectable lead (< 0.01 ppm).

Dr. Fuhrman - Test report shows no detectable lead (< 0.01 ppm).

Frontier Coop - Test report shows lead levels at 0.021 ppm. It would take six tablespoons a day (based on the manufacture's listed density) to exceed the California Office of Environmental Health Hazard Assessment Maximum Allowable Dose Level (MADL) for chemicals causing reproductive toxicity.*

KAL - Test report shows lead levels at 0.011 ppm. It would take seven tablespoons a day to exceed the MADL.*

NOW Foods - Test report shows no detectable lead (< 0.01 ppm).

Red Star - Test report shows no detectable lead (< 0.01 ppm).

Whole Foods - Test report shows lead levels at 0.012 ppm. It would take six tablespoons a day to exceed the MADL.*

So what do all those numbers mean? None of the brands tested exceeded California prop 65 standards. No matter what brand, consuming a typical serving (2 tablespoons) per day is still well within safe limits.

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:

* The Maximum Allowable Dose Level for lead as a developmental toxin is 0.5 micrograms a day. How are MADL's calculated? Basically scientists figure out what the "no observable effect level" is, the level at which no birth defects or reproductive toxicity can be found, and then introduce a 1000-fold safety buffer. So for example, let's say there's some chemical that causes birth defects if expectant moms are exposed to two drops of the chemical a day, but there's no evidence that one drop a day is harmful. Do they set the Maximum Allowable Dose Level at one drop? No, they set it at 1/1000th of a drop to account for scientific uncertainty and to err on the side of caution. So by saying six tablespoons a day of nutritional yeast may exceed the MADL is in effect saying that the level of lead found in 6,000 tablespoons of nutritional yeast may cause birth defects. Like mercury, though, as far as I'm concerned the less lead exposure the better. I hope this will inspire companies to do further testing to see if the levels we found were just flukes.

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

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