How Much Water Should We Drink Every Day?

How Much Water Should We Drink Every Day?.jpeg

More than 2000 years ago Hippocrates (460-377 BCE) said, "If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health." What does that mean when it comes to water? Water has been described as a neglected, unappreciated, and under-researched subject, and further complicating the issue, a lot of the papers extolling the need for proper hydration are funded by the bottled water industry.

It turns out the often quoted "drink at least eight glasses of water a day" dictum has little underpinning scientific evidence . Where did that idea come from? The recommendation was traced to a 1921 paper, in which the author measured his own pee and sweat and determined we lose about 3% of our body weight in water a day, or about 8 cups (see How Many Glasses of Water Should We Drink in a Day?). Consequently, for the longest time, water requirement guidelines for humanity were based on just one person.

There is evidence that not drinking enough may be associated with falls and fractures, heat stroke, heart disease, lung disorders, kidney disease, kidney stones, bladder and colon cancer, urinary tract infections, constipation, dry mouth, cavities, decreased immune function and cataract formation. The problem with many of these studies is that low water intake is associated with several unhealthy behaviors, such as low fruit and vegetable intake, more fast-food, less shopping at farmers markets. And who drinks lots of water? People who exercise a lot. No wonder they tend to have lower disease rates!

Only large and expensive randomized trials could settle these questions definitively. Given that water cannot be patented, such trials seem unlikely; who's going to pay for them? We're left with studies that find an association between disease and low water intake. But are people sick because they drink less, or are they drinking less because they're sick? There have been a few large prospective studies in which fluid intake is measured before disease develops. For example, a Harvard study of 48,000 men found that the risk of bladder cancer decreased by 7% for every extra daily cup of fluid we drink. Therefore, a high intake of water--like 8 cups a day--may reduce the risk of bladder cancer by about 50%, potentially saving thousands of lives.

The accompanying editorial commented that strategies to prevent the most prevalent cancers in the West are remarkably straightforward in principle. To prevent lung cancer, quit smoking; to prevent breast cancer, maintain your ideal body weight and exercise; and to prevent skin cancer, stay out of the sun. Now comes this seemingly simple way to reduce the risk of bladder cancer: drink more fluids.

Probably the best evidence we have for a cut off of water intake comes from the Adventist Health Study, in which 20,000 men and women were studied. About one-half were vegetarian, so they were also getting extra water by eating more fruits and vegetables. Those drinking 5 or more glasses of water a day had about half the risk of dying from heart disease compared to those who drank 2 or fewer glasses a day. Like the Harvard study, this protection was found after controlling for other factors such as diet and exercise. These data suggest that it was the water itself that was decreasing risk, perhaps by lowering blood viscosity (blood thickness).

Based on all the best evidence to date, authorities from Europe, the U.S. Institute of Medicine, and the World Health Organization recommend between 2.0 and 2.7 liters (8 to 11 cups) of water a day for women, and 2.5 to 3.7 liters (10 to 15 cups) a day for men. This includes water from all sources, not just beverages. We get about a liter from food and the water our body makes. So this translates into a recommendation for women to drink 4 to 7 cups of water a day and men 6 to 11 cups, assuming only moderate physical activity at moderate ambient temperatures.

We can also get water from all the other drinks we consume, including caffeinated drinks, with the exception of stronger alcoholic drinks like wines and spirits. Beer can leave you with more water than you started with, but wine actively dehydrates you. However, in the cancer and heart disease studies I mentioned above, the benefits were only found with increased water consumption, not other beverages.

I've previously touched on the cognitive benefits of proper hydration here: Does a Drink Of Water Make Children Smarter?

Surprised tea is hydrating? See my video Is Caffeinated Tea Dehydrating?

Surprised that the 8-a-day rested on such flimsy evidence? Unfortunately, so much of what we do in medicine has shaky underpinnings. That's the impetus behind the idea of evidence-based medicine (what a concept!). Ironically, this new movement may itself undermine some of the most effective treatments. See Evidence-Based Medicine or Evidence-Biased?

How else can we reduce our risk of bladder cancer? See Raw Broccoli and Bladder Cancer Survival.

What kind of water? I recommend tap water, which tends to be preferable from a chemical and microbial contamination standpoint. What about buying one of those fancy alkalizing machines? See Alkaline Water: a Scam?

It's so nice to have data on such a fundamental question. We have much to thank the Adventists for. You will see their studies cropping up frequently. See, for example, Plant-Based Diets and Diabetes, The Okinawa Diet: Living to 100, and Evidence-Based Eating.

In health,

Michael Greger, M.D.

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

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

Original Link

How Much Water Should We Drink Every Day?

How Much Water Should We Drink Every Day?.jpeg

More than 2000 years ago Hippocrates (460-377 BCE) said, "If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health." What does that mean when it comes to water? Water has been described as a neglected, unappreciated, and under-researched subject, and further complicating the issue, a lot of the papers extolling the need for proper hydration are funded by the bottled water industry.

It turns out the often quoted "drink at least eight glasses of water a day" dictum has little underpinning scientific evidence . Where did that idea come from? The recommendation was traced to a 1921 paper, in which the author measured his own pee and sweat and determined we lose about 3% of our body weight in water a day, or about 8 cups (see How Many Glasses of Water Should We Drink in a Day?). Consequently, for the longest time, water requirement guidelines for humanity were based on just one person.

There is evidence that not drinking enough may be associated with falls and fractures, heat stroke, heart disease, lung disorders, kidney disease, kidney stones, bladder and colon cancer, urinary tract infections, constipation, dry mouth, cavities, decreased immune function and cataract formation. The problem with many of these studies is that low water intake is associated with several unhealthy behaviors, such as low fruit and vegetable intake, more fast-food, less shopping at farmers markets. And who drinks lots of water? People who exercise a lot. No wonder they tend to have lower disease rates!

Only large and expensive randomized trials could settle these questions definitively. Given that water cannot be patented, such trials seem unlikely; who's going to pay for them? We're left with studies that find an association between disease and low water intake. But are people sick because they drink less, or are they drinking less because they're sick? There have been a few large prospective studies in which fluid intake is measured before disease develops. For example, a Harvard study of 48,000 men found that the risk of bladder cancer decreased by 7% for every extra daily cup of fluid we drink. Therefore, a high intake of water--like 8 cups a day--may reduce the risk of bladder cancer by about 50%, potentially saving thousands of lives.

The accompanying editorial commented that strategies to prevent the most prevalent cancers in the West are remarkably straightforward in principle. To prevent lung cancer, quit smoking; to prevent breast cancer, maintain your ideal body weight and exercise; and to prevent skin cancer, stay out of the sun. Now comes this seemingly simple way to reduce the risk of bladder cancer: drink more fluids.

Probably the best evidence we have for a cut off of water intake comes from the Adventist Health Study, in which 20,000 men and women were studied. About one-half were vegetarian, so they were also getting extra water by eating more fruits and vegetables. Those drinking 5 or more glasses of water a day had about half the risk of dying from heart disease compared to those who drank 2 or fewer glasses a day. Like the Harvard study, this protection was found after controlling for other factors such as diet and exercise. These data suggest that it was the water itself that was decreasing risk, perhaps by lowering blood viscosity (blood thickness).

Based on all the best evidence to date, authorities from Europe, the U.S. Institute of Medicine, and the World Health Organization recommend between 2.0 and 2.7 liters (8 to 11 cups) of water a day for women, and 2.5 to 3.7 liters (10 to 15 cups) a day for men. This includes water from all sources, not just beverages. We get about a liter from food and the water our body makes. So this translates into a recommendation for women to drink 4 to 7 cups of water a day and men 6 to 11 cups, assuming only moderate physical activity at moderate ambient temperatures.

We can also get water from all the other drinks we consume, including caffeinated drinks, with the exception of stronger alcoholic drinks like wines and spirits. Beer can leave you with more water than you started with, but wine actively dehydrates you. However, in the cancer and heart disease studies I mentioned above, the benefits were only found with increased water consumption, not other beverages.

I've previously touched on the cognitive benefits of proper hydration here: Does a Drink Of Water Make Children Smarter?

Surprised tea is hydrating? See my video Is Caffeinated Tea Dehydrating?

Surprised that the 8-a-day rested on such flimsy evidence? Unfortunately, so much of what we do in medicine has shaky underpinnings. That's the impetus behind the idea of evidence-based medicine (what a concept!). Ironically, this new movement may itself undermine some of the most effective treatments. See Evidence-Based Medicine or Evidence-Biased?

How else can we reduce our risk of bladder cancer? See Raw Broccoli and Bladder Cancer Survival.

What kind of water? I recommend tap water, which tends to be preferable from a chemical and microbial contamination standpoint. What about buying one of those fancy alkalizing machines? See Alkaline Water: a Scam?

It's so nice to have data on such a fundamental question. We have much to thank the Adventists for. You will see their studies cropping up frequently. See, for example, Plant-Based Diets and Diabetes, The Okinawa Diet: Living to 100, and Evidence-Based Eating.

In health,

Michael Greger, M.D.

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

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

Original Link

Topical Application of Turmeric Curcumin for Cancer

NF-Oct27 Topical application for turmeric curcumin for cancer .jpg
In my video, Turmeric Curcumin and Colon Cancer, I talked about a study where researchers showed that, by taking curcumin, the yellow pigment in the spices turmeric and curry powder, those at high risk for colon cancer could cut down on precancerous and even pre-precancerous lesions, in effect reversing cancer progression. Are there other high risk lesions we can try spicing up?

How about giving turmeric extracts to people who just had bladder cancer taken out? Or to those who have an early stage of squamous cell carcinoma skin cancer caused by arsenic exposure, or early stage cervical cancer, or precancerous lesions in the mouth or stomach? Researchers did this, and in about a quarter of the patients, the lesions started to get better. One out of the two bladder cancer survivors, two out of seven patients with precancerous mouth lesions, one out of six patients with precancerous stomach lesions, one out of four early stage cervical cancer cases, and two out of six patients with early stage skin cancer, all without any noticeable side-effects.

One of the reasons turmeric curcumin may work in some cancers better than others, or in some people better than others, is differences in bioavailability. Megadoses were given, yet just a tiny amount ended up in the bloodstream. If we're treating skin cancer, though, why not just put the curcumin directly on the skin?

I've talked about what turmeric compounds can do to cancer cells in a petri dish. In the video, Topical Application of Turmeric Curcumin for Cancer, you can see some before and after pics. Cervical cancer cells are laid to waste as more and more curcumin is added, and normal cells are unharmed. But to make it to the cervix, curcumin must be absorbed (though a vaginal cream has been invented).

A variety of delivery methods have been devised, including oral, intra-abdominal, intramuscular, under-the-skin injections, straight into the veins or the arteries, on the skin, up the bladder, in the nose, breathed like an inhaler, up where the sun don't shine, or straight into the spinal column, bone marrow, the tumor itself, or implanted somehow. Taken orally, some curcumin does actually get into the tissues. We can measure the amount of curcumin absorbed into the wall of the intestine by examining biopsies and surgical specimens taken after a curcumin regimen. It makes sense to take turmeric orally to try to fight colon cancer, but if we have cancer erupting on our skin why not just rub it on directly?

That's what one group of researchers did. They took some turmeric from the store, made a tincture out of it, dried it, put it in Vaseline, and then had cancer patients rub it on their cancer three times a day. What kind of cancer can you get at with a finger? These were folks with cancers of the mouth, breast, skin, vulva, and elsewhere. Isn't breast cancer under the surface? Not always. Advanced breast cancer can ulcerate right through the skin. The subjects were all people with recurrent ulcerating tumors that had failed to respond to surgery, radiation, and chemo. These open cancers can stink, itch, and ooze, and there was nothing else medicine had to offer. So they rubbed some turmeric ointment to see what happened. It produced remarkable relief. A reduction in smell was noted in 90% of the cases, even in extensively ulcerated cases of breast cancer, and a reduction in itching in almost all cases as well. For example, treatment relieved severe itching in two of the vulva cancer patients. Most of the lesions dried up, and in many cases this relief lasted for months, all from just rubbing on the harmless spice turmeric, which the researchers describe as "an indigenous drug ... highly effective in reducing smell, itching and exudate." The effect of this so-called drug is remarkable. And that "drug" is just some edible spice used in curries for centuries.

More on what this golden spice can do in:

There are ways of Boosting the Bioavailability of Curcumin to get it into our blood stream.

Some should be cautious about turmeric use, though. See Who Shouldn't Consume Curcumin or Turmeric?

-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.

Image Credit: Andrea Kirkby / Flickr

Original Link

How Phytates Fight Cancer Cells

NF-May26 Phytates for Rehabilitating Cancer Cells.jpg

Phytate is a compound found in beans, grains, nuts and seeds. The average daily intake of phytate in vegetarian diets is about twice that of those eating mixed diets of plant and animal foods, which may help explain their low cancer rates. Aside from helping to prevent cancer, dietary phytate has been reported to help prevent kidney stone formation, protect against diabetes mellitus, dental cavities, and heart disease.

Do all these potentially beneficial effects sound too good to be true? Are there other examples of compounds made by plants that can have benefits across multiple diseases? Why yes! Aspirin, for example, which is found throughout the plant kingdom may also account for a variety of plant-based benefits (See Aspirin Levels in Plant Foods).

But of all the things phytates can do, the anticancer activity of phytate (also known as phytic acid, IP6, or inositol hexaphosphate), is considered one of its most important beneficial activities. Dietary phytates are quickly absorbed from the gastrointestinal tract and rapidly taken up by cancer cells throughout the body, and have been shown to inhibit the growth of all tested cancerous cell lines in vitro. Phytates have been shown to inhibit the growth of human leukemia cells, colon cancer cells, both estrogen receptor-positive and negative breast cancer cells, voicebox cancer, cervical cancer, prostate cancer, liver tumors, pancreatic, melanoma, and muscle cancers. All at the same time not affecting normal cells. That's the most important expectation of a good anticancer agent: the ability to only affect cancerous cells and to leave normal cells alone.

In my video, Phytates for Rehabilitating Cancer Cells, you can see how leukemia cells taken from cancer patients are killed by phytates, whereas normal bone marrow cells, are spared. This may explain why bean extracts kill off colon cancer cells in vitro, but leave normal colon cells alone.

What are the mechanisms of action by which phytates battle cancer? In other words, how do phytates fight? How don't they fight? Phytate targets cancer through multiple pathways, a combination of antioxidant, anti-inflammatory, immune-enhancing activities, detox, differentiation, and anti-angiogenesis. In other words, phytate appears to affect all the principal pathways of malignancy.

The antioxidative property is one of the most impressive characteristics of phytate. In fact that's why the meat industry adds phytates to meat to prevent the fat oxidation that begins at the moment of slaughter. Phytates can also act on our immune functions by augmenting natural killer cell activity, the cells in our body that hunt down and dispose of cancer cells, as well as neutrophils, which help form our first line of defense. And then phytates starve tumors as more of a last line of defense. Not only can phytates block the formation of new blood vessels that may be feeding tumors, but disrupt pre-formed capillary tubes, indicating that phytates may not just help blockade tumors, but actively cut off existing supply lines.

What's really remarkable about phytate, though, is that unlike most other anti-cancer agents, it not only causes a reduction in cancer cell growth but also enhances differentiation, meaning it causes cancer cells to stop acting like cancer cells and go back to acting like normal cells. You can see this with colon cancer cells for example. In the presence of phytates, human colon cancer cells mature to structurally and behaviorally resemble normal cells. And this has been demonstrated in leukemia cells, prostate cancer, breast cancer, and muscle cancer cells as well.

For more on the cancer and phytate connection, check out Phytates for the Prevention of Cancer and Phytates for the Treatment of Cancer.

This video reminds me of my video on the spice, turmeric, Turmeric Curcumin Reprogramming Cancer Cell Death.

What else can we eat to improve the cancer-fighting front of our immune system? See Boosting Natural Killer Cell Activity.

More on the concept of starving tumors of their blood supply in Anti-Angiogenesis: Cutting Off Tumor Supply Lines.

Is there clinical evidence of plants actually reversing cancer progression? You won't believe your eyes:

-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, and From Table to Able.

Image Credit: Avi / Flickr

Original Link

How Curry Can Kill Cancer Cells

NF-May12 Turmeric Curcumin Reprogramming Cancer Cell Death.jpg

It is estimated that the human body consists of ten or so trillion cells. Almost all of these cells get turned over within approximately 100 days. That means we're like a new person every three months. We reinvent ourselves physically. And since we're physically made of air, water, and food--those are essentially the only inputs--we are what we eat, literally and physically. In a sense our body has to rebuild itself every three months with the building materials we deliver to it through our stomach. Our mouths are like the access road to the continual construction site of our body. Trucks roll in three times a day. What do we want them to deliver? Some shoddy cheap stuff we scrounged around for or bought at the discount outlets that's just going to fall apart? Or do we want to build our foundation solid? We are each walking inside the greatest known architectural structures in the universe. Let's not ruin such grand blueprints by consuming junk.

We only own the biological real estate we're born with, so if we need to rebuild every three months, we also need a wrecking crew. If we're replacing ten trillion cells every hundred days, that means we have to kill off about 100 billion cells every day. Out with the old, in with the new. We do that primarily through "apoptosis," pre-programmed cell death (from the Greek ptosis, meaning "falling", and apo, "away from"). For example, we all used to have webbed fingers and toes. Literally. Each one of us did in the womb until about four months, when apoptosis kicked in, and the cells in the webbing kill themselves off to separate our fingers.

However, some cells overstay their welcome: cancer cells. They don't die when they're supposed to by somehow turning off their suicide genes. What can we do about that? Well, one of the ways the yellow pigment in curry powder kills cancer cells is by reprogramming the self-destruct mechanism back into cancer cells. Let me just run through one of these pathways.

FAS is a so-called death receptor that activates the FAS associated death domain, death receptor five, and death receptor four. The FADD associated death domain then activates caspase-8, which "ignites the death machine," and kills the cell. (To see the diagram of the pathway, go to my video Turmeric Curcumin Reprogramming Cancer Cell Death). Where does curry powder fit into all this? In cancer cells, curcumin, the pigment in the spice turmeric that makes curry powder yellow, upregulates and activates death receptors (as shown in human kidney cancer cells, skin cancer cells, and nose and throat cancer cells).

Curcumin can also activate the death machine directly (as shown in lung cancer and colon cancer). Caspases are so-called "executioner enzymes," that when activated, destroy the cancer cell from within by chopping up proteins left and right--kind of like death by a thousand cuts.

And that's just one pathway. Curcumin can also affect apoptosis in a myriad other ways, affecting a multitude of different types of cancer cells. It also tends to leave normal cells alone for reasons that are not fully understood. Overall, researchers "showed that curcumin can kill a wide variety of tumor cell types through diverse mechanisms. And because curcumin can affect numerous mechanisms of cell death at the same time, it's possible that cancer cells may not easily develop resistance to curcumin-induced cell death like they do to most chemotherapy."

For more on turmeric and cancer, check out Back to Our Roots: Curry and Cancer and Carcinogen Blocking Effects of Turmeric.

Other herbs and spices such as garlic and amla have similar selective effects against cancer cell (See #1 Anticancer Vegetable and Some Ayurvedic Medicine Worse than Lead Paint Exposure).

I talk more about this concept of "apoptosis," programmed cell death in:

What else can turmeric do? Here's the videos I have so far (with more on the way!):

-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, and From Table to Able.

Image Credit: Steven Jackson / Flickr

Original Link

A Low Methionine Diet May Help Starve Cancer Cells

NF-July8 A Low Methionine Diet May Help Starve Cancer Cells.jpg

When designing an antibiotic, we can't create a drug that destroys DNA because that's something that both humans and bacteria share in common. It would kill bacteria, but it might kill us, too. Instead, many antibiotics work by attacking bacterial cell walls, which is something bacteria have that we don't.

Similarly, antifungals can attack the unique cell walls of fungus. Pesticides can work by attacking the special exoskeleton of insects. But fighting cancer is harder because cancer cells are our own cells. So fighting cancer comes down to trying to find and exploit differences between cancer cells and normal cells.

Forty years ago, a landmark paper was published showing for the first time that many human cancers have what's called "absolute methionine dependency," meaning that if we try to grow cells in a Petri dish without giving them the amino acid methionine, normal cells thrive, but without methionine, cancer cells die. Normal breast cells grow no matter what, with or without methionine, but cancer cells need that added methionine to grow.

What does cancer do with the methionine? Tumors use it to generate gaseous sulfur-containing compounds that, interestingly, can be detected by specially trained diagnostic dogs. There are mole-sniffing dogs that can pick out skin cancer. There are breath-sniffing dogs that can pick out people with lung cancer. Pee-sniffing dogs that can diagnose bladder cancer and--you guessed it--fart-sniffing dogs for colorectal cancer. Doctors can now bring their lab to the lab!

It gives a whole new meaning to the term pet scan :)

Methionine dependency is not just present in cancer cell lines in a Petri dish. Fresh tumors taken from patients show that many cancers appear to have a biochemical defect that makes them dependent on methionine, including some tumors of the colon, breast, ovary, prostate, and skin. Pharmaceutical companies are fighting to be the first to come out with a drug that decreases methionine levels. But since methionine is sourced mainly from food, a better strategy may be to lower methionine levels by lowering methionine intake, eliminating high methionine foods to control cancer growth as well as improve our lifespan (see Methionine Restriction as a Life-Extension Strategy).

Here's the thinking: smoking cessation, consumption of diets rich in plants, and other lifestyle measures can prevent the majority of cancers. Unfortunately, people don't do them, and as a result hundreds of thousands of Americans develop metastatic cancer each year. Chemotherapy cures only a few types of metastatic cancer. Unfortunately, the vast majority of common metastatic cancers, such as breast, prostate, colon, and lung, are lethal. We therefore desperately need novel treatment strategies for metastatic cancer, and dietary methionine restriction may be one such strategy.

So, where is methionine found? In my video, Starving Cancer with Methionine Restriction, you can see a graph of foods with their respective methionine levels. Chicken and fish have the highest levels. Milk, red meat, and eggs have less, but if we really want to stick with lower methionine foods, fruits, nuts, veggies, grains, and beans are the best. In other words, "In humans, methionine restriction may be achieved using a predominately vegan diet."

There are also compounds in animal products that may actually stimulate tumor growth. See, for example, How Tumors Use Meat to Grow: Xeno-Autoantibodies. Animal protein may also boost levels of the cancer-promoting hormone IGF-1 (The Answer to the Pritikin Puzzle). Combined, this could all help explain why plants and plant-based diets have been found effective in potentially reversing some cancer processes. See Cancer Reversal Through Diet?, Strawberries versus Esophageal Cancer, and Black Raspberries versus Oral Cancer.

So why isn't every oncologist prescribing a low-methionine diet? One researcher notes that "Despite many promising preclinical and clinical studies in recent years, dietary methionine restriction and other dietary approaches to cancer treatment have not yet gained wide clinical application. Most clinicians and investigators are probably unfamiliar with nutritional approaches to cancer." That's an understatement! "Many others may consider amino acid restriction as an 'old idea,' since it has been examined for several decades. However, many good ideas remain latent for decades if not centuries before they prove valuable in the clinic....With the proper development, dietary methionine restriction, either alone or in combination with other treatments, may prove to have a major impact on patients with cancer."

Why might the medical profession be so resistant to therapies proven to be effective? The Tomato Effect may be partially to blame.

In my video, Anti-Angiogenesis: Cutting Off Tumor Supply Lines, researchers come to the same plant-based conclusion from a different perspective, starving cancers of their blood supply.

-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: PNNL - Pacific Northwest National Laboratory / Flickr

Original Link