How to Treat Dry Eye Disease Naturally with Diet

Oct 31 Dry Eyes copy.jpeg

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

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

There has to be a better way.

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

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

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

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

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

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

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


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

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

In health,

Michael Greger, M.D.

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

Original Link

How to Treat Dry Eye Disease Naturally with Diet

Oct 31 Dry Eyes copy.jpeg

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

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

There has to be a better way.

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

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

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

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

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

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

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


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

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

In health,

Michael Greger, M.D.

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

Original Link

A Simple Yet Neglected Cure for Childhood Constipation

NF-Feb11 Childhood Constipation and Cow's Milk.jpeg

Back in the 1950s, it was suggested that some cases of constipation among children might be due to the consumption of cow's milk. But it wasn't until 40 years later that it was finally put to the test. We used to think that most chronic constipation in infants and young children was all in their head--they were "anal retentive"--or had some intestinal disorder, but a group of Italian researchers studied 27 consecutive infants who showed up in their pediatric gastroenterology clinic with chronic "idiopathic constipation" (meaning they had no idea what was causing it), and tried removing cow's milk protein from their diet.

Within three days on a cow's milk protein-free diet, 21 out of the 27 children were cured. There were clinical relapsea during two subsequent cow milk challenges, meaning when they tried giving the children back some cow's milk, the constipation reappeared within 24 to 48 hours. The subjects came back after a month and stayed cured, and their eczema and wheezing went away, too! The researchers concluded that many cases of chronic constipation in young children--more than three quarters it seemed, may be due to an underlying cow's milk protein allergy.

Chronic constipation is a common problem in children, for which fiber and laxatives are prescribed. If those don't work, several laxatives at progressively higher dosages can be used, and that still may not work. Five years later, a considerable number of kids are still suffering. In fact, chronic constipation may even extend into adulthood. To cure the disease in just a few days by eliminating cow's milk was a real breakthrough.

But it was an open trial, meaning not blinded or placebo-controlled. We didn't have such a trial until a landmark study was published in the New England Journal of Medicine--a double-blind, crossover study, comparing cow's milk and soy milk. The study enrolled 65 kids suffering from chronic constipation, all previously treated unsuccessfully with laxatives; 49 had anal fissures and inflammation and swelling. The researchers gave them either cow's milk or soy milk for two weeks and then switched it around.

In two thirds of the children, constipation resolved while they were receiving soy milk, and the anal fissures and pain were cured. None of the children receiving cow's milk had a positive response. In the 44 responders, the relation with cow's milk protein hypersensitivity was confirmed in all cases by a double-blind challenge with cow's milk. All those lesions, including the most severe anal fissures, disappeared on a cow's milk-free diet, yet reappeared within days after the reintroduction of cow's milk back into their diets.

This may explain why children drinking more than a cup of milk a day may have eight times the odds of developing anal fissures. Cutting out milk may help cure anal fissures in adults, too. Cow's milk may also be a major contributor to recurrent diaper rash as well.

Why does removing cow's milk treat these conditions? Studies that have looked at biopsy tissue samples in patients with chronic constipation because of cow's milk protein hypersensitivity have found signs of rectal inflammation, suggesting that cow's milk protein was inducing an inflammatory response.

Studies from around the world have subsequently confirmed these findings, curing up to 80 percent of kids' constipation by switching to soy milk or rice milk. A common problem with the studies, though, is when they switched kids from cow's milk to non-dairy milk, the kids could still have been eating other dairy products. That is, they didn't control the background diet...until recently. A 2013 study (highlighted in my video, Childhood Constipation and Cow's Milk, got constipated kids off all dairy products and 100 percent were cured, compared with 68 percent in the New England Journal study.

Isn't this amazing? I just kept thinking, "why didn't I learn this in medical school?" Is the dairy lobby so persuasive that a cheap, simple, safe, life-changing intervention like this remains buried?

Until now!

If you appreciate learning what your child's pediatrician probably never did, please consider making a donation to the 501c3 nonprofit charity that keeps this website going. I don't make a penny off the site, but it does require substantial server and logistics costs.

Make sure to check out tomorrow's video: Treating Infant Colic by Changing Mom's Diet.

Avoiding dairy may be important for infant health too. Watch my 3-part video series:

Then the effects on adolescents and beyond:

In health,
Michael Greger, M.D.

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

Image Credit: Melissa Wiese / Flickr

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The Top Three DNA Protecting Spices

NF-Jan20 Which Spices Protect Against DNA Damage?.jpg

In my video Which Spices Fight Inflammation? I profile a landmark study that compared the ability of different spices to suppress inflammation. The study also compared the spices' ability to protect DNA. Cloves, ginger, rosemary, and turmeric were able to significantly stifle the inflammatory response, but can they also protect DNA?

If a tissue sample is taken from a random person, about 7% of their cells may show evidence of DNA damage, actual breaks in the strands of their DNA. If we then blast those cells with free radicals, we can bring that number up to 10%. But if the person has been eating ginger for a week, DNA damage drops to just 8%. In the video, Spicing Up DNA Protection, you can see a comparison of DNA damage in cells from people eating different spices. Those who hadn't been eating any herbs or spices were vulnerable to DNA damage from oxidative stress. But just including ginger in our diet may cut that damage by 25%--the same with rosemary.

Turmeric is even more powerful--DNA damage was cut in half. And this was not just mixing turmeric with cells in some petri dish: This is comparing what happens when you expose the cells of spice eaters versus the cells of non-spice eaters to free radicals and count the DNA fracture rates.

And not only did the turmeric work significantly better, but it did so at a significantly smaller dose. One and a third teaspoons a day of ginger or rosemary was compared to practically just a pinch of turmeric (about an eighth of a teaspoon a day)--that's how powerful the stuff is. I encourage everyone to cook with this wonderful spice. It tastes great and may protect every cell in our body, with or without the added stress. Counting the DNA breaks in people's cells before and after a week of spices without the free radical blast revealed no significant intrinsic protection in the ginger or rosemary groups. However, the turmeric still appeared to reduce DNA damage by half.

This may be because curcumin is not just an antioxidant--it also boosts the activity of the body's own antioxidant enzymes. Catalase is one of the most active enzymes in the body: each one can detoxify millions of free radicals per second. If we consume the equivalent of about three quarters of a teaspoon of turmeric a day, the activity of this enzyme in our bloodstream gets boosted by 75%!

I suggest cooking with it rather than, for example, just throwing it in a smoothie. Why? Because this effect was found specifically for heat-treated turmeric. In practice, many herbs and spices are only consumed after cooking, so the researchers tested turmeric and oregano in both raw and cooked forms. In terms of DNA damage, the results from raw turmeric did not reach statistical significance. However, the opposite was found for its anti-inflammatory effects. So we might want to eat it both ways.

"Practical recommendations for obtaining curcumin in the diet might be to add turmeric to sweet dishes containing cinnamon and ginger." I add it to my pumpkin pie smoothies (a can of pumpkin, frozen cranberries, pitted dates, pumpkin pie spice and some nondairy milk). We can also cook with curry powder or turmeric itself. The researchers suggest something called "turmeric milk," which is a traditional Indian elixir made with milk, turmeric powder, and sugar. I'd suggest substituting a healthier sweetener and a healthier milk. Soy milk, for example, might have a double benefit. If you're taking turmeric to combat inflammation, osteoarthritis sufferers randomized to soy protein ended up with significantly improved joint range of motion compared to dairy protein.

For some other extraordinary benefits of spices, see:

There are a few herb and spice caveats. See, for example:

Too much turmeric may also not be a good idea for those at risk for kidney stones (See Oxalates in Cinnamon).

Feel free to check out my Healthy Pumpkin Pie recipe for another way to spice up your diet.

-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: Todd Huffman / Flickr

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Can Eating Soy Prevent Breast Cancer?

NF-Sep16 Can Eating Soy Prevent Breast Cancer?.jpg

In my video, Increased Lifespan From Beans, I discuss how beans may be the single most important dietary predictor of a long lifespan. But why do people who eat legumes such as beans, chickpeas, split peas, and lentils live longer? It may be because men and women who eat legumes have been shown to be lighter, have a slimmer waist, lower blood pressure, lower blood sugars, lower cholesterol, lower triglycerides, and better kidney function. Interestingly, bean intake is a better protector against mortality in women than in men. This may be because cancer--especially breast cancer--was the leading killer of women in the population studied.

Breast cancer survivors who eat soy foods, for example, have a significantly lower likelihood of cancer recurrence. A 2012 review looked at the three studies done to date on the link between soy and breast cancer survival. It showed that women who ate the most soy had a 29% lower risk of dying from breast cancer and a 36% lower risk of cancer recurrence. A fourth study has since been published that reaffirms these results. With an average intake of soy phytonutrients above 17 mg/day--the amount found in about a cup of soymilk--the mortality of breast cancer may be reduced by as much as 38%.

In my video, BRCA Breast Cancer Genes and Soy, you can see a five-year survival curve for Chinese women with breast cancer. After two years, all of the breast cancer survivors that ate lots of soy were still alive, while only about two-thirds of the women who ate the least amount of soy were alive. After five years, 90% of the tofu lovers were still alive and kicking, whereas half of the tofu haters had kicked the bucket. There is a similar relationship between breast cancer survival and soy protein intake, as opposed to just soy phytonutrient intake.

How does soy so dramatically decrease cancer risk and improve survival? Soy may actually help turn back on women's BRCA genes. BRCA is a so-called "caretaker gene," an oncosuppressor (cancer-suppressing) gene responsible for DNA repair. Mutations in this gene can cause a rare form of hereditary breast cancer, popularized by Angelina Jolie's public decision to undergo a preventive double mastectomy. But only about 5% of breast cancers run in families; 95% of breast cancer victims have fully functional BRCA genes. So if their DNA repair mechanisms are intact, how did breast cancer form, grow, and spread? It does so by suppressing the expression of the gene through a process called methylation. The gene's fine, but cancer found a way to turn it down or even off, potentially facilitating the metastatic spread of the tumor.

And that's where soy may come in.

The reason soy intake is associated with increased survival and decreased cancer recurrence may be because the phytonutrients in soy turn back on the BRCA protection, removing the methyl straightjacket the tumor tried to place on it. To find out if this is indeed the case, a group of researchers put it to the test.

In the video mentioned earlier, BRCA Breast Cancer Genes and Soy, you can see normal cells side-by-side with three different types of human breast cancer cells, specially stained so that the expression of BRCA genes shows up brown. Column 1 (far left) shows what fully functioning DNA repair looks like--what normal breast cells should look like--lots of brown, lots of BRCA expression. Column 2 shows raging breast cancer cells. If you add soy phytonutrients to the cancer (columns 3 and 4), the BRCA genes get turned back on and DNA repair appears to start ramping back up. Although this was at a pretty hefty dose (equivalent to about a cup of soybeans), the results suggest that treatment with soy phytonutrients might reverse DNA hypermethylation and restore the expression of the tumor suppressor genes BRCA1 and BRCA2. Soy appears to also help with other breast cancer genes as well, and women at increased genetic risk of breast cancer may especially benefit from high soy intake.

No matter what genes we inherit, changes in diet can affect DNA expression at a genetic level. No matter what bad genetic cards we've been dealt, we can reshuffle the deck with diet. For examples, see:

I've previously covered the available science in Breast Cancer Survival and Soy. Other effects detailed in:

It may be possible to overdo it, though. See my video How Much Soy Is Too Much?

-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: Craig Dugas / Flickr

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How to Get Parents to Eat Their Vegetables

NF-June19 Tricks to Get Adults to Eat Healthier.jpg

Changing the name of healthy foods can have a significant impact on children's eating habits (See Tricks to Get Kids to Eat Healthier at School). Are adults as gullible? Yes. For example, in one study profiled in my video Tricks to Get Adults to Eat Healtier, people reported that "traditional Cajun red beans and rice" tasted better than just "red beans with rice," even though they were both the exact same dish. (How healthy are those beans and rice, regardless of what you call them? Check out Beans and the Second Meal Effect).

Back in World War II, domestic meat was in large part shipped overseas, leaving lots of organ meats behind--"the hearts, kidneys, brains, stomachs, intestines, and even the feet, ears, and heads of cows, hogs, sheep, and chickens." The challenge was how to encourage people to eat chicken heads and sheep ears. To accomplish this, the Department of Defense evidently enlisted dozens of the brightest, most famous psychologists "to determine how dietary changes could be accomplished." Taste wasn't the problem. People would eat brains as long as you didn't tell them they were eating brains. (What's wrong with eating brains? See Avoiding Cholesterol Is a No-Brainer and Foodborne Rabies).

Their solution was to invent mystery meat. The answer was to just not tell consumers what they're eating. And the same can apply with healthy foods.

As with organ meats in the 1940s, the suggestion that a food contains soy may be so powerful that some people convince themselves they do not like the taste. For instance, if someone is given an energy bar that says it has soy protein in it, people tend to rate it as grainy and tasteless, compared to identical bars with no mention of the word soy. In reality, there was no soy in either of the bars. It's what you call a "phantom ingredient" taste test. "Simply the suggested presence of soy made people believe they tasted it, and they evaluated it accordingly." (Does soy deserve its bad rap? See Breast Cancer Survival and Soy, for example. They may be overrated in the cholesterol-lowering department, though: Soy Worth a Hill of Beans?). In general, "a large percentage of consumers taste what they want to taste."

So can we use the same vegetable sneak attack tactic that has been proven so successful in children on adults? It turns out that covertly adding hidden pureed vegetables to meals works for adults too--and even for vegetables they didn't like. "It was shown that the adults' dislike of the vegetables that were incorporated into the entrees did not affect the consumption of the vegetable-enhanced entrees. This indicates that the incorporation of pureed vegetables into entrees increased the intake of vegetables even when the added vegetable was disliked." And of course, the more vegetables we eat, the less calories we get, so we get the twin benefit. Study subjects were eating up to a pound of vegetables a day and 350 fewer calories. Keep that up and one could lose 30 pounds a year without even trying.

Another way to entice men and women to eat healthier is to appeal to their concerns about sexual function (see 50 Shades of Greens) or vanity:

For related videos, check out Tricks to Get Kids to Eat Healthier at Home and school.

-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: Don Buciak II / Flickr

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