Why Some Like Cilantro and Others Hate It

The Cilantro Gene.jpg

One sign of changing U.S. demographics is that salsa has replaced ketchup as America's #1 table condiment. One of the popular salsa ingredients is cilantro, described as one of the "most polarizing and divisive food ingredients known." Some people love it; some people hate it. What's interesting is that the lovers and the haters appear to experience the taste differently. Individuals who like cilantro may describe it as "fresh, fragrant or citrusy, whereas those who dislike cilantro report that it tastes like soap, mold, dirt, or bugs." I don't know how people know what bugs taste like, but rarely are polarizing opinions about flavors so extreme. Maybe it's genetic.

Different ethnic groups do seem to have different rates of cilantro dislike, with Ashkenazi Jews scoring highest on the cilantro hate-o-meter (see The Cilantro Gene). Another clue came from twin studies, that show that identical twins tend to share cilantro preferences, whereas regular fraternal twins do not have such a strong correlation. Our genetic code is so big, though, containing about three billion letters, that to find some cilantro gene you'd have to analyze the DNA of like 10,000 people, and obviously genetic researchers have better things to do...or maybe not.

Researchers performed a genome-wide association study among 14,000 participants who reported whether cilantro tasted soapy, with replication in a distinct set of 11,000 people who declared whether they liked cilantro or not. And lo and behold they found a spot on chromosome 11 that seemed to be a match. What's there? A gene called OR6A2 that enables us to smell certain chemicals like E-(2)-Decenal, a primary constituent of cilantro and also...the defensive secretions of stink bugs. So maybe cilantro does taste like bugs! But, cilantro lovers may be genetic mutants that have an inability to smell the unpleasant compound.

That may actually be an advantage, though, since cilantro is healthy stuff. In fact, that's the justification to do these kinds of studies: to see why some people don't like the taste of healthy foods.

Are the cilantro haters really missing out on much, though? Mother nature has been described as the "oldest and most comprehensive pharmacy of all time," and cilantro--called coriander around most of the world--is one of nature's oldest herbal prescriptions, credited with anti-microbial, anti-oxidant, anti-diabetic, anti-anxiety, and anti-epilepsy properties. However, these are all from preclinical studies, meaning studies done on cells in a test tube or lab animals. Studies like the "Anti-Despair Activity of Cilantro..." in which researchers placed animals in a "despair apparatus" (you don't want to know).

Finally, though, there was a human study, on the anti-arthritis potential of cilantro. There was an earlier study performed in Germany of a lotion made out of cilantro seeds showing it could decrease the redness of a sunburn, demonstrating it had some anti-inflammatory effects )though not as much as an over-the-counter steroid, hydrocortisone, or prescription strength steroid cream). If the cilantro plant is anti-inflammatory, why nto give it to people with osteoarthritis and see if it helps? Researchers gave about 20 sprigs of cilantro daily for two months, and reported a significant drop in ESR--a nonspecific indicator of inflammation--in the cilantro group. How did the patients do clinically, though? The study didn't say, but it did report a rather remarkable 50% drop in uric acid levels, suggesting that huge amounts of cilantro may be useful for those suffering from gout.


The cilantro lovers/haters factoid reminds me of the video Pretty in Pee-nk about the phenomenon of "beeturia," pink urine after beet consumption seen in some people.

For those that don't mind the taste of bugs, I have some nutritional info in Good Grub: The Healthiest Meat and Bug Appétit: Barriers to Entomophagy.

As an Ashkenazim myself, I'm excited to have narrowly escaped a cilantro-less existence!

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. This image has been modified.

Original Link

Why Some Like Cilantro and Others Hate It

The Cilantro Gene.jpg

One sign of changing U.S. demographics is that salsa has replaced ketchup as America's #1 table condiment. One of the popular salsa ingredients is cilantro, described as one of the "most polarizing and divisive food ingredients known." Some people love it; some people hate it. What's interesting is that the lovers and the haters appear to experience the taste differently. Individuals who like cilantro may describe it as "fresh, fragrant or citrusy, whereas those who dislike cilantro report that it tastes like soap, mold, dirt, or bugs." I don't know how people know what bugs taste like, but rarely are polarizing opinions about flavors so extreme. Maybe it's genetic.

Different ethnic groups do seem to have different rates of cilantro dislike, with Ashkenazi Jews scoring highest on the cilantro hate-o-meter (see The Cilantro Gene). Another clue came from twin studies, that show that identical twins tend to share cilantro preferences, whereas regular fraternal twins do not have such a strong correlation. Our genetic code is so big, though, containing about three billion letters, that to find some cilantro gene you'd have to analyze the DNA of like 10,000 people, and obviously genetic researchers have better things to do...or maybe not.

Researchers performed a genome-wide association study among 14,000 participants who reported whether cilantro tasted soapy, with replication in a distinct set of 11,000 people who declared whether they liked cilantro or not. And lo and behold they found a spot on chromosome 11 that seemed to be a match. What's there? A gene called OR6A2 that enables us to smell certain chemicals like E-(2)-Decenal, a primary constituent of cilantro and also...the defensive secretions of stink bugs. So maybe cilantro does taste like bugs! But, cilantro lovers may be genetic mutants that have an inability to smell the unpleasant compound.

That may actually be an advantage, though, since cilantro is healthy stuff. In fact, that's the justification to do these kinds of studies: to see why some people don't like the taste of healthy foods.

Are the cilantro haters really missing out on much, though? Mother nature has been described as the "oldest and most comprehensive pharmacy of all time," and cilantro--called coriander around most of the world--is one of nature's oldest herbal prescriptions, credited with anti-microbial, anti-oxidant, anti-diabetic, anti-anxiety, and anti-epilepsy properties. However, these are all from preclinical studies, meaning studies done on cells in a test tube or lab animals. Studies like the "Anti-Despair Activity of Cilantro..." in which researchers placed animals in a "despair apparatus" (you don't want to know).

Finally, though, there was a human study, on the anti-arthritis potential of cilantro. There was an earlier study performed in Germany of a lotion made out of cilantro seeds showing it could decrease the redness of a sunburn, demonstrating it had some anti-inflammatory effects )though not as much as an over-the-counter steroid, hydrocortisone, or prescription strength steroid cream). If the cilantro plant is anti-inflammatory, why nto give it to people with osteoarthritis and see if it helps? Researchers gave about 20 sprigs of cilantro daily for two months, and reported a significant drop in ESR--a nonspecific indicator of inflammation--in the cilantro group. How did the patients do clinically, though? The study didn't say, but it did report a rather remarkable 50% drop in uric acid levels, suggesting that huge amounts of cilantro may be useful for those suffering from gout.


The cilantro lovers/haters factoid reminds me of the video Pretty in Pee-nk about the phenomenon of "beeturia," pink urine after beet consumption seen in some people.

For those that don't mind the taste of bugs, I have some nutritional info in Good Grub: The Healthiest Meat and Bug Appétit: Barriers to Entomophagy.

As an Ashkenazim myself, I'm excited to have narrowly escaped a cilantro-less existence!

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. This image has been modified.

Original Link

How May Eating Plants Help Prevent Alzheimer’s Disease?

NF-Oct27 Preventing Alzheimers Disease with Plants.jpeg

Intake of saturated fats and added sugars, two of the primary components of a modern Western diet, is linked with the development of Alzheimer's disease. There has been a global shift in dietary composition, from traditional diets high in starches and fiber, to what has been termed the Western diet, high in fat and sugar, low in whole, plant foods. What's so great about fruits and vegetables?

Plant-derived foods contain thousands of compounds with antioxidant properties, some of which can traverse the blood-brain barrier and may have neuroprotective effects by assisting with antioxidant defense. There's this concept of "brain rust," that neurodegenerative diseases arise from excess oxidative stress. But Nature has gifted humankind with a plethora of plants--fruits, vegetables, and nuts, and the diverse array of bioactive nutrients present in these natural products may play a pivotal role in prevention and one day, perhaps, even the cure of various neurodegenerative diseases, such as Alzheimer's disease.

Accumulated evidence suggests that naturally occurring plant compounds may potentially hinder neurodegeneration, and even improve memory and cognitive function, as I've shared in my videos Preventing Alzheimer's Disease with Plants and How to Slow Brain Aging By Two Years) and treating Alzheimer's with spices such as saffron or turmeric (See Saffron for the Treatment of Alzheimer's and Treating Alzheimer's with Turmeric).

Vegetables may be particularly protective, in part because of certain compounds we eat that concentrate in the brain, found in dark green leafy vegetables, the consumption of which are associated with lower rates of age-related cognitive decline.

Yet when you look at systemic reviews on what we can do to prevent cognitive decline, you'll see conclusions like this: "The current literature does not provide adequate evidence to make recommendations for interventions." The same is said for Alzheimer's, "Currently, insufficient evidence exists to draw firm conclusions on the association of any modifiable factors with risk of Alzheimer's disease." Doctors cite the lack of randomized controlled trials (RCTs) as the basis for their conclusions. RCTs are the gold standard used to test new medicines. This is where researchers randomize people into two groups, half get the drug and half don't, to control for confounding factors. The highest level of evidence is necessary because drugs may kill a hundred thousand Americans every year - not medication errors or illicit drugs, just regular, FDA-approved prescription drugs, making medication alone the sixth leading cause of death in the United States. So, you better make absolutely sure the benefits of new drugs outweigh the often life-threatening risks.

But we're talking about diet and exercise--the side effects are all good, so we don't need the same level of rigorous evidence to prescribe them.

A "modest proposal" was published recently in the Journal of Alzheimer's Disease, an editorial calling for a longitudinal study of dementia prevention. They agreed that definitive evidence for the effectiveness of dementia prevention methods was lacking, so we need large-scaled randomized trials. They suggested we start with 10,000 healthy volunteers in their 20's and split them into five groups. There's evidence, for example, that traumatic brain injury is a risk factor for Alzheimer's, because people with head injuries appear more likely to get the disease, but it's never been put to the test. So, they say, let's take two thousand people and beat half of them in the head with baseball bats, and the other half we'll use Styrofoam bats as a control. Afterall, until we have randomized controls, how can't physicians recommend patients not get hit in the head? They go further saying we should probably chain a thousand people to a treadmill for 40 years, and a thousand people to a couch before recommending exercise. A thousand will be forced to do crossword puzzles; another thousand forced to watch Jerry Springer reruns, lots of meat and dairy or not prescribed for another group for the next 40 years, and we can hook a thousand folks on four packs a day just to be sure.

We help our patients to quit smoking despite the fact that there's not a single randomized controlled trial where they held people down and piped smoke into their lungs for a few decades. It is time to realize that the ultimate study in regard to lifestyle and cognitive health cannot be done. Yet the absence of definitive evidence should not restrict physicians from making reasonable recommendations based on the evidence that is available.

I've discussed how drug-centric approaches to evidence-based medicine may neglect some of the most convincing data: Evidence-Based Medicine or Evidence-Biased?

To see how and why I built NutritionFacts.org on evidence-based principles, see my recent introductory videos:

A sampling of some of my Alzheimer's videos:

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations--2013: Uprooting the Leading Causes of Death, More Than an Apple a Day, 2014: From Table to Able: Combating Disabling Diseases with Food, 2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet, and my latest, 2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers.

Image Credit: Michael Heim / 123rf

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How Turmeric Can Help Combat the Effects of Sitting

NF-Oct25 Turmeric vs Exercise for Artery Function.jpeg

The average American spends most of their waking life sitting down, which is associated with an increased risk of death even among people who go to the gym after work and exercise regularly. Doing lots of sitting may double our risk of diabetes and heart disease while significantly shortening our lifespan, even at the highest levels of physical activity. Sitting six or more hours a day may increase mortality rates even among those running or swimming an hour a day, every day, seven days a week. Why though? I examine this in Turmeric Cucumin vs. Exercise for Artery Function.

One factor may be endothelial dysfunction, the inability of the inner lining of our blood vessels to relax our arteries normally in response to blood flow. Just like our muscles atrophy if we don't use them, when it comes to arterial function, it's 'use it or lose it' as well. Increased blood flow promotes a healthy endothelium. The cells lining our arteries can actually sense the sheer force of the blood flowing past. That flow is what maintains the stability and integrity of the inner lining of our arteries. Without that constant tugging flow, it may help set us up for heart disease.

We actually have some data now suggesting that treadmill desks may improve the health of office workers without affecting work performance, and walking may be preferable to standing in terms of clearing fat from our bloodstream, which can play a role in endothelial dysfunction.

What if our office can't accommodate a standing or walking desk? Within an hour of sitting, blood starts pooling and blood flow starts to stagnate, so the more we can take breaks the better. Preliminary evidence from observational and interventional studies suggests that regular interruptions in sitting time can be beneficial. And it doesn't have to be long. Breaks could be as short as one minute and not necessarily entail exercise, just something like taking out the trash during commercials may be beneficial.

I've talked about the effects of different diets on endothelial function (See Eggs and Arterial Function, Walnuts and Arterial Function, Vinegar and Artery Function, and Dark Chocolate and Artery Function) and how certain foods in particular--nuts and green tea--are beneficial for endothelial health. Recently, researchers tried out curcumin, the yellow pigment in the spice turmeric.

They showed that regular ingestion of curcumin or up to an hour a day of aerobic exercise training significantly improved endothelial function. And the magnitude of improvement in endothelial function was the same. So does that mean we can just be a couch potato as long as we eat curried potatoes? No, the combination of curcumin and exercise appears to work even better than either alone.

I'm on my third treadmill desk motor, after burning out two. The 2nd one lasted 7,000 miles, though. Could have walked back and forth across the country! I do about 17 miles a day. More on treadmill desks in Standing Up for Your Health.

Amazing how much beneficial just simple walking can be: Longer Life Within Walking Distance

More exercise versus diet comparisons in Is it the Diet, the Exercise, or Both? and How Much Exercise to Sustain Weight Loss.

For more on turmeric and exercise see Heart of Gold: Turmeric vs Exercise.

Who Shouldn't Consume Curcumin or Turmeric? See the video! :)

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations--2013: Uprooting the Leading Causes of Death, More Than an Apple a Day, 2014: From Table to Able: Combating Disabling Diseases with Food, 2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet, and my latest, 2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers.

Image Credit: Decius & Josep Curto / 123rf

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Treating Pancreatic Cancer with Turmeric Curcumin

NF-May26 Turmeric Curcumin and Pancreatic Cancer.jpeg

Pancreatic cancer is among the most aggressive forms of human cancer, characterized by a very high mortality rate. It represents the fourth leading cause of cancer death in United States, killing 32,000 people annually. With a five-year survival rate of only three percent and a median survival rate of less than six months, pancreatic cancer carries one of the poorest prognoses. The diagnosis of pancreatic cancer is one of the worst things a doctor ever has to tell a patient. The only FDA-approved therapies for it, Gemcitabine and Erlotinib, produce objective responses in less than ten percent of patients, while causing severe side-effects in the majority. There is a desperate need for new options.

Clinical research to test new treatments is split into phases. Phase I trials are just to make sure the treatment is safe, to see how much you can give before it becomes toxic. Curcumin, the natural yellow pigment in the spice turmeric has passed a number of those. In fact, there was so little toxicity, the dosing appeared limited only by the number of pills patients were willing to swallow.

Phase II trials are conducted to see if the drug actually has an effect. Curcumin did, in 2 of the 21 patients that were evaluated. One patient had a 73 percent tumor reduction, but the effect was short-lived. One lesion remained small, but a curcumin-resistant tumor clone emerged. The other patient, who had a stable disease for over 18 months, showed slow improvement over a year. The only time that patient's cancer markers bumped up was during a brief three-week stint where the curcumin was stopped.

So curcumin does seem to help some patients with pancreatic cancer, and most importantly, there appears to be little downside. No curcumin-related toxic effects were observed in up to doses of eight grams per day. What happens after eight grams? We don't know because no one was willing to take that many pills. The patients were willing to go on one of the nastiest chemotherapy regimens on the planet, but didn't want to be inconvenienced with swallowing a lot of capsules.

The only surefire way to beat pancreatic cancer is to prevent it in the first place. In 2010 I profiled a study conducted by the National Institutes of Health, the largest such study in history, which found that dietary fat of animal origin was associated with increased pancreatic cancer risk.

Which animal fat is the worst? The second largest study (highlighted in my video: Turmeric Curcumin and Pancreatic Cancer) has since chimed in to help answer that question. Researchers found that poultry was the worst, with 72 percent increased risk of pancreatic cancer associated with every 50 grams of daily poultry consumption. Fifty grams is just about a quarter of a chicken breast. The reason white meat came out worse than red may be because of the cooked meat carcinogens in chicken, the heterocyclic amines that build up in grilled and baked chicken. These mutagenic chemicals have been associated with a doubling of pancreatic cancer risk (See Estrogenic Cooked Meat Carcinogens).

Meat has been associated with significantly increased risk, whereas fake meat is associated with significantly less risk. Those who eat plant-based meats like veggie burgers or veggie dogs three or more times a week had less than half the risk of fatal pancreatic cancer. Legumes and dried fruit appear to be similarly protective.

My grandfather died of pancreatic cancer. By the time the first symptom arose, a dull ache in his gut, it was too late. That's why we need to work on preventing it.

I previously touched on pancreatic cancer prevention in Poultry Exposure Tied to Liver and Pancreatic Cancer and attempts at pancreatic cancer treatment in Gerson Therapy for Cancer and Gerson-style Therapy vs. Chemotherapy.

For more on the heterocyclic amine cooked meat carcinogens:

I've done a bunch of videos on turmeric and various cancers:

And more on this amazing spice (and more to come):

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: Sara Marlowe / Flickr

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Can Turmeric Help with Alzheimer’s?

NF-Apr14 Treating Alzheimer's with Turmeric.jpeg

The spice turmeric may help prevent Alzheimer's disease (See Preventing Alzheimer's with Turmeric), but what about treating Alzheimer's disease with turmeric? An exciting case series was published in 2012 (highlighted in my video, Treating Alzheimer's with Turmeric): three Alzheimer's patients were treated with turmeric, and their symptoms improved.

In case number one, an 83-year-old woman started losing her memory and feeling disoriented. She started having problems taking care of herself, wandering aimlessly and became incontinent. After taking a teaspoon of turmeric per day however, her agitation, apathy, anxiety and irritability were relieved and she had less accidents. Furthermore, she began to laugh again, sing again, and knit again. After taking turmeric for more than a year, she came to recognize her family and now lives a peaceful life without a significant behavioral or psychological symptom of dementia.

Case number two was similar, but with the additional symptoms of hallucinations, delusions and depression, which were relieved by turmeric. She began to recognize her family again and now lives in a peacefully serene manner. And the third case, similar as well, included an improvement in cognition.

Researchers concluded that this was the first demonstration of turmeric as an effective and safe "drug" for the treatment of the behavioral and psychological symptoms of dementia in Alzheimer's patients. They call it a drug, but it's just a spice you can walk into any grocery store and buy for a few bucks. They were giving people like a teaspoon a day, which comes out to be about 15 cents.

Two trials using curcumin supplements rather than turmeric, however, failed to show a benefit. Curcumin is just one of hundreds of phytochemicals found in turmeric. Concentrated into pill form at up to 40 times the dose, no evidence of efficacy was found. Why didn't they get the same dramatic results we saw in the three case reports? Well, those three cases may have been total flukes, but on the other hand, turmeric, the whole food, may be greater than the sum of its parts.

There is a long list of compounds that have been isolated from turmeric, and it's possible that each component plays a distinct role in making it useful against Alzheimer's disease. Hence, researchers suggested that a mixture of compounds might better represent turmeric in its medicinal value better than curcumin alone. But why concoct some artificial mixture when Mother Nature already did it for us with turmeric? Because you can't patent the spice. And if you can't patent it, how are you going to charge more than 15 cents?

I've previously addressed the thorny issue of patenting natural plant remedies in my video: Plants as Intellectual Property - Patently Wrong?

The whole-greater-than-the-sum-of-its-parts theme is one that comes up over and over:

What else might the cheap, easily available spice turmeric do? It may help fight arthritis (Turmeric Curcumin and Rheumatoid Arthritis and Turmeric Curcumin and Osteoarthritis) and cancer:

But it's not for everyone: Who Shouldn't Consume Curcumin or Turmeric?

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: Steven Jackson / Flickr

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Might Turmeric Help Prevent Alzheimer’s?

NF-Apr12 Preventing Alzheimer's with Turmeric.jpeg

There are plenty of anti-inflammatory drugs out there that may reduce the risk of Alzheimer's disease, but stomach, liver, and kidney toxicity precludes their widespread use. So maybe using an anti-inflammatory food like the spice, turmeric, found in curry powder, could offer the benefits without the risks? Before even considering putting it to the test, though, one might ask, "Well, do populations that eat a lot of turmeric have a lower prevalence of dementia?" And indeed, those living in rural India who do just that may actually have the lowest reported prevalence of dementia and Alzheimer's.

In rural Pennsylvania, the incidence rate of Alzheimer's disease among seniors is 19/1000. Nineteen people in a thousand over age 65 develop Alzheimer's every year in rural Pennsylvania. In rural India, using the same diagnostic criteria, that same rate is three, confirming they have among the lowest reported Alzheimer's rates in the world.

Although the lower prevalence of Alzheimer's in India is generally attributed to the turmeric consumption as a part of curry, and it is assumed that people who use turmeric regularly have a lower incidence of the disease, but let's not just assume. As highlighted in my video, Preventing Alzheimer's with Turmeric, a thousand people were tested, and those who consumed curry at least occasionally did better on simple cognitive tests than those who didn't. Those that ate curry often also had only about half the odds of showing cognitive impairment, after adjusting for a wide variety of potential confounding factors. This suggests that curry consumption may indeed be associated with better cognitive performance.

Of course it probably matters what's being curried--are we talking chicken masala, or chana masala, with chickpeas instead of chicks? It may be no coincidence that the country with among the lowest rates of Alzheimer's also has among the lowest rates of meat consumption, with a significant percentage of Indians eating meat-free and egg-free diets.

Studies have suggested for nearly 20 years now that those who eat meat--red meat or white meat--appear between two to three times more likely to become demented compared to vegetarians. And the longer one eats meat-free, the lower the associated risk of dementia, whether or not you like curry.

There's another spice that may be useful for brain health. See my video Saffron for the Treatment of Alzheimer's. What about coconut oil? See Does Coconut Oil Cure Alzheimer's? In terms of preventing cognitive decline in the first place, check out my video How to Slow Brain Aging By Two Years.

I've raised the issue of plant-based diets and dementia in Alzheimer's Disease: Grain Brain or Meathead?

For more on spices and inflammation, see Which Spices Fight Inflammation? and the follow-up, Spicing Up DNA Protection.

What about treating Alzheimer's disease with the spice turmeric? That's the topic of my video, Treating Alzheimer's with Turmeric.

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: Marcel Oosterwijk / Flickr

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How to Cook Broccoli

NF-Feb9 Second Strategy to Cooking Broccoli.jpeg

When I used to teach medical students at Tufts, I gave a lecture about this amazing new therapeutic called "iloccor-B." I'd talk about all the new science, all the things it could do, its excellent safety profile. Just as they were all scrambling to buy stock in the company and prescribe it to all their patients, I'd do the big reveal. Apologizing for my "dyslexia," I would admit that I'd got it backwards. All this time I had been talking about broccoli.

The main active ingredient in broccoli is thought to be sulforaphane, which may protect our brains, protect our eyesight, protect our bodies against free radicals, boost our detoxification enzymes, and help prevent and treat cancer.

In my videos The Best Detox and Sometimes the Enzyme Myth is the Truth, I talked about how the formation of sulforaphane is like a chemical flare reaction, requiring the mixing of a precursor compound with an enzyme, which is destroyed by cooking. This may explain why we get dramatic suppression of cancer cell growth from raw broccoli, cauliflower and Brussels sprouts, but hardly anything from boiled, microwaved or steamed (except for microwaved broccoli, which actually retains some cancer fighting abilities). But who wants to eat raw Brussels sprouts?

There is a strategy to get the benefits of raw in cooked form. In raw broccoli, the sulforaphane precursor, called glucoraphanin, mixes with the enzyme (myrosinase) when you chew or chop it. If given enough time--such as when sitting in your upper stomach waiting to get digested--sulforaphane is born. The precursor and sulforaphane are resistant to heat and therefore cooking, but the enzyme is destroyed. No enzyme = no sulforaphane.

That's why I described the "hack and hold" technique--if we chop the broccoli, Brussels sprouts, kale, collards, or cauliflower first and then wait 40 minutes, we can cook them all we want. The sulforaphane is already made; the enzyme has already done its job, so we don't need it anymore.

When most people make broccoli soup, for example, they're doing it wrong. Most people cook the broccoli first, then blend it. We now know it should be done the exact opposite way. Blend it first, wait, and then cook it.

What if we're using frozen broccoli, though? In my video, Second Strategy to Cooking Broccoli, you can see the amount of sulforaphane in someone's body after they eat broccoli soup made from fresh broccoli versus from frozen broccoli. The difference is dramatic. Commercially produced frozen broccoli lacks the ability to form sulforaphane because vegetables are blanched (flash-cooked) before they're frozen for the very purpose of deactivating enzymes. This prolongs shelf life in the frozen foods section, but the myrosinase is dead by the time you take it out of your freezer. It doesn't matter how much you chop it, or how long you wait, no sulforaphane is going to be made. This may be why fresh kale suppresses cancer cell growth up to ten times more than frozen.

The frozen broccoli is still packed with the precursor--remember that's heat resistant--and we could get lots of sulforaphane out of the frozen broccoli by adding some outside enzyme. Where do we get myrosinase enzyme from? Researchers just buy theirs from a chemical company. But we can just walk into any grocery store.

All cruciferous vegetables have this myrosinase. Mustard greens, a cruciferous vegetable, grow out of little mustard seeds, which we can buy ground up in the spice aisle as mustard powder. If we sprinkled some mustard powder on our cooked frozen broccoli, would it start churning out sulforaphane? We didn't know...until now.

Boiling broccoli prevents the formation of any significant levels of sulforaphane due to inactivation of the enzyme. However, researchers from the University of Reading found that the addition of powdered mustard seeds to the heat processed broccoli significantly increased the formation of sulforaphane. In the video I mentioned earlier, Second Strategy to Cooking Broccoli, you can see the amount of sulforaphane in boiled broccoli versus the amount after half a teaspoon or a teaspoon of mustard powder is added. Both a half teaspoon and a full teaspoon increase sulforaphane by the same amount, suggesting that we could use even use less mustard powder for the same effect. Therefore, although domestic cooking leads to the deactivation of myrosinase and stops sulforaphane formation, the addition of powdered mustard seeds to cooked cabbage-family vegetables provides a natural source of the enzyme such that it's practically like eating them raw.

So, if we forget to chop our greens in the morning for the day, or are using frozen, we can just sprinkle some mustard powder on top at the dinner table and we're all set. Daikon radish, horseradish, or wasabi--all cruciferous vegetables packed with the enzyme--work as well. Just a quarter teaspoon of Daikon radish root for seven cups of broccoli worked--just a tiny pinch can do it. Or you can add a small amount of fresh greens to your cooked greens, because the fresh greens have myrosinase enzyme that can go to work on the cooked greens.

I love kitchen chemistry--it totally revolutionized my daily greens prep. One of the first things I used to do in the morning is chop my greens for the day, so when lunch and supper rolls around they'd be good to go. But now with the mustard powder plan, I don't have to pre-chop.

This helps explain the results I presented in Raw Broccoli and Bladder Cancer Survival.

OK, but what's so great about this sulforaphane stuff? For a taste, see:

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: Jessica Spengler / Flickr

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Making Your Own Mouthwash

NF-Jan26 Making Your Own Mouthwash.jpeg

The effects of a vegetarian diet on systemic diseases like cancer, diabetes, and heart diseases have been studied and have revealed predominantly less systemic diseases in those eating plant-based diets. However, there have only been a few studies on oral health, which I covered in my videos Plant-Based Diets: Oral Health and Plant-Based Diets: Dental Health.

What's the latest? In a study of 100 vegetarians compared to a 100 non-vegetarians, the vegetarians had better periodontal conditions, showing less signs of inflammation like gum bleeding, less periodontal damage, and better dental home care, brushing and flossing 2.17 times a day compared to 2.02 times a day. The difference in home hygiene is not that large, though, so maybe it was something about their diet. However, vegetarians may have a healthier lifestyle overall beyond just avoiding meat. The researchers controlled for smoking, but other factors like obesity can adversely affect oral health, so there may be confounding factors. What we need is an interventional study, where researchers take people eating the standard Western diet, improve their diets, and see what happens. But no such study existed... until now.

With professional support of nutritionists, the participants of the study (highlighted in my video What's the Best Mouthwash?) with existing periodontal disease changed their dietary patterns to so-called "wholesome nutrition," a diet emphasizing veggies, fruits, whole grains, potatoes, beans, peas, lentils, and spices, with water as the preferred beverage. To make sure any changes they witnessed were due to the diet, researchers made subjects maintain their same oral hygiene before and after the dietary change. What did they find? They found that eating healthier appeared to lead to a significant reduction of probing pocket depth, gingival inflammation, and levels of inflammatory cytokines, which mediate the tissue destruction in periodontal disease. Therefore, the researchers conclude that wholesome nutrition may improve periodontal health.

Why might diet help? Plant-based diets have a number of nutritional benefits in terms of nutrient density, but it also may be about improving balance between free radicals and our antioxidant defense system. Traditionally, dietary advice for oral health was just about avoiding sugar, which feed the bad bacteria on our teeth. We now realize that some foods and beverages, like green tea, possess antimicrobial properties to combat the plaque producing bacteria directly.

If plaque is caused by bacteria, why not use antibiotics? Many such attempts have been made, however undesirable side-effects such as "antibiotic resistance, vomiting, diarrhea and teeth stains have precluded their use." In a petri dish, green tea phytonutrients effectively inhibit the growth of these bacteria, but what about in our mouths? Researchers found that rinsing with green tea strongly inhibited the growth of the plaque bacteria on our teeth within minutes. Seven minutes after swishing with green tea, the number of harmful bacteria in the plaque scraped from people's teeth was cut nearly in half.

If you swish sugar water in your mouth, within three minutes the pH on our teeth can drop into the cavity formation danger zone. But if 20 minutes before swishing with sugar water, you swished with some green tea, you wipe out so many plaque bacteria that the same sugar water hardly has any effect at all. The researchers conclude that using green tea as a mouthwash or adding it to toothpaste could be a cost effective cavity prevention measure, especially in developing countries.

In the "civilized world," we have antiseptic mouthwashes with fancy chemicals like chlorhexidine, considered the gold standard anti-plaque agent. If only it didn't cause genetic damage. DNA damage has been detected in individuals who rinsed their mouths with chlorhexidine-containing mouthwashes, and not just to cells in the mouth. 13 volunteers rinsed their mouths with the stuff for a few weeks, and there was an increase in DNA damage both in the cells lining their cheeks as well as in their peripheral blood cells, suggesting that chlorhexidine was absorbed into their bodies. It reduced plaque better than other antiseptic chemicals, but it's doubtful whether chlorhexidine can still be considered the golden standard considering how toxic it is to human cells.

Are we left with having to decide between effectiveness and safety? How about a head to head test between chlorhexidine and green tea? Researchers found that green tea worked better than chlorhexidine at reducing plaque. Using green tea as a mouthwash may be cheaper, safer, and better. If, as a bonus, you want to sprinkle some amla powder (dried Indian gooseberry powder) into it, you may make it an even better plaque buster. Amla evidently shows an outstanding cavity-stopping potential not by killing off the bacteria like green tea, but by actually suppressing the bacteria's plaque forming abilities.

I now keep a mason jar filled with cold-steeped green tea (Cold Steeping Green Tea) with a spoonful of amla in the fridge and swish and swallow a few times a day. For extra credit you can gargle a bit with it too (see my video Can Gargling Prevent the Common Cold?).

Green tea shouldn't be the primary beverage of children, though, as the natural fluoride content may cause cosmetic spots on the teeth. For more check out my video Childhood Tea Drinking May Increase Fluorosis Risk.

Another reason we may want to avoid antibacterial mouthwashes is that they can kill off the good bacteria on our tongue that are instrumental in enhancing athletic performance with nitrate-containing vegetables (See Don't Use Antiseptic Mouthwash). For more on this, check out my video from yesterday, Antibacterial Toothpaste: Harmful, Helpful, or Harmless?

Need a reminder what amla is? More on dried Indian gooseberry powder power in:

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: Norio Nakayama / Flickr

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How to Suppress the Aging Enzyme TOR

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Over the last decade, more than 5,000 papers have been published about TOR, an engine-of-aging enzyme inhibited by the drug rapamycin. (What is TOR? Check out my videos Why Do We Age? and Caloric Restriction vs. Animal Protein Restriction.) Rapamycin has been used experimentally to extend lifespan, but is already in use clinically to prevent the rejection of kidney transplants. Patients who received rapamycin due to renal transplantation had a peculiar "side effect," a decrease in cancer incidence. In a set of 15 patients who had biopsy proven Kaposi's sarcoma (a cancer that often affects the skin), all cutaneous sarcoma lesions disappeared in all patients within three months after starting rapamycin therapy.

TOR functions as a master regulator of cellular growth and proliferation. For example, TOR is upregulated in nearly 100% of advanced human prostate cancers (See Prevent Cancer From Going on TOR). So, reductions in cancerous lesions after rapamycin therapy make sense. TOR may also be why dairy consumption has been found to be a major dietary risk factor for prostate cancer. We used to think it was just the hormones in milk, but maybe prostate cancer initiation and progression is also promoted by cow's milk stimulation of TOR.

Our understanding of mammalian milk has changed from a simple food to a "species-specific endocrine signaling system," which activates TOR, promoting cell growth and proliferation and suppressing our body's internal housecleaning mechanisms. Normally, milk-mediated TOR stimulation is restricted only to infancy where we really need that constant signal to our cells to grow and divide. So from an evolutionary perspective, "the persistent 'abuse' of the growth-promoting signaling system of cow's milk by drinking milk over our entire life span may maintain the most important hallmark of cancer biology, sustained proliferative signaling."

TOR appears to play a role in breast cancer, too. Higher TOR expression has been noted in breast cancer tumors, associated with more aggressive disease, and lower survival rate among breast cancer patients. Altered TOR expression could explain why women hospitalized for anorexia may end up with only half the risk of breast cancer. Severe caloric restriction in humans may confer protection from invasive breast cancer by suppressing TOR activation.

We don't have to starve ourselves to suppress TOR; just reducing animal protein intake can attenuate overall TOR activity. Moreover, diets emphasizing plants, especially cruciferous vegetables, have both decreased TOR activation from animal proteins and provide natural plant-derived inhibitors of TOR found in broccoli, green tea, soy, turmeric, and grapes, along with other fruits and vegetables such as onions, strawberries, blueberries, mangoes and the skin of cucumbers.

The downregulation of TOR may be one reason why plant-based in general are associated with lower risk for many cancers. "Are we finally on the threshold of being able to fundamentally alter human aging and age-related disease?" asks researchers in the journal Nature. Only time will tell, but if the pace and direction of recent progress are any indication, the next 5,000 studies on TOR should prove very interesting indeed.

More on dairy and prostate cancer in Prostate Cancer and Organic Milk vs. Almond Milk.

This story continues in my video: Saving Lives By Treating Acne With 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, From Table to Able, and Food as Medicine.

Image Credit: Grempz / Flickr

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