How Well Do Cholesterol-Lowering Drugs Actually Work?

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One of the reasons people may undervalue diet and lifestyle changes is an overconfidence in the ability of pills and procedures to prevent disease. For example, people tend to wildly overestimate the power of things like mammograms and colonoscopies to prevent deaths from breast and bowel cancer, or the power of drugs like Fosamax to prevent hip fractures, or the power of cholesterol drugs to prevent fatal heart attacks. Patients believe statin drugs like Lipitor are about 100 times more effective than they actually are in preventing heart attacks. Studies show most people wouldn't take multiple blood pressure medications if they knew the truth.

For most people, the chance of benefit is normally less than 5 percent over five years for cholesterol, blood pressure, and blood thinning drugs. Patients don't want to take drugs unless they have at least a one in five chance--even those who just had a heart attack. It's no wonder, then, that doctors seldom share these figures. Informing patients of the percentage chance of benefit from preventive drug strategies would likely substantially reduce the likelihood that patients would agree to take the drugs every day for the rest of their lives.

For the individual, this is unlikely to be detrimental; after all, there's a 95 percent chance it won't do anything for them. But for the population at large, it would make a difference, so doctors and drug companies oversell the benefits by conveniently not mentioning how tiny they actually are, knowing most patients wouldn't take them if doctors divulged the truth. To practice non-lifestyle medicine is to practice deceptive medicine.

The best that cholesterol-lowering statin drugs appear to do is an absolute risk reduction of 3.1 percent over six years. If Dr. Esselstyn's work can be replicated in a randomized, controlled trial, then a whole foods plant-based diet will have been shown to work twenty times better, an absolute risk reduction of 60 percent after less than four years. In Esselstyn's study, 99.4 percent of high-risk patients that stuck with the diet avoided major cardiac events, such as death from heart attack.

When we have to decide whether we want to go diet versus drugs, we're not making a choice between eating healthy to prevent a heart attack or taking a pill to prevent a heart attack. Because in 97 percent of cases in the near-term, pills don't do anything. We're risking side effects for nothing, whereas if we treat the underlying root cause of the disease by eating a healthy, cholesterol-free diet, we may even reverse the progression of the disease, as seen in my video The Actual Benefit of Diet vs. Drugs.

If we stop eating an artery-clogging diet, our bodies can start dissolving that plaque away, opening up arteries in some cases without drugs or surgery. A healthy whole food plant-based diet by itself may work 20 times better than drugs to combat our #1 killer.

Now that's something doctors may want to tell their patients.

Yes, an ounce of prevention is worth a pound of cure, but a pound isn't that heavy--why change our diet and lifestyle when we can just wait and let modern medicine fix us up? Turns out we overestimate the efficacy of treatment as well, the subject of my video Why Prevention is Worth a Ton of Cure.

Sometimes preventive medicine procedures can even be harmful. See Cancer Risk From CT Scan Radiation and Do Dental X-Rays Cause Brain Tumors?

I've previously noted how an honest physician-patient interaction might go in Fully Consensual Heart Disease Treatment, Optimal Diet: Just Give it To Me Straight, Doc and Disclosing Conflicts of Interest in Medical Research. What should we be saying? See: What Diet Should Physician's Recommend?

So why don't more doctors do it? See Barriers to Heart Disease Prevention and Find Out If Your Doctor Takes Drug Company Money.

More on Dr. Esselstyn's heart disease reversal study in: Evidence-Based Medicine or Evidence-Biased?

Of course then there's just the brute force method: Kempner Rice Diet: Whipping Us Into Shape.

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:

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How to Protect Our Telomeres with Diet

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In my video, Does Meditation Affect Cellular Aging?, I discussed how stress reduction through meditation might be able to lengthen telomeres, the protective caps at the tips of our chromosomes that tend to deplete as we age.

What about exercise? We can't always change our situation in life, but we can always go out for a walk. London researchers studied 2,400 twins, and those who exercised more may have pumped up their telomeres along with their muscles. Apparently it doesn't take much either. The "heavy" exercise group was only averaging about a half-hour a day.

These were mostly folks in their 40's, but does it still work in your 50's? Yes. A study out of South Korea found that people in their 50's who work out three hours a week had longer telomeres.

In my video, Telomeres: Cap It All Off with Diet, you can see the telomere lengths of young healthy regular folk controls at around age 20, and then at age 50. As we'd expect, the older subjects' telomeres were significantly shorter. What about athletes? The young athletes started out in the same boat, with nice, long, young, healthy telomeres capping all their chromosomes. The older athletes, in contrast to the controls, appeared to still have the chromosomes of 20-year-olds. But these were marathon runners, triathletes running 50 miles a week for 35 years.

What was it about the Ornish intervention that so powerfully protected telomeres after just three months? We saw that stress management seems to help, but what about diet and exercise? Was it the plant-based diet, was it the walking 30 minutes a day, or was it just because of the weight loss? In 2013 a study was published that can help us anser just that question.

The researchers took about 400 women and randomized them into four groups: a portion-controlled diet group, an exercise group, a portion controlled diet and exercise group, and a control group for a full year. In the video, you can see a comparison of the length of each group's telomeres. After a year of doing nothing, there was essentially no change in the control group, which is what we'd expect. The exercise group was 45 minutes of moderate-to-vigorous exercise like jogging. After a year of that, they did no better. What about just weight loss? Nothing. The same thing for exercise and weight loss, no significant change either.

So as long as we're eating the same diet, it doesn't appear to matter how small our portions are, or how much weight we lose, or how hard we exercise. After a year, the subjects saw no benefit. On the other hand, the Ornish group on the plant-based diet, who lost the same amount of weight after just three months and exercised less than half as hard, saw significant telomere protection.

It wasn't the weight loss or the exercise: it was the food.

What aspects of a plant-based diet make it so protective? Studies have associated more vegetables and fruit, and less butter, with longer telomeres. From the latest review, foods high in fiber and vitamins are strongly related to longer telomeres. However, the key may be avoiding saturated fat. Swapping just 1% of saturated fat calories in our diet for anything else can add nearly a whole year of aging's worth of length onto our telomeres.

Saturated fats like palmitic acid, the primary saturated fat in salmon, and found in meat, eggs, and dairy in general, can be toxic to cells. This has been demonstrated in heart cells, bone marrow cells, pancreatic cells, and brain cells. The toxic effects on cell death rates happen right around what you'd see in the blood stream of people who eat a lot of animal products. It may not be the saturated fat itself, however, as saturated fat may just be a marker for the increased oxidative stress and inflammation associated with those foods.

With this link to saturated fat, it's no wonder that lifelong low cholesterol levels have been related to longer telomeres and a smaller proportion of short telomeres--in other words, markers of slower biological aging. In fact, there's a rare congenital birth defect called progeria syndrome, where children age 8-10 times faster than normal. It seems associated with a particular inability to handle animal fats.

The good news is that "despite past accumulated injury leading to shorter telomere lengths, current healthy behaviors might help to decrease a person's risk of some of the potential consequences like heart disease." Eating more fruit and vegetables and less meat, and having more support from friends and family, attenuate the association between shorter telomeres and the ravages of aging.

To summarize: inflammation, oxidation, damage and dysfunction are constantly hacking away at our telomeres. At the same time, our antioxidant defenses, healthy diet, exercise and stress reduction are constantly rebuilding them.


I've asked this diet versus exercise question in a few other contexts. See:

Though dietary change appears more impactful, I'm a big fan of walking. See Longer Life Within Walking Distance and for my personal favorite exercise, Standing Up for Your Health.

For more on the role saturated fat may play in disease, see, for example, my videos Heart Disease Starts in Childhood and Treating Multiple Sclerosis with the Swank MS Diet.

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.

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How Many Minutes of Daily Meditation to Combat Stress?

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In the film The Holiday, Cameron Diaz exclaims "Severe stress ... causes the DNA in our cells to shrink until they can no longer replicate." Did Hollywood get the science right?

The enzyme that builds and maintains the caps at the tips of our chromosomes (called telomeres) appear to slow the aging of our cells. Do people who are stressed have shorter telomeres? To answer that question, researchers from the University of California, San Francisco measured the telomere lengths in mothers of chronically ill children--what could be more stressful than that? The longer a woman had spent being the main caretaker of her ill child, the shorter her telomeres. The extra telomere shortening in the most stressed mothers was equivalent to that caused by at least a decade of aging. We see the same thing in caregivers of Alzheimer's patients and those suffering severe work-related exhaustion. Even those abused as children may grow up with shorter telomeres.

There's not much we can do about our past, but if we manage our stress now, can we grow some telomeres back? If we go on a meditation retreat and meditate for 500 hours, we can indeed boost our telomerase activity (the enzyme that restores our telomeres)--but there's got to be a quicker fix.

In an exciting study from UCLA and UC San Francisco (highlighted in my video, Does Meditation Affect Cellular Aging?, caregivers of family members with dementia were randomized to just 12 minutes of daily meditation for eight weeks, or just about ten hours in total. The meditators experienced significant benefit, including better mental and psychological function accompanied by an increase in telomerase activity, suggesting an improvement in stress-induced cellular aging.

Here's a link to the backgrounder video that presents the original Ornish study: Research Into Reversing Aging. I cover the comparable effects of diet and exercise in my video Telomeres - Cap It All Off with Diet.

I have a few videos on using aromatherapy and other modalities to help deal with stress:

For life extension in general, 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.

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Why Certain Plant Compounds May Mimic Dietary Restriction

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A new concept, called xenohormesis, has arisen to explain the mystery of why so many plant molecules interact with and modulate key regulators of our physiology in ways that are beneficial to our health (explained further in my video, Xenohormesis: What Doesn't Kill Plants May Make Us Stronger).

Basically, hormesis is the biological principle of "no pain, no gain." Mild stresses like exercise can trigger a protective response that leads to strengthened defenses in the long run. But instead of exposing ourselves to the stressor to trigger our bodies' defenses and shore up protection against future stressors, why not let plants take the hit? Let the plants get stressed because, incredibly, the stress response molecules in plants may activate the same protective responses in humans. Xenohormesis "explains how environmentally stressed plants produce bioactive compounds that can confer stress resistance and survival benefits to animals that consume them." We can piggyback off of their sophisticated stress response. Indeed, the majority of known health-beneficial effects of edible plants are attributable to the pharmacologically active substances of plants' stress responses.

Hormesis may be why dietary restriction can lead to lifespan extension. The mild stress placed upon the body by not eating enough may activate a wide variety of protective pathways within the body, ramping up anti-inflammatory and antioxidant defenses. Our bodies are preparing themselves for the coming famine they think is about to occur. So is there a way to exploit the benefits of dietary restriction to prevent chronic disease? Obviously, "chronically restricting food intake is not a realistic health strategy for the majority of people--it's hard for most people to even cut food intake 10-20%, [given the powerful evolutionary drive to eat]. A more feasible alternative may be to activate dietary restriction-induced stress response pathways by other means."

In other words, xenohormesis.

If we starve plants, they do the same thing mammals do: activate preservation pathways. So let's let the plant face the adversity to create the molecules that trigger cell stress resistance, alter metabolism, and improve disease resistance, and then just come along and appropriate them for the same uses in our own bodies.

The reason phytonutrients like resveratrol in grapes, curcumin in the spice turmeric, and ECGC in green tea are called "dietary restriction mimetics" is that they mimic the physiological effects of dietary restriction. This may be no coincidence, because the plants produced these compounds to save their own green butts from scarcity. So instead of having to walk around starving all the time, thanks to xenohormesis, we may be able to let the plants bear the brunt and enable us to harness other species' hardships as a means to promote our own health.

If this subject interests you, make sure you see my video where I introduce the topic: Appropriating Plant Defenses.

I previously introduced the concept of hormesis in my videos Enhanced Athletic Recovery Without Undermining Adaptation and Is Liquid Smoke Carcinogenic?

How else might we get the benefits of dietary restriction without starving ourselves? See:

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my videos for free by clicking here and watch my full 2012 - 2015 presentations Uprooting the Leading Causes of Death, More than an Apple a Day, From Table to Able, and Food as Medicine.

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How Humans Benefit From Stressed Plants

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Plants live the ultimate sedentary lifestyle--most of us usually think of plants more as objects than as organisms. Because plants can't move, they've had to evolve a whole other way to escape threats to their well-being. Plants can "sense and respond dynamically to all sorts of stimuli: chemical concentrations in the air and soil, water, touch, motion, vibration, pathogens, predators, and, of course, light." How do they respond? Biochemically. They manufacture, from scratch, a dizzying array of compounds to deal with specific threats.

If we get too hot, we can move into the shade. If plants get too hot, they're stuck--they are the shade! As a result, "the complexity of the plant stress response humbles that of animals. Plants and their stress response have been evolving for almost a billion years." And in that time they've created a whole chemistry lab of protective substances, some of which can induce similarly protective responses in those of us who eat them.

The "best grapes in terms of health benefit often grow in relatively dry, sun-exposed, infertile soil. Similarly, drought-stressed strawberries have more antioxidants and phytonutrients. Indeed, commonly consumed foods like lettuce and fruits can be nutritionally enhanced by cold stress, light stress, water deficit, or nutrient deficit stress." Why are stressed plants often the healthiest?

Studies (such as those highlighted in my video, Appropriating Plant Defenses) suggest that plants and animals largely share the same molecular pathways in order to respond to stress, so it's conceivable that a molecule produced in plants can also be effective in people. Plants have DNA; humans have DNA. The UV rays in sunlight can damage the DNA in plants in the same way it can damage our DNA (by creating free radicals). Plants figured out how to cook up all these complex antioxidants, and instead of reinventing the wheel, animals can just expropriate those antioxidants from plants and commandeer them for the same purpose.

We get attacked by bacteria; plants get attacked by bacteria. When a particular fungus is getting muscled in on by bacteria, it creates a molecule called penicillin--provided free for us.

When plants get infected, they produce aspirin (See Aspirin Levels in Plant Foods), which can come in handy when we get infected. Plants heal wounds; we heal wounds, using similar fatty-acid signaling systems. It is "increasingly evident that plants and animals differ less than we thought in how we respond to stimuli, sharing elements of fatty acid, protein, steroidal, neurotransmitter, free radical, nitric oxide, and even plant growth hormone signaling systems." So in a sense, we're just opening up nature's drug store when we pull out the crisper in our fridge.

This whole co-evolution concept reminds me of Human Neurotransmitters In Plants and The Broccoli Receptor: Our First Line of Defense.

More on the power of plants in Power Plants.

Some of the wilder things that Phytochemicals: The Nutrition Facts Missing from the Label can do are explored in:

We evolved eating a lot of plants: Paleolithic Lessons.

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my videos for free by clicking here and watch my full 2012 - 2015 presentations Uprooting the Leading Causes of Death, More than an Apple a Day, From Table to Able, and Food as Medicine.

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Is Liquid Smoke Safe?

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We know smoke inhalation isn't good for us, but what about smoke ingestion? Decades ago, smoke flavorings were tested to see if they caused DNA mutations in bacteria--the tests came up negative. Even as more and more smoke flavoring was added, the DNA mutation rate remained about the same.

But the fact that something is not mutagenic in bacteria may have little predictive value for its effect on human cells. A group at MIT tested a hickory smoke flavoring they bought at the store against two types of human white blood cells. Unlike the bacteria, the mutation rate shot up as more and more liquid smoke was added. But, "there is no evidence that mutagenic activity in a particular human cell line is more closely related to human health risk than is mutagenic activity in bacteria." In other words: just because liquid smoke causes DNA mutations to human cells in a petri dish, doesn't mean that it does the same thing within the human body.

A good approach may be to just analyze liquid smoke for known carcinogens, chemicals that we know cause cancer.

Damaging DNA is just one of many ways chemicals can be toxic to cells. A decade later researchers tested to see what effect liquid smoke had on overall cell viability. If you drip water on cells, nothing happens, they keep powering away at around 100% survival, but drip on more and more wood fire smoke, and you start killing some of the cells off. Cigarette smoke is more toxic, but three out of four of the brands of liquid smoke they bought at the supermarket killed off even more cells, leading them to conclude that the cytotoxic potential of some commercial smoke flavorings is greater than that of liquid cigarette smoke, a finding they no doubt celebrated given that the researchers were paid employees of the R. J. Reynolds Tobacco Co.

Unfortunately they didn't name names of the offending brands. That's one of the reasons I was so excited about a new study, where they tested--and named--15 different brands of liquid smoke. This maximum "response" they were measuring was p53 activation.

P53 is a protein we make that binds to our DNA, you can see this illustrated in my video, Is Liquid Smoke Flavoring Carcinogenic?. It activates our DNA repair enzymes. So a big p53 response may be indicative of a lot of DNA damage,and a few of the liquid smoke flavorings activated p53 almost as much as a chemotherapy drug like etoposide, whose whole purpose is to break DNA strands.

Other flavorings didn't seem as bad, though there was a hickory smoke powder that ranked pretty high, as did the fish sauce, though smoked paprika didn't register at all.

The p53-activating property in liquid smoke was eliminated by standard baking conditions (350°F for 1h), so if you're baking something with liquid smoke for long enough, it should eliminate this effect, though just boiling--even for an hour, or slow cooking doesn't appear to work.

They conclude "If the DNA-damaging activities of liquid smoke were thought to be deleterious, it might be possible to replace liquid smoke with other safer, smoky substances." Why do they say if thought to be deleterious? That's because they're not really measuring DNA damage, they're measuring p53 activation, and that's not necessarily a bad thing.

P53 is considered "Guardian of our Genome," guardian of our DNA. It's considered a tumor suppressor gene, so if something boosts its activity is that good or bad? It's like the broccoli story. Cruciferous vegetables dramatically boost our liver's detoxifying enzymes. Is this because our body sees broccoli as toxic and is trying to get rid of it quicker? Either way, the end result is good, lower cancer risk.

It's a biological phenomenon known as hormesis - that which doesn't kill us may make us stronger. Like exercise is a stress on the body, but in the right amount can make us healthier in the long run. So, for example, teas and coffees caused p53 activation as well, but their consumption is associated with lower cancer risk. So it's hard to know what to make of this p53 data. Due to the limitations of the available tests it's hard to calculate the genotoxic potential of liquid smoke, or any other food for that matter. A better approach may be to just analyze liquid smoke for known carcinogens, chemicals that we know cause cancer.

This was first attempted back in 1971. One of the seven liquid smoke flavors researchers tested contained one polycyclic aromatic hydrocarbon known to be cancer-causing, but there's a bunch of similar carcinogens researchers didn't test for. A later study, however, tested across the board, looking specifically at five different carcinogens in retail liquid smoke seasonings.

The recommended daily upper safety limit for these carcinogens is 47. Hickory smoke flavoring has only 0.8 per teaspoon, so we'd have to drink three bottles a day to bump up against the limit. And mesquite liquid smoke has only 1.1.

It turns out that most of the carcinogens in smoke are fat soluble, so when we make a water-based solution, like liquid smoke, we capture the smoke flavor compounds without capturing most of the smoke cancer compounds. The only time we need to really worry is when eating smoked foods--foods directly exposed to actual smoke. For example, smoked ham has 21.3 per serving, and smoked turkey breast has 26.7 per serving. One sandwich and we may be halfway to the limit, and one serving of barbequed chicken takes us over the top. Eating less than a single drumstick and we nearly double our daily allotment of these carcinogens. Nothing, however, is as bad as fish. Smoked herring? 140 per serving. And smoked salmon? One bagel with lox could take us ten times over the limit.

I've touched on those cooked meat carcinogens before. In Estrogenic Cooked Meat Carcinogens I explored the role of these cooked meat chemicals in tumor growth. PhIP: The Three Strikes Breast Carcinogen explored their role in cancer invasion. Reducing Cancer Risk In Meateaters offered some mediation strategies. Heterocyclic Amines in Eggs, Cheese, and Creatine? showed how even vegetarians may be at risk and Cancer, Interrupted: Green Tea and Cancer, Interrupted: Garlic & Flavonoids explored some counter measures.

Some smoke compounds may be a concern even if we don't eat them. See Meat Fumes: Dietary Secondhand Smoke. Even the smell of frying bacon may be carcinogenic: Carcinogens in the Smell of Frying Bacon.

Some plant foods exposed to high temperatures may also present a concern. See Is Yerba Mate Tea Bad for You? and Acrylamide in French Fries. What about Carcinogens in Roasted Coffee?

The broccoli liver enzyme boost story is covered in The Best Detox.

-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.

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Why Athletes Should Eat Nutritional Yeast

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Does powering up at the gym also power up our immune system? Research has shown that moderate exercise improves immunity and decreases illness rates. According to an article in the American Journal of Lifestyle Medicine, "the most important finding that has emerged from exercise immunology studies during the past two decades is that positive changes in our immune system take place during each bout of moderate physical activity. Over time, this translates to fewer days of sickness from, for example, the common cold and other upper respiratory infections." The best available evidence suggests a 25% to 50% reduction in sick days. Name one drug or supplement that can do that!

And it doesn't take much. Let kids run around for just six minutes and we can boost the number of immune cells circulating in their blood stream by more than a third.

At the other end of the life cycle, exercise may help prevent age-related immune decline. Sedentary women in their 70s may have a 50% chance of getting an upper respiratory illness during the fall season every year. But with just a half-hour walk each day, their risk is down to 20%. The runners in the group got it under 10%-five times better!

While regular physical activity improves immune function and lowers upper respiratory infection risk, sustained and intense exertion may have the opposite effect, forming a so-called J-shaped curve relationship (you can see this curve diagram in my video, Preserving Immune Function in Athletes With Nutritional Yeast). As we go from inactive to active, our infection risk declines. But if we overtrain, as hardcore athletes do, we may actually put excessive stress on our body and increase our risk of infection. Then we could lose training days, and our performance could suffer.

So how can we fight off sickness while continuing to train? Traditional sports medicine doesn't appear to offer much help, advising athletes to basically not pick their nose, avoid sick people, and get a flu shot.

But there there may be a natural solution. A new study found that we can better maintain our level of circulating white blood cells after exhaustive exercise by consuming a special type of fiber found in baker's, brewer's, and nutritional yeast. (Brewer's yeast is bitter, but nutritional yeast has a nice cheesy flavor. I use it mostly to sprinkle on popcorn). Normally, two hours after hardcore cycling, there can be a dip in circulating white blood cells, one of our first lines of defense. However, after strenuous exercise, those who ate the equivalent of less than three quarters of a teaspoon a day of nutritional yeast ended up even better than when they started. But does this increase in immune cells translate into fewer illnesses? Researchers studied competitors in the Carlsbad Marathon to find out.

In the weeks following the race, a significant number of runners began experiencing upper respiratory tract infection symptoms while taking a placebo. Those runners who were taking the equivalent of a daily spoonful of nutritional yeast cut their rates of infection in half. And they felt better, too. They were asked how they felt on a scale of one to ten. People taking the sugar pills were okay, down around four or five, but those taking identical looking capsules of the fiber found in nutritional yeast were up at six or seven. Elite athletes tend to normally experience deterioration in mood state during intense training periods, and before and after a marathon race. Sprinkle on a little spoonful of nutritional yeast, though, and you may feel less tense, less fatigued, less confused, even less angry (and my personal favorite, they had significantly "increased vigor").

Don't have time to exercise? Yes you do! See Standing Up for Your Health.

Find more on the benefits of exercise in:

What else can we do to preserve our immune function? See:

Nutritional yeast that's fortified can also be a convenient source of vitamin B12 (Safest Source of B12).

-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.

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Hibiscus Tea: The Best Beverage?

A landmark investigation of the Antioxidant Content of 3,139 Foods put all previous rankings to shame. That’s where I got the data to create my videos Best Berries, which compares hundreds of berries to common fruits, and Better Than Goji Berries, which highlights the dried fruit most packed with anti-aging, anti-cancer antioxidants. Antioxidants in a Pinch and A Better Breakfast can help one visualize the effects of adding just tiny amounts of antioxidant-packed foods to our daily diets.

The international team of researchers also compared hundreds of different beverages. They tested everything from Red Bull to crowberry liqueur. I could never imagine any beverage more antioxidant-packed than matcha, which is a drink made out of powdered green tea leaves (so you’re actually eating green tea). But as I showed in Better Than Green Tea?, matcha may have met its match.

Hibiscus tea, made from the dried petals of hibiscus flowers, topped the rankings. It’s known as flor de Jamaica in Mexico, sorrel in the Caribbean, and roselle in many parts of the world. It’s what gives the “zing” to red zinger tea.

My family’s recipe is to soak a handful of bulk dried organic hibiscus flowers overnight and then blend with a knuckle of fresh ginger, a teaspoon of amla, three tablespoons of erythritol, and a handful of fresh mint leaves to make the half-gallon we drink throughout the day. By blending in the mint, you’re adding dark green leafies to what may be the highest antioxidant beverage in the world, and it tastes like fruit punch! Your kids will love it.

Just because something has antioxidant power in the test tube, though, doesn’t mean it has antioxidant flower power in the body. Maybe the phytonutrients aren’t even absorbed. A human investigation of hibiscus tea has finally been published, though.

If you take people and have them drink only water for 10 hours the antioxidant level of their bloodstream drops throughout the day. The antioxidants we’ve accumulated eating healthy foods get slowly used up throughout the day fighting off all those free radicals unless we replenish our antioxidant stores. For a primer on the fluctuating levels of oxidant stress, see Antioxidant Level Dynamics.

It’s hard to get people to fast for 10 hours, though. So, in addition to water, researchers gave the study subjects something they knew wouldn’t mess up their antioxidant measurements: white bread and cheese. What if at the beginning of the experiment you instead gave people a single cup of hibiscus tea? As you can see in my 2-min Herbal Tea Update: Hibiscus, within an hour there’s a nice spike in the antioxidant level in the blood stream. The effect disappears, however, unless you sip hibiscus throughout the day (or eat something other than Wonderbread cheese sandwiches).

Where are antioxidants concentrated the most? Whole plant foods. See the remarkable contrast in Antioxidant Power of Plant Foods Versus Animal Foods. What’s so great about antioxidants? See The Power of NO and Mitochondrial Theory of Aging. How do we know more is necessarily better? See, for example, Anti-Inflammatory Antioxidants.

For more flower power, check out what the saffron crocus can do against depression (Saffron vs. Prozac), PMS (Saffron for the Treatment of PMS), stress (Wake Up and Smell the Saffron), and dementia (Saffron for the Treatment of Alzheimer’s).

There are also chamomile flowers (Red Tea, Honeybush, & Chamomile), though Chamomile Tea May Not Be Safe During Pregnancy, and the rose bush: Dietary Osteoarthritis Treatment. More comparisons of herbal teas here: The Healthiest Herbal Tea.

I should note that there are unique phytonutrients found in the tea plant missing from all herbal teas, so one would not expect Dietary Brain Wave Alteration from drinking hibiscus. And hibiscus tea is sour, so make sure not to brush your teeth immediately after consumption (see my video Plant-Based Diets: Dental 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 and More Than an Apple a Day.

Image credit: BotMultichill / Wikimedia Commons

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