White Meat May Be as Cholesterol-Raising as Red

White Meat May Be as Cholesterol-Raising as Red.jpeg

In light of recommendations for heart healthy eating from national professional organizations encouraging Americans to limit their intake of meat, the beef industry commissioned and co-wrote a review of randomized controlled trials comparing the effects of beef versus chicken and fish on cholesterol levels published over the last 60 years. They found that the impact of beef consumption on the cholesterol profile of humans is similar to that of fish and/or poultry--meaning that switching from red meat to white meat likely wouldn't make any difference. And that's really no surprise, given how fat we've genetically manipulated chickens to be these days, up to ten times more fat than they had a century ago (see Does Eating Obesity Cause Obesity?).

There are a number of cuts of beef that have less cholesterol-raising saturated fat than chicken (see BOLD Indeed: Beef Lowers Cholesterol?), so it's not so surprising that white meat was found to be no better than red, but the beef industry researchers conclusion was that "therefore you can eat beef as part of a balanced diet to manage your cholesterol."

Think of the Coke versus Pepsi analogy. Coke has less sugar than Pepsi: 15 spoonfuls of sugar per bottle instead of 16. If studies on blood sugar found no difference between drinking Coke versus Pepsi, you wouldn't conclude that "Pepsi may be considered when recommending diets for the management of blood sugars," you'd say they're both equally as bad so we should ideally consume neither.

That's a standard drug industry trick. You don't compare your fancy new drug to the best out there, but to some miserable drug to make yours look better. Note they didn't compare beef to plant proteins, like in this study published in the American Journal of Clinical Nutrition. As I started reading it, though, I was surprised that they found no benefit of switching to a plant protein diet either. What were they eating? You can see the comparison in Switching from Beef to Chicken & Fish May Not Lower Cholesterol.

For breakfast, the plant group got a kidney bean and tomato casserole and a salad, instead of a burger. And for dinner, instead of another burger, the plant protein group just got some boring vegetables. So why was the cholesterol of the plant group as bad as the animal group? They had the plant protein group eating three tablespoons of beef tallow every day--three tablespoons of straight beef fat!

This was part of a series of studies that tried to figure out what was so cholesterol-raising about meat--was it the animal protein or was it the animal fat? So, researchers created fake meat products made to have the same amount of saturated fat and cholesterol by adding extracted animal fats and cholesterol. Who could they get to make such strange concoctions? The Ralston Purina dog food company.

But what's crazy is that even when keeping the saturated animal fat and cholesterol the same (by adding meat fats to the veggie burgers and making the plant group swallow cholesterol pills to equal it out), sometimes they still saw a cholesterol lowering advantage in the plant protein group.

If you switch people from meat to tofu, their cholesterol goes down, but what if you switch them from meat to tofu plus lard? Then their cholesterol may stay the same, though tofu and lard may indeed actually be better than meat, since it may result in less oxidized cholesterol. More on the role of oxidized cholesterol can be found in my videos Does Cholesterol Size Matter? and Arterial Acne.

Just swapping plant protein for animal protein may have advantages, but if you really want to maximize the power of diet to lower cholesterol, you may have to move entirely toward plants. The standard dietary advice to cut down on fatty meat, dairy, and eggs may lower cholesterol 5-10%, but flexitarian or vegetarian diets may drop our levels 10 to 15%, vegan diets 15 to 25%, and healthier vegan diets can cut up to 35%, as seen in this study out of Canada showing a whopping 61 point drop in LDL cholesterol within a matter of weeks.


You thought chicken was a low-fat food? It used to be a century ago, but not anymore. It may even be one of the reasons we're getting fatter as well: Chicken Big: Poultry and Obesity and Infectobesity: Adenovirus 36 and Childhood Obesity.

Isn't protein just protein? How does our body know if it's coming from a plant or an animal? How could it have different effects on cardiovascular risk? See Protein and Heart Disease, another reason why Plant Protein [is] Preferable.

Lowering cholesterol in your blood is as simple as reducing one's intake of three things: Trans Fat, Saturated Fat, and Cholesterol: Tolerable Upper Intake of Zero.

What about those news stories on the "vindication" of saturated fat? See the sneaky science in The Saturated Fat Studies: Buttering Up the Public and The Saturated Fat Studies: Set Up to Fail.

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: CDC/Debora Cartagena via Freestockphotos.biz. This image has been modified.

Original Link

White Meat May Be as Cholesterol-Raising as Red

White Meat May Be as Cholesterol-Raising as Red.jpeg

In light of recommendations for heart healthy eating from national professional organizations encouraging Americans to limit their intake of meat, the beef industry commissioned and co-wrote a review of randomized controlled trials comparing the effects of beef versus chicken and fish on cholesterol levels published over the last 60 years. They found that the impact of beef consumption on the cholesterol profile of humans is similar to that of fish and/or poultry--meaning that switching from red meat to white meat likely wouldn't make any difference. And that's really no surprise, given how fat we've genetically manipulated chickens to be these days, up to ten times more fat than they had a century ago (see Does Eating Obesity Cause Obesity?).

There are a number of cuts of beef that have less cholesterol-raising saturated fat than chicken (see BOLD Indeed: Beef Lowers Cholesterol?), so it's not so surprising that white meat was found to be no better than red, but the beef industry researchers conclusion was that "therefore you can eat beef as part of a balanced diet to manage your cholesterol."

Think of the Coke versus Pepsi analogy. Coke has less sugar than Pepsi: 15 spoonfuls of sugar per bottle instead of 16. If studies on blood sugar found no difference between drinking Coke versus Pepsi, you wouldn't conclude that "Pepsi may be considered when recommending diets for the management of blood sugars," you'd say they're both equally as bad so we should ideally consume neither.

That's a standard drug industry trick. You don't compare your fancy new drug to the best out there, but to some miserable drug to make yours look better. Note they didn't compare beef to plant proteins, like in this study published in the American Journal of Clinical Nutrition. As I started reading it, though, I was surprised that they found no benefit of switching to a plant protein diet either. What were they eating? You can see the comparison in Switching from Beef to Chicken & Fish May Not Lower Cholesterol.

For breakfast, the plant group got a kidney bean and tomato casserole and a salad, instead of a burger. And for dinner, instead of another burger, the plant protein group just got some boring vegetables. So why was the cholesterol of the plant group as bad as the animal group? They had the plant protein group eating three tablespoons of beef tallow every day--three tablespoons of straight beef fat!

This was part of a series of studies that tried to figure out what was so cholesterol-raising about meat--was it the animal protein or was it the animal fat? So, researchers created fake meat products made to have the same amount of saturated fat and cholesterol by adding extracted animal fats and cholesterol. Who could they get to make such strange concoctions? The Ralston Purina dog food company.

But what's crazy is that even when keeping the saturated animal fat and cholesterol the same (by adding meat fats to the veggie burgers and making the plant group swallow cholesterol pills to equal it out), sometimes they still saw a cholesterol lowering advantage in the plant protein group.

If you switch people from meat to tofu, their cholesterol goes down, but what if you switch them from meat to tofu plus lard? Then their cholesterol may stay the same, though tofu and lard may indeed actually be better than meat, since it may result in less oxidized cholesterol. More on the role of oxidized cholesterol can be found in my videos Does Cholesterol Size Matter? and Arterial Acne.

Just swapping plant protein for animal protein may have advantages, but if you really want to maximize the power of diet to lower cholesterol, you may have to move entirely toward plants. The standard dietary advice to cut down on fatty meat, dairy, and eggs may lower cholesterol 5-10%, but flexitarian or vegetarian diets may drop our levels 10 to 15%, vegan diets 15 to 25%, and healthier vegan diets can cut up to 35%, as seen in this study out of Canada showing a whopping 61 point drop in LDL cholesterol within a matter of weeks.


You thought chicken was a low-fat food? It used to be a century ago, but not anymore. It may even be one of the reasons we're getting fatter as well: Chicken Big: Poultry and Obesity and Infectobesity: Adenovirus 36 and Childhood Obesity.

Isn't protein just protein? How does our body know if it's coming from a plant or an animal? How could it have different effects on cardiovascular risk? See Protein and Heart Disease, another reason why Plant Protein [is] Preferable.

Lowering cholesterol in your blood is as simple as reducing one's intake of three things: Trans Fat, Saturated Fat, and Cholesterol: Tolerable Upper Intake of Zero.

What about those news stories on the "vindication" of saturated fat? See the sneaky science in The Saturated Fat Studies: Buttering Up the Public and The Saturated Fat Studies: Set Up to Fail.

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: CDC/Debora Cartagena via Freestockphotos.biz. This image has been modified.

Original Link

Can You Eat Too Much Fruit?

Can You Eat Too Much Fruit?.jpeg

In my video If Fructose is Bad, What About Fruit?, I explored how adding berries to our meals can actually blunt the detrimental effects of high glycemic foods, but how many berries? The purpose of one study out of Finland was to determine the minimum level of blueberry consumption at which a consumer may realistically expect to receive antioxidant benefits after eating blueberries with a sugary breakfast cereal. If we eat a bowl of corn flakes with no berries, within two hours, so many free radicals are created that it puts us into oxidative debt. The antioxidant power of our bloodstream drops below where we started from before breakfast, as the antioxidants in our bodies get used up dealing with such a crappy breakfast. As you can see in How Much Fruit is Too Much? video, a quarter cup of blueberries didn't seem to help much, but a half cup of blueberries did.

What about fruit for diabetics? Most guidelines recommend eating a diet with a high intake of fiber-rich food, including fruit, because they're so healthy--antioxidants, anti-inflammatory, improving artery function, and reducing cancer risk. However, some health professionals have concerns about the sugar content of fruit and therefore recommend restricting the fruit intake. So let's put it to the test! In a study from Denmark, diabetics were randomized into two groups: one told to eat at least two pieces of fruit a day, and the other told at most, two fruits a day. The reduce fruit group indeed reduce their fruit consumption, but it had no effect on the control of their diabetes or weight, and so, the researchers concluded, the intake of fruit should not be restricted in patients with type 2 diabetes. An emerging literature has shown that low-dose fructose may actually benefit blood sugar control. Having a piece of fruit with each meal would be expected to lower, not raise the blood sugar response.

The threshold for toxicity of fructose may be around 50 grams. The problem is that's the current average adult fructose consumption. So, the levels of half of all adults are likely above the threshold for fructose toxicity, and adolescents currently average 75. Is that limit for added sugars or for all fructose? If we don't want more than 50 and there's about ten in a piece of fruit, should we not eat more than five fruit a day? Quoting from the Harvard Health Letter, "the nutritional problems of fructose and sugar come when they are added to foods. Fruit, on the other hand, is beneficial in almost any amount." What do they mean almost? Can we eat ten fruit a day? How about twenty fruit a day?

It's actually been put to the test.

Seventeen people were made to eat 20 servings a day of fruit. Despite the extraordinarily high fructose content of this diet, presumably about 200 g/d--eight cans of soda worth, the investigators reported no adverse effects (and possible benefit actually) for body weight, blood pressure, and insulin and lipid levels after three to six months. More recently, Jenkins and colleagues put people on about a 20 servings of fruit a day diet for a few weeks and found no adverse effects on weight or blood pressure or triglycerides, and an astounding 38 point drop in LDL cholesterol.

There was one side effect, though. Given the 44 servings of vegetables they had on top of all that fruit, they recorded the largest bowl movements apparently ever documented in a dietary intervention.


Cutting down on sugary foods may be easier said than done (see Are Sugary Foods Addictive?) but it's worth it. For more on the dangers of high levels of fructose in added sugars, see How Much Added Sugar Is Too Much?.

What's that about being in oxidative debt? See my three part series on how to pull yourself out of the red:

Ironically, fat may be more of a problem when it comes to diabetes than sugar, 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:

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

Original Link

Can You Eat Too Much Fruit?

Can You Eat Too Much Fruit?.jpeg

In my video If Fructose is Bad, What About Fruit?, I explored how adding berries to our meals can actually blunt the detrimental effects of high glycemic foods, but how many berries? The purpose of one study out of Finland was to determine the minimum level of blueberry consumption at which a consumer may realistically expect to receive antioxidant benefits after eating blueberries with a sugary breakfast cereal. If we eat a bowl of corn flakes with no berries, within two hours, so many free radicals are created that it puts us into oxidative debt. The antioxidant power of our bloodstream drops below where we started from before breakfast, as the antioxidants in our bodies get used up dealing with such a crappy breakfast. As you can see in How Much Fruit is Too Much? video, a quarter cup of blueberries didn't seem to help much, but a half cup of blueberries did.

What about fruit for diabetics? Most guidelines recommend eating a diet with a high intake of fiber-rich food, including fruit, because they're so healthy--antioxidants, anti-inflammatory, improving artery function, and reducing cancer risk. However, some health professionals have concerns about the sugar content of fruit and therefore recommend restricting the fruit intake. So let's put it to the test! In a study from Denmark, diabetics were randomized into two groups: one told to eat at least two pieces of fruit a day, and the other told at most, two fruits a day. The reduce fruit group indeed reduce their fruit consumption, but it had no effect on the control of their diabetes or weight, and so, the researchers concluded, the intake of fruit should not be restricted in patients with type 2 diabetes. An emerging literature has shown that low-dose fructose may actually benefit blood sugar control. Having a piece of fruit with each meal would be expected to lower, not raise the blood sugar response.

The threshold for toxicity of fructose may be around 50 grams. The problem is that's the current average adult fructose consumption. So, the levels of half of all adults are likely above the threshold for fructose toxicity, and adolescents currently average 75. Is that limit for added sugars or for all fructose? If we don't want more than 50 and there's about ten in a piece of fruit, should we not eat more than five fruit a day? Quoting from the Harvard Health Letter, "the nutritional problems of fructose and sugar come when they are added to foods. Fruit, on the other hand, is beneficial in almost any amount." What do they mean almost? Can we eat ten fruit a day? How about twenty fruit a day?

It's actually been put to the test.

Seventeen people were made to eat 20 servings a day of fruit. Despite the extraordinarily high fructose content of this diet, presumably about 200 g/d--eight cans of soda worth, the investigators reported no adverse effects (and possible benefit actually) for body weight, blood pressure, and insulin and lipid levels after three to six months. More recently, Jenkins and colleagues put people on about a 20 servings of fruit a day diet for a few weeks and found no adverse effects on weight or blood pressure or triglycerides, and an astounding 38 point drop in LDL cholesterol.

There was one side effect, though. Given the 44 servings of vegetables they had on top of all that fruit, they recorded the largest bowl movements apparently ever documented in a dietary intervention.


Cutting down on sugary foods may be easier said than done (see Are Sugary Foods Addictive?) but it's worth it. For more on the dangers of high levels of fructose in added sugars, see How Much Added Sugar Is Too Much?.

What's that about being in oxidative debt? See my three part series on how to pull yourself out of the red:

Ironically, fat may be more of a problem when it comes to diabetes than sugar, 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:

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

Original Link

What Not to Add to White Rice, Potatoes, or Pasta

What Not to Add to White Rice, Potatoes, or Pasta.jpeg

Rice currently feeds almost half the human population, making it the single most important staple food in the world, but a meta-analysis of seven cohort studies following 350,000 people for up to 20 years found that higher consumption of white rice was associated with a significantly increased risk of type 2 diabetes, especially in Asian populations. They estimated each serving per day of white rice was associated with an 11% increase in risk of diabetes. This could explain why China has almost the same diabetes rates as we do.

Diabetes rates in China are at about 10%; we're at about 11%, despite seven times less obesity in China. Japan has eight times less obesity than we do, yet may have a higher incidence of newly diagnosed diabetes cases than we do--nine per a thousand compared to our eight. They're skinnier and still may have more diabetes. Maybe it's because of all the white rice they eat.

Eating whole fruit is associated with lower risk of diabetes, whereas eating fruit processed into juice may not just be neutral, but actually increases diabetes risk. In the same way, eating whole grains, like whole wheat bread or brown rice is associated with lower risk of diabetes, whereas eating white rice, a processed grain, may not just be neutral, but actually increase diabetes risk.

White rice consumption does not appear to be associated with increased risk of heart attack or stroke, though, which is a relief after an earlier study in China suggested a connection with stroke. But do we want to eat a food that's just neutral regarding some of our leading causes of death, when we can eat whole foods that are associated with lower risk of diabetes, heart attack, stroke, and weight gain?

If the modern diabetes epidemic in China and Japan has been linked to white rice consumption, how can we reconcile that with low diabetes rates just a few decades ago when they ate even more rice? If you look at the Cornell-Oxford-China Project, rural plant-based diets centered around rice were associated with relatively low risk of the so-called diseases of affluence, which includes diabetes. Maybe Asians just genetically don't get the same blood sugar spike when they eat white rice? This is not the case; if anything people of Chinese ethnicity get higher blood sugar spikes.

The rise in these diseases of affluence in China over the last half century has been blamed in part on the tripling of the consumption of animal source foods. The upsurge in diabetes has been most dramatic, and it's mostly just happened over the last decade. That crazy 9.7% diabetes prevalence figure that rivals ours is new--they appeared to have one of the lowest diabetes rates in the world in the year 2000.

So what happened to their diets in the last 20 years or so? Oil consumption went up 20%, pork consumption went up 40%, and rice consumption dropped about 30%. As diabetes rates were skyrocketing, rice consumption was going down, so maybe it's the animal products and junk food that are the problem. Yes, brown rice is better than white rice, but to stop the mounting Asian epidemic, maybe we should focus on removing the cause--the toxic Western diet. That would be consistent with data showing animal protein and fat consumption associated with increased diabetes risk.

But that doesn't explain why the biggest recent studies in Japan and China associate white rice intake with diabetes. One possibility is that animal protein is making the rice worse. If you feed people mashed white potatoes, a high glycemic food like white rice, you can see in my video If White Rice is Linked to Diabetes, What About China? the level of insulin your pancreas has to pump out to keep your blood sugars in check. But what if you added some tuna fish? Tuna doesn't have any carbs, sugar, or starch so it shouldn't make a difference. Or maybe it would even lower the mashed potato spike by lowering the glycemic load of the whole meal? Instead you get twice the insulin spike. This also happens with white flour spaghetti versus white flour spaghetti with meat. The addition of animal protein makes the pancreas work twice as hard.

You can do it with straight sugar water too. If you do a glucose challenge test to test for diabetes, where you drink a certain amount of sugar and add some meat, you get a much bigger spike than without meat. And the more meat you add, the worse it gets. Just adding a little meat to carbs doesn't seem to do much, but once you get up to around a third of a chicken breast's worth, you can elicit a significantly increased surge of insulin. This may help explain why those eating plant-based have such low diabetes rates, because animal protein can markedly potentiate the insulin secretion triggered by carbohydrate ingestion.

The protein exacerbation of the effect of refined carbs could help explain the remarkable results achieved by Dr. Kempner with a don't-try-this-at-home diet composed of mostly white rice and sugar. See my video, Kempner Rice Diet: Whipping Us Into Shape.

Refined grains may also not be good for our blood pressure (see Whole Grains May Work As Well As Drugs).

What should we be eating to best decrease our risk of diabetes? See:

And check out my summary video, How Not to Die from Diabetes.

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

What Not to Add to White Rice, Potatoes, or Pasta

What Not to Add to White Rice, Potatoes, or Pasta.jpeg

Rice currently feeds almost half the human population, making it the single most important staple food in the world, but a meta-analysis of seven cohort studies following 350,000 people for up to 20 years found that higher consumption of white rice was associated with a significantly increased risk of type 2 diabetes, especially in Asian populations. They estimated each serving per day of white rice was associated with an 11% increase in risk of diabetes. This could explain why China has almost the same diabetes rates as we do.

Diabetes rates in China are at about 10%; we're at about 11%, despite seven times less obesity in China. Japan has eight times less obesity than we do, yet may have a higher incidence of newly diagnosed diabetes cases than we do--nine per a thousand compared to our eight. They're skinnier and still may have more diabetes. Maybe it's because of all the white rice they eat.

Eating whole fruit is associated with lower risk of diabetes, whereas eating fruit processed into juice may not just be neutral, but actually increases diabetes risk. In the same way, eating whole grains, like whole wheat bread or brown rice is associated with lower risk of diabetes, whereas eating white rice, a processed grain, may not just be neutral, but actually increase diabetes risk.

White rice consumption does not appear to be associated with increased risk of heart attack or stroke, though, which is a relief after an earlier study in China suggested a connection with stroke. But do we want to eat a food that's just neutral regarding some of our leading causes of death, when we can eat whole foods that are associated with lower risk of diabetes, heart attack, stroke, and weight gain?

If the modern diabetes epidemic in China and Japan has been linked to white rice consumption, how can we reconcile that with low diabetes rates just a few decades ago when they ate even more rice? If you look at the Cornell-Oxford-China Project, rural plant-based diets centered around rice were associated with relatively low risk of the so-called diseases of affluence, which includes diabetes. Maybe Asians just genetically don't get the same blood sugar spike when they eat white rice? This is not the case; if anything people of Chinese ethnicity get higher blood sugar spikes.

The rise in these diseases of affluence in China over the last half century has been blamed in part on the tripling of the consumption of animal source foods. The upsurge in diabetes has been most dramatic, and it's mostly just happened over the last decade. That crazy 9.7% diabetes prevalence figure that rivals ours is new--they appeared to have one of the lowest diabetes rates in the world in the year 2000.

So what happened to their diets in the last 20 years or so? Oil consumption went up 20%, pork consumption went up 40%, and rice consumption dropped about 30%. As diabetes rates were skyrocketing, rice consumption was going down, so maybe it's the animal products and junk food that are the problem. Yes, brown rice is better than white rice, but to stop the mounting Asian epidemic, maybe we should focus on removing the cause--the toxic Western diet. That would be consistent with data showing animal protein and fat consumption associated with increased diabetes risk.

But that doesn't explain why the biggest recent studies in Japan and China associate white rice intake with diabetes. One possibility is that animal protein is making the rice worse. If you feed people mashed white potatoes, a high glycemic food like white rice, you can see in my video If White Rice is Linked to Diabetes, What About China? the level of insulin your pancreas has to pump out to keep your blood sugars in check. But what if you added some tuna fish? Tuna doesn't have any carbs, sugar, or starch so it shouldn't make a difference. Or maybe it would even lower the mashed potato spike by lowering the glycemic load of the whole meal? Instead you get twice the insulin spike. This also happens with white flour spaghetti versus white flour spaghetti with meat. The addition of animal protein makes the pancreas work twice as hard.

You can do it with straight sugar water too. If you do a glucose challenge test to test for diabetes, where you drink a certain amount of sugar and add some meat, you get a much bigger spike than without meat. And the more meat you add, the worse it gets. Just adding a little meat to carbs doesn't seem to do much, but once you get up to around a third of a chicken breast's worth, you can elicit a significantly increased surge of insulin. This may help explain why those eating plant-based have such low diabetes rates, because animal protein can markedly potentiate the insulin secretion triggered by carbohydrate ingestion.

The protein exacerbation of the effect of refined carbs could help explain the remarkable results achieved by Dr. Kempner with a don't-try-this-at-home diet composed of mostly white rice and sugar. See my video, Kempner Rice Diet: Whipping Us Into Shape.

Refined grains may also not be good for our blood pressure (see Whole Grains May Work As Well As Drugs).

What should we be eating to best decrease our risk of diabetes? See:

And check out my summary video, How Not to Die from Diabetes.

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 a Low-Carb Diet is Metabolically Like Being Obese

NF-Nov22 The Spillover Effect copy.jpg

Free fatty acids (meaning fat circulating in the bloodstream not packaged into triglycerides) result in inflammation, toxic fat breakdown products, and oxidative stress, which can gum up the insulin receptor pathway and lead to insulin resistance in our muscles. Insulin resistance is what causes prediabetes and type 2 diabetes. I explain the process in my video What Causes Insulin Resistance? As the level of fat in the blood rises, the body's ability to clear sugar from the blood drops dramatically.

Where does this fat in our blood that's wreaking all this havoc come from? It comes from the fat that we eat and from the fat that we wear.

The number of fat cells we have stays constant in adulthood. The way researchers figured that out is by measuring the amount of radioactive carbon still trapped in our DNA from all the nuclear bomb tests. After massive weight loss, our fat cells shrink as they offload fat, but the number stays the same. Conversely, when we gain weight, our fat cells stretch as we pack more and more into each individual fat cell. So, when our belly, butt, or thighs get big, we're not adding more fat cells, we're just cramming more fat into each cell. At a certain point, our cells become so bloated that they spill fat back into the bloodstream.

This is called the spillover effect. Not only does an obese person have more fat, but they're constantly spilling that fat into their bloodstream. So that could be the link between obesity and diabetes. Fat is spilling out from our fat cells and gets lodged in our muscle cells, leading to the insulin resistance that promotes the onset of type 2 diabetes. I show this in my video The Spillover Effect Links Obesity to Diabetes.

The fat can also enter our bloodstream through our mouth. If you put people on a low carb diet, fat builds up in their muscle within two hours and insulin sensitivity drops. And the more fat found in the muscle, the lower the ability to clear sugar from the blood. It doesn't take years for this to happen, just hours after fatty foods go into our mouths. A fat-rich diet can increase fat in the blood and this increase is accompanied by a decrease in insulin sensitivity.

Studies clearly demonstrate that fat in the blood directly inhibit glucose transport and usage in our muscles, which is responsible for clearing about 85% of the glucose out of blood. These findings indicate that fat consumption can play an important role in the development of insulin resistance.

Normally we only have 10 to 50 micromoles of free fat floating around in our blood stream at any one time, but those who are obese have between 60 to 80. But, we can reach 80 just eating a high fat diet. So a skinny person eating a low-carb diet can have the same level of fat in their blood that obese people do. Similarly, being obese is like eating some horrible bacon and butter diet all day, because obese persons are constantly spilling fat into their bloodstream, no matter what goes in their mouth.

Are all types of fat the same? Find out the answer in my video Lipotoxicity: How Saturated Fat Raises Blood Sugar.

The fat leaking into our bloodstream may also contain fat-soluble pollutants that accumulated from our diet: Pollutants in Salmon and Our Own Fat.

The spillover effect may also help explain the increased heart disease risk associated with obesity: Low Carb Diets and Coronary Blood Flow.

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: [Eugene Bochkarev] © 123RF.com

Original Link

How a Low-Carb Diet is Metabolically Like Being Obese

NF-Nov22 The Spillover Effect copy.jpg

Free fatty acids (meaning fat circulating in the bloodstream not packaged into triglycerides) result in inflammation, toxic fat breakdown products, and oxidative stress, which can gum up the insulin receptor pathway and lead to insulin resistance in our muscles. Insulin resistance is what causes prediabetes and type 2 diabetes. I explain the process in my video What Causes Insulin Resistance? As the level of fat in the blood rises, the body's ability to clear sugar from the blood drops dramatically.

Where does this fat in our blood that's wreaking all this havoc come from? It comes from the fat that we eat and from the fat that we wear.

The number of fat cells we have stays constant in adulthood. The way researchers figured that out is by measuring the amount of radioactive carbon still trapped in our DNA from all the nuclear bomb tests. After massive weight loss, our fat cells shrink as they offload fat, but the number stays the same. Conversely, when we gain weight, our fat cells stretch as we pack more and more into each individual fat cell. So, when our belly, butt, or thighs get big, we're not adding more fat cells, we're just cramming more fat into each cell. At a certain point, our cells become so bloated that they spill fat back into the bloodstream.

This is called the spillover effect. Not only does an obese person have more fat, but they're constantly spilling that fat into their bloodstream. So that could be the link between obesity and diabetes. Fat is spilling out from our fat cells and gets lodged in our muscle cells, leading to the insulin resistance that promotes the onset of type 2 diabetes. I show this in my video The Spillover Effect Links Obesity to Diabetes.

The fat can also enter our bloodstream through our mouth. If you put people on a low carb diet, fat builds up in their muscle within two hours and insulin sensitivity drops. And the more fat found in the muscle, the lower the ability to clear sugar from the blood. It doesn't take years for this to happen, just hours after fatty foods go into our mouths. A fat-rich diet can increase fat in the blood and this increase is accompanied by a decrease in insulin sensitivity.

Studies clearly demonstrate that fat in the blood directly inhibit glucose transport and usage in our muscles, which is responsible for clearing about 85% of the glucose out of blood. These findings indicate that fat consumption can play an important role in the development of insulin resistance.

Normally we only have 10 to 50 micromoles of free fat floating around in our blood stream at any one time, but those who are obese have between 60 to 80. But, we can reach 80 just eating a high fat diet. So a skinny person eating a low-carb diet can have the same level of fat in their blood that obese people do. Similarly, being obese is like eating some horrible bacon and butter diet all day, because obese persons are constantly spilling fat into their bloodstream, no matter what goes in their mouth.

Are all types of fat the same? Find out the answer in my video Lipotoxicity: How Saturated Fat Raises Blood Sugar.

The fat leaking into our bloodstream may also contain fat-soluble pollutants that accumulated from our diet: Pollutants in Salmon and Our Own Fat.

The spillover effect may also help explain the increased heart disease risk associated with obesity: Low Carb Diets and Coronary Blood Flow.

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: [Eugene Bochkarev] © 123RF.com

Original Link

Flax Seeds Can Have Profound Effect on Hypertension

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A recent article in the journal, Meat Science, acknowledged that a sector of the population perceives meat as a food that is detrimental to their health because of studies associating meat consumption with heart disease and cancer. So, the article continues, meat consumers may look for healthier food alternatives as a means to maintain good health, which represents a good opportunity for the meat industry to develop some new products. The industry felt that natural foods could be added to meat to reach those health-oriented consumers by boosting antioxidants levels, for example. Foods like flax seeds and tomatoes are healthy, associated with reduced risks of cancer and cardiovascular disease. So by making flax-y tomato burgers, they figure they can reduce saturated fat intake and maybe eat less sugar somehow. Wouldn't it be easier to just cut out the middle-cow and eat flax seeds ourselves?

Flax seeds have been described as a "miraculous defense against some critical maladies." I'm a fan of flax, but this title seemed a bit over-exuberant; I figured something just got lost in translation, but then I found a prospective, double-blinded, placebo-controlled, randomized trial--you know how hard that is in a nutrition study? For drugs, it's easy: you have two identical looking pills, one's active, one's placebo, and until the end of the study, neither the researcher nor the patient has any idea which is which, hence "double blind." But people tend to notice what they're eating. So how did they sneak a quarter cup of ground flax seeds into half of the people's diets without them knowing? They created all these various flax or placebo containing foods, and even added bran and molasses to match the color and texture, so it was all a big secret until six months later when they broke the code to see who ate which.

Why test it on hypertension? Because having a systolic blood pressure over 115--that's the top number--may be the single most important determinant for death in the world today. If you take a bunch of older folks, most of them on an array of blood pressure pills, and don't improve their diet at all, despite the drugs, they may start out on average hypertensive and stay hypertensive six months later. But those who were unknowingly eating ground flaxseeds every day, dropped their systolic blood pressure about ten points, and their diastolic, the lower number, by about seven points. That might not sound like a lot, but a drop like that could cut stroke risk 46 percent and heart disease 29 percent, and that ten point drop in the top number could have a similar effect on strokes and heart attacks. And for those that started out over 140, they got a 15-point drop.

In summary, flaxseed induced one of the most potent antihypertensive effects ever achieved by a dietary intervention. In other words, the magnitude of this decrease in blood pressure demonstrated by dietary flaxseed, is as good or better than other nutritional interventions and comparable to many drugs, which can have serious side effects. And they're not exaggerating about the comparable to drugs bit. The flax dropped systolic and diastolic up to 15 and 7. Compare that to powerful ACE inhibitors like Vasotec, which may only drop pressures five and two, and calcium channel blockers like Norvasc or Cardizem which drop pressures eight and three. Side effects of these drugs include a large list of serious medical issues, as seen in my video Flax Seeds for Hypertension, compared to the side effect of flax seeds, "its pleasant nutty flavor."

During the six-month trial there were strokes and heart attacks in both groups, though. Even if the flax seeds can cut risk in half, any avoidable risk is unacceptable. Isn't high blood pressure just inevitable as we get older? No - the prevalence of hypertension does increase dramatically with age, but not for everyone. People who eat more plant-based diets or keep their salt intake low enough tend not to exhibit any change in blood pressure with advancing age. It's always better to prevent the disease in the first place.

And that's not all flax can do. Check out:

Hibiscus tea may help with high blood pressure as well: Hibiscus Tea vs. Plant-Based Diets for Hypertension

Diet can also play an important role in preventing heart disease (How Not to Die from Heart Disease and One in a Thousand: Ending the Heart Disease Epidemic) and diabetes (How Not to Die from Diabetes and Plant-Based Diets and Diabetes). In some cases diet can even reverse some of the worst ravages of high blood pressure: How Not to Die from High Blood Pressure and 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:

Image Credit: Veganbaking.net / Flickr

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How May Eating Plants Help Prevent Alzheimer’s Disease?

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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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