Deep Breathing Exercise for Nausea

Deep Breathing Exercise for Nausea.jpeg

One of the most common fears patients express when facing surgery is postoperative nausea, which can range from minor queasiness to protracted periods of vomiting. Feeling sick to one's stomach and throwing up after surgery is a common problem, affecting between a quarter and a half of those placed under general anesthesia, and more than half of those at high risk (women who don't smoke and have a history of motion sickness).

I've explored the science behind treating nausea with ginger (see Natural Nausea Remedy Recipe), but if you're too nauseous to eat, what do you do? Well, people are often sent home with anti-nausea rectal suppositories. Surveys, however, show that cultural and sexual attitudes may make a number of people sensitive to anything involving the rectum. Though the wording of the question researchers asked was, "are you happy to have a drug put in your back passage?" I can imagine many of the respondents thinking "well, maybe I wouldn't so much mind, but wouldn't exactly be happy about it," especially when you're feeling sick and throwing up.

For women who've had a C-section, they might not want to take drugs at all if they're breastfeeding, so researchers decided to put aromatherapy to the test. Research has shown that essential oils of both spearmint and peppermint are effective in reducing nausea and vomiting after chemotherapy, but this was after swallowing them.

Would just the smell of peppermint help with nausea? I explore this in my video Peppermint Aromatherapy for Nausea. Researchers had women take deep whiffs of peppermint extract (like you'd buy at a store) and it seemed to work. Eighty percent of the mint-sniffers felt better within just a few minutes, compared to no improvement in the placebo group who sniffed water with green food coloring, or the control group who didn't sniff anything.

The study was criticized for being small and for not using pure peppermint oil. Peppermint extract is peppermint oil plus alcohol. Maybe it was the smell of alcohol that made people better? And that's actually not too much of a stretch. In 1997, researchers reported a simple, innocuous, and inexpensive treatment for postoperative nausea and vomiting--the smell of isopropyl alcohol, which is what is found in those alcohol wipes, the little prep pads that nurses swab you with before shots. They found that they could just effectively tear one open and wave it under someone's nose and relieve nausea and vomiting in more than 80% of folks after surgery. It has been since shown to work as well as a leading anti-nausea drug, and may even work faster, cutting nausea in half within 10 to 15 minutes, rather than 20 or 25.

So was it the alcohol, the peppermint, or both? Researchers decided to put it to the test. They instructed patients to take three slow, deep breaths, smelling alcohol, peppermint, or nothing. The smell of peppermint cut nausea in half within five minutes, and so did the alcohol. But so did smelling nothing! So maybe it had nothing to do with the scent; maybe it was just the instruction to take slow, deep breaths. That would make it a really cost-effective intervention. Maybe it shouldn't be so surprising, given the proximity of the vomiting and breathing centers within the brain.

And indeed, controlled breathing was found effective with or without any scent. So next time you feel nauseous, inhale deeply through your nose to the count of three, hold your breath to the count of three, and exhale out the mouth to the count of three. Do that three times.

Ironically, the researchers continued to advocate using those nasty smelling alcohol pads even though they themselves showed they weren't any more effective than breathing alone. Why? Since isopropyl alcohol has a readily detectable odor, patients are more likely to think that their post-operation nausea and vomiting is being actively treated when they inhale alcohol vapors rather than just engaging in breathing exercises.


What do you think of still using the alcohol pads even though they were shown to offer no additional benefit? I have a whole video on such questions: The Lie That Heals: Should Doctors Give Placebos?

For those who can swallow, I offer more about powdered ginger in my video Dangerous Advice From Health Food Store Employees.

There's more on aromatherapy here:

What about actually eating the peppermint?

Of course, the best way to avoid postsurgical nausea is to try to avoid surgery in the first place. Those that eat healthy may be less likely to go under the knife. See Say No to Drugs by Saying Yes to More Plants.

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

Deep Breathing Exercise for Nausea

Deep Breathing Exercise for Nausea.jpeg

One of the most common fears patients express when facing surgery is postoperative nausea, which can range from minor queasiness to protracted periods of vomiting. Feeling sick to one's stomach and throwing up after surgery is a common problem, affecting between a quarter and a half of those placed under general anesthesia, and more than half of those at high risk (women who don't smoke and have a history of motion sickness).

I've explored the science behind treating nausea with ginger (see Natural Nausea Remedy Recipe), but if you're too nauseous to eat, what do you do? Well, people are often sent home with anti-nausea rectal suppositories. Surveys, however, show that cultural and sexual attitudes may make a number of people sensitive to anything involving the rectum. Though the wording of the question researchers asked was, "are you happy to have a drug put in your back passage?" I can imagine many of the respondents thinking "well, maybe I wouldn't so much mind, but wouldn't exactly be happy about it," especially when you're feeling sick and throwing up.

For women who've had a C-section, they might not want to take drugs at all if they're breastfeeding, so researchers decided to put aromatherapy to the test. Research has shown that essential oils of both spearmint and peppermint are effective in reducing nausea and vomiting after chemotherapy, but this was after swallowing them.

Would just the smell of peppermint help with nausea? I explore this in my video Peppermint Aromatherapy for Nausea. Researchers had women take deep whiffs of peppermint extract (like you'd buy at a store) and it seemed to work. Eighty percent of the mint-sniffers felt better within just a few minutes, compared to no improvement in the placebo group who sniffed water with green food coloring, or the control group who didn't sniff anything.

The study was criticized for being small and for not using pure peppermint oil. Peppermint extract is peppermint oil plus alcohol. Maybe it was the smell of alcohol that made people better? And that's actually not too much of a stretch. In 1997, researchers reported a simple, innocuous, and inexpensive treatment for postoperative nausea and vomiting--the smell of isopropyl alcohol, which is what is found in those alcohol wipes, the little prep pads that nurses swab you with before shots. They found that they could just effectively tear one open and wave it under someone's nose and relieve nausea and vomiting in more than 80% of folks after surgery. It has been since shown to work as well as a leading anti-nausea drug, and may even work faster, cutting nausea in half within 10 to 15 minutes, rather than 20 or 25.

So was it the alcohol, the peppermint, or both? Researchers decided to put it to the test. They instructed patients to take three slow, deep breaths, smelling alcohol, peppermint, or nothing. The smell of peppermint cut nausea in half within five minutes, and so did the alcohol. But so did smelling nothing! So maybe it had nothing to do with the scent; maybe it was just the instruction to take slow, deep breaths. That would make it a really cost-effective intervention. Maybe it shouldn't be so surprising, given the proximity of the vomiting and breathing centers within the brain.

And indeed, controlled breathing was found effective with or without any scent. So next time you feel nauseous, inhale deeply through your nose to the count of three, hold your breath to the count of three, and exhale out the mouth to the count of three. Do that three times.

Ironically, the researchers continued to advocate using those nasty smelling alcohol pads even though they themselves showed they weren't any more effective than breathing alone. Why? Since isopropyl alcohol has a readily detectable odor, patients are more likely to think that their post-operation nausea and vomiting is being actively treated when they inhale alcohol vapors rather than just engaging in breathing exercises.


What do you think of still using the alcohol pads even though they were shown to offer no additional benefit? I have a whole video on such questions: The Lie That Heals: Should Doctors Give Placebos?

For those who can swallow, I offer more about powdered ginger in my video Dangerous Advice From Health Food Store Employees.

There's more on aromatherapy here:

What about actually eating the peppermint?

Of course, the best way to avoid postsurgical nausea is to try to avoid surgery in the first place. Those that eat healthy may be less likely to go under the knife. See Say No to Drugs by Saying Yes to More Plants.

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

Medical Care: The Third Leading Cause of Death

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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? In my video The Actual Benefit of Diet vs. Drugs, I noted that patients tend to wildly overestimate the ability of cancer screening and cholesterol-lowering medications to prevent disease. Surveyed patients report they were told the truth about how little they'd benefit, 90% said they wouldn't even bother.

The reason we should eat healthier, rather than just counting on a medical technofix, is that we may hold this same overconfidence for treatment, too. In a massive study of more than 200,000 trials, researchers discovered that pills and procedures can certainly help, but genuine, very large effects with extensive support from substantial evidence appear to be rare in medicine. Further, large benefits for mortality--making people live significantly longer--are almost entirely nonexistent. Modern medicine is great for acute conditions--broken bones and curing infections--but for chronic disease, our leading causes of death and disability, we don't have much to offer. In fact, we sometimes do more harm than good.

In my Uprooting the Leading Causes of Death presentation, I noted that side-effects from prescription drugs kill an estimated 100,000 Americans every year, making medical care the sixth leading cause of death in the United States. There are another 7,000 deaths from getting the wrong medicine by mistake and 20,000 deaths from other errors in hospitals. Hospitals are dangerous places. An additional 99,000 of us die from hospital-acquired infections. But can we really blame doctors for those deaths, though? We can when they don't wash their hands.

We've known since the 1840's that the best way to prevent hospital-acquired infections is through handwashing, yet compliance rates among healthcare workers rarely exceeds 50%, and doctors are the worst, as highlighted in my video Why Prevention is Worth a Ton of Cure. Even in a medical intensive care unit with a "contact precautions" sign, signaling a particularly high risk patient, less than a quarter of doctors were found to wash their hands. Many physicians greeted the horrendous mortality data due to medical error with disbelief and concern that the information would undermine public trust. But if doctors still won't even wash their hands, how much trust do we deserve?

We could go in for a simple operation and come out with a life-threatening infection, or not come out at all. 12,000 more die from surgeries that were unnecessary in the first place. For those keeping score, that's 225,000 people dead from iatrogenic ("relating to medical care") causes. And that's mostly just for patients in a hospital. In an outpatient setting, side-effects from prescription drugs send millions to the hospital and result in perhaps 199,000 additional deaths. This is not including all those non-fatally injured (such as the case where doctors accidentally amputated the tip of a man's penis. Oops).

These estimates are on the low end. The Institute of Medicine estimated that deaths from medical errors may kill up to 98,000 Americans. That would bump us up to 284,000 dead. Even if we use the lower estimate, the medical profession constitutes the third leading cause of death in the United States. It goes heart disease, cancer, then... me.

One respondent pointed out that it was misleading to call medicine the third leading cause of death since many of those we kill also had heart disease or cancer. It's not like doctors are out there gunning down healthy people. Only people on medications are killed by medication errors or side-effects. You have to be in the hospital to be killed by a hospital error.

To which I respond: Exactly.

That's why lifestyle medicine is so important. The most common reasons people are on drugs and in hospitals is for diseases that can be prevented with a healthy diet and lifestyle. The best way to avoid the adverse effects of medical care is to not get sick in the first place.

For more background on how scandalous our handwashing history has been, see my Q&A: What about Semmelweis and medicine's shameful handwashing history? It's truly an unbelievable story.

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: Portal PBH / Flickr

Original Link

Antibiotic-Resistant "Superbugs" in Meat

NF-Mar10 MRSA Superbugs in Meat.jpeg

As a rule, "high-ranking public-health officials try to avoid apocalyptic descriptors. So it's worrying to hear those like the Director of the CDC warn of a coming health 'nightmare' and a 'catastrophic threat.'" A number of prominent publications recently warned of the threat of antibiotic resistance. The CDC estimates that at a minimum, more than two million people are sickened every year with antibiotic-resistant infections in the United States, with at least 23,000 dying as a result (See MRSA Superbugs in Meat).

We may be at the dawn of a post-antibiotic era. Achievements in modern medicine that we today take for granted, such as surgery and the treatment of preterm babies, would not be possible without access to effective treatment for bacterial infections. For example, without antibiotics, the rate of postoperative infection after a procedure like a hip replacement would be 40-50% and about one in three of those patients would die. So the so-called worst case scenarios where resistant infections could cost $50 billion a year might still be an underestimate. "From cradle to grave, antibiotics have become pivotal in safeguarding the overall health of human societies."

So the dire phrasing from head officials may be warranted. There are now infections like carbapenem-resistant enterobacter that are resistant to nearly all antibiotics, even to so-called drugs of last resort. Worryingly, some of these last resort drugs are being used extensively in animal agriculture.

According to the World Health Organization, more antibiotics are fed to farmed animals than are used to treat disease in human patients. Doctors overprescribe antibiotics, but huge amounts of antibiotics are used in fish farming and other intensive animal agriculture, up to four times the amount used in human medicine. Why? "Suboptimum growth to slaughter weight caused by unsanitary conditions can be compensated with the addition of antibiotics to feed." Instead of relieving any stressful overcrowded unhygienic conditions, it may be cheaper to just dose the animals with drugs.

In this way, factory farms are driving the growth of antibiotic-resistant organisms that cause human diseases. "This may help bolster the industry's bottom line, but in the process, bacteria are developing antimicrobial resistance, which affects human health."

In the United States, the FDA reports that 80% of antimicrobial drugs in the United States are used in food animals, mainly to promote growth in this kind of high-density production. This can select for antibiotic-resistant bacteria like methicillin-resistant Staph aureus, or MRSA, considered a serious threat in the United States.

These industrial pig operations may provide optimal conditions for the introduction and transmission of MRSA. U.S. pork producers are currently permitted to use 29 antibiotic drugs in feed--all without a prescription. Antiobitics are currently added to about 90% of pigs starter feeds.

When animals receive unnecessary antibiotics, bacteria can be come resistant to the drugs, then travel on meat to the store, and end up causing hard-to-treat illnesses in people.

MRSA present in retail raw meat may serve as a possible source of bacterial infections of food preparers in the food industry and the hands of consumers in the home. Once MRSA gets into our homes on meat, it can transfer to our cutting boards, knives, and onto our skin at a rate similar to the rate of transmission from touching an infected patient contaminated with MRSA. Washing of hands after touching raw pork is advised.

I know I've already covered this topic before, but it never fails to shock me that the meat industry can get away with something so forcefully and universally condemned by the public health community. What other industrial sector could get away with putting people at such risk? It speaks to the combined might of the livestock industry and the pharmaceutical industry in holding sway over our democratic process, no matter what the human health consequences.

If you've missed my other MRSA videos, check out:

And for more on this critical issue in general:

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: Jellaluna / Flickr

Original Link

Dr. Greger’s 2015 Live Year-in-Review Presentation

Food as Medicine

View my new live presentation here: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet

Every year I scour the world's scholarly literature on clinical nutrition, pulling together what I find to be the most interesting, practical, and groundbreaking science on how to best feed ourselves and our families. I start with the thousands of papers published annually on nutrition (27,000 this year--a new record!) and, thanks to a crack team of volunteers (and now staff!), I'm able to whittle those down (to a mere 8,000 this year). They are then downloaded, categorized, read, analyzed, and churned into the few hundred short videos. This allows me to post new videos and articles every day, year-round, to NutritionFacts.org. This certainly makes the site unique. There's no other science-based source for free daily updates on the latest discoveries in nutrition. The problem is that the amount of information can be overwhelming.

Currently I have more than a thousand videos covering 1,931 nutrition topics. Where do you even begin? Many have expressed their appreciation for the breadth of material, but asked that I try to distill it into a coherent summary of how best to use diet to prevent and treat chronic disease. I took this feedback to heart and in 2012 developed Uprooting the Leading Causes of Death, which explored the role diet may play in preventing, arresting, and even reversing our top 15 killers. Not only did it rise to become one of the Top 10 Most Popular Videos of 2012, it remains my single most viewed video to date, watched over a million times (NutritionFacts.org is now up to more than 1.5 million hits a month!).

In 2013 I developed the sequel, More Than an Apple a Day, in which I explored the role diet could play in treating some of our most common conditions. I presented it around the country and it ended up #1 on our Top 10 Most Popular Videos of 2013. Then in 2014 I premiered the sequel-sequel, From Table to Able, in which I explored the role diet could play in treating some of our most disabling diseases, landing #1 on our Top 10 Most Popular Videos of 2014.

Every year I wonder how I'm going to top the year before. Knowing how popular these live presentations can be and hearing all the stories from folks about what a powerful impact they can have on people's lives, I put my all into this new 2015 one. I spent more time putting together this presentation than any other in my life. It took me an entire month, and when you see it I think you'll appreciate why.

This year, I'm honored to bring you Food as Medicine, in which I go through our most dreaded diseases--but that's not even the best part! I'm really proud of what I put together for the ending. I spend the last 20 minutes or so (starting at 56:22) going through a thought experiment that I'm hoping everyone will find compelling. I think it may be my best presentation ever. You be the judge.

You can watch it at no cost online, but it is also available on DVD through my website or on Amazon. If you want to share copies with others, I have a five for $40 special (enter coupon code 5FOR40FAM). All proceeds from the sales of all my books, DVDs, downloads, and presentations go to the 501c3 nonprofit charity that keeps NutritionFacts.org free for all, for all time. If you want to support this initiative to educate millions about eradicating dietary diseases, please consider making a donation.

After you've watched the new presentation, make sure you're subscribed to get my video updates daily, weekly, or monthly to stay on top of all the latest.

-Michael Greger

Original Link

Why Do Heart Doctors Favor Surgery and Drugs Over Diet?

NF-June2 Fully Consensual Heart Disease Treatment.jpg

When he was a surgeon at the Cleveland Clinic, Dr. Caldwell Esselstyn Jr. published a controversial paper in the American Journal of Cardiology, highlighted in my video, Fully Consensual Heart Disease Treatment, noting that heart bypass operations carry significant risks including the potential to cause further heart damage, stroke, and brain dysfunction. Angioplasty isn't much better, also carrying significant mortality and morbidity, and often doesn't work (in terms of decreasing the risk of subsequent heart attack or death). "So," he writes, "it seems we have an enormous paradox. The disease that is the leading killer of men and women in Western civilization is largely untreated." The benefits of bypass surgery and angioplasty "are at best temporary and erode over time, with most patients eventually succumbing to their disease." In cancer management, we call that palliative care, where we just kind of throw up our hands, throw in the towel, and give up actually trying to treat the disease.

Why does this juggernaut of invasive procedures persist? Well one reason he suggests is that performing surgical interventions has the potential for enormous financial reward. Conversely, lack of adequate return is considered one of the barriers to the practice of preventive cardiology. Diet and lifestyle interventions lose money for the physician.

Another barrier is that doctors don't think patients want it. Physician surveys show that doctors often don't even bring up diet and lifestyle options because they assume that patients would prefer to be on cholesterol-lowering drugs every day for the rest of their lives rather than change their eating habits. That may be true for some, but it's up to the patient, not the doctor, to decide.

According to the official AMA Code of Medical Ethics, physicians are supposed to disclose all relevant medical information to patients. "The patient's right of self-decision can be effectively exercised only if the patient possesses enough information to enable an informed choice. The physician's obligation is to present the medical facts accurately to the patient." For example, before starting someone at moderate risk on a cholesterol-lowering statin drug, a physician might ideally say something like:

"You should know that for folks in your situation, the number of individuals who must be treated with a statin to prevent one death from a cardiovascular event such as a heart attack or stroke is generally between 60 and 100, which means that if I treated 60 people in your situation, 1 would benefit and 59 would not. As these numbers show, it is important for you to know that most of the people who take a statin will not benefit from doing so and, moreover, that statins can have side effects, such as muscle pain, liver damage, and upset stomach, even in people who do not benefit from the medication. I am giving you this information so that you can weigh the risks and benefits of drugs versus diet and then make an informed decision."

Yet, how many physicians have these kinds of frank and open discussions with their patients? Non-disclosure of medical information by doctors--that kind of paternalism is supposed to be a thing of the past. Today's physicians are supposed to honor informed consent under all but a very specific set of conditions (such as the patient is in a coma or it's an emergency). However, too many physicians continue to treat their patients as if they were unconscious.

At the end of this long roundtable discussion on angioplasty and stents, the editor-in-chief of the American Journal of Cardiology reminded us of an important fact to place it all in context. Atherosclerosis is due to high cholesterol, which is due to poor dietary choices, so if we all existed on a plant-based diet, we would not have even needed this discussion.

The lack of nutrition training in medical school is another barrier. See, for example, my videos Doctors' Nutritional Ignorance and Doctors Know Less Than They Think About Nutrition.

Shockingly, mainstream medical associations actively oppose attempts to educate physicians about clinical nutrition. See my 4-part video series:

  1. Nutrition Education Mandate Introduced for Doctors
  2. Medical Associations Oppose Bill to Mandate Nutrition Training
  3. California Medical Association Tries to Kill Nutrition Bill
  4. Nutrition Bill Doctored in the California Senate

For more on why doctors don't make more dietary prescriptions, see my video The Tomato Effect, Lifestyle Medicine: Treating the Cause of Disease, and Convincing Doctors to Embrace Lifestyle Medicine.

Heart disease may be a choice. See Cavities and Coronaries: Our Choice and One in a Thousand: Ending the Heart Disease Epidemic.

-Michael Greger, M.D.

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

Image Credit: Leandro Ciuffo / Flickr

Original Link

Obesity: Supporting satisfaction instead of surgery

Obesity Surgery.jpg

Hot news from down under - a couple of surgeons who perform bariatric (stomach-stapling) operations would like to perform more of them on us, and would like tax money to fund their work. The media is running their advertisement as if it were a public health statement.

I've battled weight problems for my adult life, and I know there is no magic bullet for maintaining a healthy weight. Neither is there a magic scalpel. Cutting open your body to reduce your stomach capacity and all that could mean for your future is not a tenable general treatment.

Battling obesity en masse

New Zealand is, like most developed countries, guilty of more reporting than acting on the growing obesity problem. While this is always a sensitive subject, a recent longterm study showed that while there are obese healthy people, they are much less likely to remain healthy over the years.

So is it true that "Surgery still remains the most capable strategy for inducing robust and long-term weight loss"? May I see the source please? The (US) National Weight Control Registry research does not mention surgery at all in their summary of how most of their participants lost long-term weight.

But I am even more interested that New Zealand's tax money supports industries that support obesity. Fatty cholesterol-rich foods like beef, pork, chicken, eggs, and dairy. "Added-value" processed foods, which take natural raw foods and package them for the highest profit and shelf life instead of fiber and nutrients. Food technology trumps food quality.

Calorie density

Why does this matter? Jeff Novick, RD, MS explains in this article and this video presentation, but in short, calorie density reigns supreme in how much people eat.

Steak doesn't fill you up like oatmeal. Potato chips won't fill you up like potatoes.

Where the money goes

So if we're going to tweak our economic contribution to solve the obesity epidemic, let's not psych everyone into thinking we have to catch up with the Aussies in dangerous life-altering surgery rates.

Let's at least stop being part of the problem, and remove tax funding from those industries harming our national health. Restrict their advertising which often reports positive health benefits or just plain fun...and often arrives in our schools to advertise to our children.

Help make healthy food cheaper, more available, and more acceptable instead.

Original Link

We Can End the Heart Disease Epidemic

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Many of the diseases that are common in United States are rare or even nonexistent in populations eating mainly whole plant foods.

These so-called Western Diseases are some of our most common conditions:

  • Obesity, the most important nutritional disease
  • Hiatal hernia, one of the most common stomach problems
  • Hemorrhoids and varicose veins, the most common venous disorders
  • Colorectal cancer, the number two cause of cancer death
  • Diverticulosis, the #1 disease of the intestine
  • Appendicitis, the #1 cause for emergency abdominal surgery
  • Gallbladder disease, the #1 cause for nonemergency abdominal surgery
  • Ischemic heart disease, the #1 cause of death

These diseases are common in the West, but are rarities among plant-based populations.

A landmark study in 1959 I profiled in my video Cavities and Coronaries: Our Choice, for example, suggested that coronary heart disease was practically non-existent among those eating traditional plant-based diets in Uganda.

"Doctors in sub-Saharan Africa during the '30s and '40s recognized that certain diseases commonly seen in Western communities were rare in rural African peasants. This hearsay talk greeted any new doctor on arrival in Africa. Even the teaching manuals stated that diabetes, coronary heart disease, appendicitis, peptic ulcer, gallstones, hemorrhoids, and constipation were rare in African blacks who eat foods that contain many skins and fibers, such as beans and corn, and pass a bulky stool two or three times a day. Surgeons noticed that the common acute abdominal emergencies in Western communities were virtually absent in rural African peasants."

But did they have hard data to back it up? Yes.

Major autopsy series were performed. In one thousand Kenyan autopsies, there were "no cases of appendicitis, not a single heart attack, only three cases of diabetes, one peptic ulcer, no gallstones, and no evidence of high blood pressure" (which alone affects one out of three Americans).

Maybe the Africans were just dying early of other diseases and so never lived long enough to get heart disease? No. In the video One in a Thousand: Ending the Heart Disease Epidemic, you can see the age-matched heart attack rates in Uganda versus St. Louis. Out of 632 autopsies in Uganda, only one myocardial infarction. Out of 632 Missourians--with the same age and gender distribution--there were 136 myocardial infarctions. More than 100 times the rate of our number one killer. In fact, researchers were so blown away that they decided to do another 800 autopsies in Uganda. Still, just that one small healed infarct (meaning it wasn't even the cause of death) out of 1,427 patients. Less than one in a thousand, whereas in the U.S., it's an epidemic.

If heart disease is so rare in rural Africa, how do the local doctors even know what to look for? Though practically unheard of among the native population, the physicians are quite familiar with heart disease because of all the Westerners that immigrate to the country.

The famous surgeon Dr. Denis Burkitt insisted that modern medicine is treating disease all wrong:

"A highly unacceptable fact--that is rarely considered yet indisputable--is that, with rare exceptions, there is no evidence that the incidence of any disease was ever reduced by treatment. Improved therapies may reduce mortality but may not reduce the incidence of the disease."

Take cancer, for example, where the vast majority of effort is devoted to advances in treatment, and second priority is given to screening programs attempting early diagnosis. Is there any evidence that the incidence of any form of cancer has been reduced by improved treatment or by early detection? Early diagnosis may reduce mortality rates, and medical services can have a profoundly beneficial effect on sick people, but neither have little (if any) effect on the number of people becoming ill. No matter how fancy heart disease surgery gets, it's never going to reduce the number of people falling victim to the disease.

Dr. Burkitt compared the situation to an engine left out in the rain:

"If an engine repeatedly stops as a consequence of being exposed to the elements, it is of limited value to rely on the aid of mechanics to detect and remedy the fault. Examination of all engines would reveal that those out in the rain were stopping, but those under cover were running well. The correct approach would then be to provide protection from the offending environment. However, considering the failing engine as the ailing patient, this is seldom the priority of modern medicine."

Dr. Burkitt sums it up with the analogy of The Cliff or the Ambulance:

"If people are falling over the edge of a cliff and sustaining injuries, the problem could be dealt with by stationing ambulances at the bottom or erecting a fence at the top. Unfortunately, we put far too much effort into the provision of ambulances and far too little into the simple approach of erecting fences."

And of course there are all the industries enticing people to the edge, and profiting from pushing people off.

If all plant-based diets could do is reverse our number one killer, then shouldn't that be the default diet until proven otherwise? The fact that it also appears to reverse other leading killers like diabetes and hypertension appears to make the case for plant-based eating overwhelming. So why doesn't the medical profession embrace it? It may be because of The Tomato Effect. Why don't many individual doctors do it? It may be because lifestyle medicine hurts the bottom line (see Lifestyle Medicine: Treating the Causes of Disease). Why doesn't the federal government recommend it? It may be because of the self-interest of powerful industries (see The McGovern Report). But you can take your destiny into your own hands (mouth?) and work with your doctor to clean up your diet and maximize your chances of living happily ever after.

-Michael Greger, M.D.

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

Image Credit: Sinn Fien / Flickr

Original Link

4 Things To Help Prevent Most Disease

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Though I was trained as a general practitioner, my chosen specialty is lifestyle medicine. Most of the reasons we go see our doctors are for diseases that could have been prevented. But lifestyle medicine is not just about preventing chronic disease--it's also about treating it. And not just treating the disease, but treating the causes of disease.

If people just did four simple things--not smoking, exercising a half hour a day, eating a diet that emphasizes whole plant foods, and not becoming obese--they may prevent most cases of diabetes and heart attacks, half of strokes, and a third of cancers. Even modest changes may be more effective in reducing cardiovascular disease, high blood pressure, heart failure, stroke, cancer, diabetes, and all-cause mortality than almost any other medical intervention.

The key difference between conventional medicine and lifestyle medicine is instead of just treating risk factors, we treat the underlying causes of disease, as Drs. Hyman, Ornish, and Roizen describe in their landmark editorial Lifestyle medicine: treating the causes of disease. Doctors typically treat "risk factors" for disease by giving a lifetime's worth of medications to lower high blood pressure, elevated blood sugar, and high cholesterol. But think about it: high blood pressure is just a symptom of diseased and dysfunctional arteries. We can artificially lower blood pressure with drugs, but that's not treating the underlying cause. To treat the underlying cause, we need things like diet and exercise, the "penicillin" of lifestyle medicine (See Lifestyle Medicine: Treating the Causes of Disease).

As Dr. Dean Ornish is fond of saying, disregarding the underlying causes and treating only risk factors is somewhat like mopping up the floor around an over-flowing sink instead of just turning off the faucet, which is why medications usually have to be taken for a lifetime. As Dr. Denis Burkitt described, "if a floor is flooded as a result of a dripping tap, it is of little use to mop up the floor unless the tap is turned off. The water from the tap represents the cost of disease, and the flooded floor represents the diseases filling our hospital beds. Medical students learn far more about methods of floor mopping than about turning off taps, and doctors who are specialists in mops and brushes can earn infinitely more money than those dedicated to shutting off taps." And the drug companies are more than happy to sell rolls of paper towels so patients can buy a new roll every day for the rest of their lives. Paraphrasing poet, Ogden Nash, modern medicine is making great progress, but is headed in the wrong direction.

When the underlying lifestyle causes are addressed, patients often are able to stop taking medication or avoid surgery. We spend billions cracking patients' chests open, but only rarely does it actually prolong anyone's life. Instead of surgery, why not instead wipe out at least 90% of heart disease through prevention? Heart disease accounts for more premature deaths than any other illness and is almost completely preventable simply by changing diet and lifestyle, and the same dietary changes required can prevent or reverse many other chronic diseases as well.

So why don't more doctors do it?

One reason is doctors don't get paid to do it. No one profits from lifestyle medicine, so it is not part of medical education or practice. Presently, physicians lack training and financial incentives, so they continue to do what they know how to do: prescribe medication and perform surgery.

After Dean Ornish proved you could open up arteries and reverse our number one cause of death, heart disease, with just a plant-based diet and other healthy lifestyle changes (see Resuscitating Medicare and Our Number One Killer Can Be Stopped), he thought that his studies would have a meaningful effect on the practice of mainstream cardiology. After all, he had found a cure for our #1 killer! But, he admits, he was mistaken. "Physician reimbursement," he realized, "is a much more powerful determinant of medical practice than research."

Reimbursement over research. Salary over science. Wealth over health. Not a very flattering portrayal of the healing profession. But if doctors won't do it without getting paid, let's get them paid.

So Dr. Ornish went to Washington. He argued that if we train and pay for doctors to learn how to help patients address the real causes of disease with lifestyle medicine and not just treat disease risk factors we could save trillions of dollars. And that's considering only heart disease, diabetes, prostate and breast cancer. The Take Back Your Health Act was introduced in the U.S. Senate to induce doctors to learn and practice lifestyle medicine, not only because it works better, but because they will be paid to do it. Sadly, the bill died, just like millions of Americans will continue to do with reversible chronic diseases.

By treating the root causes of diseases with plants not pills, we can also avoid the adverse side effects of prescription drugs that kill more than 100,000 Americans every year, effectively making doctors a leading cause of death in the United States. See One in a Thousand: Ending the Heart Disease Epidemic and my live presentation Uprooting the Leading Causes of Death.

-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 More Than an Apple a Day and From Table to Able.

Image Credit: Punchyy / Flickr

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Chronic Headaches and Pork Parasites

NF-Aug26 Chronic Headaches and Pork Parasite.jpg

Neurocysticercosis is the sciencey name for an infection of the human central nervous system by pork tapeworm larvae. The invasion of baby pork tapeworms in the brain "has become an increasingly important emerging infection in the United States," and is the #1 cause of epilepsy in the world. It is the most common parasitic disease of the human brain and used to be found throughout only the developing world (with the exception of Muslim countries, since less pork is consumed there). That all changed about 30 years ago, and now it's increasingly found throughout North America.

Besides seizures, the pork parasites may actually trigger brain tumors or cause an aneurism or psychiatric manifestation like depression. It can also result in dementia, but with deworming drugs this is often reversible. Only rarely do surgeons have to surgically remove the larvae.

I've talked about pork tapeworms before (see my videos Pork Tapeworms on the Brain, Avoiding Epilepsy Through Diet, and Not So Delusional Parasitosis). What's new is that we now know that they may present as chronic headaches--either migraines or so-called "tension-headaches"--even when the worms in our head are dead. What researchers think is happening is that as our body tries to chip away at the worms' calcified bodies, bits of them may be released into the rest of our brain causing inflammation that could be contributing to headaches.

This condition is rare even in endemic areas, but we can avoid getting infested with an adult tapeworm in the first place by cooking pork thoroughly. It's found in some parts of pig carcasses more than others (see the meat chart here), and the worms can be frozen to death no matter how infested the muscles are by storing pork (cut up into small pieces) for a month at subzero temperatures. Then to ensure the larvae are dead the meat is recommended to be cooked for more than two hours. That's one well-done pork chop!

The New England Journal of Medicine recently featured a case of some guy who must have had thousands of pork tapeworm larvae wriggling through his muscles. In my video, Chronic Headaches and Pork Tapeworms, you can see an x-ray, showing the thousands of little white streaks in this man's body. Each white streak is a baby tapeworm. That's why you can get infected by pork, it gets in the muscles. So cannibals might want to cook for two hours too.

Not all parasites are associated with meat, though. An anxious but healthy 32-year-old male physician presented to the family medicine clinic with a sample of suspected parasites from his stools, which had been retrieved from the toilet that same day. They looked to be about an inch long. He had previously traveled to India, had Chinese food the night before--who knows what he had. Maybe it was hookworms? The sample was sent to the microbiology laboratory for analysis. Later that day, the microbiology physician called to report positive identification of Vigna radiata (previously known as Phaseolus aureus) in the stool sample. Or in common parlance, a bean sprout. They were bean sprouts!

"The patient was called and gently but firmly informed of the diagnosis. Given the nature of the identified specimen, the information was presented in a non-judgmental, respectful manner so as not to offend the sensibilities or sensitivities of the patient."

Their parting advice to fellow physicians in cases of this nature was as follows: "as comical as the findings might seem--try not to laugh!"

Other parasites in meat include toxoplasma (Brain Parasites in Meat), sarcosystis (USDA Parasite Game), and Anisakis (Allergenic Fish Worms). There can even be critters in some dairy products (Cheese Mites and Maggots). Eating Outside Our Kingdom describes a brain malady caused not by meat parasites, but by meat proteins themselves.

One of the nice things about eating plant-based is that plant parasites, like aphids, don't affect people. When is the last time you heard of someone coming down with a bad case of Dutch elm disease?

If you haven't yet, you can subscribe to my videos for free by clicking here.

-Michael Greger, M.D.

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

Image Credit: ML Cohen / Flickr

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