Why Would Eating Fish Increase Diabetes Risk?

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In the past two years, six separate meta-analyses have been published on the relationship between fish consumption and type 2 diabetes. The whole point of a meta-analysis is to compile the best studies done to date and see what the overall balance of evidence shows. The fact that there are six different ones published recently highlights how open the question remains. One thread of consistency, though, was that fish consumers in the United States tended to be at greater risk for diabetes.

If we include Europe, then fish eaters appeared to have a 38% increased risk of diabetes. On a per serving basis, that comes out to be about a 5% increase in risk for every serving of fish one has per week. To put that into perspective, a serving of red meat per day is associated with 19% increase in risk. Just one serving per day of fish would be equivalent to a 35% increase in risk. But why might fish be worse than red meat?

Fish intake may increase type 2 diabetes risk by increasing blood sugar levels, as a review of the evidence commissioned by the U.S. government found. The review found that blood sugars increase in diabetics given fish oil. Another possible cause is that omega 3's appear to cause oxidative stress. A recent study, highlighted in my video, Fish and Diabetes, found that the insulin producing cells in the pancreas don't appear to work as well in people who eat two or more servings of fish a week. Or it may not be related to omega 3's at all but rather the environmental contaminants that build up in fish.

It all started with Agent Orange. We sprayed 20 million gallons of the stuff on Vietnam, and some of it was contaminated with trace amounts of dioxins. Though the Red Cross estimates that a million Vietnamese were adversely affected, what about all the servicemen who were exposed spraying it across the countryside? Reports started showing up that veterans exposed to Agent Orange appeared to have higher diabetes rates than unexposed veterans, a link that's now officially recognized.

These so-called "persistent organic pollutants" are mainly man-made industrial chemicals and are among the most hazardous compounds ever synthesized. They include dioxins, PCBs, and certain chlorine-containing pesticides, all of which are highly resistant to breakdown in the environment.

Initially condemned for their deleterious effect on reproductive function and their ability to cause cancer, there is now a growing body of evidence showing that exposure to these pollutants leads to metabolic diseases such as diabetes. This is a breakthrough that "should require our greatest attention."

For more on the role industrial pollutants may play in our diabetes epidemic, see Diabetes and Dioxins and Pollutants in Salmon and Our Own Fat.

More on the changing views surrounding fish oil supplements in Is Fish Oil Just Snake Oil?

Other foods associated with diabetes risk include processed meat and eggs. See Bacon, Eggs, and Gestational Diabetes During Pregnancy and Eggs and Diabetes, while Indian gooseberries and flaxseeds may help (Amla Versus Diabetes and Flaxseed vs. Diabetes).

Other videos on how polluted our oceans now are include:

-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: Gideon / Flickr

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6 Ways To Strengthen Immunity

A vegan diet has been shown to reduce your risk for many chronic illnesses and many people report a reduced incidence of viruses and other common bugs. However, it is not foolproof. Vegans are human. Vegans get sick, too. Here are 6 ways to strengthen immunity: 1.Exercise. The lymphatic system is perpetuated and stimulated by …

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Tarragon Toxicity?

 

 

 

 

 

 

 

 

The Safety of Tarragon

Decades ago, concern was raised about some of the components of the herb tarragon. The European Union’s Health & Consumer Protection Scientific Committee on Food concluded that one of the constituents may act as a carcinogen and damage DNA, and so recommended its use be restricted. But they were talking about an isolated chemical from tarragon being used as a flavoring agent in items like alcoholic beverages, canned fish, and fats and oils. As recently as 2011, reviews concluded that consumption of the tarragon leaves themselves should present little or no risk, but that was based on studies done on rats.

A 2012 study made me feel better, suggesting that while the isolated tarragon chemical was toxic to human liver cells, full extracts of the leaves were not, so the whole food may contain compounds that counteract the toxic effects.

I was going to leave it at that and not even do a video about it, but a 2013 study on human white blood cells reopened the question, finding that whole leaf tarragon extracts may have DNA damaging properties after all. I show the results of the comet test in my 3-min video The Safety of Tarragon.  For those scratching their heads over the significance of that red smudge, see my explanation of the comet tail test in Cancer, Interrupted: Garlic & Flavonoids.

The researchers postulate that tarragon does indeed appear to be mutagenic, however the current data is “not comprehensive enough to draw definitive conclusions regarding its potential risk to human health with sustained use.” “Nevertheless,” they warn, “future use of tarragon… should be undertaken with an awareness of the… potential toxicity.”

So what have I taken away from all this? Well my family eats tarragon so rarely that it’s probably not going to change our intake at all, but if you’re a tarragon fanatic, I’d suggest moderating your intake and substituting another herb like a dash of fennel or anise seed, or chervil, all of which have a similar licorice-like tarragon taste. The only caveat I could find for chervil is that you probably shouldn’t pick it wild, as it bears a resemblance to an herb known all too well to Socrates (poison hemlock).

For those that missed my last two videos on the safety of common spices, see Update on Cinnamon for Blood Sugar Control and Don’t Eat Too Much Nutmeg.

This new tarragon finding reminds me a bit about the in vitro data raising questions about the safety of avocados (Are Avocados Bad for You?) that thankfully appeared to not translate out in a population study. I’ll keep an eye out for new data and post to the NutritionFacts.org Facebook page if I find anything. Meanwhile, there are a bunch of other reasons to avoid canned fish beyond just the potential tarragon extract toxicity:

-Michael Greger, M.D.

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

Image credit: Tim Dorr / Flickr

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Nutmeg Toxicity

 

 

 

 

 

 

 

 

Can Too Much Nutmeg Be Toxic?

The spice nutmeg appears to have a relatively narrow margin of safety.

In my research on cinnamon I ran across a peculiar paper entitled “Christmas Gingerbread and Christmas Cheer: Review of the Potential Role of Mood Elevating Amphetamine-like Compounds.” The author suggested that certain natural constituents of spices such as nutmeg may form amphetamine compounds within the body “sufficient to elevate the mood and help provide some added Christmas cheer” during the holiday season.

This hypothetical risk was raised as far back as the Sixties in the New England Journal of Medicine in an article called “Nutmeg Intoxication.” The paper pondered whether the age-old custom of adding nutmeg to eggnog arose from the psychopharmacological effects described in cases of nutmeg intoxication. Such cases evidently go back to the 1500s, when it was used as an abortifacient to induce a miscarriage and in the 1960s as a psychotropic drug.

Mental health professionals from the ’60s concluded that while nutmeg “is much cheaper for use and probably less dangerous than the habit-forming heroin, it must be stated that it is not free from danger and may cause death.”

The toxic dose of nutmeg is two to three teaspoons.

I assumed no one would ever come close to that amount unintentionally until I saw report in which a couple ate some pasta, collapsed, and were subsequently hospitalized. It was a big mystery until “On close questioning, the husband revealed that he had accidentally added one third of a 30g spice jar of nutmeg to the meal whilst cooking it.” That’s about 4 teaspoons–I don’t know how they could have eaten it! I imagine the poor wife just trying to be polite.

There are also potentially toxic compounds in certain types of cinnamon. See my video Update on Cinnamon for Blood Sugar Control.

We can also overdo other healthful plant foods if we consume too much of the yellow curry spice turmeric, drink too much tea, or eat too much soytoo much seaweedtoo many broccoli sprouts, and even too many raw cruciferous vegetables.

The final video in this three part series on the latest on spice safety is The Safety of Tarragon.

-Michael Greger, M.D.

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

Image credit: Simo ubuntu / Wikimedia Commons

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Cinnamon for Diabetes

 

 

 

 

 

 

 

 

Does Cinnamon Help Lower Blood Sugars?

The use of cinnamon to help treat diabetes remains controversial. We know that cinnamon is so good at controlling one’s blood sugar that you can cheat on a diabetes test by consuming two teaspoons of cinnamon the night before your glucose tolerance test. That’s where they make you drink some sugar water to see how well your body can keep your blood sugar levels under control, and if you eat those two teaspoons right when the test starts or 12 hours before you can significantly blunt the spike. Even a teaspoon a day appears to make a significant difference. A review of the best studies done to date found that the intake of cinnamon by type 2 diabetics or prediabetics does lower their blood glucose significantly. So what’s the controversy?

Well, as I described in my video The Safer Cinnamon, cassia cinnamon, also known as Chinese cinnamon (probably what you’re getting at the store if it just says “cinnamon”) contains a compound called coumarin which may be toxic to the liver at high doses. Originally the concern was mainly for kids during Christmas-time where they might get an above average exposure, but more recently some researchers suggest that kids just sprinkling some cassia cinnamon on their oatmeal a few times a week might exceed the recommended safety limit.

As you can see in my 5-min video Update on Cinnamon for Blood Sugar Control just a quarter teaspoon of cinnamon a few times a week may be too much for little kids, and if they’re eating that cinnamon-sprinkled oatmeal more like every day they can bump up against the limit for adults. So a teaspoon a day of cassia cinnamon might be too much for anyone, but can’t we just switch from cassia cinnamon to Ceylon cinnamon and get the benefits without the potential risks? Without the risks, yes, but we’re no longer so sure about the benefits.

Nearly all of the studies showing blood sugar benefits of cinnamon have been done on cassia. We’ve just assumed that the same would apply for the safer cinnamon, Ceylon, but only recently was it put to the test. That nice blunting of blood sugars we saw in response to cassia cinnamon disappeared when the researchers tried Ceylon cinnamon instead.  In fact, it may actually be the potentially toxic coumarin that was the active ingredient in the cassia cinnamon all along. Thus, sidestepping the toxin by switching may sidestep the benefit.

So should we just give up on going out of our way to add cinnamon to our diet? No, I think it’s still a good idea to shoot for a teaspoon a day of Ceylon cinnamon since there are a bunch of other benefits linked to cinnamon besides blood sugar control, not the least of which is it’s potent antioxidant content (as I show in my one of my favorite videos Antioxidants in a Pinch). In my Superfood Bargains video, where I rank foods in terms of antioxidants per unit cost, cinnamon comes out as one of the cheapest food sources of antioxidants, beating out cloves and coming in just under purple cabbage. What about the Oxalates in Cinnamon? Not a problem, but the oxalates in too much turmeric may be a concern. As you’re making a Healthy Pumpkin Pie with all that cinnamon, don’t accidentally add too much nutmeg, though, the subject of my follow-up video Don’t Eat Too Much Nutmeg.

Ultimately cinnamon can no longer be considered a safe and effective treatment for diabetes. Either you’re using cassia cinnamon, and it’s effective, but may not be safe, or you’re using Ceylon cinnamon, which is safe, but does not appear effective. Note that even the cassia cinnamon only brought down blood sugars modestly (in other words, only as good as the leading diabetes drug in the world, metformin, sold as Glucophage). So yes, it may work as good as the leading drug, but that’s not saying much. The best way to treat diabetes is to attempt to cure it completely, reversing diabetes with a healthy diet.  Books I would recommend (in order of publication) are Defeating DiabetesDr. Neal Barnard’s Program for Reversing Diabetes, and The End of Diabetes.

I talk more about the potential potency of plants in general in Power Plants and more about spices in particular in videos such as:

Amla Versus Diabetes explores the use of Indian gooseberries as a way to help control blood sugar, though, again, the best way to deal with diabetes is to prevent and treat it with a healthy diet.

-Michael Greger, M.D.

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

Image credit: CINNAMON VOGUE / Flickr

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