Treating Kidney Stones with Diet

Treating Kidney Stones with Diet.jpeg

Studies suggest that excessive consumption of animal protein poses a risk of kidney stone formation, likely due to the acid load contributed by the high content of sulfur-containing amino acids in animal protein, a topic I explore in my video, Preventing Kidney Stones with Diet. What about treating kidney stones, though? I discuss that in How to Treat Kidney Stones with Diet. Most stones are calcium oxalate, formed like rock candy when the urine becomes supersaturated. Doctors just assumed that if stones are made out of calcium, we simply have to tell people to reduce their calcium intake. That was the dietary gospel for kidney stone sufferers until a 2002 study published in the New England Journal of Medicine pitted two diets against one another--a low-calcium diet versus a diet low in animal protein and salt. The restriction of animal protein and salt provided greater protection, cutting the risk of having another kidney stone within five years in half.

What about cutting down on oxalates, which are concentrated in certain vegetables? A recent study found there was no increased risk of stone formation with higher vegetable intake. In fact, greater dietary intake of whole plant foods, fruits, and vegetables were each associated with reduced risk independent of other known risk factors for kidney stones. This means we may get additional benefits bulking up on plant foods in addition to just restricting animal foods.

A reduction in animal protein not only reduces the production of acids within the body, but should also limit the excretion of urate, uric acid crystals that can act as seeds to form calcium stones or create entire stones themselves. (Uric acid stones are the second most common kidney stones after calcium.)

There are two ways to reduce uric acid levels in the urine: a reduction of animal protein ingestion, or a variety of drugs. Removing all meat--that is, switching from the standard Western diet to a vegetarian diet--can remove 93% of uric acid crystallization risk within days.

To minimize uric acid crystallization, the goal is to get our urine pH up to ideally as high as 6.8. A number of alkalinizing chemicals have been developed for just this purpose, but we can naturally alkalize our urine up to the recommended 6.8 using purely dietary means. Namely, by removing all meat, someone eating the standard Western diet can go from a pH of 5.95 to the goal target of 6.8--simply by eating plant-based. As I describe in my video, Testing Your Diet with Pee & Purple Cabbage, we can inexpensively test our own diets with a little bathroom chemistry, for not all plant foods are alkalinizing and not all animal foods are equally acidifying.

A Load of Acid to Kidney Evaluation (LAKE) score has been developed to take into account both the acid load of foods and their typical serving sizes. It can be used to help people modify their diet for the prevention of both uric acid and calcium kidney stones, as well as other diseases. What did researchers find? The single most acid-producing food is fish, like tuna. Then, in descending order, are pork, then poultry, cheese (though milk and other dairy are much less acidifying), and beef followed by eggs. (Eggs are actually more acidic than beef, but people tend to eat fewer eggs in one sitting.) Some grains, like bread and rice, can be a little acid-forming, but pasta is not. Beans are significantly alkaline-forming, but not as much as fruits or even better, vegetables, which are the most alkaline-forming of all.

Through dietary changes alone, we may be able to dissolve uric acid stones completely and cure patients without drugs or surgery.

To summarize, the most important things we can do diet-wise is to drink 10 to 12 cups of water a day, reduce animal protein, reduce salt, and eat more vegetables and more vegetarian.

Want to try to calculate their LAKE score for the day? Just multiply the number of servings you have of each of the food groups listed in the graph in the video times the score.

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

Original Link

Treating Kidney Stones with Diet

Treating Kidney Stones with Diet.jpeg

Studies suggest that excessive consumption of animal protein poses a risk of kidney stone formation, likely due to the acid load contributed by the high content of sulfur-containing amino acids in animal protein, a topic I explore in my video, Preventing Kidney Stones with Diet. What about treating kidney stones, though? I discuss that in How to Treat Kidney Stones with Diet. Most stones are calcium oxalate, formed like rock candy when the urine becomes supersaturated. Doctors just assumed that if stones are made out of calcium, we simply have to tell people to reduce their calcium intake. That was the dietary gospel for kidney stone sufferers until a 2002 study published in the New England Journal of Medicine pitted two diets against one another--a low-calcium diet versus a diet low in animal protein and salt. The restriction of animal protein and salt provided greater protection, cutting the risk of having another kidney stone within five years in half.

What about cutting down on oxalates, which are concentrated in certain vegetables? A recent study found there was no increased risk of stone formation with higher vegetable intake. In fact, greater dietary intake of whole plant foods, fruits, and vegetables were each associated with reduced risk independent of other known risk factors for kidney stones. This means we may get additional benefits bulking up on plant foods in addition to just restricting animal foods.

A reduction in animal protein not only reduces the production of acids within the body, but should also limit the excretion of urate, uric acid crystals that can act as seeds to form calcium stones or create entire stones themselves. (Uric acid stones are the second most common kidney stones after calcium.)

There are two ways to reduce uric acid levels in the urine: a reduction of animal protein ingestion, or a variety of drugs. Removing all meat--that is, switching from the standard Western diet to a vegetarian diet--can remove 93% of uric acid crystallization risk within days.

To minimize uric acid crystallization, the goal is to get our urine pH up to ideally as high as 6.8. A number of alkalinizing chemicals have been developed for just this purpose, but we can naturally alkalize our urine up to the recommended 6.8 using purely dietary means. Namely, by removing all meat, someone eating the standard Western diet can go from a pH of 5.95 to the goal target of 6.8--simply by eating plant-based. As I describe in my video, Testing Your Diet with Pee & Purple Cabbage, we can inexpensively test our own diets with a little bathroom chemistry, for not all plant foods are alkalinizing and not all animal foods are equally acidifying.

A Load of Acid to Kidney Evaluation (LAKE) score has been developed to take into account both the acid load of foods and their typical serving sizes. It can be used to help people modify their diet for the prevention of both uric acid and calcium kidney stones, as well as other diseases. What did researchers find? The single most acid-producing food is fish, like tuna. Then, in descending order, are pork, then poultry, cheese (though milk and other dairy are much less acidifying), and beef followed by eggs. (Eggs are actually more acidic than beef, but people tend to eat fewer eggs in one sitting.) Some grains, like bread and rice, can be a little acid-forming, but pasta is not. Beans are significantly alkaline-forming, but not as much as fruits or even better, vegetables, which are the most alkaline-forming of all.

Through dietary changes alone, we may be able to dissolve uric acid stones completely and cure patients without drugs or surgery.

To summarize, the most important things we can do diet-wise is to drink 10 to 12 cups of water a day, reduce animal protein, reduce salt, and eat more vegetables and more vegetarian.

Want to try to calculate their LAKE score for the day? Just multiply the number of servings you have of each of the food groups listed in the graph in the video times the score.

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

Original Link

Ginger Root for Migraines

Ginger Root for Migraines.jpeg

Many successful herbal treatments start like this: Some doctor learns that some plant has been used in some ancient medical tradition, like ginger for headaches. Well, the physician has patients with headaches and so tries advising one with migraines to give it a try since it's just some safe, common spice. At the first sign of a migraine coming on, the patient mixed a quarter teaspoon of powdered ginger in some water, drank it down, and poof! Within a half-hour, the migraine went away. It worked every time for them with no side effects. That's what's called a case report.

In my video, Ginger for Migraines, I show the remarkable case report, but case reports are really just glorified anecdotes. Case reports have played an important role in the history of medicine, though. AIDS was first discovered as a series of case reports. Some young guy walks into a clinic in Los Angeles with a bad case of thrush, and the rest is history. Reports of an unusual side effect of a failed chest pain drug led to the billion-dollar blockbuster, Viagra. Case reports may represent the weakest level of evidence, but they are often the first line of evidence, where everything starts. The ginger and migraine report isn't helpful in itself, but it can inspire researchers to put the treatment to the test.

The problem is, who's going to fund it? The market for migraine drugs is worth billions of dollars. A quarter teaspoon of powdered ginger costs about a penny. Who would fund a study pitting ginger versus the leading migraine drug?

No one... that is, until now. A double-blinded, randomized, controlled, clinical trial compared the efficacy of ginger to sumatriptan, also known as Imitrex, one of the top-selling billion-dollar drugs in the world in the treatment of migraine headaches. Researchers tried using only one-eighth of a teaspoon of powdered ginger versus a good dose of the drug.

They both worked just as well and just as fast.

Most patients started out in moderate or severe pain but, after taking the ginger or the drug, ended up in mild pain or completely pain-free. The same proportion of migraine sufferers reported satisfaction with the results either way. As far as I'm concerned, ginger won--not only because it's a few billion dollars cheaper than the drug, but because there were significantly fewer side effects in the ginger group. People taking sumatriptan reported dizziness, a sedative effect, vertigo, and heartburn. The only thing reported for ginger was an upset tummy in about 1 out of 25 people. (As a note of caution, taking a whole tablespoon of ginger powder at one time on an empty stomach could irritate anyone's stomach.)

An eighth of a teaspoon of ginger is not only up to 3000-times cheaper than the drug, but you're also less likely to end up as a case report yourself of someone who had a heart attack or died after taking the drug--tragedies that have occurred due to sumatriptan.

These are my favorite kinds of posts to do because I can offer something that is immediately practical, cheap, safe, and effective to reduce suffering. If this kind of information helps you or someone you love, I hope you'll consider making a tax-deductible donation to support the nonprofit organization that runs NutritionFacts.org. We have a growing staff and server costs to cover, and any help you could give would be much appreciated (and there are perks!).

For more on ginger root:

Avoiding aspartame (Aspartame and the Brain) and using lavender may also help (Lavender for Migraine Headaches). If you have cluster headaches, ask your physician about capsaicin (Hot Sauce in the Nose for Cluster Headaches?).

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

Original Link

Ginger Root for Migraines

Ginger Root for Migraines.jpeg

Many successful herbal treatments start like this: Some doctor learns that some plant has been used in some ancient medical tradition, like ginger for headaches. Well, the physician has patients with headaches and so tries advising one with migraines to give it a try since it's just some safe, common spice. At the first sign of a migraine coming on, the patient mixed a quarter teaspoon of powdered ginger in some water, drank it down, and poof! Within a half-hour, the migraine went away. It worked every time for them with no side effects. That's what's called a case report.

In my video, Ginger for Migraines, I show the remarkable case report, but case reports are really just glorified anecdotes. Case reports have played an important role in the history of medicine, though. AIDS was first discovered as a series of case reports. Some young guy walks into a clinic in Los Angeles with a bad case of thrush, and the rest is history. Reports of an unusual side effect of a failed chest pain drug led to the billion-dollar blockbuster, Viagra. Case reports may represent the weakest level of evidence, but they are often the first line of evidence, where everything starts. The ginger and migraine report isn't helpful in itself, but it can inspire researchers to put the treatment to the test.

The problem is, who's going to fund it? The market for migraine drugs is worth billions of dollars. A quarter teaspoon of powdered ginger costs about a penny. Who would fund a study pitting ginger versus the leading migraine drug?

No one... that is, until now. A double-blinded, randomized, controlled, clinical trial compared the efficacy of ginger to sumatriptan, also known as Imitrex, one of the top-selling billion-dollar drugs in the world in the treatment of migraine headaches. Researchers tried using only one-eighth of a teaspoon of powdered ginger versus a good dose of the drug.

They both worked just as well and just as fast.

Most patients started out in moderate or severe pain but, after taking the ginger or the drug, ended up in mild pain or completely pain-free. The same proportion of migraine sufferers reported satisfaction with the results either way. As far as I'm concerned, ginger won--not only because it's a few billion dollars cheaper than the drug, but because there were significantly fewer side effects in the ginger group. People taking sumatriptan reported dizziness, a sedative effect, vertigo, and heartburn. The only thing reported for ginger was an upset tummy in about 1 out of 25 people. (As a note of caution, taking a whole tablespoon of ginger powder at one time on an empty stomach could irritate anyone's stomach.)

An eighth of a teaspoon of ginger is not only up to 3000-times cheaper than the drug, but you're also less likely to end up as a case report yourself of someone who had a heart attack or died after taking the drug--tragedies that have occurred due to sumatriptan.

These are my favorite kinds of posts to do because I can offer something that is immediately practical, cheap, safe, and effective to reduce suffering. If this kind of information helps you or someone you love, I hope you'll consider making a tax-deductible donation to support the nonprofit organization that runs NutritionFacts.org. We have a growing staff and server costs to cover, and any help you could give would be much appreciated (and there are perks!).

For more on ginger root:

Avoiding aspartame (Aspartame and the Brain) and using lavender may also help (Lavender for Migraine Headaches). If you have cluster headaches, ask your physician about capsaicin (Hot Sauce in the Nose for Cluster Headaches?).

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

Original Link

How Much Water Should We Drink Every Day?

How Much Water Should We Drink Every Day?.jpeg

More than 2000 years ago Hippocrates (460-377 BCE) said, "If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health." What does that mean when it comes to water? Water has been described as a neglected, unappreciated, and under-researched subject, and further complicating the issue, a lot of the papers extolling the need for proper hydration are funded by the bottled water industry.

It turns out the often quoted "drink at least eight glasses of water a day" dictum has little underpinning scientific evidence . Where did that idea come from? The recommendation was traced to a 1921 paper, in which the author measured his own pee and sweat and determined we lose about 3% of our body weight in water a day, or about 8 cups (see How Many Glasses of Water Should We Drink in a Day?). Consequently, for the longest time, water requirement guidelines for humanity were based on just one person.

There is evidence that not drinking enough may be associated with falls and fractures, heat stroke, heart disease, lung disorders, kidney disease, kidney stones, bladder and colon cancer, urinary tract infections, constipation, dry mouth, cavities, decreased immune function and cataract formation. The problem with many of these studies is that low water intake is associated with several unhealthy behaviors, such as low fruit and vegetable intake, more fast-food, less shopping at farmers markets. And who drinks lots of water? People who exercise a lot. No wonder they tend to have lower disease rates!

Only large and expensive randomized trials could settle these questions definitively. Given that water cannot be patented, such trials seem unlikely; who's going to pay for them? We're left with studies that find an association between disease and low water intake. But are people sick because they drink less, or are they drinking less because they're sick? There have been a few large prospective studies in which fluid intake is measured before disease develops. For example, a Harvard study of 48,000 men found that the risk of bladder cancer decreased by 7% for every extra daily cup of fluid we drink. Therefore, a high intake of water--like 8 cups a day--may reduce the risk of bladder cancer by about 50%, potentially saving thousands of lives.

The accompanying editorial commented that strategies to prevent the most prevalent cancers in the West are remarkably straightforward in principle. To prevent lung cancer, quit smoking; to prevent breast cancer, maintain your ideal body weight and exercise; and to prevent skin cancer, stay out of the sun. Now comes this seemingly simple way to reduce the risk of bladder cancer: drink more fluids.

Probably the best evidence we have for a cut off of water intake comes from the Adventist Health Study, in which 20,000 men and women were studied. About one-half were vegetarian, so they were also getting extra water by eating more fruits and vegetables. Those drinking 5 or more glasses of water a day had about half the risk of dying from heart disease compared to those who drank 2 or fewer glasses a day. Like the Harvard study, this protection was found after controlling for other factors such as diet and exercise. These data suggest that it was the water itself that was decreasing risk, perhaps by lowering blood viscosity (blood thickness).

Based on all the best evidence to date, authorities from Europe, the U.S. Institute of Medicine, and the World Health Organization recommend between 2.0 and 2.7 liters (8 to 11 cups) of water a day for women, and 2.5 to 3.7 liters (10 to 15 cups) a day for men. This includes water from all sources, not just beverages. We get about a liter from food and the water our body makes. So this translates into a recommendation for women to drink 4 to 7 cups of water a day and men 6 to 11 cups, assuming only moderate physical activity at moderate ambient temperatures.

We can also get water from all the other drinks we consume, including caffeinated drinks, with the exception of stronger alcoholic drinks like wines and spirits. Beer can leave you with more water than you started with, but wine actively dehydrates you. However, in the cancer and heart disease studies I mentioned above, the benefits were only found with increased water consumption, not other beverages.

I've previously touched on the cognitive benefits of proper hydration here: Does a Drink Of Water Make Children Smarter?

Surprised tea is hydrating? See my video Is Caffeinated Tea Dehydrating?

Surprised that the 8-a-day rested on such flimsy evidence? Unfortunately, so much of what we do in medicine has shaky underpinnings. That's the impetus behind the idea of evidence-based medicine (what a concept!). Ironically, this new movement may itself undermine some of the most effective treatments. See Evidence-Based Medicine or Evidence-Biased?

How else can we reduce our risk of bladder cancer? See Raw Broccoli and Bladder Cancer Survival.

What kind of water? I recommend tap water, which tends to be preferable from a chemical and microbial contamination standpoint. What about buying one of those fancy alkalizing machines? See Alkaline Water: a Scam?

It's so nice to have data on such a fundamental question. We have much to thank the Adventists for. You will see their studies cropping up frequently. See, for example, Plant-Based Diets and Diabetes, The Okinawa Diet: Living to 100, and Evidence-Based Eating.

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. Image has been modified.

Original Link

How Much Water Should We Drink Every Day?

How Much Water Should We Drink Every Day?.jpeg

More than 2000 years ago Hippocrates (460-377 BCE) said, "If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health." What does that mean when it comes to water? Water has been described as a neglected, unappreciated, and under-researched subject, and further complicating the issue, a lot of the papers extolling the need for proper hydration are funded by the bottled water industry.

It turns out the often quoted "drink at least eight glasses of water a day" dictum has little underpinning scientific evidence . Where did that idea come from? The recommendation was traced to a 1921 paper, in which the author measured his own pee and sweat and determined we lose about 3% of our body weight in water a day, or about 8 cups (see How Many Glasses of Water Should We Drink in a Day?). Consequently, for the longest time, water requirement guidelines for humanity were based on just one person.

There is evidence that not drinking enough may be associated with falls and fractures, heat stroke, heart disease, lung disorders, kidney disease, kidney stones, bladder and colon cancer, urinary tract infections, constipation, dry mouth, cavities, decreased immune function and cataract formation. The problem with many of these studies is that low water intake is associated with several unhealthy behaviors, such as low fruit and vegetable intake, more fast-food, less shopping at farmers markets. And who drinks lots of water? People who exercise a lot. No wonder they tend to have lower disease rates!

Only large and expensive randomized trials could settle these questions definitively. Given that water cannot be patented, such trials seem unlikely; who's going to pay for them? We're left with studies that find an association between disease and low water intake. But are people sick because they drink less, or are they drinking less because they're sick? There have been a few large prospective studies in which fluid intake is measured before disease develops. For example, a Harvard study of 48,000 men found that the risk of bladder cancer decreased by 7% for every extra daily cup of fluid we drink. Therefore, a high intake of water--like 8 cups a day--may reduce the risk of bladder cancer by about 50%, potentially saving thousands of lives.

The accompanying editorial commented that strategies to prevent the most prevalent cancers in the West are remarkably straightforward in principle. To prevent lung cancer, quit smoking; to prevent breast cancer, maintain your ideal body weight and exercise; and to prevent skin cancer, stay out of the sun. Now comes this seemingly simple way to reduce the risk of bladder cancer: drink more fluids.

Probably the best evidence we have for a cut off of water intake comes from the Adventist Health Study, in which 20,000 men and women were studied. About one-half were vegetarian, so they were also getting extra water by eating more fruits and vegetables. Those drinking 5 or more glasses of water a day had about half the risk of dying from heart disease compared to those who drank 2 or fewer glasses a day. Like the Harvard study, this protection was found after controlling for other factors such as diet and exercise. These data suggest that it was the water itself that was decreasing risk, perhaps by lowering blood viscosity (blood thickness).

Based on all the best evidence to date, authorities from Europe, the U.S. Institute of Medicine, and the World Health Organization recommend between 2.0 and 2.7 liters (8 to 11 cups) of water a day for women, and 2.5 to 3.7 liters (10 to 15 cups) a day for men. This includes water from all sources, not just beverages. We get about a liter from food and the water our body makes. So this translates into a recommendation for women to drink 4 to 7 cups of water a day and men 6 to 11 cups, assuming only moderate physical activity at moderate ambient temperatures.

We can also get water from all the other drinks we consume, including caffeinated drinks, with the exception of stronger alcoholic drinks like wines and spirits. Beer can leave you with more water than you started with, but wine actively dehydrates you. However, in the cancer and heart disease studies I mentioned above, the benefits were only found with increased water consumption, not other beverages.

I've previously touched on the cognitive benefits of proper hydration here: Does a Drink Of Water Make Children Smarter?

Surprised tea is hydrating? See my video Is Caffeinated Tea Dehydrating?

Surprised that the 8-a-day rested on such flimsy evidence? Unfortunately, so much of what we do in medicine has shaky underpinnings. That's the impetus behind the idea of evidence-based medicine (what a concept!). Ironically, this new movement may itself undermine some of the most effective treatments. See Evidence-Based Medicine or Evidence-Biased?

How else can we reduce our risk of bladder cancer? See Raw Broccoli and Bladder Cancer Survival.

What kind of water? I recommend tap water, which tends to be preferable from a chemical and microbial contamination standpoint. What about buying one of those fancy alkalizing machines? See Alkaline Water: a Scam?

It's so nice to have data on such a fundamental question. We have much to thank the Adventists for. You will see their studies cropping up frequently. See, for example, Plant-Based Diets and Diabetes, The Okinawa Diet: Living to 100, and Evidence-Based Eating.

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. Image has been modified.

Original Link

The Best Way to Wash Fruit and Vegetables

The Best Way to Wash Fruit and Vegetables.jpeg

How might we reduce our exposure to pesticide residues on fruits and vegetables? What about staying away from imported produce? Well, it turns out domestic produce may be even worse, dispelling the notion that imported fruits and vegetables pose greater potential health risks to consumers.

Buying organic dramatically reduces dietary exposure to pesticides, but it does not eliminate the potential risk. Pesticide residues are detectable in about one in ten organic crop samples, due to cross-contamination from neighboring fields, the continued presence of very persistent pesticides like DDT in the soil, and accidental or fraudulent use.

By choosing organic, one hopes to shift exposures from a range of uncertain risk to more of a range of negligible risk, but even if all we had to eat were the most pesticide-laden of conventional produce, there is a clear consensus in the scientific community that the health benefits from consuming fruits and vegetables outweigh any potential risks from pesticide residues. And we can easily reduce whatever risk there is by rinsing our fruits and vegetables under running water.

There are, however, a plethora of products alleged by advertisers to reduce fruit and produce pesticide residues more effectively than water and touted to concerned consumers. For example, Procter & Gamble introduced a fruit and vegetable wash. As part of the introduction, T.G.I. Friday's jumped on board bragging on their menus that the cheese and bacon puddles they call potato skins were first washed with the new product. After all, it was proclaimed proven to be 98% more effective than water in removing pesticides.

So researchers put it to the test and it did no better than plain tap water.

Shortly thereafter Procter & Gamble discontinued the product, but numerous others took its place claiming their vegetable washes are three, four, five or even ten times more effective than water, to which a researcher replied, "That's mathematically impossible." If water removes 50%, you can't take off ten times more than 50%. They actually found water removed up to 80% of pesticide residues like the fungicide, Captan, for example. So, for veggie washes to brag they are three, four, five, ten times better than water is indeed mathematically questionable.

Other fruit and vegetable washes have since been put to the test. Researchers compared FIT Fruit & Vegetable Wash, Organiclean, Vegi-Clean, and dishwashing soap to just rinsing in plain tap water. 196 samples of lettuce, strawberries, and tomatoes were tested, and researchers found little or no difference between just rinsing with tap water compared to any of the veggie washes (or the dish soap). They all just seemed like a waste of money. The researchers concluded that just the mechanical action of rubbing the produce under tap water seemed to do it, and that using detergents or fruit and vegetable washes do not enhance the removal of pesticide residues from produce above that of just rinsing with tap water alone.

That may not be saying much, though. Captan appears to be the exception. When plain water was tried against a half dozen other pesticides, less than half the residues were removed.

Fingernail polish works better, but the goal is to end up with a less toxic, not a more toxic tomato.

We need a straightforward, plausible, and safe method for enhanced pesticide removal. Is there anything we can add to the water to boost its pesticide-stripping abilities? Check out my video, How to Make Your Own Fruit & Vegetable Wash.

If you soak potatoes in water, between about 2% to 13% of the pesticides are removed, but a 5% acetic acid solution removes up to 100%. What's that? Plain white vinegar. But 5% is full strength.

What about diluted vinegar? Diluted vinegar only seemed marginally better than tap water for removing pesticide residues. Using full strength vinegar would get expensive, though. Thankfully there's something cheaper that works even better: salt water.

A 10% salt solution appears to work as good or better than full-strength vinegar. To make a 10% salt solution you just have to mix up about one-part salt to nine-parts water (though make sure to rinse all of the salt off before eating!).

There's not much you can do for the pesticides in animal products, though. The top sources of some pesticides are fruits and vegetables; but for other pesticides, it's dairy, eggs, and meat because the chemicals build up in fat. What do you do about pesticides in animal products? Hard boiling eggs appears to destroy more pesticides that scrambling, but for the pesticides that build up in the fat in fish or chicken, cooking can sometimes increase pesticide levels that obviously can't just wash off. In fact, washing meat, poultry, or eggs is considered one of the top ten dangerous food safety mistakes.

For more on organic foods, see:

The most important reason to wash produce is to reduce the risk of food-borne illness. Ironically, the food poisoning viruses may be found in the pesticides themselves. Check out my video Norovirus Food Poisoning from Pesticides.

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

The Best Way to Wash Fruit and Vegetables

The Best Way to Wash Fruit and Vegetables.jpeg

How might we reduce our exposure to pesticide residues on fruits and vegetables? What about staying away from imported produce? Well, it turns out domestic produce may be even worse, dispelling the notion that imported fruits and vegetables pose greater potential health risks to consumers.

Buying organic dramatically reduces dietary exposure to pesticides, but it does not eliminate the potential risk. Pesticide residues are detectable in about one in ten organic crop samples, due to cross-contamination from neighboring fields, the continued presence of very persistent pesticides like DDT in the soil, and accidental or fraudulent use.

By choosing organic, one hopes to shift exposures from a range of uncertain risk to more of a range of negligible risk, but even if all we had to eat were the most pesticide-laden of conventional produce, there is a clear consensus in the scientific community that the health benefits from consuming fruits and vegetables outweigh any potential risks from pesticide residues. And we can easily reduce whatever risk there is by rinsing our fruits and vegetables under running water.

There are, however, a plethora of products alleged by advertisers to reduce fruit and produce pesticide residues more effectively than water and touted to concerned consumers. For example, Procter & Gamble introduced a fruit and vegetable wash. As part of the introduction, T.G.I. Friday's jumped on board bragging on their menus that the cheese and bacon puddles they call potato skins were first washed with the new product. After all, it was proclaimed proven to be 98% more effective than water in removing pesticides.

So researchers put it to the test and it did no better than plain tap water.

Shortly thereafter Procter & Gamble discontinued the product, but numerous others took its place claiming their vegetable washes are three, four, five or even ten times more effective than water, to which a researcher replied, "That's mathematically impossible." If water removes 50%, you can't take off ten times more than 50%. They actually found water removed up to 80% of pesticide residues like the fungicide, Captan, for example. So, for veggie washes to brag they are three, four, five, ten times better than water is indeed mathematically questionable.

Other fruit and vegetable washes have since been put to the test. Researchers compared FIT Fruit & Vegetable Wash, Organiclean, Vegi-Clean, and dishwashing soap to just rinsing in plain tap water. 196 samples of lettuce, strawberries, and tomatoes were tested, and researchers found little or no difference between just rinsing with tap water compared to any of the veggie washes (or the dish soap). They all just seemed like a waste of money. The researchers concluded that just the mechanical action of rubbing the produce under tap water seemed to do it, and that using detergents or fruit and vegetable washes do not enhance the removal of pesticide residues from produce above that of just rinsing with tap water alone.

That may not be saying much, though. Captan appears to be the exception. When plain water was tried against a half dozen other pesticides, less than half the residues were removed.

Fingernail polish works better, but the goal is to end up with a less toxic, not a more toxic tomato.

We need a straightforward, plausible, and safe method for enhanced pesticide removal. Is there anything we can add to the water to boost its pesticide-stripping abilities? Check out my video, How to Make Your Own Fruit & Vegetable Wash.

If you soak potatoes in water, between about 2% to 13% of the pesticides are removed, but a 5% acetic acid solution removes up to 100%. What's that? Plain white vinegar. But 5% is full strength.

What about diluted vinegar? Diluted vinegar only seemed marginally better than tap water for removing pesticide residues. Using full strength vinegar would get expensive, though. Thankfully there's something cheaper that works even better: salt water.

A 10% salt solution appears to work as good or better than full-strength vinegar. To make a 10% salt solution you just have to mix up about one-part salt to nine-parts water (though make sure to rinse all of the salt off before eating!).

There's not much you can do for the pesticides in animal products, though. The top sources of some pesticides are fruits and vegetables; but for other pesticides, it's dairy, eggs, and meat because the chemicals build up in fat. What do you do about pesticides in animal products? Hard boiling eggs appears to destroy more pesticides that scrambling, but for the pesticides that build up in the fat in fish or chicken, cooking can sometimes increase pesticide levels that obviously can't just wash off. In fact, washing meat, poultry, or eggs is considered one of the top ten dangerous food safety mistakes.

For more on organic foods, see:

The most important reason to wash produce is to reduce the risk of food-borne illness. Ironically, the food poisoning viruses may be found in the pesticides themselves. Check out my video Norovirus Food Poisoning from Pesticides.

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

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