Chocolate is Finally Put to the Test

Oct 10 Chocolate copy.jpeg

Botanically speaking, seeds are small embryonic plants--the whole plant stuffed into a tiny seed and surrounded by an outer layer packed with vitamins, minerals, and phytochemicals to protect the seedling plant's DNA from free radicals. No wonder they're so healthy. By seeds, using the formal definition, we're talking all whole grains; grains are seeds--you plant them and they grow. Nuts are just dry fruits with one or two seeds. Legumes (beans, peas, and lentils) are seeds, too, as are cocoa and coffee beans. So, finding health-promoting effects in something like cocoa or coffee should not be all that surprising. There is substantial evidence that increased consumption of all these little plants is associated with lower risk of cardiovascular disease.

Of course, much of chocolate research is just on how to get consumers to eat more. While it didn't seem to matter what kind of music people were listening to when it came to the flavor intensity, pleasantness, or texture of a bell pepper, people liked chocolate more when listening to jazz than classical, rock, or hip hop. Why is this important? So food industries can "integrate specific musical stimuli" in order to maximize their profits. For example, purveyors may play jazz in the background to increase consumers' acceptance of their chocolates. Along these lines, another study demonstrated that people rated the oyster eaten "more pleasant in the presence of the 'sound of the sea' than in the presence of 'farmyard noises.'"

You'd think chocolate would just sell itself, given that it's considered the most commonly craved food in the world. The same degree of interest doesn't seem to exist as to whether or not Brussels sprouts might provide similar cardiovascular protection. So, it's understandable to hope chocolate provides health benefits. Meanwhile, despite their known benefits, Brussels sprouts don't get the love they deserve.

One of the potential downsides of chocolate is weight gain, which is the subject of my Does Chocolate Cause Weight Gain? video. Though cocoa hardly has any calories, chocolate is one of the most calorie-dense foods. For example: A hundred calories of chocolate is less than a quarter of a bar, compared to a hundred calories of strawberries, which is more than two cups..

A few years ago, a study funded by the National Confectioners Association--an organization that, among other things, runs the website voteforcandy.com--reported that Americans who eat chocolate weigh, on average, four pounds less than those who don't. But maybe chocolate-eaters exercise more or eat more fruits and vegetables. The researchers didn't control for any of that.

The findings of a more recent study published in the Archives of Internal Medicine were less easy to dismiss and there were no apparent ties to Big Chocolate. The researchers reported that out of a thousand men and women they studied in San Diego, those who frequently consumed chocolate had a lower BMI--actually weighed less--than those who ate chocolate less often. And this was even after adjusting for physical activity and diet quality. But, it was a cross-sectional study, meaning a snapshot in time, so you can't prove cause and effect. Maybe not eating chocolate leads to being fatter, or maybe being fatter leads to not eating chocolate. Maybe people who are overweight are trying to cut down on sweets. What we need is a study in which people are followed over time.

There was no such prospective study, until now. More than 10,000 people were followed for six years, and a chocolate habit was associated with long-term weight gain in a dose-response manner. This means the greatest weight gain over time was seen in those with the highest frequency of chocolate intake. It appears the reason the cross-sectional studies found the opposite is that subjects diagnosed with obesity-related illnesses tended to reduce their intake of things like chocolate in an attempt to improve their prognosis. This explains why heavier people may, on average, eat less chocolate.

To bolster this finding came the strongest type of evidence--an interventional trial--in which you split people up into two groups and change half their diets. Indeed, adding four squares of chocolate to peoples' daily diets does appear to add a few pounds.

So, what do we tell our patients? In 2013, researchers wrote in the American Family Physician journal that "because many cocoa products are high in sugar and saturated fat, family physicians should refrain from recommending cocoa...." That's a little patronizing, though. You can get the benefits of chocolate without any sugar or fat by adding cocoa powder to a smoothie, for example. Too often, doctors think patients can't handle the truth. Case in point: If your patients inquire, one medical journal editorial suggest, ask them what type of chocolate they prefer. If they respond with milk chocolate, then it is best to answer that it is not good for them. If the answer is dark chocolate, then you can lay out the evidence.


Even better than dark chocolate would be cocoa powder, which contains the phytonutrients without the saturated fat. I've happily (and deliciously) created other videos on cocoa and chocolate, so check out Update on Chocolate, Healthiest Chocolate Fix, A Treatment for Chronic Fatigue Syndrome, and Dark Chocolate and Artery Function.

Whether with Big Candy, Big Chocolate, or some other player, you always have to be careful about conflict of interest. For more information, watch my Food Industry Funded Research Bias video.

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:

Original Link

Chocolate is Finally Put to the Test

Oct 10 Chocolate copy.jpeg

Botanically speaking, seeds are small embryonic plants--the whole plant stuffed into a tiny seed and surrounded by an outer layer packed with vitamins, minerals, and phytochemicals to protect the seedling plant's DNA from free radicals. No wonder they're so healthy. By seeds, using the formal definition, we're talking all whole grains; grains are seeds--you plant them and they grow. Nuts are just dry fruits with one or two seeds. Legumes (beans, peas, and lentils) are seeds, too, as are cocoa and coffee beans. So, finding health-promoting effects in something like cocoa or coffee should not be all that surprising. There is substantial evidence that increased consumption of all these little plants is associated with lower risk of cardiovascular disease.

Of course, much of chocolate research is just on how to get consumers to eat more. While it didn't seem to matter what kind of music people were listening to when it came to the flavor intensity, pleasantness, or texture of a bell pepper, people liked chocolate more when listening to jazz than classical, rock, or hip hop. Why is this important? So food industries can "integrate specific musical stimuli" in order to maximize their profits. For example, purveyors may play jazz in the background to increase consumers' acceptance of their chocolates. Along these lines, another study demonstrated that people rated the oyster eaten "more pleasant in the presence of the 'sound of the sea' than in the presence of 'farmyard noises.'"

You'd think chocolate would just sell itself, given that it's considered the most commonly craved food in the world. The same degree of interest doesn't seem to exist as to whether or not Brussels sprouts might provide similar cardiovascular protection. So, it's understandable to hope chocolate provides health benefits. Meanwhile, despite their known benefits, Brussels sprouts don't get the love they deserve.

One of the potential downsides of chocolate is weight gain, which is the subject of my Does Chocolate Cause Weight Gain? video. Though cocoa hardly has any calories, chocolate is one of the most calorie-dense foods. For example: A hundred calories of chocolate is less than a quarter of a bar, compared to a hundred calories of strawberries, which is more than two cups..

A few years ago, a study funded by the National Confectioners Association--an organization that, among other things, runs the website voteforcandy.com--reported that Americans who eat chocolate weigh, on average, four pounds less than those who don't. But maybe chocolate-eaters exercise more or eat more fruits and vegetables. The researchers didn't control for any of that.

The findings of a more recent study published in the Archives of Internal Medicine were less easy to dismiss and there were no apparent ties to Big Chocolate. The researchers reported that out of a thousand men and women they studied in San Diego, those who frequently consumed chocolate had a lower BMI--actually weighed less--than those who ate chocolate less often. And this was even after adjusting for physical activity and diet quality. But, it was a cross-sectional study, meaning a snapshot in time, so you can't prove cause and effect. Maybe not eating chocolate leads to being fatter, or maybe being fatter leads to not eating chocolate. Maybe people who are overweight are trying to cut down on sweets. What we need is a study in which people are followed over time.

There was no such prospective study, until now. More than 10,000 people were followed for six years, and a chocolate habit was associated with long-term weight gain in a dose-response manner. This means the greatest weight gain over time was seen in those with the highest frequency of chocolate intake. It appears the reason the cross-sectional studies found the opposite is that subjects diagnosed with obesity-related illnesses tended to reduce their intake of things like chocolate in an attempt to improve their prognosis. This explains why heavier people may, on average, eat less chocolate.

To bolster this finding came the strongest type of evidence--an interventional trial--in which you split people up into two groups and change half their diets. Indeed, adding four squares of chocolate to peoples' daily diets does appear to add a few pounds.

So, what do we tell our patients? In 2013, researchers wrote in the American Family Physician journal that "because many cocoa products are high in sugar and saturated fat, family physicians should refrain from recommending cocoa...." That's a little patronizing, though. You can get the benefits of chocolate without any sugar or fat by adding cocoa powder to a smoothie, for example. Too often, doctors think patients can't handle the truth. Case in point: If your patients inquire, one medical journal editorial suggest, ask them what type of chocolate they prefer. If they respond with milk chocolate, then it is best to answer that it is not good for them. If the answer is dark chocolate, then you can lay out the evidence.


Even better than dark chocolate would be cocoa powder, which contains the phytonutrients without the saturated fat. I've happily (and deliciously) created other videos on cocoa and chocolate, so check out Update on Chocolate, Healthiest Chocolate Fix, A Treatment for Chronic Fatigue Syndrome, and Dark Chocolate and Artery Function.

Whether with Big Candy, Big Chocolate, or some other player, you always have to be careful about conflict of interest. For more information, watch my Food Industry Funded Research Bias video.

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:

Original Link

Boosting Brown Fat Through Diet

Sept 26 Boosting Brown Fat copy.jpeg

Until about ten years ago, brown adipose tissue (BAT) was considered to be biologically active only in babies and small children where it generates heat by burning fat. But now, there is no doubt that active brown fat is present in adult humans and is involved in cold-induced increases in whole-body calorie expenditure and, thereby, helps control of not only body temperature but also how fat we are.

In 2013, researchers showed that one could activate brown adipose tissue if you chill out people long enough, specifically, by exposing them to two hours of cold every day for six weeks, which can lead to a significant reduction in body fat. You can see an illustrative graph in my video Boosting Brown Fat Through Diet. Although researchers demonstrated the effective recruitment of human brown fat, it would seem difficult to increase exposure to cold in daily life. Thankfully, our brown fat can also be activated by some food ingredients, such as capsaicin, the compound that makes hot peppers hot.

While physical activity is usually recommended to increase energy expenditure, there are specific food components, such as capsaicin, that are known to burn off calories. For example, one study found that there was a significant rise in energy expenditure within 30 minutes of eating the equivalent of a jalapeño pepper.

Normally when we cut down on calories, our metabolism slows down, undercutting our weight loss attempts; but sprinkling a third of a teaspoon of red chili pepper powder onto our meals counteracts that metabolic slow down and promotes fat burning. Researchers wanted to try giving participants more chili pepper in order to try to match some of the studies done in Asia, but the Caucasian subjects couldn't take it. But by adding more than a tablespoon of red pepper powder to a high-fat meal, Japanese women burned significantly more fat.

We've known for decades that cayenne pepper increases metabolic rate, but we didn't know how. But studies show that this class of compounds increases energy expenditure in human individuals with brown fat, but not in those without it, indicating that individuals increase expenditure right off the BAT. Additionally, there is a variety of structurally similar flavor molecules in other foods, like black pepper and ginger, that may activate thermogenesis as well, but they haven't been directly tested.

All these results suggest that the anti-obesity effects of pepper compounds are based on the heat-generating activity of recruited brown fat. Thus, repeated ingestion can mimic the chronic effects of cold exposure without having to freeze ourselves.

Consumption of spicy foods may help us lose weight, but what about the sensory burn and pain on our tongues and sometimes in our stomachs as well as further on down? Are our only two options for boosting brown fat to freeze our legs or burn our butts?

Arginine-rich foods may also stimulate brown adipose tissue growth and development through a variety of mechanisms, which is achieved by consuming more soy foods, seeds, nuts, and beans.


For more on brown adipose tissue, see Brown Fat: Losing Weight Through Thermogenesis.

What about arginine? Check out Fat Burning Via Arginine. And, did you know arginine may also play a role in the effects nuts may have on penile blood flow? I discuss this in Pistachio Nuts for Erectile Dysfunction.

For more on spicy foods, see my videos Cayenne Pepper for Irritable Bowel Syndrome and Chronic Indigestion to learn how digestive disorders may be helped and Hot Sauce in the Nose for Cluster Headaches? for information on how the hot pepper compound can be a lifesaver for people suffering from "suicide" 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:

Original Link

Boosting Brown Fat Through Diet

Sept 26 Boosting Brown Fat copy.jpeg

Until about ten years ago, brown adipose tissue (BAT) was considered to be biologically active only in babies and small children where it generates heat by burning fat. But now, there is no doubt that active brown fat is present in adult humans and is involved in cold-induced increases in whole-body calorie expenditure and, thereby, helps control of not only body temperature but also how fat we are.

In 2013, researchers showed that one could activate brown adipose tissue if you chill out people long enough, specifically, by exposing them to two hours of cold every day for six weeks, which can lead to a significant reduction in body fat. You can see an illustrative graph in my video Boosting Brown Fat Through Diet. Although researchers demonstrated the effective recruitment of human brown fat, it would seem difficult to increase exposure to cold in daily life. Thankfully, our brown fat can also be activated by some food ingredients, such as capsaicin, the compound that makes hot peppers hot.

While physical activity is usually recommended to increase energy expenditure, there are specific food components, such as capsaicin, that are known to burn off calories. For example, one study found that there was a significant rise in energy expenditure within 30 minutes of eating the equivalent of a jalapeño pepper.

Normally when we cut down on calories, our metabolism slows down, undercutting our weight loss attempts; but sprinkling a third of a teaspoon of red chili pepper powder onto our meals counteracts that metabolic slow down and promotes fat burning. Researchers wanted to try giving participants more chili pepper in order to try to match some of the studies done in Asia, but the Caucasian subjects couldn't take it. But by adding more than a tablespoon of red pepper powder to a high-fat meal, Japanese women burned significantly more fat.

We've known for decades that cayenne pepper increases metabolic rate, but we didn't know how. But studies show that this class of compounds increases energy expenditure in human individuals with brown fat, but not in those without it, indicating that individuals increase expenditure right off the BAT. Additionally, there is a variety of structurally similar flavor molecules in other foods, like black pepper and ginger, that may activate thermogenesis as well, but they haven't been directly tested.

All these results suggest that the anti-obesity effects of pepper compounds are based on the heat-generating activity of recruited brown fat. Thus, repeated ingestion can mimic the chronic effects of cold exposure without having to freeze ourselves.

Consumption of spicy foods may help us lose weight, but what about the sensory burn and pain on our tongues and sometimes in our stomachs as well as further on down? Are our only two options for boosting brown fat to freeze our legs or burn our butts?

Arginine-rich foods may also stimulate brown adipose tissue growth and development through a variety of mechanisms, which is achieved by consuming more soy foods, seeds, nuts, and beans.


For more on brown adipose tissue, see Brown Fat: Losing Weight Through Thermogenesis.

What about arginine? Check out Fat Burning Via Arginine. And, did you know arginine may also play a role in the effects nuts may have on penile blood flow? I discuss this in Pistachio Nuts for Erectile Dysfunction.

For more on spicy foods, see my videos Cayenne Pepper for Irritable Bowel Syndrome and Chronic Indigestion to learn how digestive disorders may be helped and Hot Sauce in the Nose for Cluster Headaches? for information on how the hot pepper compound can be a lifesaver for people suffering from "suicide" 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:

Original Link

Brown Fat: Losing Weight Through Thermogenesis

Sept 21 Brown Fat Thermo copy.jpeg

During World War I, it was discovered that many of the chemicals for new explosives had toxic or even lethal effects on the workers in the munitions factories. Chemicals such as di-nitro-phenol (DNP) can boost metabolism so much that workers were too often found wandering along the road after work, covered in sweat with temperatures of 106 to 109 degrees Fahrenheit before they died. Even after death, their temperatures kept going up, as if they were having a total body meltdown. At subacute doses, however, workers claimed to have grown thin to a notable extent after several months working with the chemical.

That got some Stanford pharmacologists excited about the "promising metabolic applications" of DNP. Our resting metabolic rate jumps up 30% after one dose of DNP, and therefore, it becomes an actual fat-burning drug. People started losing weight, as you can see in my video Brown Fat: Losing Weight Through Thermogenesis, with no apparent side effects. They felt great... and then thousands of people started going blind and users started dropping dead from hyperpyrexia, fatal fever due to the heat created by the burning fat. Of course, it continued to be sold. Ad copy read:

"Here, at last, is a [weight] reducing remedy that will bring you a figure men admire and women envy, without danger to your health or change in your regular mode of living....No diet, no exercise!"

It did work, but the therapeutic index--the difference between the effective dose and the deadly dose--was razor thin. It was not until thousands suffered irreversible harm that it got pulled from the market and remained unavailable. Unavailable, that is, until it was brought back by the internet for those dying to be thin.

There is, however, a way our body naturally burns fat to create heat. When we're born, we go from a nice tropical 98.6 in our mother's womb straight to room temperature, just when we're still all wet and slimy. As an adaptive mechanism to maintain warmth, the appearance of a unique organ around 150 million years ago allowed mammals to maintain our high body temperatures.

That unique organ is called brown adipose tissue, or BAT, and its role is to consume fat calories by generating heat in response to cold exposure. The white fat in our bellies stores fat, but the brown fat, located up between our shoulder blades, burns fat. BAT is essential for thermogenesis, the creation of heat in newborns, but has been considered unnecessary in adults who have higher metabolic rates and increased muscle mass for shivering to warm us up when we get chilled. We used to think brown tissue just shrank away when we grew up, but, if it was there, then it could potentially make a big difference for how many calories we burn every day.

When PET scans were invented to detect metabolically active tissues like cancer, oncologists kept finding hot spots in the neck and shoulder regions that on CT scans turned out not to be cancer, just fat. Then, some observant radiologists noticed they appeared in patients mostly during the cold winter months. When they looked closer at tissue samples taken from people who had undergone neck surgery, they found it: brown fat in adults.

The common message from a number of studies is that BAT is present and active in adults, and the more we have and the more active it is, the thinner we are. And we can rapidly activate our fat-burning brown fat by exposure to cold temperatures. For example, if you hang out in a cold room for two hours in your undies and put your legs on a block of ice for four minutes every five minutes, you can elicit a marked increase in energy expenditure, thanks to brown fat activation. So, the studies point to a potential "natural" intervention to stimulate energy expenditure: Turn down the heat to burn calories (and reduce the carbon footprint in the process).

Thankfully, for those of us who would rather not lay our bare legs on blocks of ice, our brown fat can also be activated by some food ingredients such as those that are covered in my Boosting Brown Fat Through Diet video.


I briefly touch on the role cold temperatures can play in weight loss in The Ice Diet and talk more about calories in (Nutrient-Dense Approach to Weight Management) and calories out (How Much Exercise to Sustain Weight Loss).

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:

Original Link

Brown Fat: Losing Weight Through Thermogenesis

Sept 21 Brown Fat Thermo copy.jpeg

During World War I, it was discovered that many of the chemicals for new explosives had toxic or even lethal effects on the workers in the munitions factories. Chemicals such as di-nitro-phenol (DNP) can boost metabolism so much that workers were too often found wandering along the road after work, covered in sweat with temperatures of 106 to 109 degrees Fahrenheit before they died. Even after death, their temperatures kept going up, as if they were having a total body meltdown. At subacute doses, however, workers claimed to have grown thin to a notable extent after several months working with the chemical.

That got some Stanford pharmacologists excited about the "promising metabolic applications" of DNP. Our resting metabolic rate jumps up 30% after one dose of DNP, and therefore, it becomes an actual fat-burning drug. People started losing weight, as you can see in my video Brown Fat: Losing Weight Through Thermogenesis, with no apparent side effects. They felt great... and then thousands of people started going blind and users started dropping dead from hyperpyrexia, fatal fever due to the heat created by the burning fat. Of course, it continued to be sold. Ad copy read:

"Here, at last, is a [weight] reducing remedy that will bring you a figure men admire and women envy, without danger to your health or change in your regular mode of living....No diet, no exercise!"

It did work, but the therapeutic index--the difference between the effective dose and the deadly dose--was razor thin. It was not until thousands suffered irreversible harm that it got pulled from the market and remained unavailable. Unavailable, that is, until it was brought back by the internet for those dying to be thin.

There is, however, a way our body naturally burns fat to create heat. When we're born, we go from a nice tropical 98.6 in our mother's womb straight to room temperature, just when we're still all wet and slimy. As an adaptive mechanism to maintain warmth, the appearance of a unique organ around 150 million years ago allowed mammals to maintain our high body temperatures.

That unique organ is called brown adipose tissue, or BAT, and its role is to consume fat calories by generating heat in response to cold exposure. The white fat in our bellies stores fat, but the brown fat, located up between our shoulder blades, burns fat. BAT is essential for thermogenesis, the creation of heat in newborns, but has been considered unnecessary in adults who have higher metabolic rates and increased muscle mass for shivering to warm us up when we get chilled. We used to think brown tissue just shrank away when we grew up, but, if it was there, then it could potentially make a big difference for how many calories we burn every day.

When PET scans were invented to detect metabolically active tissues like cancer, oncologists kept finding hot spots in the neck and shoulder regions that on CT scans turned out not to be cancer, just fat. Then, some observant radiologists noticed they appeared in patients mostly during the cold winter months. When they looked closer at tissue samples taken from people who had undergone neck surgery, they found it: brown fat in adults.

The common message from a number of studies is that BAT is present and active in adults, and the more we have and the more active it is, the thinner we are. And we can rapidly activate our fat-burning brown fat by exposure to cold temperatures. For example, if you hang out in a cold room for two hours in your undies and put your legs on a block of ice for four minutes every five minutes, you can elicit a marked increase in energy expenditure, thanks to brown fat activation. So, the studies point to a potential "natural" intervention to stimulate energy expenditure: Turn down the heat to burn calories (and reduce the carbon footprint in the process).

Thankfully, for those of us who would rather not lay our bare legs on blocks of ice, our brown fat can also be activated by some food ingredients such as those that are covered in my Boosting Brown Fat Through Diet video.


I briefly touch on the role cold temperatures can play in weight loss in The Ice Diet and talk more about calories in (Nutrient-Dense Approach to Weight Management) and calories out (How Much Exercise to Sustain Weight Loss).

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:

Original Link

Reversing Diabetic Blindness with Diet

Reversing Diabetic Blindness with Diet.jpeg

Though many reported feeling better on Dr. Walter Kempner's rice and fruit diet, he refused to accept such anecdotal evidence as proof of success. He wanted objective measurements. The most famous were his "eyegrounds photographs," taken with a special camera that allowed one to visualize the back of the eye. In doing so, he proved diet can arrest the bleeding, oozing, and swelling you see in the back of the eye in people with severe kidney, hypertensive, or heart disease. Even more than that, he proved that diet could actually reverse it, something never thought possible.

In my video, Can Diabetic Retinopathy Be Reversed?, you can see before and after images of the back of patients' eyes. He found reversal to such a degree that even those who could no longer distinguish large objects were able to once again read fine print. Dr. Kempner had shown a reversal of blindness with diet.

The results were so dramatic that the head of the department of ophthalmology at Duke, where Kempner worked, was questioned as to whether they were somehow faked. He assured them they were not. In fact, he wrote in one person's chart, "This patient's eyegrounds are improved to an unbelievable degree." Not only had he never seen anything like it, he couldn't remember ever seeing a patient with such advanced disease even being alive 15 months later.

The magnitude of the improvements Kempner got--reversal of end-stage heart and kidney failure--was surprising, simply beyond belief. But as Kempner said as his closing sentence of a presentation before the American College of Physicians, "The important result is not that the change in the course of the disease has been achieved by the rice diet but that the course of the disease can be changed."

Now that we have high blood pressure drugs, we see less hypertensive retinopathy, but we still see a lot of diabetic retinopathy, now the leading cause of blindness in American adults. Even with intensive diabetes treatment--at least three insulin injections a day with the best modern technology has to offer--the best we can offer is usually just a slowing of the progression of the disease.

So, in the 21st century, we slow down your blindness. Yet a half century ago, Kempner proved we could reverse it. Kempner started out using his plant-based rice diet ultra-low in sodium, fat, cholesterol, and protein to reverse kidney and heart failure; he actually assumed the diet would make diabetes worse. He expected a 90% carbohydrate diet would increase insulin requirements, however, the opposite proved to be true. He took the next 100 patients with diabetes who walked through his door who went on the rice diet for at least three months and found their fasting blood sugars dropped despite a drop in the insulin they were taking. What really blew people away was this: Forty-four of the patients had diabetic retinopathy, and, in 30% of the cases, their eyes improved. That's not supposed to happen; diabetic retinopathy had been considered "a sign of irreversible destruction." What does this change mean in real life? Patients went from unable to even read headlines to normal vision.

The remarkable success Dr. Kempner had reversing some of the most dreaded complications of diabetes with his rice and fruit diet was not because of weight loss. The improvements occurred even in those patients who did not lose significant weight, so it must have been something specific about the diet. Maybe it was his total elimination of animal protein, animal fat, and cholesterol? Or perhaps it was his radical reduction in sodium, fat, and protein in general? We don't know.

How do we treat diabetic retinopathy these days? With steroids and other drugs injected straight into the eyeball. If that doesn't work, there's always pan-retinal laser photocoagulation, in which laser burns are etched over nearly the entire retina. Surgeons literally burn out the back of your eye. Why would they do that? The theory is that by killing off most of the retina, the little pieces you leave behind may get more blood flow.

When I see that, along with Kempner's work, I can't help but feel like history has been reversed. It seems as though it should have gone like, "Can you believe 50 years ago the best we had was this barbaric, burn-out-your-socket surgery? Thank goodness we've since learned that through dietary means alone, we can reverse the blindness." But instead of learning, medicine seems to have forgotten.

I documented the extraordinary Kempner story previously in Kempner Rice Diet: Whipping Us Into Shape and Drugs and the Demise of the Rice Diet. The reason I keep coming back to this is not to suggest people should go on such a diet (it is too extreme and potentially dangerous to do without strict medical supervision), but to show the power of dietary change to yield tremendous healing effects.

The best way to prevent diabetic blindness is to prevent or reverse diabetes in the first place. See, for example:

Why wouldn't a diet of white rice make diabetes worse? See If White Rice Is Linked to Diabetes, What About China?

For more on the nitty gritty on what is the actual cause of type 2 diabetes, see:

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Community Eye Health / Flickr. This image has been modified.

Original Link

Reversing Diabetic Blindness with Diet

Reversing Diabetic Blindness with Diet.jpeg

Though many reported feeling better on Dr. Walter Kempner's rice and fruit diet, he refused to accept such anecdotal evidence as proof of success. He wanted objective measurements. The most famous were his "eyegrounds photographs," taken with a special camera that allowed one to visualize the back of the eye. In doing so, he proved diet can arrest the bleeding, oozing, and swelling you see in the back of the eye in people with severe kidney, hypertensive, or heart disease. Even more than that, he proved that diet could actually reverse it, something never thought possible.

In my video, Can Diabetic Retinopathy Be Reversed?, you can see before and after images of the back of patients' eyes. He found reversal to such a degree that even those who could no longer distinguish large objects were able to once again read fine print. Dr. Kempner had shown a reversal of blindness with diet.

The results were so dramatic that the head of the department of ophthalmology at Duke, where Kempner worked, was questioned as to whether they were somehow faked. He assured them they were not. In fact, he wrote in one person's chart, "This patient's eyegrounds are improved to an unbelievable degree." Not only had he never seen anything like it, he couldn't remember ever seeing a patient with such advanced disease even being alive 15 months later.

The magnitude of the improvements Kempner got--reversal of end-stage heart and kidney failure--was surprising, simply beyond belief. But as Kempner said as his closing sentence of a presentation before the American College of Physicians, "The important result is not that the change in the course of the disease has been achieved by the rice diet but that the course of the disease can be changed."

Now that we have high blood pressure drugs, we see less hypertensive retinopathy, but we still see a lot of diabetic retinopathy, now the leading cause of blindness in American adults. Even with intensive diabetes treatment--at least three insulin injections a day with the best modern technology has to offer--the best we can offer is usually just a slowing of the progression of the disease.

So, in the 21st century, we slow down your blindness. Yet a half century ago, Kempner proved we could reverse it. Kempner started out using his plant-based rice diet ultra-low in sodium, fat, cholesterol, and protein to reverse kidney and heart failure; he actually assumed the diet would make diabetes worse. He expected a 90% carbohydrate diet would increase insulin requirements, however, the opposite proved to be true. He took the next 100 patients with diabetes who walked through his door who went on the rice diet for at least three months and found their fasting blood sugars dropped despite a drop in the insulin they were taking. What really blew people away was this: Forty-four of the patients had diabetic retinopathy, and, in 30% of the cases, their eyes improved. That's not supposed to happen; diabetic retinopathy had been considered "a sign of irreversible destruction." What does this change mean in real life? Patients went from unable to even read headlines to normal vision.

The remarkable success Dr. Kempner had reversing some of the most dreaded complications of diabetes with his rice and fruit diet was not because of weight loss. The improvements occurred even in those patients who did not lose significant weight, so it must have been something specific about the diet. Maybe it was his total elimination of animal protein, animal fat, and cholesterol? Or perhaps it was his radical reduction in sodium, fat, and protein in general? We don't know.

How do we treat diabetic retinopathy these days? With steroids and other drugs injected straight into the eyeball. If that doesn't work, there's always pan-retinal laser photocoagulation, in which laser burns are etched over nearly the entire retina. Surgeons literally burn out the back of your eye. Why would they do that? The theory is that by killing off most of the retina, the little pieces you leave behind may get more blood flow.

When I see that, along with Kempner's work, I can't help but feel like history has been reversed. It seems as though it should have gone like, "Can you believe 50 years ago the best we had was this barbaric, burn-out-your-socket surgery? Thank goodness we've since learned that through dietary means alone, we can reverse the blindness." But instead of learning, medicine seems to have forgotten.

I documented the extraordinary Kempner story previously in Kempner Rice Diet: Whipping Us Into Shape and Drugs and the Demise of the Rice Diet. The reason I keep coming back to this is not to suggest people should go on such a diet (it is too extreme and potentially dangerous to do without strict medical supervision), but to show the power of dietary change to yield tremendous healing effects.

The best way to prevent diabetic blindness is to prevent or reverse diabetes in the first place. See, for example:

Why wouldn't a diet of white rice make diabetes worse? See If White Rice Is Linked to Diabetes, What About China?

For more on the nitty gritty on what is the actual cause of type 2 diabetes, see:

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Community Eye Health / Flickr. This image has been modified.

Original Link

Stomach Stapling Kids

Stomach Stapling Kids.jpeg

Weight loss surgery for children and adolescents is becoming widespread and is being performed in children as young as five years old. Roux-en-Y gastric bypass is the most common type of procedure, in which surgeons cut out nearly the entire stomach, as you can see in my video, Stomach Stapling Kids. Bariatric surgery in pediatric patients does result in weight loss, but also has the potential for serious complications. These include pulmonary embolism, shock, intestinal obstruction, postoperative bleeding, leaking along the staple line, severe malnutrition, and even death at a rate of 0.5%. This means that 1 in 200 kids who go under the knife may die. Infection is identified as the leading cause of death and is most often associated with leaking of intestinal contents into the abdominal cavity.

Sometimes the surgery doesn't work, and you have to go in and do another procedure. If that doesn't work either, you can always try implanting electrodes into patients' brains, a "novel antiobesity strategy" reported in the Journal of Neurosurgery. The concept of deep brain stimulation "since its inception has been that placing an electrode somewhere in the brain could make people eat less." You drill two little holes in the patient's skull, snake in some electrodes a few inches, and then tunnel the wires under the scalp into a pulse generator implanted under the skin on the chest. You evidently can't crank it up past 5 volts because it induces anxiety and nausea. But even without the nausea, people with electrodes stuck in their brains lost an average of about 10 pounds a year.

The childhood obesity epidemic is so tragic. It pains me to see insult piled on injury. Too often, medical treatments can be worse than the disease. See my video, Why Prevention Is Worth a Ton of Cure.

Speaking of prevention, what might be the best diet for our young ones? See:

There are complications associated with gastric bypass in adults, too. See my video The Dangers of Broccoli?.

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: ReSurge International / Flickr. This image has been modified.

Original Link

Stomach Stapling Kids

Stomach Stapling Kids.jpeg

Weight loss surgery for children and adolescents is becoming widespread and is being performed in children as young as five years old. Roux-en-Y gastric bypass is the most common type of procedure, in which surgeons cut out nearly the entire stomach, as you can see in my video, Stomach Stapling Kids. Bariatric surgery in pediatric patients does result in weight loss, but also has the potential for serious complications. These include pulmonary embolism, shock, intestinal obstruction, postoperative bleeding, leaking along the staple line, severe malnutrition, and even death at a rate of 0.5%. This means that 1 in 200 kids who go under the knife may die. Infection is identified as the leading cause of death and is most often associated with leaking of intestinal contents into the abdominal cavity.

Sometimes the surgery doesn't work, and you have to go in and do another procedure. If that doesn't work either, you can always try implanting electrodes into patients' brains, a "novel antiobesity strategy" reported in the Journal of Neurosurgery. The concept of deep brain stimulation "since its inception has been that placing an electrode somewhere in the brain could make people eat less." You drill two little holes in the patient's skull, snake in some electrodes a few inches, and then tunnel the wires under the scalp into a pulse generator implanted under the skin on the chest. You evidently can't crank it up past 5 volts because it induces anxiety and nausea. But even without the nausea, people with electrodes stuck in their brains lost an average of about 10 pounds a year.

The childhood obesity epidemic is so tragic. It pains me to see insult piled on injury. Too often, medical treatments can be worse than the disease. See my video, Why Prevention Is Worth a Ton of Cure.

Speaking of prevention, what might be the best diet for our young ones? See:

There are complications associated with gastric bypass in adults, too. See my video The Dangers of Broccoli?.

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: ReSurge International / Flickr. This image has been modified.

Original Link