Music as Medicine

Music as Medicine.jpeg

We've been playing music since the Paleolithic Era, 40,000 years ago. Music as therapy has been documented since at least biblical times. The first music therapy experiment was published in the Journal of the American Medical Association in 1914. As to why he placed a phonograph in the operating room as his patients lay fully conscious and awake during surgery, the surgeon explained it was "a means of calming and distracting my patients from the horror of the situation."

Now that we have anesthesia, music is used to calm nerves before surgery. Normally we use Valium-type drugs like midazolam (sold as Versed), but they can have a variety of side effects, including sometimes even making people more agitated. A study from Sweden sought to determine if relaxing music has a greater anxiety-reducing effect than a standard dose of midazolam. Researchers whipped out some Kenny G, and the music worked significantly better than the drug. Those listening to Mr. G had lower anxiety scores, heart rates, and blood pressures. This is perhaps the first report of any anti-anxiety therapy working not only as good as, but even better than, benzodiazepine drugs. The difference in side effects of relaxing music compared to the drug is obvious: There were none. Soft jazz causes no post-operative hangover. The researchers suggest we should start using music instead of midazolam.

Music may also reduce anxiety and pain in children undergoing minor medical and dental procedures, helping with blood draws and shots. It may even reduce the pain of spinal taps. However, Mozart is evidently powerless against the pain of circumcision.

It doesn't take a randomized controlled trial to demonstrate that listening to music can be relaxing. Tell me something I don't know. Well, if you take someone with a latex allergy and inject their skin with latex, they get a big, red, angry bump. But if you repeat the test after they've been listening to Mozart for 30 minutes, they develop a much smaller bump (as you can see in my video, Music as Medicine). That is, they have less of an allergic reaction. If you think that's wild, get ready for this: Beethoven didn't work. The subjects had the same reaction before and after listening to his music! Schubert, Hayden, and Brahms didn't work either, as all failed to reduce the allergic skin response. The reducing effect on allergic responses may be specific to Mozart.

So Mozart's looking pretty good, but what if he could be suppressing our immune systems in general? That would not be good. The same researchers also injected a chemical that causes reactions in everyone, not just in allergic people. Mozart had no effect. It seems Mozart suppresses only the pathological allergic reaction. If that isn't crazy enough for you, the researchers drew subjects' blood after the music, stuck their white blood cells in a petri dish with a little latex, and measured the allergic antibody response. The white blood cells from those exposed to Mozart had less of an allergic response even outside the body compared to cells taken from Beethoven blood. How cool is that?

Music may even impact our metabolism. This inquiry started with a 2012 study published in the journal Pediatrics, which found the resting energy expenditure (the number of calories burned when just lying around) was lower in preterm infants when researchers piped in Mozart. This may explain why infants exposed to music put on weight faster, so much so they are able to go home earlier.

Gaining weight faster is great for premature babies, but not necessarily for adults. Could listening to music slow our metabolism and contribute to weight gain? Well, one study found no effect on adults. But the researchers used Bach, not Mozart. Bach doesn't cause a drop in energy expenditure in babies either. These data suggest there may be "more a 'Mozart effect' than a universal 'music effect'."

What if we just listen to music of our choice? Does that affect our metabolism? We didn't know... until now. It turns out that listening to music appears to actually increase our metabolic rate, such that we burn an average of 27.6 more calories a day just lying in bed. That's only like six M&M's worth, though, so it's better to use music to get up and start dancing or exercising. Music can not only improve exercise enjoyment but also performance--a way to improve athletic performance that's legal.

Male bodybuilders may be less enthused music's effects. After listening to music for just 30 minutes, testosterone levels drop 14% in young men and go up 21% in young women. Do all kinds of music have this effect or just some types? Thirty minutes of silence had no effect on testosterone levels at all, while a half-hour of Mozart, jazz, pop, or Gregorian chants (no relation :) all suppressed testosterone. What about a half-hour of people's personal favorites? Testosterone levels were cut in half! Testosterone decreased in males under all music conditions, whereas testosterone increased in females. What is going on? Well, in men, testosterone is related to libido, dominance, and aggressiveness, whereas women get a bigger boost in testosterone from cuddling than from sex. So maybe we evolved using music as a way to ensure we all got along, like a melodious cold shower to keep everyone chill.

Is that crazy or what? I'm fascinated by the whole topic. For more, see Music for Anxiety: Mozart vs. Metal.

Sounds are the only sensory-stimulators that can have an effect on us--so can scents! See:

Exposure to industrial pollutants may also affect both allergic diseases and testosterone levels:

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. This image has been modified.

Original Link

Music as Medicine

Music as Medicine.jpeg

We've been playing music since the Paleolithic Era, 40,000 years ago. Music as therapy has been documented since at least biblical times. The first music therapy experiment was published in the Journal of the American Medical Association in 1914. As to why he placed a phonograph in the operating room as his patients lay fully conscious and awake during surgery, the surgeon explained it was "a means of calming and distracting my patients from the horror of the situation."

Now that we have anesthesia, music is used to calm nerves before surgery. Normally we use Valium-type drugs like midazolam (sold as Versed), but they can have a variety of side effects, including sometimes even making people more agitated. A study from Sweden sought to determine if relaxing music has a greater anxiety-reducing effect than a standard dose of midazolam. Researchers whipped out some Kenny G, and the music worked significantly better than the drug. Those listening to Mr. G had lower anxiety scores, heart rates, and blood pressures. This is perhaps the first report of any anti-anxiety therapy working not only as good as, but even better than, benzodiazepine drugs. The difference in side effects of relaxing music compared to the drug is obvious: There were none. Soft jazz causes no post-operative hangover. The researchers suggest we should start using music instead of midazolam.

Music may also reduce anxiety and pain in children undergoing minor medical and dental procedures, helping with blood draws and shots. It may even reduce the pain of spinal taps. However, Mozart is evidently powerless against the pain of circumcision.

It doesn't take a randomized controlled trial to demonstrate that listening to music can be relaxing. Tell me something I don't know. Well, if you take someone with a latex allergy and inject their skin with latex, they get a big, red, angry bump. But if you repeat the test after they've been listening to Mozart for 30 minutes, they develop a much smaller bump (as you can see in my video, Music as Medicine). That is, they have less of an allergic reaction. If you think that's wild, get ready for this: Beethoven didn't work. The subjects had the same reaction before and after listening to his music! Schubert, Hayden, and Brahms didn't work either, as all failed to reduce the allergic skin response. The reducing effect on allergic responses may be specific to Mozart.

So Mozart's looking pretty good, but what if he could be suppressing our immune systems in general? That would not be good. The same researchers also injected a chemical that causes reactions in everyone, not just in allergic people. Mozart had no effect. It seems Mozart suppresses only the pathological allergic reaction. If that isn't crazy enough for you, the researchers drew subjects' blood after the music, stuck their white blood cells in a petri dish with a little latex, and measured the allergic antibody response. The white blood cells from those exposed to Mozart had less of an allergic response even outside the body compared to cells taken from Beethoven blood. How cool is that?

Music may even impact our metabolism. This inquiry started with a 2012 study published in the journal Pediatrics, which found the resting energy expenditure (the number of calories burned when just lying around) was lower in preterm infants when researchers piped in Mozart. This may explain why infants exposed to music put on weight faster, so much so they are able to go home earlier.

Gaining weight faster is great for premature babies, but not necessarily for adults. Could listening to music slow our metabolism and contribute to weight gain? Well, one study found no effect on adults. But the researchers used Bach, not Mozart. Bach doesn't cause a drop in energy expenditure in babies either. These data suggest there may be "more a 'Mozart effect' than a universal 'music effect'."

What if we just listen to music of our choice? Does that affect our metabolism? We didn't know... until now. It turns out that listening to music appears to actually increase our metabolic rate, such that we burn an average of 27.6 more calories a day just lying in bed. That's only like six M&M's worth, though, so it's better to use music to get up and start dancing or exercising. Music can not only improve exercise enjoyment but also performance--a way to improve athletic performance that's legal.

Male bodybuilders may be less enthused music's effects. After listening to music for just 30 minutes, testosterone levels drop 14% in young men and go up 21% in young women. Do all kinds of music have this effect or just some types? Thirty minutes of silence had no effect on testosterone levels at all, while a half-hour of Mozart, jazz, pop, or Gregorian chants (no relation :) all suppressed testosterone. What about a half-hour of people's personal favorites? Testosterone levels were cut in half! Testosterone decreased in males under all music conditions, whereas testosterone increased in females. What is going on? Well, in men, testosterone is related to libido, dominance, and aggressiveness, whereas women get a bigger boost in testosterone from cuddling than from sex. So maybe we evolved using music as a way to ensure we all got along, like a melodious cold shower to keep everyone chill.

Is that crazy or what? I'm fascinated by the whole topic. For more, see Music for Anxiety: Mozart vs. Metal.

Sounds are the only sensory-stimulators that can have an effect on us--so can scents! See:

Exposure to industrial pollutants may also affect both allergic diseases and testosterone levels:

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. This image has been modified.

Original Link

Can Oatmeal Reverse Heart Disease?

Can Oatmeal Reverse Heart Disease?.jpeg

Fiber continues to be singled out as a nutrient of public health concern. We're getting only about half the minimum recommended intake on average. There is a fiber gap in America. Less than 3 percent meet the recommended minimum. This means that less than 3 percent of all Americans eat enough whole plant foods, the only place fiber is found in abundance. If even half of the adult population ate 3 more grams a day--a quarter cup of beans or a bowl of oatmeal--we could potentially save billions in medical costs. And that's just for constipation! The consumption of plant foods, of fiber-containing foods, may reduce the risk for diabetes, heart disease, stroke, cancer, and obesity as well.

The first to make this link between fiber intake and killer disease was probably Dr. Hugh Trowell. He spent 30 years practicing medicine in Africa and suspected it was the Africans high consumption of corn, millet, sweet potatoes, greens, and beans that protected them from chronic disease. This twisted into the so-called "fiber hypothesis," but Trowell didn't think it was the fiber itself, but the high-fiber foods themselves that were protective. There are hundreds of different substances in whole plant foods besides fiber that may have beneficial effects. For example, the fiber in oatmeal can lower our blood cholesterol levels so that less gets stuck in our arteries, but there also are anti-inflammatory and antioxidant phytonutrients in oats that can prevent atherosclerotic build-up and then help maintain arterial function (see Can Oatmeal Reverse Heart Disease?).

Visionaries like Trowell were not entrapped by the reductionist "simple-minded" focus on dietary fiber and insisted that the whole plant foods should receive the emphasis. Fiber intake was just a marker for plant food intake. Those with the highest fiber intake and the lowest cholesterol were those whose who ate exclusively plant-based diets.

Risk factors like cholesterol are one thing, but can these individual foods actually affect the progression of heart disease, the #1 killer of Americans? We didn't know until 2005. Hundreds of older women were subjected to coronary angiograms, where we inject dye into the coronary arteries of the heart to see how wide open they are. Each participant got an angiogram at the beginning of the study and one a few years later, all while researchers analyzed their diets. The arteries of women eating less than a serving of whole grains a day significantly narrowed, whereas the arteries of women who ate just a single serving or more also significantly narrowed, but they narrowed less. These were all women with heart disease eating the standard American diet, so their arteries were progressively clogging shut. But there was significantly less clogging in the women eating more whole grains, significantly less progression of their atherosclerosis. A similar slowing of their disease might be expected from taking cholesterol-lowering statin drugs. But do we want to just slow the rate at which we die from heart disease, or do we want to not die from heart disease at all?

A strictly plant-based diet has been shown to reverse the progression of heart disease, opening up arteries back up. Yes, whole grains, like drugs, can help counter the artery-clogging effects of the rest of the diet. Having oatmeal with bacon and eggs is better than just eating bacon and eggs, but why not stop eating an artery-clogging diet altogether?

Oatmeal offers a lot more than fiber, though. See Oatmeal Lotion for Chemotherapy-Induced Rash and Can Oatmeal Help Fatty Liver Disease?

Trowell's work had a big influence on Dr. Denis Burkitt. See Dr. Burkitt's F-Word Diet.

This reminds me of other interventions like hibiscus tea for high blood pressure (Hibiscus Tea vs. Plant-Based Diets for Hypertension) or amla for diabetes (Amla Versus Diabetes). Better to reverse the disease completely.

And for an overview of how whole plant foods affect disease risks, be sure to check out the videos on our new Introduction page!

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: Rachel Hathaway / Flickr. This image has been modified.

Original Link

Can Oatmeal Reverse Heart Disease?

Can Oatmeal Reverse Heart Disease?.jpeg

Fiber continues to be singled out as a nutrient of public health concern. We're getting only about half the minimum recommended intake on average. There is a fiber gap in America. Less than 3 percent meet the recommended minimum. This means that less than 3 percent of all Americans eat enough whole plant foods, the only place fiber is found in abundance. If even half of the adult population ate 3 more grams a day--a quarter cup of beans or a bowl of oatmeal--we could potentially save billions in medical costs. And that's just for constipation! The consumption of plant foods, of fiber-containing foods, may reduce the risk for diabetes, heart disease, stroke, cancer, and obesity as well.

The first to make this link between fiber intake and killer disease was probably Dr. Hugh Trowell. He spent 30 years practicing medicine in Africa and suspected it was the Africans high consumption of corn, millet, sweet potatoes, greens, and beans that protected them from chronic disease. This twisted into the so-called "fiber hypothesis," but Trowell didn't think it was the fiber itself, but the high-fiber foods themselves that were protective. There are hundreds of different substances in whole plant foods besides fiber that may have beneficial effects. For example, the fiber in oatmeal can lower our blood cholesterol levels so that less gets stuck in our arteries, but there also are anti-inflammatory and antioxidant phytonutrients in oats that can prevent atherosclerotic build-up and then help maintain arterial function (see Can Oatmeal Reverse Heart Disease?).

Visionaries like Trowell were not entrapped by the reductionist "simple-minded" focus on dietary fiber and insisted that the whole plant foods should receive the emphasis. Fiber intake was just a marker for plant food intake. Those with the highest fiber intake and the lowest cholesterol were those whose who ate exclusively plant-based diets.

Risk factors like cholesterol are one thing, but can these individual foods actually affect the progression of heart disease, the #1 killer of Americans? We didn't know until 2005. Hundreds of older women were subjected to coronary angiograms, where we inject dye into the coronary arteries of the heart to see how wide open they are. Each participant got an angiogram at the beginning of the study and one a few years later, all while researchers analyzed their diets. The arteries of women eating less than a serving of whole grains a day significantly narrowed, whereas the arteries of women who ate just a single serving or more also significantly narrowed, but they narrowed less. These were all women with heart disease eating the standard American diet, so their arteries were progressively clogging shut. But there was significantly less clogging in the women eating more whole grains, significantly less progression of their atherosclerosis. A similar slowing of their disease might be expected from taking cholesterol-lowering statin drugs. But do we want to just slow the rate at which we die from heart disease, or do we want to not die from heart disease at all?

A strictly plant-based diet has been shown to reverse the progression of heart disease, opening up arteries back up. Yes, whole grains, like drugs, can help counter the artery-clogging effects of the rest of the diet. Having oatmeal with bacon and eggs is better than just eating bacon and eggs, but why not stop eating an artery-clogging diet altogether?

Oatmeal offers a lot more than fiber, though. See Oatmeal Lotion for Chemotherapy-Induced Rash and Can Oatmeal Help Fatty Liver Disease?

Trowell's work had a big influence on Dr. Denis Burkitt. See Dr. Burkitt's F-Word Diet.

This reminds me of other interventions like hibiscus tea for high blood pressure (Hibiscus Tea vs. Plant-Based Diets for Hypertension) or amla for diabetes (Amla Versus Diabetes). Better to reverse the disease completely.

And for an overview of how whole plant foods affect disease risks, be sure to check out the videos on our new Introduction page!

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: Rachel Hathaway / Flickr. This 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

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

Best Foods for Acid Reflux

Best Foods for Acid Reflux.jpeg

Gastroesophageal reflux disease (GERD) is one of the most common disorders of the digestive tract. The two most typical symptoms are heartburn and regurgitation of stomach contents into the back of the throat, but GERD is not just burning pain and a sour taste in your mouth. It causes millions of doctor visits and hospitalizations every year in the United States. The most feared complication is cancer.

You start out with a normal esophagus. If the acid keeps creeping up, your esophagus can get inflamed and result in esophagitis. Esophagitis can transform into Barrett's esophagus, a precancerous condition which can then turn into adenocarcinoma (a type of cancer). To prevent all that, we need to prevent the acid reflux in the first place.

In the last three decades, the incidence of this cancer in the US has increased six-fold, an increase greater than that of melanoma, breast, or prostate cancer. This is because acid reflux is on the rise. In the United States, we're up to about 1 in 4 people suffering at least weekly heartburn and/or acid regurgitation, compared to around 5% in Asia. This suggests that dietary factors may play a role.

In general, high fat intake is associated with increased risk, whereas high fiber foods appear to be protective. The reason fat intake may be associated with GERD symptoms and erosive esophagitis is because when we eat fatty foods, the sphincter at the top of the stomach that's supposed to keep the food down becomes relaxed, so more acid can creep up into the esophagus. In my video Diet & GERD Acid Reflux Heartburn, you can see a study in which researchers fed volunteers a high-fat meal--a McDonald's sausage and egg McMuffin--compared to a low-fat meal (McDonald's hot cakes), and there was significantly more acid squirted up in the esophagus after the high-fat meal.

In terms of later stages of disease progression, over the last twenty years 45 studies have been published in the association between diet and Barrett's esophagus and esophageal cancer. In general, they found that meat and high-fat meals appeared to increase cancer risk. Different meats were associated with cancers in different locations, thoughj. Red meat was more associated with cancer in the esophagus, whereas poultry was more associated with cancer at the top of the stomach. Plant-based sources of protein, such as beans and nuts, were associated with a significantly decreased risk of cancer.

Those eating the most antioxidant-rich foods have half the odds of esophageal cancer, while there is practically no reduction in risk among those who used antioxidant vitamin supplements, such as vitamin C or E pills. The most protective produce may be red-orange vegetables, dark green leafies, berries, apples, and citrus. The benefit may come from more than just eating plants. Eating healthy foods crowds out less healthy foods, so it may be a combination of both.

Based on a study of 3,000 people, the consumption of non-vegetarian foods (including eggs) was an independent predictor of GERD. Egg yolks cause an increase in the hormone cholecystokinin, which may overly relax the sphincter that separates the esophagus from the stomach. The same hormone is increased by meat, which may help explain why plant-based diets appear to be a protective factor for reflux esophagitis.

Researchers found that those eating meat had twice the odds of reflux-induced esophageal inflammation. Therefore, plant-based diets may offer protection, though it's uncertain whether it's attributable to the absence of meat in the diet or the increased consumption of healthy foods. Those eating vegetarian consume greater amounts of fruits and vegetables containing innumerable phytochemicals, dietary fiber, and antioxidants. They also restrict their consumption of animal sources of food, which tend to be fattier and can thus relax that sphincter and aggravate reflux.

GERD is common; its burdens are enormous. It relapses frequently and can cause bleeding, strictures, and a deadly cancer. The mainstay of treatment is proton pump inhibitor drugs, which rake in billions of dollars. We spend four billion dollars on Nexium alone, three billion on Prevacid, two billion on Protonix, one billion on Aciphex. These drugs can cause nutrient deficiencies and increase the risk for pneumonia, food poisoning, and bone fractures. Thus, it is important to find correctable risk factors and correct them. Known correctable risk factors have been things like obesity, smoking and alcohol consumption. Until recently, though, there hadn't been studies on specifically what to eat and what to avoid, but now we have other correctable factors to help prevent this disease.

For more on GERD, see: Diet & Hiatal Hernia, Coffee & Mortality, and Club Soda for Stomach Pain & Constipation.

I also have a video about esophageal cancer, detailing the extraordinary reversal of the kinds of precancerous changes that lead to the devastating condition--with nothing but strawberries: Strawberries versus Esophageal Cancer.

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: PDPics / Pixabay. Image has been modified.

Original Link

Best Foods for Acid Reflux

Best Foods for Acid Reflux.jpeg

Gastroesophageal reflux disease (GERD) is one of the most common disorders of the digestive tract. The two most typical symptoms are heartburn and regurgitation of stomach contents into the back of the throat, but GERD is not just burning pain and a sour taste in your mouth. It causes millions of doctor visits and hospitalizations every year in the United States. The most feared complication is cancer.

You start out with a normal esophagus. If the acid keeps creeping up, your esophagus can get inflamed and result in esophagitis. Esophagitis can transform into Barrett's esophagus, a precancerous condition which can then turn into adenocarcinoma (a type of cancer). To prevent all that, we need to prevent the acid reflux in the first place.

In the last three decades, the incidence of this cancer in the US has increased six-fold, an increase greater than that of melanoma, breast, or prostate cancer. This is because acid reflux is on the rise. In the United States, we're up to about 1 in 4 people suffering at least weekly heartburn and/or acid regurgitation, compared to around 5% in Asia. This suggests that dietary factors may play a role.

In general, high fat intake is associated with increased risk, whereas high fiber foods appear to be protective. The reason fat intake may be associated with GERD symptoms and erosive esophagitis is because when we eat fatty foods, the sphincter at the top of the stomach that's supposed to keep the food down becomes relaxed, so more acid can creep up into the esophagus. In my video Diet & GERD Acid Reflux Heartburn, you can see a study in which researchers fed volunteers a high-fat meal--a McDonald's sausage and egg McMuffin--compared to a low-fat meal (McDonald's hot cakes), and there was significantly more acid squirted up in the esophagus after the high-fat meal.

In terms of later stages of disease progression, over the last twenty years 45 studies have been published in the association between diet and Barrett's esophagus and esophageal cancer. In general, they found that meat and high-fat meals appeared to increase cancer risk. Different meats were associated with cancers in different locations, thoughj. Red meat was more associated with cancer in the esophagus, whereas poultry was more associated with cancer at the top of the stomach. Plant-based sources of protein, such as beans and nuts, were associated with a significantly decreased risk of cancer.

Those eating the most antioxidant-rich foods have half the odds of esophageal cancer, while there is practically no reduction in risk among those who used antioxidant vitamin supplements, such as vitamin C or E pills. The most protective produce may be red-orange vegetables, dark green leafies, berries, apples, and citrus. The benefit may come from more than just eating plants. Eating healthy foods crowds out less healthy foods, so it may be a combination of both.

Based on a study of 3,000 people, the consumption of non-vegetarian foods (including eggs) was an independent predictor of GERD. Egg yolks cause an increase in the hormone cholecystokinin, which may overly relax the sphincter that separates the esophagus from the stomach. The same hormone is increased by meat, which may help explain why plant-based diets appear to be a protective factor for reflux esophagitis.

Researchers found that those eating meat had twice the odds of reflux-induced esophageal inflammation. Therefore, plant-based diets may offer protection, though it's uncertain whether it's attributable to the absence of meat in the diet or the increased consumption of healthy foods. Those eating vegetarian consume greater amounts of fruits and vegetables containing innumerable phytochemicals, dietary fiber, and antioxidants. They also restrict their consumption of animal sources of food, which tend to be fattier and can thus relax that sphincter and aggravate reflux.

GERD is common; its burdens are enormous. It relapses frequently and can cause bleeding, strictures, and a deadly cancer. The mainstay of treatment is proton pump inhibitor drugs, which rake in billions of dollars. We spend four billion dollars on Nexium alone, three billion on Prevacid, two billion on Protonix, one billion on Aciphex. These drugs can cause nutrient deficiencies and increase the risk for pneumonia, food poisoning, and bone fractures. Thus, it is important to find correctable risk factors and correct them. Known correctable risk factors have been things like obesity, smoking and alcohol consumption. Until recently, though, there hadn't been studies on specifically what to eat and what to avoid, but now we have other correctable factors to help prevent this disease.

For more on GERD, see: Diet & Hiatal Hernia, Coffee & Mortality, and Club Soda for Stomach Pain & Constipation.

I also have a video about esophageal cancer, detailing the extraordinary reversal of the kinds of precancerous changes that lead to the devastating condition--with nothing but strawberries: Strawberries versus Esophageal Cancer.

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: PDPics / Pixabay. Image has been modified.

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Foods that Affect Testosterone Levels

Foods that Affect Testosterone Levels.jpeg

A number of studies suggest that exposure to industrial pollutants may affect sexual function, for example, loss of libido, sexual dysfunction, and impotence. This may be due to effects on testosterone levels. In a study of men who ate a lot of contaminated fish, an elevation in PCB levels in the blood was associated with a lower concentration of testosterone levels. These pollutants are found predominantly in fish, but also meat and dairy. The lowest levels are found in plants (see Dietary Pollutants May Affect Testosterone Levels).

Testosterone doesn't just play a role in the determination of secondary sex characteristics like facial hair at puberty. It also regulates normal sexual functioning and the overall physical and psychological well-being of adult men. Abnormally low levels of testosterone can lead to decreased physical endurance and memory capacity, loss of libido, drop in sperm count, loss of bone density, obesity, and depression.

Endocrine-disrupting compounds that build up in fish may be able to mimic or block hormone receptors, or alter rates of synthesis or breakdown of sex steroid hormones. In children, these pollutants may actually impair sexual development. Boys who are exposed may grow up with smaller penises (although only by about two-thirds of an inch shorter at most). Researchers have tried exposing cells from aborted fetal human penises to these kinds of dietary pollutants, and gene expression related to genital development is indeed affected at real-life exposure levels. We're not sure if the effects on penis length are due to the pro-estrogenic effects of the toxins, though, or the anti-testosterone effects.

You've heard of save the whales? Well, male reproductive organs may be at risk from environmental hazards as well.

I previously addressed how we discovered the endocrine disruptor phenomenon in Alkylphenol Endocrine Disruptors and Allergies, as well as where they're found (Dietary Sources of Alkylphenol Endocrine Disruptors).

For more on sustaining male virility, see Male Fertility and Diet, The Role of Diet in Declining Sperm Counts, and Dairy Estrogen and Male Fertility.

I've talked about the role a plastics chemical may play in male sexual functioning (BPA Plastic and Male Sexual Dysfunction). But it's not just toxins, it's the total diet (Survival of the Firmest: Erectile Dysfunction and Death), and not only in men (Cholesterol and Female Sexual Dysfunction). My latest on the topic is Best Foods to Improve Sexual Function.

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

Foods that Affect Testosterone Levels

Foods that Affect Testosterone Levels.jpeg

A number of studies suggest that exposure to industrial pollutants may affect sexual function, for example, loss of libido, sexual dysfunction, and impotence. This may be due to effects on testosterone levels. In a study of men who ate a lot of contaminated fish, an elevation in PCB levels in the blood was associated with a lower concentration of testosterone levels. These pollutants are found predominantly in fish, but also meat and dairy. The lowest levels are found in plants (see Dietary Pollutants May Affect Testosterone Levels).

Testosterone doesn't just play a role in the determination of secondary sex characteristics like facial hair at puberty. It also regulates normal sexual functioning and the overall physical and psychological well-being of adult men. Abnormally low levels of testosterone can lead to decreased physical endurance and memory capacity, loss of libido, drop in sperm count, loss of bone density, obesity, and depression.

Endocrine-disrupting compounds that build up in fish may be able to mimic or block hormone receptors, or alter rates of synthesis or breakdown of sex steroid hormones. In children, these pollutants may actually impair sexual development. Boys who are exposed may grow up with smaller penises (although only by about two-thirds of an inch shorter at most). Researchers have tried exposing cells from aborted fetal human penises to these kinds of dietary pollutants, and gene expression related to genital development is indeed affected at real-life exposure levels. We're not sure if the effects on penis length are due to the pro-estrogenic effects of the toxins, though, or the anti-testosterone effects.

You've heard of save the whales? Well, male reproductive organs may be at risk from environmental hazards as well.

I previously addressed how we discovered the endocrine disruptor phenomenon in Alkylphenol Endocrine Disruptors and Allergies, as well as where they're found (Dietary Sources of Alkylphenol Endocrine Disruptors).

For more on sustaining male virility, see Male Fertility and Diet, The Role of Diet in Declining Sperm Counts, and Dairy Estrogen and Male Fertility.

I've talked about the role a plastics chemical may play in male sexual functioning (BPA Plastic and Male Sexual Dysfunction). But it's not just toxins, it's the total diet (Survival of the Firmest: Erectile Dysfunction and Death), and not only in men (Cholesterol and Female Sexual Dysfunction). My latest on the topic is Best Foods to Improve Sexual Function.

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