It all started with a 2008 study in New Zealand. Short-term studies have shown that calcium supplementation may drop blood pressures by about a point. Though the effect appears to be transient, disappearing after a few months, it’s better than nothing. Further, excess calcium in the gut can cause fat malabsorption by forming soap fat, reducing saturated fat absorption, and increasing fecal saturated fat content. Indeed, if you take a couple Tums along with your half bucket of KFC, up to twice as much fat could end up in your stool. With less saturated fat absorbed into your system, your cholesterol might drop. Given this, the New Zealand researchers were expecting to lower heart attack rates by giving women calcium supplements. To the researchers’ surprise, however, there appeared to be more heart attacks in the calcium supplement group.
Was this just a fluke? All eyes turned to the Women’s Health Initiative, the largest and longest randomized, controlled trial of calcium supplementation. The name may sound familiar—it’s the same study that uncovered how dangerous hormone replacement therapy is. Would it uncover the same for calcium supplements? The Women’s Health Initiative reported no adverse effects. However, the majority of the participants were already taking calcium supplements before the study started. So, effectively, the study was just comparing higher versus lower doses of calcium supplementation rather than supplementation versus no supplementation. What if you go back and see what happened to the women who started out not taking supplements and then were randomized to the supplement group? Those who started calcium supplements suffered significantly more heart attacks or strokes. Thus, high dose or low dose, any calcium supplementation seemed to increase cardiovascular disease risk.
Researchers went back, digging through other trial data for heart attack and stroke rates in women randomized to calcium supplements with or without vitamin D added, and they confirmed the danger. Most of the population studies agreed: users of calcium supplements tended to have increased rates of heart disease, stroke, and death.
The supplement industry was not happy, accusing researchers of relying in part on self-reported data—that is, simply asking if people had had a heart attack or not, rather than verifying it. In fact, long-term calcium supplementation causes all sorts of gastrointestinal distress, including twice the risk of being hospitalized with acute symptoms that may have been confused with a heart attack. However, the increased risk was seen consistently across the trials, regardless of whether the heart attacks were verified or not.
Okay, but why do calcium supplements increase heart attack risk, but the calcium you get in your diet doesn’t? Perhaps because when you take calcium pills, you get a spike of calcium in your bloodstream that you don’t get from just eating calcium-rich foods. Within hours of taking supplemental calcium, the calcium levels in the blood shoot up and can stay up for as long as eight hours. This evidently produces what’s called a hypercoagulable state. That is, your blood clots more easily, which could increase the risk of clots in the heart or brain. Indeed, higher calcium blood levels are tied to higher heart attack and stroke rates. So, the mechanism may be that calcium supplements lead to unnaturally large, rapid, and sustained calcium levels in the blood, which can have a variety of potentially problematic effects.
Calcium supplements have been “widely embraced…on the grounds that they are a natural and, therefore, safe way of preventing osteoporotic fractures.” However, it is now becoming clear that taking calcium in one or two daily doses is not natural, in that “it does not reproduce the same metabolic effects as calcium in food,” the way nature intended. Furthermore, the evidence is also becoming steadily stronger that calcium supplementation may not be safe. This is why most organizations providing advice regarding bone health, now “recommend that individuals should obtain their calcium requirement from diet in preference to supplements.”
Syncope, otherwise known as fainting, is the sudden, brief loss of consciousness caused by diminished blood flow to our brain. About one in five people experience this at least once, and about one in ten may have repeated episodes of syncope, causing millions of emergency room visits and hospitalizations. Though fainting can be caused by heart problems, it is most often triggered simply by vasovagal reactions, such as standing (because blood pools in our legs) or strong emotions. “Under certain circumstances, such as blood donation, syncope has important medical and societal significance” as fainting may, for example, prevent donors from wanting to give blood again. Indeed, more than 150,000 people experience fainting or near-fainting spells each year when they donate blood.
Speaking of the medical and societal significance, what about fainting while driving? It goes without saying that losing consciousness while driving can pose a serious threat to both the patient and society. Of a group of individuals getting tested for syncope, 9 percent reported they had lost consciousness while driving.
When syncope happens repeatedly, drugs and surgery are used, such as installing a pacemaker. But such “therapy is expensive, efficacy is questionable, and adverse effects are common.” In fact, “results of most drug treatment trials have been disappointing” and the “value of implanting pacemakers has been repeatedly questioned, and now there is evidence of their lack of effectiveness.” So, what do we do?
According to one study, “In Italy, the older generation of general practitioners advised patients prone to fainting to carry a wooden egg (used in the old days for darning socks) and to apply muscle tension by gripping the wooden egg forcefully as soon as a faint was imminent.” These folklore stories inspired an Italian cardiologist to apply arm muscle tensing to combat vasovagal fainting, but it had not been put to the test until recently.
About a minute before losing consciousness, most people about to faint experience so-called prodromal symptoms—that is, they feel dizzy, queasy, or break out into a sweat, signaling they are just about to blackout. When that happens, there are a number of maneuvers shown to successfully abort the impending episode. One is called isometric arm counter-pressure, where you grip one hand in the other and exert pressure, trying to pull apart your arms, and continuing to do so until the symptoms go away. How successful is it? Patients were shown how to do it and reported it was successful 99 percent of the time. Safe and effective, isometric arm counter-pressure is proposed to be the new first-line treatment for those who start to feel faint. You can see a picture of this move in my video How to Prevent Fainting.
Leg crossing and muscle tensing have also been shown to work. You cross your legs and squeeze them together as you tense your leg, stomach, and butt muscles. Safe, inexpensive, and effective, no wonder researchers propose having patients try this before having a cardiac pacemaker surgically implanted. Squatting is another maneuver if all else fails.
Is there anything we can do to prevent the symptoms in the first place? Do we have to wait until we’re dizzy, clammy, and nauseated? Well, also cheap, safe, and effective, simply drinking water can prevent fainting. If you know that needles, for example, make you woozy, five minutes before you get stuck, chug down two cups of water, which can dramatically stabilize blood pressures within minutes in people who are predisposed to fainting, and it has similar effects in normal healthy adults.
“The fact that acute ingestion of water exerts such profound effects may be exploited” by blood donation programs to help prevent people from fainting. It is also the current recommended treatment for so-called blood, injury, or injection phobia, which is actually pretty common, affecting about 1 in 25 people, 75 percent of whom “report a history of fainting in response” to needle sticks. The problem is not just that they won’t donate blood. Avoiding anything related to blood, injury, and injections could pose a particularly serious threat if people neglect to seek medical care when necessary. However, all one may need to do is preload with two cups of water. “The knowledge that such simple self-help maneuvers are readily available and could be lifesaving should prove valuable and helpful in everyday life.”
Quench your curiosity about proper hydration with these videos:
How many years of life are lost to potentially preventable cancers? Every year, more than five million expected years of life are lost to lung cancer, breast cancer, and colorectal cancer alone; “[t]herefore, identifying and improving strategies for prevention of cancer remains a priority…” This is especially important since “not more than 2% of all human cancer is attributable to purely genetic or congenital factors.” The rest involve external factors such as our diet, as I discuss in my video How Much Cancer Does Lunch Meat Cause?.
The most comprehensive summary of evidence on diet and cancer ever compiled recommends we should eat mostly foods of plant origin to help prevent cancer. This means centering one’s diet on plant foods—not just whole grains and beans every day, but every meal.
When it comes to foods that may increase cancer risk, the summary was similarly bold. Unlike many other dietary guidelines that wimp out and just advise people to “moderate” their intake of bad foods (like eat less candy), the cancer guidelines don’t mince words when it came to the worst of the worst. For example, don’t just minimize soda intake; avoid it. Don’t just cut back on bacon, ham, hot dogs, sausage, and lunch meats; avoid processed meats because “data do not show any level of intake that can confidently be shown not to be associated with risk.”
Processed meat cannot only be thought of as a “powerful multi-organ carcinogen,” but it may increase the risk of heart disease and diabetes. Red meat is bad, but processed meat is worse, and that includes white meat like chicken and turkey slices. So, with more heart disease, cancer, and diabetes, it’s no surprise “[p]rocessed meat consumption [has been] associated with increased risk of death.”
The second-largest prospective study ever done on diet and cancer involved more than 400,000 people in Europe. Researchers calculated that by reducing processed meat consumption to less than about a quarter of a hot dog per day, more than 3 percent of all deaths would be prevented.
The largest study, with 600,000 people, was the AARP study done in the United States. Researchers found the preventable fraction of deaths to be much higher than 3 percent, suggesting, for example, that 20 percent of heart disease deaths among women could be averted if the highest consumers cut down to less than approximately a half strip of bacon a day.
More information on processed meat can be found in videos such as:
Medicine is messy. One of reasons researchers experiment on animals is they can create uniform, standardized injuries to test potential remedies. It’s not like you can just cut open 50 people and see if something works better than a sugar pill. But, wait a second, we cut people open all the time. It’s called surgery.
In my video Speeding Recovery from Surgery with Turmeric, I discuss a double-blind, randomized, placebo-controlled study that investigated the efficacy of turmeric curcumin in pain and post-operative fatigue in patients who had their gall bladders removed. Fifty people were cut into and given either curcumin or an identical-looking placebo, along with rescue analgesics—i.e., actual painkillers to take if the pain became unbearable. Even though it’s just laparoscopic surgery, people don’t realize what a toll it can take. (You can be out of commission for a month!) In India, turmeric—found in curry powder—has traditionally been used as a remedy for traumatic pain and fatigue, so the researchers decided to put it to the test.
According to the study, in the weeks following surgery, there was a dramatic drop in pain and fatigue scores in the turmeric curcumin group, with p-values of 0.000. Those are my kind of p-values! The “p-value” refers to a measure of the strength of evidence. The smaller it is, the stronger the evidence is that the result they found didn’t just happen by chance. By convention, a p-value under 0.05 is considered small enough for a result to be considered statistically significant. This means that you’d only expect to find a result that remarkable simply by coincidence 5% of the time, or in 1 out of 20 cases. So a p-value like the one in the study, <0.000, suggests you’d have to run the experiment thousands of times before you’d come up with such a dramatic result just by chance.
It’s hard to come up with objective measures of pain and fatigue, but drug-wise, the curcumin group was still in so much pain they were forced to take 7 of the rescue painkillers. In the same time period, though, the control group had to take 39 pain pills. Of course, it’s better not to get gallstones in the first place, which you can learn more about in my video Cholesterol Gallstones, but the researchers’ conclusion was like no other I’ve ever read in a drug trial.
“Turmeric is a natural food ingredient, palatable, and harmless.” Okay, so far so good. It continued: “It proves to be beneficial as it may be an ecofriendly alternative to synthesized anti-inflammatory drugs which have a definite carbon footprint due to industrial production.” Since when do surgery journals care about the greenhouse gas emissions from drug companies? I just had to look up the reference in the journal Surgical Endoscopy entitled “Journey of the Carbon-Literate and Climate-Conscious Endosurgeon Having a Head, Heart, Hands, And Holistic Sense Of Responsibdlity.” I don’t know what’s stranger, seeing the word “holistic” in a surgical journal or the name of this guy’s practice: “Dr. Agarwal’s Surgery & Yoga.”
The benefits of turmeric are clear—and not just as a remedy for pain. The spice also serves as a potent treatment against cancer, as I explain in these videos:
The processed food industries now use tactics similar to those used by cigarette companies to undermine public health interventions.
“In 1954 the tobacco industry paid to publish the ‘Frank Statement to Cigarette Smokers’ in hundreds of U.S. newspapers. It stated that the public’s health was the industry’s concern above all others and promised a variety of good-faith changes….The ‘Frank Statement’ was a charade, the first step in a concerted, half-century-long campaign to mislead Americans about the catastrophic effects of smoking and to avoid public policy that might damage sales.” As a result, millions of lives were lost during decades of lies and deceptive actions. In the hope that food industry’s history will be written differently, researchers spotlighted important lessons that can be learned from the tobacco experience.
As I discuss in my video, Big Food Using the Tobacco Industry Playbook, the “processed food industries use tactics similar to those used by tobacco companies to undermine public health interventions. They do this by distorting research findings, co-opting policy makers and health professionals, and lobbying politicians and public officials.” In his book about his fight with the tobacco industry, former FDA commissioner David Kesslerrecounted similar strong-arm tactics used by the meat industry to try to squash nutrition regulations.
The Supreme Court’s Citizens United decision allowing corporations to spend unlimited amounts on political ads during election campaigns could make things even worse by working against candidates who support public health positions.
“Another similarity between tobacco and food companies is the introduction and heavy marketing of ‘safer’ or ‘healthier’ products. When cigarette sales dropped…[due] to health concerns, the industry introduced ‘safer’ [filtered] cigarettes that gave health-conscious smokers an alternative to quitting,” and sales shot back up. Ironically, the filters originally had asbestos in them.
Cigarette ads have proudly proclaimed that the brands they were promoting had “less nicotine, “less tar,” and even “reduced carcinogens”! And, how could anything be bad for you if it is “100% organic,” as another ad promoted?
Today, leaner pork or eggs with less cholesterol may be the food industry’s low-tar cigarettes. Indeed, food industry ads and the messages they tout can be head-scratchers. “A KFC ad campaign depicted an African American family in which the father was told by the mother that ‘KFC has 0 grams of trans fat now.’ The father, in the presence of children, shouts, ‘Yeah baby! Whoooo!!’ and then begins eating the fried chicken” by the bucketful.
What about cereal companies touting all of the whole grains in their Cocoa Puffs Brownie Crunch? Fruit Loops “now provides fiber” was the message emblazoned on its packaging.
A U.S. District Judge overseeing a tobacco industry case put it well: “‘All too often in the choice between the physical health of consumers and the financial well-being of business, concealment is chosen over disclosure, sales over safety, and money over morality. Who are these persons who knowingly and secretly decide to put the buying public at risk solely for the purpose of making profits, and who believe that illness and death of consumers is an apparent cost of their own prosperity?’ Above all, the experience of tobacco shows how powerful profits can be as a motivator, even at the cost of millions of lives and unspeakable suffering.”
I know some people don’t like my “political” videos and wish I’d stick to the science, but it’s impossible to understand the disconnect between the balance of evidence and dietary recommendations without understanding the impact of commercial influence. See, for example, these videos:
When you count all the little folds, the total surface area of our gut is about 3,000 square feet. That’s larger than a tennis court. Yet, only a single layer of cells separates our inner core from the outer chaos. The primary fuel that keeps this critical cell layer alive is a short-chain fatty acid called butyrate, which our good bacteria make from the fiber we eat. We feed the good bacteria in our gut, and they feed us right back. As shown in my video, Prebiotics: Tending Our Inner Garden, our good gut bacteria take the prebiotics we eat, like fiber, and, in return, provide the vital fuel source that feeds the cells that line our colon—a prototypical example of the symbiosis between us and our gut flora.
How important are these compounds that our good bacteria derive from fiber? Researchers have explained that a condition known as diversion colitis “frequently develops in segments of the colorectum after surgical diversion of the fecal stream.” What does that mean? If you skip a segment of the bowel (like with an ileostomy) so food no longer passes through that section, it becomes inflamed and can start bleeding, breaking down, and closing off. How frequently does this happen? It can occur up to 100% of the time, but the inflammation uniformly disappears after you reattach it to the fecal flow.
We didn’t know what caused this. Perhaps it was some kind of bacterial overgrowth or bad bacteria? No, it was a nutritional deficiency of the lining of the colon due to the absence of the fiber needed to create the short-chain fatty acids. This was proven in a study wherein researchers cured the inflammation by bathing the lining in what it so desperately needed: fiber breakdown products. Severe inflammation was gone in just a few weeks, demonstrating that when we feed the good bacteria in our gut, they feed us right back.
It makes sense that we have good bacteria in our gut that feed us and try to keep us healthy—they have a pretty good thing going. Our guts are warm and moist, and food just keeps magically coming down the pipe. But if we die, they lose out on all of that. If we die, they die, so it’s in their best evolutionary interest to keep us happy.
But, there are bad bugs, too, like cholera that cause diarrhea. These have a different strategy: The sicker they can make us, the more explosive the diarrhea, and the better their chances of spreading to other people and into other colons. They don’t care if we die, because they don’t intend on going down with the ship.
So, how does the body keep the good bacteria around while getting rid of the bad? Think about it. We have literally trillions of bacteria in our gut, so our immune system must constantly maintain a balance between tolerating good bacteria while attacking bad bacteria. If we mess up this fine balance and start attacking harmless bacteria, it could lead to inflammatory bowel disease, where we’re in constant red-alert attack mode. Researchers explained, “The mechanisms by which the immune system maintains this critical balance remain largely undefined.” That was true…until now.
If you think about it, there has to be a way for our good bacteria to signal to our immune system that they’re the good guys. There is. And that signal is butyrate. Researchers found that butyrate suppresses the inflammatory reaction and tells our immune system to stand down, so butyrate “may behave as a microbial signal to inform [our] immune system that the relative levels of [good] bacteria are within the desired range.” Butyrate calms the immune system down, saying in effect, “All’s well. You’ve got the good guys on board.” This ultimately renders the intestinal immune system hyporesponsive, (i.e., accommodating) to the beneficial bacteria. But, in the absence of the calming effect of butyrate, our immune system is back in full force, attacking the bacteria within our gut under the assumption that those are obviously not the good ones since butyrate levels are so low.
We evolved to have butyrate suppress our immune reaction, so should our good bacteria ever get wiped out and bad bacteria take over, our immune system would be able to sense this and go on a rampage to destroy the invaders and continue rampaging until there were only good bacteria creating butyrate to put the immune system back to sleep.
But what if we don’t eat enough fiber? Remember, our good bacteria use fiber to create butyrate. So, if we don’t eat enough fiber, we can’t make enough butyrate. We could have lots of good bacteria, but if we don’t feed them fiber, they can’t make butyrate. And when our body senses low levels of butyrate, it thinks our gut must be filled with bad bacteria and reacts accordingly. In other words, our body can mistake low fiber intake for having a population of bad bacteria in our gut.
Our body doesn’t know about processed food—it evolved over millions of years getting massive fiber intake. Even during the Paleolithic period, humans ingested 100 grams of fiber a day. So, on fiber-deficient Western diets (Spam on Wonder Bread, anyone?), when our body detects low butyrate levels in the gut, it doesn’t think low fiber. As far as our body is concerned, there’s no such thing as low fiber. So, instead, it thinks bad bacteria. For millions of years, low butyrate has meant bad bacteria, so that’s the signal for our body to go on the inflammatory offensive. That’s one reason why fiber can be so anti-inflammatory and one of the reasons it’s said that “[f]iber intake is critical for optimal health.”
It’s important to note that we’re not referring to fiber supplements here, but whole plant foods. Fiber supplementation with something like Metamucil may “not replicate the results seen with a diet naturally high in fiber.”
For additional background on the advantages of fiber-rich whole foods over fiber supplements, watch my video entitled Is the Fiber Theory Wrong?
There is plenty more evidence supporting the role a fiber-rich diet—that is, a whole plant diet—plays in maintaining optimal health, which you can learn about in these videos:
I recently took the stage at TEDxSedona to talk about Food as Medicine. Watch it here. And if you missed my appearance on Live with Kelly and Ryan, you can still check it out here.
New DVD covers acne, aloe, and alcohol
My new DVD is out today and is available as a streaming video so you can start watching it immediately. I’m really excited about this one. Lots of good juicy practical bits—like How to Access Research Articles for Free—on a huge variety of topics including new research on cocoa powder and alcohol that have changed my clinical practice recommendations. All of these videos will eventually be available for free online over the next few months, but if you don’t want to wait, you can watch them all streaming right now. You can also order it as a physical DVD on DrGreger.org or on Amazon.
Here’s the full list of chapters from the new volume—a preview of what’s to come over the next few months on NutritionFacts.org:
Does Chocolate Cause Acne?
Does Cocoa Powder Cause Acne?
How Much Lead Is in Organic Chicken Soup (Bone Broth)?
Is Aloe Effective for Blood Pressure, Inflammatory Bowel, Wound Healing and Burns?
Apple Peels Put to the Test for Chronic Joint Pain
Can Alcohol Cause Cancer?
The Best Source of Resveratrol
Is It Better to Drink Little Alcohol Than None at All?
Do Any Benefits of Alcohol Outweigh the Risks?
How to Prevent Alzheimer’s with Diet
Heavy Metal Urine Testing and Chelation for Autism
Are Avocados Good for You?
Does Marijuana Cause Permanent Brain Damage in Teens?
Does Marijuana Cause Permanent Brain Damage in Adults?
Do Mobile Phones Affect Brain Function?
The Risks of Shark Cartilage Supplements
Shark Cartilage Supplements Put to the Test to Cure Cancer
Should Women with Fibroids Avoid Soy?
Do Natural and DIY Tea Tree Oil Cleaning Products Disinfect as Well as Bleach?
Coconut Water for Athletic Performance vs. Sports Drinks
If you were a regular supporter, you’d be an alcohol expert by now, having already received a link to the new DVD or download. New DVDs are released every nine weeks. If you’d like to automatically receive them before they’re even available to the public, please consider becoming a monthly donor.
Anyone signing up on the donation page to become a $25 monthly contributor will receive the next three downloads for free, and anyone signing up as a $50 monthly contributor will get a whole year’s worth of new DVDs (as physical DVDs, downloads, streaming, your choice). If you signed up for physical copies, you should have already received this volume, but if not please email DVDhelp@NutritionFacts.org and we’ll make everything all better.
Get a Signed Bookplate
Now is your chance to get a signed bookplate for your How Not to Die or How Not to Die Cookbook. Make a donation of any amount here and I will send you a signed bookplate. (Please note you must use the link to the form in the previous sentence in order to receive your bookplate.)
One Day to Wellness
Meet fitness industry icons Bruce and Mindy Mylrea. They are channeling all their energy, time, and talent into a new nonprofit organization they formed called One Day to Wellness to spread the good news that the vast majority of premature death and disability is preventable with a healthy diet and lifestyle. I’m taking most of this year off from traveling to write my next book, but they are launching a nationwide 100-city tour. Check out their schedule to see when they will be near you at http://onedaytowellness.org.
In 2017, over 80 volunteers worked hard to translate NutritionFacts.org videos into 21 languages! To find out if a video has been translated into your language, simply click on the cogwheel on the bottom right of any video and then click “subtitles.”
Live Q&A March 22
Every month now I do Q&As live from my treadmill, and March 22 is the day.
Facebook Live: At 12:00 p.m. ET go to our Facebook page to watch live and ask questions.
YouTube Live Stream: At 1:00 p.m. ET go here to watch live and ask even more questions!
You can access all of my past live Q&As right here on NutritionFacts.org. If that’s not enough, remember I have an audio podcast to keep you company at http://nutritionfacts.org/audio.
Michael Greger, M.D.
PS: If you haven’t yet, you can subscribe to my free videos hereand watch my live, year-in-review presentations:
The microbiome revolution in medicine is beginning to uncover the underappreciated role our healthy gut bacteria play in nutrition and health.
Recently, it has become apparent that our DNA “does not tell the whole story of our individuality and other factors, environmental factors, play an important role in human health and disease,” researchers concluded. We can thank two revolutions in biology for this revelation. First, there was epigenetics, where diet and lifestyle changes have been shown to turn genes on and off. Second was our unfolding understanding of our microbiome—that is, how changes in our gut flora “appear to impact greatly on human biology.”
“Until relatively recently, the colon was viewed as a retention tank for waste,” and water absorption was its big biological function. The problem was it was hard to get in there, and we weren’t able to grow most of the bugs in a lab. As many as 99% of all microbes fail to grow under standard laboratory conditions. How do you study something you can’t study? Well, now we have fancy genetic techniques.
It took 13 years to sequence the DNA of the first bacteria ever. These days, the same feat might only take two hours. What we’ve learned is that we can each be thought of as a super-organism, a kind of “human-
microbe hybrid,” as one researcher called it. We have trillions of bacteria living inside us. One commentator went as far as to say, “We are all bacteria,” which is a provocative way of acknowledging there are more bacterial cells and genes in our own body than there are human cells and genes, and most of those bacteria live in our gut.
All animals and plants appear to establish symbiotic relationships with microorganisms and, in us, our gut flora can be considered like a “forgotten organ.” Studies indicate that the health-promoting effects of our good bacteria include boosting our immune system, improving digestion and absorption, making vitamins, inhibiting the growth of potential pathogens, and keeping us from feeling bloated. But, should bad bacteria take roost, they can release carcinogens, putrefy protein in our gut, produce toxins, mess up our bowel function, and cause infections.
Researchers are still in the process of figuring out which bacteria are which. There are more than a thousand different types of bacteria that take up residence in the human colon. In my video, Microbiome: The Inside Story, I include a diagram from a typical study of gut flora that gives a sense of the complexity. It comes from what happens to be the largest such study done on the elderly and shows that the frailest tend to harbor similar bugs. The study goes on to suggest that it may be the lousy diet in nursing homes that’s causing this shift, which may play a role in ill health as we grow older.
Based on studying what comes out of fraternal versus identical twins, those who eat different habitual diets, and stools from around the world, “[i]t has become evident that diet has a dominant role on the [bacteria in our colon] and that diet-driven changes in it occur within days to weeks,” the research found. Change your diet, change your gut flora.
“The hope of impacting health through diet may be one of the oldest concepts in medicine; however, only in recent years has our understanding of human physiology grown to the point where we can begin to understand how individual dietary components affect specific illnesses,” researchers explain, through our gut bacteria. Milk fat on that piece of pizza, for example, may feed the bacteria that produces the rotten egg gas hydrogen sulfide, and has experimentally been associated with colitis (inflammatory bowel disease). Fiber, on the other hand, feeds our good bacteria and decreases inflammation in the colon. Both choline, which is found in eggs, seafood, and poultry, and carnitine, which is found in red meat, can be turned into trimethylamine oxide and contribute to heart disease and perhaps fatty liver disease. Excess iron may also muck with our good bacteria and contribute to inflammation, as well.
The good news, researchers found, is that “[s]pecific dietary interventions offer exciting potential for nontoxic, physiologic ways to alter [gut microbiology] and metabolism to benefit the natural history of many intestinal and systemic disorders.”
If you’re interested in more information about friendly flora, I suggest watching the following:
What is the optimal timing and dose of nitrate-containing vegetables? In terms of timing for improving athletic performance, since every person is different, two to three hours before a competition is about as specific as we can get.
What about the best dose? How much borscht do we have to have for breakfast? To date, most studies have used a narrow range of doses so it’s not clear if it’s a matter of more is better or if there’s a ceiling, or threshold amount. A group of researchers decided to find out. They set up folks on an exercise bike and had them cycle furiously until they dropped. The subjects made it about eight minutes after drinking a placebo. After one shot of beetroot juice, which is about a quarter of a cup, they may or may not have gained a few seconds. However, drinking a half-cup gave them about a full extra minute. Drinking even more didn’t seem to offer any additional benefit.
That half-cup or so of beet juice corresponds to 8 “units” of nitrate. So, 4 units didn’t significantly work, and 16 did no better than 8. Thus, 8 units appear to be the sweet spot for improving athletic performance. What about for lowering blood pressure? Again, we see the same thing. Blood pressure may have been helped a little by 4 units, but 8 worked better and about equally well as 16. A 10-point drop in blood pressure, which may not sound like a lot, but that may translate into dropping heart attack risk by 25% and stroke risk by 35%.
But, beet juice is perishable and hard to find. What about V8 juice, which has both beet and spinach juice? It must not have much, though, because you’d have to drink 19 quarts a day to hit the target. That why I have a cooking video on making my own!
Straight beet juice is nitrate-packed, but it’s a processed food. How many actual beets or green leafy vegetables would one have to eat to reach the target of eight units? Well, the British Heart Foundation did the work for you and produced a useful chart that you can see in my “Veg-Table” Dietary Nitrate Scoring Method video at the 2:10 minute mark. They took into account both nitrate concentration and serving size for a range of foods, and arranged all of the foods into three groups: a high nitrate group that’s worth two nitrate units per serving, a medium group that’s worth about a half unit per serving, and a low nitrate group that’s worth one-tenth of a unit per serving. The serving sizes they analyzed are pretty small, though, less than three ounces. (Remember, we’re trying to get up to eight units a day.) So, a typical 15-ounce can of beets would nail the daily eight-unit target, as would a really big salad of greens, both of which are in the high nitrate group. Most people only get about a unit a day, and even vegetarians need to double their vegetable intake, and those eating organic may have to eat even more.
Organic produce may have more vitamin C, iron, magnesium, and phosphorus, but it tends to have fewer nitrates since synthetic nitrogen fertilizers are banned by law from organic agriculture. Eating 15% more organic veggies to get the same nitrate intake is easy, but, for beets, the spread can be larger. On the other hand, organic beets may have more of certain phytonutrients, like the red pigment for which beets are known, which may explain why the organic beet extracts had significantly higher anti-cancer effects in vitro compared to conventional beets.
It’s been a bad few years for fish oil, as I discuss in my video, Omega 3s, Prostate Cancer, and Atrial Fibrillation. Claims were crushed that the long-chain omega 3s in fish oil—EPA/DHA—would stop the progression of heart disease. Then, DHA was associated with increased risk of prostate cancer and “monumentally” failed to treat macular degeneration. This over-the-top rhetoric sounded a little suspicious, and, indeed, the paper was retracted because the author sells some rival supplement he failed to disclose, but he does have a point.
I covered the fish oil failure for heart disease in my Is Fish Oil Just Snake Oil? video. But, what about the increased cancer risk? Men with the highest circulating levels in their blood of the long-chain omega 3 fat DHA were found to be at higher risk for prostate cancer, though a subsequent compilation of all such studies suggested EPA, the other major long-chain omega 3 in fish and fish oil, may be more closely associated with increased cancer risk. Either way, these long-chain omega 3s have been promoted for prevention of heart disease and cancer. We now know, however, that not only does there appear to be no benefit for death, heart attack, or stroke, there may be an elevation in cancer risk. The general recommendations to increase the intake of these fats should consider its potential risks.
How could eating more fish or fish oil increase cancer risk? Well, there are some industrial pollutants, like PCBs, linked to increased prostate cancer risk, and the “primary source of exposure in the general population is believed to be through diet from fish, meat, and dairy products.” If you do a supermarket survey, the PCBs are highest in freshwater fish and lowest in plant-based foods. Vegans have been tested, and they were found to be significantly less polluted than omnivores of the PCB linked to prostate cancer.
However, the prostate cancer study was done in North America where people don’t eat a lot of fish, and indeed, even the group with the highest DHA levels weren’t that high. So, maybe the confounding factor was meat consumption in general, not just fish. Lower meat consumption may be a reason for the lower rates of prostate cancer in the lower DHA group, as the consumption of well-done meat is associated with an increased risk of prostate cancer, and intake should therefore be restricted.
We also used to think omega 3s could protect us from arrhythmias—abnormal heart rhythms, like atrial fibrillation. Millions suffer from the condition, which causes an irregular heartbeat and a higher risk of stroke and death, but fish and fish oil consumption does not appear effective for preventing it or treating it.
Other arrhythmias can be life-threatening and can cause sudden death. Despite initial encouraging results, more recent studies have not only failed to reduce sudden cardiac death with omega 3s, but have actually increased mortality in cardiac patients. For example, men with heart disease advised to eat more oily fish or supplied with fish oil capsules were found to have a higher risk of cardiac death, possibly because of the contaminants in fish, such as mercury. In either case, given the inconsistent benefits and the potential adverse effects, omega 3s must be prescribed with caution and generalized recommendations to increase fish intake or to take fish oil capsules need to be reconsidered.