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Ninety percent of women report having painful menstrual cramps at least some of the time. Around the Mediterranean, fennel seeds have been traditionally used to relieve painful menstruation. We call them seeds, but they’re actually whole little fruits. I discuss their effectiveness in the treatment of menstrual cramps in my video Fennel Seeds for Menstrual Cramps and PMS. It’s hard to create placebo seeds, so researchers used fennel seed extract to put it to the test. The women started out rating their pain as six out of ten, which then went down to a four within an hour after the taking the fennel seed extract. Fifty-two percent of the women rated the fennel seed treatment as excellent, compared with only 8 percent of those in the placebo group who were just unknowingly given placebo capsules just containing flour.

But women don’t take flour for cramps; they take drugs such as ibuprofen. Mefenamic acid is in the same class of nonsteroidal anti-inflammatory (NSAID) drugs and may actually work better than ibuprofen, but it is not available over the counter. How did it do against an extract of fennel seeds? In a head-to-head study, most women started out in severe pain but ended up pain-free after treatment, and the fennel worked just as well as the drug class considered the treatment of choice––but without the drug’s side effects, which include diarrhea, rashes, autoimmune anemia, and kidney toxicity.

The drug also doesn’t help with the other symptoms of bad periods. During menstruation, women can feel nauseated, out of sorts, weak, achy, and diarrheic. But when put to the test, fennel seeds seemed to help; however, the control group wasn’t given a placebo, so we don’t know how much of that was a placebo effect.

One downside of taking fennel is that women bleed about 10 percent more. Menstrual cramps are caused by the uterus contracting so hard its blood supply is compromised, and we think fennel works through muscle relaxation. It also helps with infant colic, which is thought to be due to intestinal spasms. The advantage of fennel there, too, is the lack of side effects, unlike the drug commonly used for colic. Indeed, dicyclomine hydrochloride can work a little too well to get your baby to stop crying––by developing side effects like death.

Ginger is effective for cramps and reduces bleeding when an eighth of a teaspoon of ginger powder is taken three times a day during one’s period. This is important since up to 18 million young women in the United States experience iron deficiency anemia due to heavy menstrual bleeding. In a study, the amount of blood loss was estimated using a scoring system that gave points for level of saturation and clot size. On ginger, they went from half a cup per period down to a quarter cup. Ginger appears to be a highly effective treatment for the reduction of menstrual blood loss. It is cheap, at only about 6 cents a month, easy to use, and may have fewer side effects than medications and invasive approaches, even sometimes fewer than placebo! The researchers used lactose (milk sugar) for the sugar pills, which may have caused the reported flatulence.

Ginger may also work better for premenstrual syndrome (PMS). An eighth of a teaspoon twice a day of ginger powder for a week before one’s period yields a significant drop in PMS mood, physical, and behavioral symptoms, whereas fennel may help with PMS anxiety and depression but not with the emotional or physical symptoms.

Other dietary interventions that may help include a reduction in salt and animal fat consumption, which I address in my video Dietary Treatment for Painful Menstrual Periods.

We should use whatever works––because sometimes, evidently, PMS symptoms can lead to death. Case in point: Christine English who, at that time of the month, ran down her husband. Accepting PMS as a defense, the court released her with one year of probation.

For more on treating menstrual pain and PMS, 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:

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Why do dogs lick their wounds? They even lick our wounds. This leads to a question posed in the medical literature nearly a half century ago: Might there be some healing property of dog saliva? Well, it appears that there are a number of immune defense mechanisms in saliva, one of which involves nitric oxide. Licking of human skin results in production of nitric oxide from salivary nitrite, which kills skin pathogens and comes from the nitrates we eat in our diet.

How do we know we can get nitric oxide from licked human skin? Researchers had a bunch of volunteers lick their hands all over, front and back. Today, we have a better way to clean wounds: soap and water. (And we should never let our pets lick open wounds because cases of serious infections have been reported).

The reason I bring it up is that this transformation of nitrates from our diet into nitrites in our mouth has important implications for our health. Insufficient nitric oxide production is recognized as the earliest event in the onset and progression of a number of chronic diseases, including high blood pressure, peripheral artery disease, and a number of inflammatory conditions.

Nitrates come from vegetables in our diets, such as beets and green leafy vegetables. Good bacteria on our tongue convert nitrates into nitrites which can circulate throughout the body to create nitric oxide, and any nitrates our tongue bacteria missed the first time around get pumped by our body back into our saliva to give our tongue bacteria a second chance. One way we can become nitric-oxide-production-deficient is by not eating enough vegetables in the first place. So, eating vegetables should be the first step. But, if our tongue bacteria die off, the cycle is broken no matter how many vegetables we eat.

That’s why we should not use antiseptic mouthwash. Previously, I profiled an important study in my video Don’t Use Antiseptic Mouthwash. The most protective food for our heart may be green leafy vegetables because, like beets, they have lots of nitrates. So, if you drink some beet juice, you can get a remarkable drop in blood pressure within just hours, but only if you swallow.

The nitric oxide pathway can be interrupted if you use an antibacterial mouthwash or by spitting and not swallowing beet juice because of the critical action of our tongue bacteria on the nitrates in our saliva. So, we have to eat our vegetables and keep our tongue bacteria happy––so, no antibacterial mouthwash. But what about antibacterial toothpaste?

There’s a toothpaste on the market that contains an antibacterial chemical called triclosan. In my video Antibacterial Toothpaste: Harmful, Helpful, or Harmless?, I present a study was done that showed there was no difference in the levels of nitric oxide, nitrite, and nitrate after brushing with regular toothpaste and triclosan toothpaste. Our good tongue bacteria live in the cracks on the surface of our tongue, so if you just brush your teeth and not your tongue, the chemical doesn’t seem to get down there. Does that mean triclosan toothpaste is safe?

The use of triclosan toothpaste may not be associated with any increase in serious adverse cardiac events. And though studies on rats suggest the chemical can affect thyroid function, the use of triclosan toothpaste does not seem to affect human thyroid function. A study funded by Colgate concluded that triclosan was both safe and effective, producing “a significant reduction in gingivitis, plaque, and bleeding.” However, an independent review by the Cochrane Group suggested the reduction may be statistically significant but may not be beneficial enough to yield clinical significance.

Regarding safety, states are starting to ban the stuff because of data showing that despite the lack of efficacy, triclosan is so ubiquitous that most of the U.S. population is exposed to it. “Because the rapid rise in obesity in the U.S. parallels the introduction of triclosan, and because triclosan has two potential mechanisms by which it might alter human weight”—that is, by mucking with our gut flora or our hormones––researchers at Stanford decided to assess the association between triclosan levels flowing through people’s bodies and how heavy they are. And, indeed, they found an association between triclosan levels and increase in body mass index, and suggested further studies on how this chemical could be altering human growth and well-being.

If we shouldn’t use antiseptic mouthwash, What’s the Best Mouthwash? (Spoiler alert: It’s green tea!)

I’ve created an extensive video library on the benefits of nitrate-containing vegetables for both athletic performance and cardiovascular benefits. Here are some of the latest:

For more on nontoxic ways to maintain oral health, 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:

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NutritionFacts.org | The Latest in Nutri.. by Michael Greger M.d. Faclm - 1w ago

As I reviewed in my video Is Fish Oil Just Snake Oil?, the revelation that fish oil appears useless in preventing heart disease—in both heart patients and those trying to prevent heart disease in the first place—leads one to wonder how this whole fish tale began.

The common mythology is that in response to anecdotal reports of a low prevalence of coronary heart disease among the Eskimo, Danish researchers Bang and Dyerberg went there and confirmed a very low incidence of heart attack. The absence of coronary artery disease would be strange in a meat-based diet with hardly any fruits and vegetables—“in other words, a diet that violates all principles of balanced and heart-healthy nutrition.” This paradox was attributed to all the seal and whale blubber, which is extremely rich in omega-3 fish fat, and the rest is history.

There’s a problem, though. It isn’t true.

As I discuss in my video Omega-3s and the Eskimo Fish Tale, the fact is Bang and Dyerberg never examined the cardiovascular status of the Eskimo; they just accepted at face value this notion that coronary atherosclerosis is almost unknown among the Eskimo, a concept that has been disproven over and over starting back in the 1930s. In fact, going back more than a thousand years, we have frozen Eskimo mummies with atherosclerosis. From 500 years ago, a woman in her early 40s had atherosclerosis in her aorta and coronary arteries. And these aren’t just isolated cases. The totality of evidence from actual clinical investigations, autopsies, and imaging techniques is that they have the same plague of coronary artery disease that non-Eskimo populations have, and the Eskimo actually have twice the fatal stroke rate and don’t live particularly long.

“Considering the dismal health status of Eskimos, it is remarkable that instead of labelling their diet as dangerous to health,” they just accepted and echoed the myth, and tried to come up with a reason to explain the false premise. The Eskimo had such dismal health that the Westernization of their diets actually lowered their rates of ischemic heart disease. You know your diet’s bad when the arrival of Twinkies improves your health.

So, why do so many researchers to this day unquestioningly parrot the myth? “Publications still referring to Bang and Dyerberg’s nutritional studies as proof that Eskimos have low prevalence of [heart disease] represent either misinterpretation of the original findings or an example of confirmation bias,” which is when people cherry-pick or slant information to confirm their preconceived notions. As the great scientist Francis Bacon put it: “Man prefers to believe what he prefers to be true.” So, we get literally thousands of articles on the alleged benefits of omega-3 fatty acids, a billion-dollar industry selling fish oil capsules, and millions of Americans taking the stuff—all based on a hypothesis that was questionable from the very beginning.

What’s this about no benefit for fish oil consumption and heart disease? See my video Is Fish Oil Just Snake Oil?.

What about fish oil for mood disorders? See Fish Consumption and Suicide. Is Fish “Brain Food” for Older Adults? Should Vegans Take DHA to Preserve Brain Function? Consumption of long-chain omega-3s (EPA and DHA) may be useful for forming and maintaining brain health, but there’s a struggle between Mercury vs. Omega-3s for Brain Development when coming from fish or fish oil, thanks to how polluted our oceans have become. In fact, this is the case even in “distilled” fish oil; see Fish Oil in Troubled Waters for more. The marine pollutants may explain the relationship between Fish and Diabetes and ALS (Lou Gehrig’s Disease): Fishing for Answers. Thankfully, there are now pollutant-free (yeast- and microalgae-derived) sources.

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:

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From a medical journal editor:

“Like any group with vested interests, the food industry resists regulation. Faced with a growing scientific consensus that salt increases blood pressure…major food manufacturers have adopted desperate measures to try to stop governments from recommending salt reduction. Rather than reformulate their products, manufacturers have lobbied governments, refused to cooperate with expert working parties, encouraged misinformation campaigns, and tried to discredit the evidence.”

After all, salt is the main source of flavor in processed foods. Of course, they could improve flavor by adding real ingredients, but making a pop-tart with actual strawberries would be more expensive and cut into profits.

The evidence they’re trying to discredit includes double-blind, randomized trials dating back decades. When you take people with high blood pressure and put them on a sodium-restricted diet, their blood pressure drops. Then, if you keep them on the low-salt diet and add a placebo, nothing happens. But, if you instead secretly give them salt in the form of a time-release sodium pill, their blood pressure goes back up. And, the more sodium you secretly give them, the higher their blood pressure climbs. You can see these trials in my video The Evidence That Salt Raises Blood Pressure.

Even just a single meal can do it. If you take people with normal blood pressure and give them a bowl of soup containing the amount of salt a regular meal might contain, their blood pressure goes up over the next three hours compared to those who had the same soup with no added salt. Why, though? High blood pressure appears to be our body’s way to push the excess salt out of our system.

Dozens of such studies have been done, showing that if we reduce our salt intake, we can reduce our blood pressure, and the greater the reduction, the greater the benefit. The so-called DASH diet, which I covered in my video How to Treat High Blood Pressure with Diet, is commonly used to capture the blood pressure benefits of a more plant-based diet, but how do we know the benefits have anything to do with eating less salt instead of just from eating more fruits and vegetables? Because it was put to the test. Sure, eating more healthfully lowers blood pressure no matter how much salt we eat, but, even if we stick to the same diet, lowering salt helps independently of other dietary improvements.

You can do this on a community level with two matched villages that both start out about the same. In one such study, on average, blood pressures in the control village went up or stayed the same. But, in the village where they were able to cut down on salt intake, blood pressures went down.

If we don’t cut down chronic high salt intake can lead to a gradual increase in blood pressure throughout life, as shown in the famous Intersalt study. Fifty-two centers from 32 countries participated, with hundreds of participants each, and four of those centers were in populations that ate so little salt they actually complied with the American Heart Association guidelines for salt reduction, something less than 1 percent of Americans achieve. In a population where everyone made the cut off, not a single case of high blood pressure was found. What’s more, the older folks had the same blood pressure as the teenagers.

This is why including such populations is so important. If you just look at the 48 centers in the industrialized Western world, there does not appear to be any relationship between rising blood pressure with age and how much sodium people are getting every day. Now, the salt industry looks at this and says, “Aha! I told you so! There isn’t any relationship between salt and increasing blood pressures as you get older.” But maybe that’s because they’re all getting too much salt.

In the Intersalt study, they were all way over the American Heart Association recommendation for salt intake. You can imagine a similar result if this was instead lung cancer rates versus packs of cigarettes smoked every year. Whether you smoked 150 packs a year or 200 packs a year, it might not make much of a difference. To see a relationship between smoking and cancer, you’d have to compare smokers to those who rarely light up. And, indeed, if you add in those low-salt populations who get little or no high blood pressure as they get older, you end up with a highly statistically significant relationship between increasing sodium and increasing blood pressure—but only if you include people that actually comply with the salt guidelines.

As with so many lifestyle interventions, they only work if you actually do it.

This is part of my extended dive into the manufactured controversy about the health effects of sodium. Check out:

Will cutting back on salt make everything tastes like cardboard? Don’t worry! Check out Changing Our Taste Buds.

For more on the DASH diet, check out How to Treat High Blood Pressure with Diet.

Interested in more on the blood pressures of those on plant-based, salt-shaker-free diets? 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:

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The strategy of trying to prevent heart disease risk in childhood has been described as radical, but is the concept really so radical? What truly would be radical would be to adopt this concept and actually do something about our #1 killer epidemic. “The alternative is to continue indefinitely to rely upon the late and incompletely effective strategies, with their recognized costs, for detecting and treating already established risk factors” like high cholesterol levels that may have been causing progression of the disease their whole lives. As I discuss in my video Heart Disease May Start in the Womb, “a failure to diagnose and treat risk factors in youth may miss an opportunity to prevent the long-term consequences of [heart] disease,” the leading cause of disability and death in the United States for both men and women.

We could prevent 90 percent of heart attacks. Such a claim would have seemed outrageous 50 years ago, but now we know stopping this epidemic is achievable. There are two ways we can do this. The first is the clinical medicine approach, in which physicians identify kids at risk and vigorously advocate lifestyle changes or drug them. However, “[t]his model can, at best, be applied to only a few individuals, because physician effort is limited”—we have 15-minute doctor visits—“preventive care is not reimbursed, and interventions directed toward individuals are often ineffective because they are not supported by the surrounding culture.” To stop the disease process completely, one may have to go to an almost exclusively plant-based diet, something that hasn’t been officially recommended for fear of “discouraging” the public. But our job as physicians is to tell the truth and let the public decide.

That’s why, to prevent atherosclerosis, we need broad social and cultural changes that pervade the entire population. The evidence justifies igniting a veritable social movement that eventually will be supported officially by the powers that be. “The goal of eliminating 90% of [coronary heart disease] is feasible,” but the “cultural and societal changes necessary to achieve this goal won’t be easy, and they won’t happen soon, but it’s time to start.”

So, it may be that the newest Academy of Pediatrics-approved guidelines for universal cholesterol screening of all children, starting around age nine, might actually be too conservative. How about starting at age two? That’s “when parents are generally engaged and vigilant about well-child checkups and when there are additional opportunities for provider-parent education about the importance of diet, exercise, and a healthy lifestyle,” not only for their kids but for themselves as well, because atherosclerosis can start even before birth and depend on what our moms ate.

Fatty streak formation occurs in human fetal arteries and is worsened greatly by how high the pregnant mother’s cholesterol is. In one study, arteries were obtained from spontaneous miscarriages and premature newborns who died within 12 hours of birth around the end of the second trimester. They looked at the arteries of fetuses from mothers with normal cholesterol levels and from pregnant moms with high cholesterol, and fetal arteries from mothers with high cholesterol contained significantly greater lesions.

This suggests not only that heart disease may start much earlier than we had previously assumed, but that it also depends on maternal cholesterol levels. So, atherosclerosis might not just start out as a nutritional disease of childhood, but also as a nutritional disease of pregnancy.

And I thought my video Heart Disease Starts in Childhood was a shocker! Just like it’s Never Too Late to Start Eating Healthier, it’s evidently never too early either.

More on healthy pregnancies in:

Some of my videos on raising healthy kids include:

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:

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In my video Turmeric Curcumin for Prediabetes, I talk about “Curcumin extract for prevention of type 2 diabetes,” an extraordinary study published in the journal of the American Diabetes Association. In this randomized, double-blind, placebo-controlled trial of folks diagnosed with prediabetes, half of the subjects got supplements of curcumin, the yellow pigment in the spice turmeric and curry powder, while the other half got identical-looking placebos, and the researchers just followed them for nine months to see who ended up with diabetes.

After nine months of treatment, 16 percent of subjects in the placebo group went on to get full-blown diabetes. How many in the curcumin group? None. The curcumin group saw a significant improvement in fasting blood sugars, glucose tolerance, hemoglobin A1C, insulin sensitivity and pancreatic insulin-producing beta cell function (measured two different ways.)

What if you already have diabetes? Another study found the same beneficial effects—and at a fraction of the dose. The prediabetes study mentioned above used the equivalent of a quarter cup of turmeric a day, whereas this other study used only about a teaspoon’s worth, which is doable through diet rather than supplements.

What’s particularly interesting here is the purported mechanism: Fat in the bloodstream plays “an important role in the development of insulin resistance and ultimately type 2 diabetes.” Fat builds up inside your muscle cells and gums up the works, and all the inflammation this causes interferes with insulin signaling. However, curcumin decreases fat levels in the blood, making this the first study to show that these turmeric spice compounds may have an anti-diabetic effect.

So, if you are pre-diabetic, it might be a good idea to add turmeric to your diet, but it’s important to recognize that prediabetes is a disease in itself, increasing the risk of death, cancer, heart disease, and vision loss. So, it’s not enough to just prevent progression to full-blown diabetes when prediabetes may be cured completely with a healthy plant-based diet.

As was the case in the smoker pee study I covered in Carcinogen-Blocking Effects of Turmeric, those who abuse their bodies with unhealthy diets can lower their risk by eating powerful plants. Of course, it’s better to cut the crap out altogether. Indeed, if just one plant can have that effect, what about a whole diet composed of plants? Watch Plant-Based Diets and Diabetes and How May Plants Protect Against Diabetes? to get the inside scoop.

Interested in learning more about how fat is involved in the development of diabetes? See:

For more on treating prediabetes and preventing it in the first place, check out:

Diabetes is not the only reason I encourage everyone to consume a quarter teaspoon of turmeric every day. Learn more with these videos:

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:

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Have you wanted to get healthier menus in your local schools, hospitals, or other institutions but didn’t know where to start? Now you can use Balanced’s new resources to lead healthy-menu campaigns where you live. Balanced is the nonprofit public health and nutrition advocacy group that NutritionFacts helped launch last year, and they just released their Community Advocacy Program.

This program provides resources for advocates to lead successful healthy menu campaigns in their communities. It includes a downloadable advocacy guide and resource toolkits, an optional 30-day training series, support from the Balanced team, connection to a network of like-minded advocates across the country, and specially tailored resources for each campaign.

To get the toolkit and sign up for the training series, or donate to sponsor an advocate, visit balanced.org/lead

New DVD updates the latest on coffee, chlorella, and the CHIP program

My new DVD is out today and is available as a streaming video so you can start watching it immediately. 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.

 
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:
  1. Aloe for the Treatment of Advanced Metastatic Cancer
  2. Can Aloe Cure Cancer?
  3. Are Apples the Best Food for a Better Sex Life in Women?
  4. Ground Ginger to Reduce Muscle Pain
  5. Alternative Treatments for Autism
  6. What Is the Optimal Diet?
  7. The Weight Loss Program that Got Better with Time
  8. CHIP, the Complete Health Improvement Program
  9. A Workplace Wellness Program that Works
  10. Benefits of Lentils and Chickpeas
  11. Benefits of Blueberries for the Brain
  12. Benefits of Cabbage Leaves for Relief of Engorged Breasts
  13. Effects of Smoking Marijuana on the Lungs
  14. Smoking Marijuana vs. Using a Cannabis Vaporizer
  15. Is Electromagnetic Hypersensitivity Real?
  16. How to Shop for, Handle, and Store Chicken
  17. Does Coffee Affect Cholesterol?
  18. How to Treat Jet Lag with Light
  19. Are Melatonin Supplements Safe?
  20. How to Treat Jet Lag with Melatonin-Rich Food
  21. Detoxifying with Chlorella
  22. Is Henna Safe?
  23. Is Tea Tree Oil Safe?
  24. Does Tea Tree Oil Have Hormonal Side Effects?
  25. Best Supplement for Canker Sores
  26. The Best Advice on Diet and Cancer
Order my new DVD at DrGreger.org/collections/dvds or as a video download/streaming at DrGreger.org/collections/downloads. And remember, if you watch the videos on NutritionFacts.org or YouTube, you can access captions in several different languages. To find yours, click on the settings wheel on the lower-right of the video and then “Subtitles/CC.” 

 
If you were a regular supporter, you’d already be a coffee expert by now, having already received a link to the new DVD. New DVDs and downloads 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, your copy is already on it’s way to you, if you do not have it by June 25th, please email DVDhelp@NutritionFacts.org and we’ll make everything all better.

Get Dr. Greger’s Free Daily Dozen App

Want to know which healthiest-of-healthy foods I suggest eating on a regular basis?  Find out by downloading my free Daily Dozen app where you can see the list of foods, examples, and even links to videos about each item. Just search for Dr. Greger’s Daily Dozen in your Apple or Android app store and get started tracking your progress right away. Then take the Daily Dozen Challenge by checking off all of the boxes in one day; share your success with us by using the #dailydozenchallenge hashtag. 

The How Not to Die Cookbook

The How Not to Die Cookbook is packed with over 100 recipes for delicious meals, snacks, and beverages made with 100% green-light ingredients to help you eat your way to better health. I was fortunate to work with skilled recipe-developer Robin Robertson who helped turn my Daily Dozen and Dining by Traffic Light strategies into delicious recipes. Get a taste right now at nutritionfacts.org/recipes

*100% of the proceeds I receive from all of my books are donated to charity.

    Live Q&A Today, June 28th

Every month now I do Q&As live from my treadmill, and today is the day.

  • Facebook Live: At 1:00 p.m. ET go to our Facebook page to watch live and ask questions.
  • YouTube Live Stream: At 1:30 p.m. ET go here to watch live and ask even more questions! 

You can now find links to all of my past live YouTube and Facebook 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. 

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:

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Back in the 1990s, a major susceptibility gene was discovered for Alzheimer’s, called ApoE4. If we have one ApoE4 gene, either from our mom or dad, like about 15 percent of the U.S. population does, our risk of getting Alzheimer’s is tripled. If we’re like the 1-in-50 folks who have ApoE4 genes from both parents, we may be at nine times the risk. But there are ways to minimize that risk, which is the focus of my video The Alzheimer’s Gene: Controlling ApoE.

The highest frequency of ApoE4 in the world is in Nigeria, but Nigerians also have some of the lowest Alzheimer’s rates. To understand this paradox, one has to understand the role of ApoE. What does the ApoE gene do? ApoE is “the principal cholesterol carrier in the brain.” So, the Nigerians’ diet appeared to have trumped their genes, with their low cholesterol levels from their low intake of animal fat from living off of mainly grains and vegetables.

Indeed, Nigerians have high ApoE4, but Alzheimer’s is a rarity, thanks, perhaps, to low cholesterol levels, which any of us can achieve by eating healthfully. These findings suggest that “long-term changes in plasma cholesterol…can lead to changes in brain ApoE expression.”

Just because we may have been dealt some bad genetic cards doesn’t mean we can’t reshuffle the deck with diet.

We cannot change our genetic makeup, but we can “reduce or prevent high cholesterol.” In a study of a thousand people for more than 20 years, ApoE4 doubled the odds of Alzheimer’s, but high cholesterol nearly tripled the threat. So, the “risk for Alzheimer disease from treatable factors—elevated total cholesterol level and blood pressure—appears to be greater” than that from the dreaded Alzheimer’s susceptibility gene. In fact, projecting from their data, controlling lifestyle factors could reduce a person’s risk for Alzheimer’s disease from nine or ten times the odds down to just two—even if they have the double barrel ApoE4 gene from both parents.

“People tend to have a fatalistic view toward developing Alzheimer disease,” as though it’s going to happen if it’s going to happen, but such a view has been undermined. We just need to emphasize the need for preventing and treating high blood pressure and cholesterol in the first place to reduce our risks for heart disease, stroke, and Alzheimer’s disease, and, “as a result, potentially enhance quantity and quality of life….Of equal importance, these data should be comforting to anyone interested in attempting to reduce the risk for and future burden of Alzheimer disease.”

So what are these dietary changes that help lower our risk? See some of my latest videos on preventing Alzheimer’s disease:

If you’d like to learn more about the exciting world of epigenetics and this concept of switching genes on and off, see BRCA Breast Cancer Genes and Soy and Cancer Reversal Through Diet?.

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:

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Studies in the 1970s showed an extraordinary survival gain in terminal cancer patients with vitamin C, a “simple and relatively nontoxic therapy.” It’s no wonder it got a lot of attention, especially when reported by a world-renowned scientist, Linus Pauling. But studies in the 1980s found no such benefit, so scientists were “left with the inevitable conclusion that the apparent positive results [in the original study] were the product of case-selection bias rather than treatment effectiveness.” In the 1990s, though, an alternative explanation arose: The disappointing ’80s research only used oral vitamin C, whereas the apparently successful ’70s experiments also gave vitamin C intravenously, and we didn’t realize until the ’90s that the same dose given intravenously can lead to dramatically higher levels in the bloodstream than when taken orally. So maybe high dose vitamin C does help in terminal cancer, but maybe only when given intravenously. This is the topic of discussion in my video The Role of Vitamin C in the Treatment of Terminal Cancer.

Encouraging case reports continued to be published. Regression, remission, and cure had been documented in individual cases of advanced kidney cancer, bladder cancer, and lymphoma, but that was three success stories out of how many? If it was three out of a hundred, or even three out of a thousand, then okay, if the treatment is sufficiently nontoxic. But there is evidence that IV vitamin C is widely used in the alternative medicine world, as in 86 percent of 172 practitioners surveyed. Just those 172 practitioners alone treated about 10,000 patients a year, and manufacturers are selling hundreds of thousands of vials of this stuff in the United States. It’s not all being used for cancer, but, presumably, at least thousands of cancer patients are being treated every year with IV vitamin C, making the publication of three remarkable case reports seem less impressive. So no matter how amazing these cases seemed, it’s possible the cancers just spontaneously regressed all on their own, and it was just a coincidence that it happened after the patients were given vitamin C. To know for sure, you have to put it to the test.

To date, there have been some small pilot studies, and the results so far have been disappointing. The good news is that even insane doses of IV vitamin C seem remarkably safe, but failed in a study of two dozen patients “to demonstrate anticancer activity.” Similar small studies have been published, all the way through to the present, with results that are tantalizing but inconclusive. What we do know is that the present state of cancer chemotherapy is “unsatisfactory.” People have a perception that chemotherapy “will significantly enhance their chances of cure,” but if you put all our cancer-killing chemo together, the overall contribution to five-year survival is on the order of 2 percent—all those side effects for a 2.1 percent survival rate bump, at a cost of maybe $100,000 per patient per year. So, it may be worth looking deeper into therapies like IV vitamin C. However, the lack of financial reward (since vitamin C can’t be patented and sold for $100,000) and bias against alternative medicine “could dissuade conventional investigators and funding agencies from seriously considering this approach.”

So, decades later, what can we conclude? “After trials which have included at least 1,609 patients over 33 years, we have to conclude that we still do not know whether Vitamin C has any clinically significant antitumor activity.” Although “there is currently no definitive evidence” of benefit, the Mayo Clinic’s randomized controlled trials “do not negate the potential benefit” based on what we now know about oral-versus-IV routes of administration. So, we’re kind of back at square one: Does it work or not? There are highly polarized views on both sides, but everyone’s working off the same incomplete data. What we need are carefully controlled clinical trials. The question, though, is what do we do until then?

If it was completely nontoxic, one could argue, “Well, what have you got to lose?” But it is not—it’s only relatively nontoxic. For example, there have been rare but serious cases of kidney injury reported. After all, if it’s so safe, why did our bodies evolve to so tightly control against excess absorption? It can also be expensive and time-consuming. Each infusion can cost $100 to $200 out of pocket since insurance doesn’t pay for it, which can be quite a boon for alternative medicine practitioners. About 90 percent of the millions of doses of vitamin C being dispensed are in for-profit arrangements, so there are financial pressures pushing in both directions, for and against this treatment.

Given the relative safety and expense, though, if controlled studies even find a small benefit, it would be considered worthwhile. And if they don’t, the vitamin C question can be put to rest once and for all. But “[i]n cancer treatment we currently do not have the luxury of jettisoning possibly effective and nontoxic treatments. We should revisit promising avenues, without prejudice and with open minds…”

This video is the third installment in a three-part series. For the complete saga, watch the other two videos Intravenous Vitamin C for Terminal Cancer Patients and Vitamin C Supplements for Terminal Cancer Patients.

I discuss the conundrum of what do to about funding research of non-patentable natural treatments in Plants as Intellectual Property: Patently Wrong?.

Additional videos of interest include:

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:

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Vitamin C “is no stranger to controversy, as evidenced by the fact that over 40 years lapsed” from the time citrus fruits were shown to cure scurvy in the 1700s and the widespread implementation of eating citrus to save lives. Is it possible we’re in the midst of a similar 40-year lag with research in the mid-1970s purporting to show that terminal cancer patients treated with vitamin C lived 4 times longer and sometimes 20 times longer? I explore this in my video Vitamin C Supplements for Terminal Cancer Patients.

Researchers at the venerable Mayo Clinic decided to put vitamin C to the test, and they failed to show any benefit. The survival curves for both groups of patients were essentially identical. In fact, the one success story, a man with end-stage pancreatic cancer who had shown no response to any previous attempts at chemotherapy but started improving and was still alive five years later, was one of the patients who got the sugar pill placebos. It was official: Vitamin C didn’t work. “The apparently positive results reported…almost certainly resulted” from systematic bias in terms of which historic controls were chosen to compare with the treatment group, read the accompanying National Cancer Institute editorial.

Linus Pauling disagreed, arguing that the prior chemotherapy in nearly all the Mayo Clinic study patients may have negated the effect of the vitamin C. If the vitamin C works by boosting your immune system but your immune system is first destroyed by chemo, the thinking goes, no wonder it didn’t work. In the original vitamin C study that showed remarkable benefit, only 4 out of the 100 patients had ever received chemo. The Mayo Clinic researchers were skeptical, but “Pauling had a legendary reputation for being right about all sorts of things,” so “one might perhaps do worse than rely at least partly on Pauling’s awesome intuition.” Thus, a second, randomized, double-blind, placebo-controlled study was performed on patients with advanced cancer, but, this time, those who had no prior chemotherapy.

Again, it was a spectacular failure.

Researchers found no measurable response. The cancer in the vitamin C group progressed just as rapidly, and the patients on the placebo sugar pills lived just as long. In fact, if anything, the sugar pill group lived longer. At two years, everyone in the vitamin C group had died, but there were still a few survivors in the placebo group who lived at least past three years. The researchers concluded that “high-dose vitamin C therapy is not effective against advanced malignant disease, regardless of whether the patient has had any prior chemotherapy.”

Because the Mayo studies were taken as definitive, the medical community concluded that vitamin C was useless. However, in the Mayo Clinic studies, they gave the vitamin C orally in supplements, not intravenously. In retrospect, the route of administration may have been key.

In the original study, Pauling and his researchers started out infusing 10 grams of vitamin C a day intravenously, whereas in both of the Mayo studies designed to replicate the protocol, the researchers just gave people vitamin C supplements to take orally. Patients were sent home to swallow 20 capsules a day. They got the same dose, but 10 grams given orally is not the same thing as 10 grams given intravenously. They can’t be blamed for their ignorance, though. This fact wasn’t discovered until decades later.

It turns out vitamin C concentration in our bloodstream is tightly controlled, such that if you try to swallow more than you’d get eating five servings of fruits and vegetables, your body cuts down on the absorption in the intestine. For example, if you go from eating 200 mg to eating about ten times more (2,500 mg), the level in your bloodstream only goes up 3 mg per liter or quart of blood. “In contrast, because intravenous injection bypasses the intestinal absorption system,” it can result in super high blood concentrations—as in 100 to 200 times the level you can achieve taking vitamin C orally. Maybe that explains why the original studies seemed so promising but the follow-up studies were so disappointing. This raises the controversial question of the re-evaluation of vitamin C in cancer treatment. Researchers responded to the challenge and took up the mantle, and I discuss this in my video The Role of Vitamin C in the Treatment of Terminal Cancer.

To learn more about the history of vitamin C and cancer, see Intravenous Vitamin C for Terminal Cancer Patients.

To learn more about vitamin C, see Do Vitamin C Supplements Prevent Colds But Cause Kidney Stones? and What Is the Optimal Vitamin C Intake?.

Can eating citrus protect against cancer? Find out in Citrus Peels and Cancer: Zest for Life?.

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:

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