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Tag: inflammation

  • Brain-Boosting Grapes  | NutritionFacts.org

    Brain-Boosting Grapes  | NutritionFacts.org

    Grape juice and whole grapes are put to the test for brain function, including cognitive decline in early Alzheimer’s.

    In 2010, the first controlled trial was published that examined how the brain responds to grape juice. It helped aged rats, but what about people? “Concord grape juice supplementation improves memory function in older adults with mild cognitive impairment”—or so says the title. The problem is that the study was funded by Welch’s, and, though the authors claim they have no financial interest in the outcome, that seems disingenuous. I mean, do they think Welch’s would ever fund them again if they found grape juice wasn’t good for you? And, indeed, that title is a bit of industry spin. I’m sure that’s what they wanted to find.

    Older adults with memory decline (but not dementia) were randomized into a placebo-controlled, double-blind trial with Concord grape juice versus a similarly looking and tasting Kool-Aid type of drink with the same calories and same sugars. That’s a solid study design. And, berries have those wonderful polyphenol phytonutrients, which have anti-inflammatory and antioxidant properties, so it certainly could help brain function and it did seem to help with verbal learning, as you can see in the graph below and at 1:21 in my video Friday Favorites: Benefits of Grapes for Brain Health.

    The odds you’d get such notable results just by chance are like 1 in 25, whereas the higher recall scores are not considered to be statistically significant, since even if there wasn’t an effect, you might get those kinds of results by chance 1 in every 8 or 10 times you’d run the experiment, as shown in the graph below and at 1:38 in my video. And, by convention, we like at least 1 in 20—a p-value of 0.05 or less—especially if we’re looking at multiple outcomes, which increases the likelihood that something will pop up as a fluke. The bottom line is that we’re less confident in these memory outcomes. If this study hadn’t had industry funding, I imagine it would be titled more accurately. Perhaps “Concord grape juice supplementation improves verbal learning in older adults with mild cognitive impairment”—which is still an important finding, and we have the Welch’s corporation to thank for it. Without industry funding, a study like this might never get done. 

    The findings suggest that drinking grape juice is superior to drinking a grape Kool-Aid type of beverage, not necessarily for helping memory, but maybe for helping with learning. When the study was repeated, though, it did seem to help one measure of memory, but no benefit was found for verbal learning, even when using the same test as before, which calls the previous results into question. So, we’re left uncertain about what effects, if any, grape juice has on the aging brain. 

    What about the brains of middle-aged mothers? The Welch’s-funded researchers noted significant improvements in one measure of memory and driving performance as measured in a fancy driving simulator, suggesting you might be able to stop a dozen yards earlier on the highway after drinking grape juice than if you had instead had a grape Kool-Aid type of drink. I do like how they tried to translate the cognitive effects into more meaningful metrics, but it’s important to acknowledge, as they did, that no effects were found for the majority of cognitive consequences. And, when you study 20 different outcomes, the odds are pretty good that you’d just get a statistically significant result or two by chance, as you can see below and at 3:33 in my video. 

    The latest study involved giving a single dose of a cup of purple grape juice or white grape juice (to which flavor and color had been added to disguise it) to young adults with an average age of 21. In this way, researchers could see if there’s something special about those deep purple polyphenol pigments in Concord grape juice. Their findings? They got the same kind of results: two cognitive measures just reaching statistical significance, but that’s out of seven different outcomes, as you can see below and at 4:12 in my video. So, instead of a p-value of 0.05 as the cut-off for significance, we’d really like to see closer to 0.007, and none hit that. Maybe it’s because they didn’t use whole food like in that blueberry study I profiled before. 

    There was a study that looked at actual grape consumption by utilizing freeze-dried grape powder to capture the whole food (instead of just the juice) versus a sugar-matched placebo. The researchers used PET scans to track changes in brain metabolism associated with early Alzheimer’s in a group of older adults already suffering from mild cognitive decline. Although the changes couldn’t be picked up on neuropsychological testing, in those early-stage Alzheimer’s regions, the placebo group continued to worsen, but the grape group “was spared such decline,” suggesting a protective effect of grapes. You can see these points illustrated in a graph and brain mapping pictures below and from 5:11 in my video. You can see locations where brain metabolism declined after eating six months of placebo grapes (colored red in the video), compared to the level of decline in a brain after six months of eating actual grapes. 

    When commercial entities fund studies, it’s more for marketing purposes than science. That doesn’t necessarily mean the findings are invalid, but you do have to pay special attention to things like the framing of the research question, the experimental methods, statistical analysis, biased interpretation of results, or spin.

    The blueberry video I mentioned is Flashback Friday: Benefits of Blueberries for the Brain. You may also be interested in the Benefits of Blueberries for Mood and Mobility.

    What else might help protect brain function? Check out related posts below.

    Michael Greger M.D. FACLM

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  • A King’s Breakfast, a Prince’s Lunch, and a Pauper’s Dinner  | NutritionFacts.org

    A King’s Breakfast, a Prince’s Lunch, and a Pauper’s Dinner  | NutritionFacts.org

    Harness the power of your circadian rhythms for weight loss by making breakfast or lunch your main meal of the day.

    In my last chronobiology video, we learned that calories eaten at breakfast are significantly less fattening than the same number of calories eaten at dinner, as you can see at 0:14 in my video Breakfast Like a King, Lunch Like a Prince, Dinner Like a Pauper, but who eats just one meal a day? 

    What about simply shifting our daily distribution of calories to earlier in the day? Israeli researchers randomized overweight and obese women into one of two isocaloric groups, meaning each group was given the same number of total calories. One group got a 700-calorie breakfast, a 500-calorie lunch, and a 200-calorie dinner, and the other group got the opposite—200 calories for breakfast, 500 for lunch, and 700 for dinner. Since all of the study participants were eating the same number of calories overall, the king-prince-pauper group should have lost the same amount of weight as the pauper-prince-king group, right? But, no. As you can see in the graph below and at 1:01 in my video, the bigger breakfast group lost more than twice as much weight, in addition to slimming about an extra two inches off their waistline. By the end of the 12-week study, the king-prince-pauper group lost 11 more pounds than the bigger dinner group, dropping 19 pounds compared to only 8 pounds lost by the pauper-prince-king group—despite eating the same number of calories. That’s the power of chronobiology, the power of our circadian rhythm. 

    What was the caloric distribution of the king-prince-pauper group getting 700 calories at breakfast, 500 at lunch, and 200 at dinner? They got 50 percent of calories at breakfast, 36 percent at lunch, and only 14 percent of calories at dinner, which is pretty skewed. What about 20 percent for dinner instead? A 50% – 30% – 20% spread, compared to 20% – 30% – 50%?

    Again, the bigger breakfast group experienced “dramatically increased” weight loss, a difference of about nine pounds in eight weeks with no significant difference in overall caloric intake or physical activity between the groups, as shown in the graph below and at 1:57 in my video. 

    Instead of 80 percent of calories consumed at breakfast and lunch, what about 70 percent compared to 55 percent? Researchers randomized overweight “homemakers” to eat 70 percent of their calories at breakfast, a morning snack, and lunch, leaving 30 percent for an afternoon snack and dinner, or a more balanced 55 percent from the time they woke up through lunch. In both cases, only a minority of calories were eaten for dinner, as you can see below, and at 2:25 in my video. Was there any difference between eating 70 percent of calories through lunch versus only 55 percent? Yes, those eating more calories earlier in the day had significantly more weight loss and slimming. 

    Concluded the researchers: “Stories about food and nutrition are in the news on an almost daily basis, but information can sometimes be confusing and contradictory. Clear messages should be proposed to reach the greatest number of people. One clear communication from physicians could be ‘If you want to lose weight, eat more in the morning than in the evening.’” 

    Even just telling people to eat their main meal at lunch rather than dinner may help. Despite comparable caloric intakes, participants in a weight-loss program randomized to get advice to make lunch their main meal beat out those who instead were told to make dinner their main meal.

    The proverb “Eat breakfast like a king, lunch like a prince, and dinner like a pauper” evidently has another variant: “Eat breakfast yourself, share lunch with a friend, and give dinner away to your enemy.” I wouldn’t go that far, but there does appear to be a metabolic benefit to frontloading the bulk of your calories earlier in the day.

    The evidence isn’t completely consistent, though. A review of dietary pattern studies questioned whether reducing evening intake would facilitate weight loss, citing a study that showed the evening-weighted group did better than the heavy-morning-meal group. Perhaps that was because the morning meal group was given “chocolate, cookies, cake, ice cream, chocolate mousse or donuts” for breakfast. So, chronobiology can be trumped by a junk-food methodology. Overall, the what is still more important than the when. Caloric timing may be used to accelerate weight loss, but it doesn’t substitute for a healthy diet. When he said there was a time for every purpose under heaven, Ecclesiastes probably wasn’t talking about donuts.

    When I heard about this, what I wanted to know was how. Why does our body store less food as fat in the morning? I explore the mechanism in my next video, Eat More Calories in the Morning Than the Evening.

    This is the fifth video in an 11-part series on chronobiology. If you missed the first four, check out the related posts below. 

    Michael Greger M.D. FACLM

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  • 4 Ways To Build A Brain Bank & Prevent Cognitive Decline

    4 Ways To Build A Brain Bank & Prevent Cognitive Decline

    Cognitive decline and even just normal brain changes associated with aging threaten to impact our memories and way of thinking—two things we very much want to hold on to as long as possible. But some people are more resilient to signs of memory loss than others, even when there’s physiologic evidence of memory loss. 

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  • New Study Proves This Vitamin Lowers Signs Of Inflammation After Menopause

    New Study Proves This Vitamin Lowers Signs Of Inflammation After Menopause

    And about 41% of all people have insufficient levels of it.

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  • How To Eat If You Have An Autoimmune Disease: An MD’s Top 4 Tips

    How To Eat If You Have An Autoimmune Disease: An MD’s Top 4 Tips

    What you eat and drink can be the potential cause of autoimmunity, or the most nourishing influence in terms of helping to prevent or reverse autoimmunity. But what principles should you keep in mind when you eat for the long term? There are four main areas to address via nutritional modulation when you have an autoimmune disease: nutritional gaps, poor digestion, toxic backlog, and blood sugar spikes. Let’s dig into the importance of each:

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  • Pre-Cut Vegetables and Endotoxins  | NutritionFacts.org

    Pre-Cut Vegetables and Endotoxins  | NutritionFacts.org

    Endotoxins can build up on pre-cut vegetables and undermine some of their benefits.

    You may remember when I introduced the endotoxin theory literature in my video The Exogenous Endotoxin Theory, which sought to explain how a single Sausage and Egg McMuffin meal could cripple artery function within hours of consumption. Maybe it’s because such a meal causes inflammation within hours of consumption by inducing low-grade endotoxemia, endotoxins in the bloodstream, as I previously discussed in my video Dead Meat Bacteria Endotoxemia. Endotoxins are structural components of gram-negative bacteria like E. coli, as you can see below and at 0:35 in my video Are Pre-Cut Vegetables Just as Healthy?. Certain foods, like ground meat, have high bacterial loads, so the thought was that the endotoxins in the food were triggering the inflammation.

    Critics of the theory argued that because we already have so many bacteria living in our colon, so many endotoxins just sitting down in our large intestine, a few more endotoxins in our food wouldn’t matter much in terms of causing systemic inflammation. After all, we have about two pounds of pure bacteria down there where the sun don’t shine, so there could be about a whole ounce of endotoxin. The lethal dose of intravenously injected endotoxin can be just a few millionths of a gram, so we could have a million lethal doses down there. However, the apparent paradox is explained by compartmentalization. It’s location, location, location.

    Poop is harmless when it’s in your colon, but it shouldn’t be injected into your bloodstream or eaten for that matter, particularly with fat, as that can promote the absorption of endotoxins in the small intestine. That goes for well-cooked poop, too.

    As you can see in the graph below and at 1:44 in my video, you can boil endotoxins for two hours straight with no detriment in their ability to induce inflammation. You could easily kill off any bacteria if you boiled your poop soup long enough, but you can’t kill off the endotoxins they make, just like you can’t cook the crap out of the meat. The consumption of meat contaminated with feces doesn’t just cause food poisoning. It can spill out onto the animal’s skin during the evisceration process when the digestive tract is ruptured. 

    Even when slaughterhouse workers trim off “visible fecal contamination,” the trimming itself can, ironically, sometimes lead to an increase in certain fecal bacteria, thought to be caused by “cross-contamination resulting from the handling to removal fecal contamination” from one carcass to the next. Then, even when properly stored in the fridge, endotoxins start accumulating along with the bacterial growth, as you can see in the graph below and at 2:30 in my video. 

    What about other foods? The highest levels of endotoxins were found in meat and dairy, and the lowest levels in fresh fruits and vegetables. That was testing whole fruits and vegetables, though. “Most spoilage organisms cannot penetrate the plant’s surface barrier and spoil the inner tissues.” That’s why fruits and veggies can sit out in the fields all day in the sun. But, once you cut them open, bacteria can gain access to the inner tissues, and, within a matter of days, your veggies can start to spoil. So, what does that mean for all those convenient pre-cut veggies these days?

    While endotoxins were not detectable in the majority of unprocessed vegetables, once you damage the protective outer layers of vegetables, you diminish their resistance to microbial growth. So, while freshly cut carrots and onions start with undetectable levels, day after day after they’ve been chopped, you start to get the growth of bacteria and, along with them, endotoxin buildup—even if they’ve been kept chilled in the fridge. Not as much as meat, but not insignificant either, as you can see in the graph below and at 3:27 in my video. Enough to make a difference, though? You don’t know until you put it to the test.

    What would happen if you switched people between foods expected to have a lower endotoxin load to foods containing more endotoxins? For instance, going from intact meat, such as a steak, and whole fruits and vegetables, to more like ground beef, pre-cut veggies, and more ready-made meals, as shown below and at 3:39 in my video. After just one week on the lower-endotoxin diet, people’s white blood cell count, which is an indicator of total body inflammation, dropped by 12 percent, then bumped back up by 14 percent after just four days on the higher-endotoxin diet. They also lost a pound and a half on the lower-endotoxin diet and slimmed their waists a bit. 

    They weren’t eating otherwise identical diets, though. It looks like they were eating more meat and cheese on the higher-endotoxin diet and perhaps getting more food additives in the ready-made meals. So, how do we know endotoxins had anything to do with it? That’s where the onion study comes in. Another study was designed based on two meals that differed in their content of bacterial products but were otherwise nutritionally identical. So, researchers compared freshly chopped onion to prechopped onion that had been refrigerated for a few days. The pre-chopped onion wasn’t spoiled; it was still before the “best before” date. So, would it make any difference?

    Within three hours of consumption, the fresh onion meal caused significant reductions in several markers of inflammation. That’s what fruits and vegetables do—they reduce inflammation—but these effects were not observed after eating the pre-chopped onions. For example, three hours after eating freshly chopped onions, researchers saw a significant drop in inflammatory status, but there was no significant change three hours after eating the same amount of pre-chopped onions, as you can see in the graph below and at 5:06 in my video. So, it’s not like the pre-chopped onions caused more inflammation, like in the meat, eggs, and dairy studies, but it did appear that some of the onion’s anti-inflammatory effects were extinguished. “In conclusion, the modern trend towards eating minimally processed vegetables”—pre-cut vegetables—“rather than whole [intact] foods is likely to be associated with increased oral endotoxin exposure.” It’s still better to eat pre-cut veggies than no veggies, but cutting your own might be the healthiest.

     For some other practical veggie videos and blogs check out the related posts below. 

    Michael Greger M.D. FACLM

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  • A Love Letter To Mandelic Acid: An Underrated Exfoliator

    A Love Letter To Mandelic Acid: An Underrated Exfoliator

    I tend to follow a regular skin cycling routine: exfoliation one night, then retinol, two nights of solely hydration, and repeat. On exfoliation night, I usually opt for the latest acid-infused treatment to cross my desk, but recently, I’ve been reaching for mandelic acid formulas only (cleansers, treatments, serums), and my skin has never looked better. 

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  • Fighting Inflammation with Flaxseeds  | NutritionFacts.org

    Fighting Inflammation with Flaxseeds  | NutritionFacts.org

    Elevated levels of pro-inflammatory, aging-associated oxylipins can be normalized by eating ground flaxseed. 

    I previously explored the “Potent Antihypertensive Effect of Dietary Flaxseed in Hypertensive Patients” study in my video Flaxseeds for Hypertension. That was a double-blind, randomized, placebo-controlled trial where researchers disguised ground flaxseed in baked goods versus flax-free placebo muffins and saw an extraordinary drop in high blood pressure. As you can imagine, the flaxseed industry was overjoyed, praising the “impressive” findings, as was I. After all, high blood pressure is “the single largest risk factor” for death in the world. Yes, we give people medications, lots and lots of medications, but most people don’t take them. Nine out of ten people take less than 80 percent of their prescribed blood pressure pills. 
     
    It’s not difficult to understand why. “Patients are asked to follow an inconvenient and potentially costly regimen, which will likely have a detrimental effect on health-related quality of life, to treat a mostly asymptomatic condition that commonly does not cause problems for many years.” So, they may feel worse instead of better, due to the side effects. Then, some think the answer is to give them even more drugs to counteract the effects of the first drugs, like giving men Viagra to counteract the erectile dysfunction caused by their blood pressure pills. 
     
    How about using a dietary strategy instead, especially if it can be just as effective? And, indeed, the drop in blood pressure the researchers saw in the flaxseed study “was greater than the average decrease observed with the standard dose of anti-hypertensive medications.” Flaxseeds are cheaper, too, compared to even single medications, and most patients are on multiple drugs. Plus, flaxseeds have good side effects beyond their anti-hypertensive actions. Taking tablespoons of flaxseed a day is a lot of fiber for people living off of cheeseburgers and milkshakes their whole lives, and your gut bacteria may need a little time to adjust to the new bounty. So, those who start with low-fiber diets may want to take it a little slow with the flaxseeds at first. 
     
    Not all studies have shown significant blood pressure–lowering effects, though. There have been more than a dozen trials by now, involving more than a thousand subjects. And, yes, when you put them all together, overall, there were “significant reductions in both SBP and DBP”—systolic blood pressure (the upper number) and diastolic blood pressure (the lower number)—“following supplementation with various flaxseed products.” But none was as dramatic as what the researchers had found in that six-month trial. The longer trials tended to show better results, and some of the trials just used flaxseed oil or some kind of flaxseed extract. We think this is because the whole is greater than the sum of its parts. “Each of the components of interest within flaxseed, ALA, lignans, fiber, and peptides”—the omega-3s, the cancer-fighting lignans, all the soluble fiber, and the plant proteins, for instance—“all contribute towards BP reduction.” Okay, but how? Why? What is the mechanism? 
     
    Some common blood-pressure medications like Norvasc or Procardia work in part by reducing the ability of the heart to contract or by slowing down the heart. So, might it be that’s how flaxseeds work, too? But, no. In my video Benefits of Flaxseeds for Inflammation, I profile the “Dietary Flaxseed Reduces Central Aortic Blood Pressure Without Cardiac Involvement but Through Changes in Plasma Oxylipins” study. What are oxylipins? 
     
    “Oxylipins are a group of fatty acid metabolites” involved in inflammation and, as a result, have been implicated in many pro-inflammatory conditions, including aging and cardiovascular disease. “The best-characterized oxylipins about cardiovascular disease are derived from the w-6 fatty acid arachidonic acid,” a long-chain omega-6 fatty acid. These are found preformed in animal products, particularly chicken and eggs, and can be made inside the body from junky oils rich in omega-6, such as cottonseed oil, as noted below and at 3:49 in my video. But, as this study is titled, “Elevated levels of pro-inflammatory oxylipins in older subjects are normalized by flaxseed consumption.” 

    That’s how we think flaxseed consumption reduces blood pressure in patients with hypertension: by inhibiting the enzyme that makes these pro-inflammatory oxylipins. I’ll spare you from acronym overload, but eating flaxseeds inhibits the activity of the enzyme that makes these pro-inflammatory oxylipins, called leukotoxin diols, which in turn may lower blood pressure. “Identifying the biological mechanism adds confidence to the antihypertensive actions of dietary flaxseed,” but that’s not all oxylipins do. Oxylipins may also play a role in the aging process. However, we may be able to “beneficially disrupt these biological changes associated with inflammation and aging” with a nutritional intervention like flaxseed. Older adults around age 50 have higher levels of this arachidonic acid–derived oxylipin compared to younger adults around age 20, as you can see in the graph below and at 4:56 in my video. “These elevated concentrations of pro-inflammatory oxylipins in the older age group…may…explain the higher levels of inflammation in older versus younger individuals.” As we get older, we’re more likely to be stricken with inflammatory conditions like arthritis. So, this “elevation of pro-inflammatory oxylipins…may predispose individuals to chronic disease conditions.”

    What if you took those older adults and gave them muffins, like the ones with ground flaxseed? That’s just what a group of researchers did. Four weeks later, the subjects’ levels dropped down to like 20-year-olds’ levels, as seen in the graph below and at 5:32 in my video, “demonstrating that a potential therapeutic strategy to correct the deleterious pro-inflammatory oxylipin profile is via a dietary supplementation with flaxseed.”

    What about flax and cancer? See the related posts below. 

    I also have a video on diabetes: Flaxseeds vs. Diabetes. 

    If you’re interested in weight loss, see Benefits of Flaxseed Meal for Weight Loss. 

    What about the cyanide content of flax? I answered that in Friday Favorites: How Well Does Cooking Destroy the Cyanide in Flaxseeds and Should We Be Concerned About It?.

    What else can help fight inflammation? Check out in related posts below.

    Michael Greger M.D. FACLM

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  • The Pros of Early Time-Restricted Eating  | NutritionFacts.org

    The Pros of Early Time-Restricted Eating  | NutritionFacts.org

    Calories eaten in the morning count less than calories eaten in the evening, and they’re healthier, too.
     
    Time-restricted feeding, where you limit the same amount of eating to a narrow evening window, has benefits compared to eating in the evening and earlier in the day, but it also has adverse effects because you’re eating so much, so late, as you can see below and at 0:12 my video The Benefits of Early Time-Restricted Eating. 

    The best of both worlds was demonstrated in 2018 when researchers put time-restricted feeding into a narrow window earlier in the day. As you can see below and at 0:28 in my video, individuals who were randomized to eat the same food, but only during an 8:00 a.m. to 3:00 p.m. eating window, experienced a drop in blood pressure, oxidative stress, and insulin resistance, even when all of the study subjects were maintained at the same weight. Same food, same weight, but with different results. The drops in blood pressure were extraordinary, from 123/82 down to 112/72 in five weeks, and that is comparable to the effectiveness of potent blood-pressure drugs.


    The longest study to date on time-restricted feeding only lasted for 16 weeks. It was a pilot study without a control group that involved only eight people, but the results are still worth noting. Overweight individuals, who, like most of us, had been eating for more than 14 hours a day, were instructed to stick to a consistent 10- to 12-hour feeding window of their own choosing, as you can see below and at 1:17 in my video. On average, they were able to successfully reduce their daily eating duration by about four and a half hours and had lost seven pounds within 16 weeks. 

    They also reported feeling more energetic and sleeping better, as seen in the graph below and at 1:32 in my video. This may help explain why “all participants voluntarily expressed an interest in continuing unsupervised with the 10-11 hr time-restricted eating regimen after the conclusion of the 16-week supervised intervention.” You don’t often see that after weight-loss studies. 

    Even more remarkably, eight months later and even one year post-study, they had retained their improved energy and sleep (see in the graph below and 1:55 in my video), as well as retained their weight loss (see in the graph below and 1:58 in my video)—all from one of the simplest of interventions: sticking to a consistent 10- to 12-hour feeding window of their own choosing. 
    How did it work? Even though the study “participants were not overtly asked to change nutrition quality or quantity,” they appeared to unintentionally eat hundreds of fewer calories a day. With self-selected time frames for eating, you wouldn’t necessarily think to expect circadian benefits, but because they had been asked to keep the eating window consistent throughout the week, “metabolic jet lag could be minimized.” The thinking is that because people tend to start their days later on weekends, they disrupt their own circadian rhythm. And, indeed, it is as if they had flown a few time zones west on Friday evening, then flew back east on Monday morning, as you can see in the graph below and at 2:40 in my video. So, some of the metabolic advantages may have been due to maintaining a more regular eating schedule. 


    Early or mid-day time-restricted feeding may have other benefits as well. Prolonged nightly fasting with reduced evening food intake has been associated with lower levels of inflammation and has also been linked to better blood sugar control, both of which might be expected to lower the risk of diseases, such as breast cancer. So, data were collected on thousands of breast cancer survivors to see if nightly fasting duration made a difference. Those who couldn’t go more than 13 hours every night without eating had a 36 percent higher risk of cancer recurrence. These findings have led to the suggestion that efforts to “avoid eating after 8 pm and fast for 13 h or more overnight may be a beneficial consideration for those patients looking to decrease cancer risk and recurrence,” though we would need a randomized controlled trial to know for sure. 
     
    Early time-restricted feeding may even play a role in the health of perhaps the longest-living population in the world, the Seventh-day Adventist Blue Zone in California. As you can see in the graph below and at 3:55 in my video, slim, vegetarian, nut-eating, exercising, non-smoking Adventists live about a decade longer than the general population. 

    Their greater life expectancy has been ascribed to these healthy lifestyle behaviors, but there’s one lesser-known component that may also be playing a role. Historically, eating two large meals a day, breakfast and lunch, with a prolonged overnight fast, was a part of Adventist teachings. Today, only about one in ten Adventists surveyed were eating just two meals a day. However, most of them, more than 60 percent of them, reported that breakfast or lunch was their largest meal of the day, as you can see below and at 4:26 in my video. Though this has yet to be studied concerning longevity, frontloading one’s calories earlier in the day with a prolonged nightly fast has been associated with significant weight loss over time. This led the researchers to conclude: “Eating breakfast and lunch 5–6 h apart and making the overnight fast last 18–19 h may be a useful practical strategy” for weight control. The weight may be worth the wait. 


    For more on fasting, click here. 
     
    My big takeaway from all of the intermittent fasting research I looked at is, whenever possible, eat earlier in the day. At the very least, avoid late-night eating whenever you can. Eating breakfast like a king and lunch like a prince, with or without an early dinner for a pauper, would probably be best. 
     
    For more on fasting, fasting for disease reversal, and fasting and cancer, check the related videos below.  

    Michael Greger M.D. FACLM

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  • Should You Use Cannabis Instead Of Ice For Injuries

    Should You Use Cannabis Instead Of Ice For Injuries

    The old go to for a strain or injury is ice or cold compress. Pulling a bag of frozen peas from the fridge is a go to and provides some relief. It’s usually most effective shortly after the injury  This involves an ice pack or ice compress placed on the affected area, designed to reduce inflammation and numb out any pain while reducing swelling. Exposure to the cold has been known to decrease circulation and constrict the blood vessels.

    RELATED: Science Says Medical Marijuana Improves Quality Of Life

    But maybe you should open your mindset. Should you use cannabis instead of ice for injuries? Or maybe additionally? Cannabidiol (CBD), the non-psychoactive component of marijuana, may be more effective (and practical) for treating sprains and injuries. CBD is can be convenient since you can carry topicals for spot treatment as well as oral CBD products for when you have an accident. It also has the added benefit of being free from THC, which is an advantage for athletes.

    Photo by peterschreiber.media/Getty Images

    Sports injuries can also happen when running or jumping on hard surfaces, wearing improper shoes, doing the wrong exercise techniques, poor flexibility, old injuries, or doing the same sport all year round among others.  Add in activities like running, skiing, snowboarding and more, you have a recipes for at least one muscle issue.

    RELATED: Cannabis And Inflammation — What’s The Connection?

    A sprain or injury is a major inconvenience every time it happens. Whether you are an athlete or not, recovery and healing as soon as possible is critical, not to mention painful. Using topical CBD for pain relief and for fighting inflammation is a better option because it activates the endocannabinoid receptors in the affected area to help control stiffness and pain. In addition, CBD interacts with the CB1 and CB2 receptors that can reduce the inflammation and pain caused by irritations and sports injuries.

    Photo by Colin Lloyd via Unsplash

    RELATED: Is Cannabis Better For Sports Injuries Than Traditional Painkillers?

    “Sports injuries most often involve either significant inflammation response or mild micro-traumas,” Dr. Andrew Kerklaan of Dr. Kerklaan Therapeutics shared. “Because of CBD’s anti-inflammatory potential, it may be useful in a myriad of symptoms — from mild everyday aches and pains to minor injuries.” He also explains that CBD can help individuals recover from common injuries caused by exercise. “These will all trigger inflammatory responses and therefore CBD may have potential to help in the recovery process,” he says.

    There are dozens of studies too, which tout the analgesic benefits of  cananbis and CBD. One study revealed CBD is beneficial for chronic pain while improving inflammation and sleep. In a another published in the journal Frontiers in Neurology, researchers discovered that CBD was effective in treating inflammation, reducing pain, and improving mobility in individuals with multiple sclerosis. “It is anti-inflammatory, antioxidative, antiemetic, antipsychotic, and neuroprotective,” wrote the study authors.

    Topical products act faster than edibles. However, for those in serious pain, tinctures and sublingual drops are recommended since they are the quickest of all consumption methods.

    Sarah Johns

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  • A Look at the 5:2 Diet and the Fasting-Mimicking Diet  | NutritionFacts.org

    A Look at the 5:2 Diet and the Fasting-Mimicking Diet  | NutritionFacts.org

    What are the effects of eating only five days a week or following a fasting-mimicking diet five days a month? 
     
    Instead of eating every other day, what if you ate five days a week and fasted for the other two? As I discuss in my video The 5:2 Diet and the Fasting-Mimicking Diet Put to the Test, the available data are similar to that of alternate-day fasting: About a dozen pounds of weight loss was reported in overweight men and also reported in overweight women over six months, with no difference found between participants on the 5:2 intermittent fasting regimen and those on a continuous 500-calories-a-day restriction. The largest trial to date found an 18-pound weight loss within six months in the 5:2 group, which isn’t significantly different from the 20 pounds lost in the continuous calorie restriction group. Weight maintenance over the subsequent six months was also found to be no different.
     
    Though feelings of hunger may be more pronounced on the 5:2 pattern than on an equivalent level of daily calorie cutting, it does not seem to lead to overeating on non-fasting days. One might expect going two days without food may negatively impact mood, but no such adverse impact was noted for those fully fasting on zero calories or sticking to just two packets of oatmeal on each of the “fasting” days. (The oatmeal provides about 500 calories a day.) Like alternate-day fasting, the 5:2 fasting pattern appeared to have inconsistent effects on cognition and on preserving lean mass, and it also failed to live up to the “popular notion” that intermittent fasting would be “easier” to adhere to than daily calorie restriction. 
     
    Compared to those in the continuous-restriction control group, fewer subjects in the 5:2 pattern group expressed interest in continuing their diet after the study was over. This was attributed to quality-of-life issues, with 5:2 fasting participants citing headaches, lack of energy, and difficulty fitting the fasting days into their weekly routine. However, as you can see below and at 1:53 in my video, there has yet to be a single 5:2 diet study showing elevated LDL cholesterol compared with continuous calorie restriction at six months. Nor has it been shown for a year. This offers a potential advantage over alternate-day regimens. 

    Instead of 5:2, what about 25:5, spending five consecutive days a month on a “fasting-mimicking diet” (FMD)? Longevity researcher Valter Longo designed a five-day meal plan to try to simulate the metabolic effects of fasting by being low in protein, sugars, and calories with zero animal protein and zero animal fat. By making the diet plant-based, he hoped to lower the level of the cancer-promoting growth hormone IGF-1. He indeed accomplished this goal, along with a drop in markers of inflammation, after three cycles of his five-days-a-month program, as you can see below and at 2:33 in my video. 

    One hundred men and women were randomized to consume his fasting-mimicking diet for five consecutive days per month or maintain their regular diet the whole time. As you can see in the graph below and at 2:47 in my video, after three months, the FMD group was down about six pounds compared to the control group, with significant drops in body fat and waist circumference, accompanied by a drop in blood pressure. 

    Those who were the worst off accrued the most dramatic benefits, as seen in the graph below and at 3:04 in my video. What’s even wilder is that three further months after completion, some of the benefits appeared to persist, suggesting the effects “may last for several months.” It’s unclear, though, if those randomized to the FMD group used it as an opportunity to make positive lifestyle changes that helped maintain some of the weight loss. 


    Dr. Longo created a company to market his meal plan commercially, but, to his credit, says “he does not receive a salary or a consulting fee from the company…and will donate 100% of his shares to charity.” The whole diet appears to be mostly dehydrated soup mixes, herbal teas like hibiscus and chamomile, kale chips, nut-based energy bars, an algae-based DHA supplement, and a multivitamin dusted with vegetable powder. Why spend 50 dollars a day on a few processed snacks when you could instead eat a few hundred calories a day of real vegetables? 
     
    How interesting was that? All-you-can-eat above-ground vegetables for five days would have the same low amount of protein, sugars, and calories with zero animal protein or animal fat. But we’ll probably never know if it works as well, better, or worse because it’s hard to imagine such a study ever getting done without the financial incentive. 

    To learn more about IGF-1, see my video Flashback Friday: Animal Protein Compared to Cigarette Smoking.
     
    In this series on fasting, I’ve covered several topics, including the basics of calories and weight loss, water-only fasting, and the types of alternate-day fasting, see them all in the related videos below. 
     
    I close out the series with videos on time-restricted eating: Time-Restricted Eating Put to the Test and The Benefits of Early Time-Restricted Eating. 
     
    If you want all of the videos in one place, I’ve done three webinars on fasting—Intermittent Fasting, Fasting for Disease Reversal, and Fasting and Cancer—and they’re all available for download now. 

    Michael Greger M.D. FACLM

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  • How Safe Is Alternate-Day Intermittent Fasting?  | NutritionFacts.org

    How Safe Is Alternate-Day Intermittent Fasting?  | NutritionFacts.org


    Eating every other day can raise your cholesterol. 
     
    Are there any downsides to fasting every other day? For example, might go all day without eating impair your ability to think clearly? Surprisingly, as I discuss in my video Is Alternate-Day Intermittent Fasting Safe?, the results appear to be “equivocal.” Some studies show no measurable effects and the ones that do fail to agree on which cognitive domains are affected. Might the cycles of fasting and feasting cause eating disorder–type behaviors, like bingeing? So far, no harmful psychological effects have been found. In fact, there may be some benefit. However, the studies that have put it to the test specifically excluded those with a documented history of eating disorders, for whom the effects may differ. 
     
    What about bone health? No change in bone mineral density was noted after six months of alternate-day fasting despite about 16 pounds of weight loss, which would typically result in a dip in bone mass. However, the researchers did not note any skeletal changes in the control group either, and they lost a similar amount of weight using continuous caloric restriction. They suggested this is because both groups tended to be “more physically active than the average obese American,” getting about 1,000 to 2,000 more steps a day. 
     
    Proponents of intermittent fasting suggest it can better protect lean body mass, but most of the intermittent trials have employed less accurate methods of body composition analysis, whereas the majority of continuous caloric restriction trials used “vastly more accurate techniques.” So, to date, it is not clear if there’s a difference in lean mass preservation. 
     
    Improvements in blood pressure and triglycerides have been noted on intermittent fasting regimens, though this is presumed to be due to the reduction in body fat since the effect appears to be “dependent on the amount of weight lost.” Alternate-day fasting can improve artery function, too, as you can see in the graph below and at 1:55 in my video, though it does depend on what you’re eating on the non-fasting day. For study participants randomized to an alternate-day diet high in saturated fat, their artery function worsened despite a ten-pound weight loss, whereas it improved, as expected, in the lower-fat group. The decline in artery function was presumed to be because of the pro-inflammatory nature of saturated fat. 

    A concern has been raised about the effects of alternate-day fasting on cholesterol. After 24 hours without food, LDL cholesterol may temporarily bump up, but this is presumably because so much fat is being released into the system by the fast. As you can see in the graph below and at 2:33 in my video, an immediate negative effect on carbohydrate tolerance may stem from the same phenomenon—the repeated elevations of free fat floating around in the bloodstream. After a few weeks, though, LDL levels start to drop as the weight comes off. However, results from the largest and longest trial of alternate-day fasting have given me pause. 


    A hundred obese men and women were randomized into one of three groups: alternate-day modified fasting (25 percent of their baseline calories on fasting days and 125 percent calories on eating days), continuous, daily caloric restriction (75 percent of baseline), or a control group instructed to maintain their regular diet. So, for those going into the trial eating 2,000 calories a day, they would continue to eat 2,000 calories a day in the control group. The calorie-restriction group would get 1,500 calories every day, and the intermittent-restriction group would alternate between 500 calories a day and 2,500 calories the next. 
     
    As you can see in the graph below and at 3:32 in my video, with the same overall, average, prescribed calorie cutting in the two weight-loss groups, they both lost about the same amount of weight, but, surprisingly, the cholesterol effects were different. In the continuous calorie-restriction group, the LDL levels dropped as expected compared to the control group as the pounds came off. 

    But, in the alternate-day modified fasting group, they didn’t, as you can see below, and at 3:55 in my video. At the end of the year, the LDL cholesterol in the intermittent fasting group ended up being 10 percent higher than in the constant calorie-restriction group—despite the same loss of body fat. Given that LDL cholesterol is a prime causal risk factor for heart disease, our number one killer—or is even the prime risk factor—this strikes a significant blow against alternate-day fasting. If you want to try it anyway, I would advise you to have your cholesterol monitored to make sure it comes down with your weight. 


    If you’re diabetic, you must talk with your physician about medication adjustment for any changes in diet, including fasting of any duration. Even with proactive medication reduction, advice to immediately break the fast should sugars drop too low, and weekly medical supervision, people with type 2 diabetes who fasted for even just two days a week were twice as likely to suffer from hypoglycemic episodes compared to an unfasted control group. We still don’t know the best way to tweak blood sugar medications to prevent blood sugar from dropping too low on fasting days. 
     
    Even fasting for just one day can significantly slow the clearance of some drugs (like the blood-thinning drug Coumadin) or increase the clearance of others (like caffeine). Fasting for 36 hours can cut your caffeine buzz by 20 percent. So, consultation with your medical professional before fasting is an especially good idea for anyone on any kind of medication. 

    If you missed it, check out Alternate-Day Intermittent Fasting Put to the Test. 
     
    So, with ambiguous cognitive, lean mass, and bone effects, plus these cholesterol findings, I wouldn’t suggest alternate-day fasting for weight loss, but dropping pounds isn’t the only thing this way of eating is purported to do. Check out Does Intermittent Fasting Increase Human Life Expectancy?. 
     
    For other types of intermittent fasting, total fasting, and more on fasting, check out the related videos below. 





    Michael Greger M.D. FACLM

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  • The Optimal Cold Plunge Temperature For Women + Other Tips

    The Optimal Cold Plunge Temperature For Women + Other Tips

    Assistant Beauty & Health Editor

    Hannah Frye is the Assistant Beauty Editor at mindbodygreen. She has a B.S. in journalism and a minor in women’s, gender, and queer studies from California Polytechnic State University, San Luis Obispo. Hannah has written across lifestyle sections including health, wellness, sustainability, personal development, and more.

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  • I’m A Nutritional Psychiatrist: My #1 Tip For Eating For Anxiety

    I’m A Nutritional Psychiatrist: My #1 Tip For Eating For Anxiety

    Psychiatrist and Nutritional Expert

    Dr. Uma Naidoo is a Harvard-trained nutritional psychiatrist, nutritional biologist, professional chef, and author of the upcoming title, “Calm Your Mind With Food,” which is now available for preorder, as well as the international bestseller, “This Is Your Brain on Food (An Indispensible Guide to the Surprising Foods that Fight Depression, Anxiety, PTSD, OCD, ADHD, and More).” She is currently the Founder and Director of Nutritional and Lifestyle Psychiatry at Massachusetts General Hospital (MGH), the first US clinic of its kind where she consults on nutritional interventions for the psychiatrically and medically ill.

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  • 6 Drinks That Help With Period Cramps (Beyond Water)

    6 Drinks That Help With Period Cramps (Beyond Water)

    Period cramps can be brutal, but there are several ways to reduce their severity and frequency. Keeping your body hydrated by sipping on drinks that contain anti-inflammatory and antispasmodic ingredients, such as magnesium drinks, beet juice, ginger tea, and chamomile tea, may be an effective way to reduce period cramp pain so you can get back to your normal routine. Certain supplements can also help ease painful symptoms—here are a few to look into.

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  • The Safety of Keto Diets  | NutritionFacts.org

    The Safety of Keto Diets  | NutritionFacts.org

    What are the effects of ketogenic diets on nutrient sufficiency, gut flora, and heart disease risk? 

    Given the decades of experience using ketogenic diets to treat certain cases of pediatric epilepsy, a body of safety data has accumulated. Nutrient deficiencies would seem to be the obvious issue. Inadequate intake of 17 micronutrients, vitamins, and minerals has been documented in those on strict ketogenic diets, as you can see in the graph below and at 0:14 in my video Are Keto Diets Safe?. 

    Dieting is a particularly important time to make sure you’re meeting all of your essential nutrient requirements, since you may be taking in less food. Ketogenic diets tend to be so nutritionally vacuous that one assessment estimated that you’d have to eat more than 37,000 calories a day to get a sufficient daily intake of all essential vitamins and minerals, as you can see in the graph below and at 0:39 in my video. 


    That is one of the advantages of more plant-based approaches. As the editor-in-chief of the Journal of the American Dietetic Association put it, “What could be more nutrient-dense than a vegetarian diet?” Choosing a healthy diet may be easier than eating more than 37,000 daily calories, which is like putting 50 sticks of butter in your morning coffee. 
     
    We aren’t just talking about not reaching your daily allowances either. Children have gotten scurvy on ketogenic diets, and some have even died from selenium deficiency, which can cause sudden cardiac death. The vitamin and mineral deficiencies can be solved with supplements, but what about the paucity of prebiotics, the dozens of types of fiber, and resistant starches found concentrated in whole grains and beans that you’d miss out on? 
     
    Not surprisingly, constipation is very common on keto diets. As I’ve reviewed before, starving our microbial self of prebiotics can have a whole array of negative consequences. Ketogenic diets have been shown to “reduce the species richness and diversity of intestinal microbiota,” our gut flora. Microbiome changes can be detected within 24 hours of switching to a high-fat, low-fiber diet. A lack of fiber starves our good gut bacteria. We used to think that dietary fat itself was nearly all absorbed in the small intestine, but based on studies using radioactive tracers, we now know that about 7 percent of the saturated fat in a fat-rich meal can make it down to the colon. This may result in “detrimental changes” in our gut microbiome, as well as weight gain, increased leaky gut, and pro-inflammatory changes. For example, there may be a drop in beneficial Bifidobacteria and a decrease in overall short-chain fatty acid production, both of which would be expected to increase the risk of gastrointestinal disorders. 
     
    Striking at the heart of the matter, what might all of that saturated fat be doing to our heart? If you look at low-carbohydrate diets and all-cause mortality, those who eat lower-carb diets suffer “a significantly higher risk of all-cause mortality,” meaning they live, on average, significantly shorter lives. However, from a heart-disease perspective, it matters if it’s animal fat or plant fat. Based on the famous Harvard cohorts, eating more of an animal-based, low-carb diet was associated with higher death rates from cardiovascular disease and a 50 percent higher risk of dying from a heart attack or stroke, but no such association was found for lower-carb diets based on plant sources.  
     
    And it wasn’t just Harvard. Other researchers have also found that “low-carbohydrate dietary patterns favoring animal-derived protein and fat sources, from sources such as lamb, beef, pork, and chicken, were associated with higher mortality, whereas those that favored plant-derived protein and fat intake, from sources such as vegetables, nuts, peanut butter, and whole-grain bread, were associated with lower mortality…” 
     
    Cholesterol production in the body is directly correlated to body weight, as you can see in the graph below and at 3:50 in my video. 

    Every pound of weight loss by nearly any means is associated with about a one-point drop in cholesterol levels in the blood. But if we put people on very-low-carb ketogenic diets, the beneficial effect on LDL bad cholesterol is blunted or even completely neutralized. Counterbalancing changes in LDL or HDL (what we used to think of as good cholesterol) are not considered sufficient to offset this risk. You don’t have to wait until cholesterol builds up in your arteries to have adverse effects either; within three hours of eating a meal high in saturated fat, you can see a significant impairment of artery function. Even with a dozen pounds of weight loss, artery function worsens on a ketogenic diet instead of getting better, which appears to be the case with low-carb diets in general.  

    For more on keto diets, check out my video series here. 

    And, to learn more about your microbiome, see the related videos below.

    Michael Greger M.D. FACLM

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  • Use These 3 Spices To Make Your Food Anti-Inflammatory & Better For Blood Sugar

    Use These 3 Spices To Make Your Food Anti-Inflammatory & Better For Blood Sugar

    Flavor & healthy benefits? Yes, please!

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  • How To Relieve Sore Muscles: Expert-Backed Methods & Tips

    How To Relieve Sore Muscles: Expert-Backed Methods & Tips

    If you want to build muscle and gain strength, muscle soreness is inevitable. Yet everywhere you look, someone is promoting the latest and greatest hack for relieving sore muscles quickly. We reached out to exercise physiologists to get the scoop on which of these tools and techniques are actually effective—and which ones are overhyped with little science to back them up.

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  • Eating A Mediterranean Diet May Reduce Chronic Pain, Study Finds

    Eating A Mediterranean Diet May Reduce Chronic Pain, Study Finds

    Life with chronic pain can feel hopeless and debilitating. And while no two pain experiences are the same, there are a few practices that have helped many people feel like themselves again. Practicing gentle movement, easing the strain on your adrenal glands by reducing stress, and taking targeted supplements for pain relief and joint comfort can all be effective.

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  • An Anti-Inflammatory Ginger Turmeric Latte Recipe

    An Anti-Inflammatory Ginger Turmeric Latte Recipe

    Looking to upgrade your golden latte with even more inflammation-fighting power as we head into cold and flu season? This ginger turmeric latte helps minimize inflammation in the body, plus it tastes delicious and only takes a few minutes to make.

    Inflammation is part of the body’s innate healing response to injury or infection. At the microscopic level, it’s a sign of damage to your cells and DNA. Day in and day out, we can fight chronic inflammation in many ways, including by minimizing our exposure to chemicals, pollutants, or excessive sunlight and helping our bodies prevent free radical damage by eating and drinking antioxidant-rich foods. Herbs and spices, fruit (especially berries), vegetables, dark chocolate, and nuts all fall under the anti-inflammatory category.

    The two stars of this latte—ginger and turmeric—also have powerful inflammation-fighting benefits of their own.

    Turmeric (Curcuma longa) has been clinically shown to fight inflammation and has a long history of use for joint pain. But even if you don’t have a health condition, its antioxidant and anti-inflammatory properties can still be beneficial. As an antioxidant, curcumin scavenges different free radicals, including reactive oxygen and nitrogen species, and even slows the production of some types of free radicals. By neutralizing free radicals before they can damage cells or DNA, curcumin minimizes the body’s need to fire up its inflammatory response. 

    Like turmeric, ginger (Zingiber officinale) has been used for millenniums as a tonic to support health. And more recently, scientific studies have confirmed that the phytochemicals in ginger—gingerols, shogaols, paradols, and zingerone–have anti-inflammatory properties. These bioactive molecules scavenge free radicals, minimizing the oxidative stress that damages cells and DNA. Because oxidative stress and inflammation can trigger one another, keeping oxidative stress low keeps the inflammatory cycle in check.

    There’s also evidence that ginger and turmeric work synergistically to support a healthy inflammatory response in the body, hence why they are sometimes found together in supplements that target inflammation.

    Kami McBride

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