nutritionfactsorg--2020-10-20--What About the Trans Fat in Animal Fat?

What About the Trans Fat in Animal Fat?

The years of healthy life lost due to our consumption of trans fats are comparable to the impact of conditions like meningitis , cervical cancer , and multiple sclerosis .
But , if “ food zealots ” get their wish in banning added trans fats , what ’ s next ?
I explore this in my video Banning Trans Fat in Processed Foods but Not Animal Fat .
Vested corporate interests rally around these kinds of slippery slope arguments to distract from the fact that people are dying .
New York Mayor Bloomberg was decried as a “ meddling nanny @ @ @ @ @ @ @ attempt to cap soft drink sizes .
How dare he try to manipulate consumer choice !
But isn ’ t that what the food industry has done ?
“ Soft drink portion sizes have grown dramatically , along with Americans ’ waistlines.
” In 1950 , a 12-ounce soda was the king-sized option .
Now , it ’ s the kiddie size .
Similarly , with trans fats , it was the industry that limited our choice by putting trans fats into everything without even telling us .
Who ’ s the nanny @ @ @ @ @ @ @ its trans fat fight , preserving its status as a public health leader .
“ For example , it took decades to achieve a national prohibition of lead paint , despite unequivocal evidence of harm , ” but New York City ’ s Board of Health led the way , banning it “ 18 years before federal action.
” There ’ s irony in the slippery slope argument : First , they ’ ll come for your fries ; next , they ’ ll come for your burger .
After the trans fat @ @ @ @ @ @ @ remaining sources of trans fat is in the meat itself .
“ Trans fats naturally exist in small amounts in the fat in meat and milk , ” as I ’ ve discussed before in my video Trans Fat in Meat and Dairy .
Before the trans fat ban , animal products only provided about one fifth of America ’ s trans fat intake , but since the U.S. trans fat ban exempts animal products , they will soon take over as the leading source .
As you can see at 2:09 in @ @ @ @ @ @ @ Not Animal Fat , now that added trans fats are banned in Denmark , for example , the only real trans fat exposure left is from animal products found in the U.S. dairy , beef , chicken fat , turkey meat , lunch meat , and hot dogs , with trace amounts in vegetable oils due to the refining process .
The question is : Are animal trans fats as bad as processed food trans fats ?
As you can see at 2:38 in my video , a compilation of randomized interventional trials @ @ @ @ @ @ @ go up and they both make good cholesterol go down .
So , both animal trans fats and processed food trans fats make the ratio of bad to good cholesterol go up—which is bad .
Therefore , all trans fats cause negative effects “ irrespective of their origin.
” The researchers suspect that also removing natural trans fats from the diet could prevent tens of thousands of heart attacks , but unlike processed foods , you can ’ t remove trans fats from milk and meat because trans fats are there naturally .
@ @ @ @ @ @ @ bit of their trans fats might not be too bad , but you saw the same everything-in-moderation argument coming from the Institute of Shortening and Edible Oils after industrial trans fats were first exposed as a threat .
The bottom line is “ that intake of all sources of trans fat should be minimized.
” The trans fat in processed foods can be banned , and just adhering to the current dietary guidelines to restrict saturated fat intake , which is primarily found in meat and dairy , would automatically cut trans fat @ @ @ @ @ @ @ no progress may have been made on animal trans fat reduction in Denmark is because The Danish Nutrition Council that pushed for the trans fat ban was a joint initiative of The Danish Medical Association and The Danish Dairy Board .
They recognized that “ the economic support from The Danish Dairy Council could be perceived as problematic ” from a scientific integrity point of view , but , not to worry— “ The Danish Medical Association expanded the Executive Board and the funding members to also include the Danish pork industry , @ @ @ @ @ @ @ and Egg Council and The Danish Margarine Industry Association.
” If people want to eat trans fat , isn ’ t that their right ?
Yes , but only if they ’ re informed about the risks—yet The Food Industry Wants the Public Confused About Nutrition .
For more on the industry pushback , see my video Controversy Over the Trans Fat Ban .
There does not appear to be a safe level of exposure to trans fat—or to saturated fat or dietary cholesterol , for that matter .
See Trans Fat , @ @ @ @ @ @ @ Upper Intake of Zero .
If you find these videos about industry influence on public policy compelling , check out my many others , including : • None Who Determines If Food Additives Are Safe ?
• None Collaboration with the New Vectors of Disease • None The Saturated Fat Studies : Buttering Up the Public • None The Role of the Toxic Food Environment in the Obesity Epidemic • None The Role of Corporate Influence in the Obesity Epidemic • None The Role of Food Advertisements in the Obesity Epidemic • None @ @ @ @ @ @ @ Epidemic • None The Role of Processed Foods in the Obesity Epidemic Note that the concept of raising or lowering HDL ( the so-called good cholesterol ) playing a causal role in heart disease has come into question .
See Coconut Oil and the Boost in HDL “ Good ” Cholesterol .
PS : If you haven ’ t yet , you can subscribe to my free videos here and watch my live presentations : • 2016 : How Not To Die : The Role of Diet in Preventing , Arresting , and @ @ @ @ @ @ @ : Food as Medicine : Preventing and Treating the Most Dreaded Diseases with Diet • 2014 : From Table to Able : Combating Disabling Diseases with Food • 2013 : More Than an Apple a Day • 2012 : Uprooting the Leading Causes of Death

The years of healthy life lost due to our consumption of trans fats are comparable to the impact of conditions like meningitis, cervical cancer, and multiple sclerosis. But, if “food zealots” get their wish in banning added trans fats, what’s next? I explore this in my video Banning Trans Fat in Processed Foods but Not Animal Fat.
Vested corporate interests rally around these kinds of slippery slope arguments to distract from the fact that people are dying. New York Mayor Bloomberg was decried as a “meddling nanny” for his trans fat ban and attempt to cap soft drink sizes. How dare he try to manipulate consumer choice! But isn’t that what the food industry has done? “Soft drink portion sizes have grown dramatically, along with Americans’ waistlines.” In 1950, a 12-ounce soda was the king-sized option. Now, it’s the kiddie size. Similarly, with trans fats, it was the industry that limited our choice by putting trans fats into everything without even telling us. Who’s the nanny now?
New York City finally won its trans fat fight, preserving its status as a public health leader. “For example, it took decades to achieve a national prohibition of lead paint, despite unequivocal evidence of harm,” but New York City’s Board of Health led the way, banning it “18 years before federal action.”
There’s irony in the slippery slope argument: First, they’ll come for your fries; next, they’ll come for your burger. After the trans fat oil ban, one of the only remaining sources of trans fat is in the meat itself. “Trans fats naturally exist in small amounts in the fat in meat and milk,” as I’ve discussed before in my video Trans Fat in Meat and Dairy. Before the trans fat ban, animal products only provided about one fifth of America’s trans fat intake, but since the U.S. trans fat ban exempts animal products, they will soon take over as the leading source. As you can see at 2:09 in Banning Trans Fat in Processed Foods but Not Animal Fat, now that added trans fats are banned in Denmark, for example, the only real trans fat exposure left is from animal products found in the U.S. dairy, beef, chicken fat, turkey meat, lunch meat, and hot dogs, with trace amounts in vegetable oils due to the refining process.
The question is: Are animal trans fats as bad as processed food trans fats? As you can see at 2:38 in my video, a compilation of randomized interventional trials found that they both make bad cholesterol go up and they both make good cholesterol go down. So, both animal trans fats and processed food trans fats make the ratio of bad to good cholesterol go up—which is bad. Therefore, all trans fats cause negative effects “irrespective of their origin.” The researchers suspect that also removing natural trans fats from the diet could prevent tens of thousands of heart attacks, but unlike processed foods, you can’t remove trans fats from milk and meat because trans fats are there naturally.
The livestock industry suggests that a little bit of their trans fats might not be too bad, but you saw the same everything-in-moderation argument coming from the Institute of Shortening and Edible Oils after industrial trans fats were first exposed as a threat. The bottom line is “that intake of all sources of trans fat should be minimized.” The trans fat in processed foods can be banned, and just adhering to the current dietary guidelines to restrict saturated fat intake, which is primarily found in meat and dairy, would automatically cut trans fat intake from animal fats.
The reason no progress may have been made on animal trans fat reduction in Denmark is because The Danish Nutrition Council that pushed for the trans fat ban was a joint initiative of The Danish Medical Association and The Danish Dairy Board. They recognized that “the economic support from The Danish Dairy Council could be perceived as problematic” from a scientific integrity point of view, but, not to worry—“The Danish Medical Association expanded the Executive Board and the funding members to also include the Danish pork industry, the Danish meat industry, The Poultry and Egg Council and The Danish Margarine Industry Association.”
If people want to eat trans fat, isn’t that their right? Yes, but only if they’re informed about the risks—yet The Food Industry Wants the Public Confused About Nutrition.
For more on the industry pushback, see my video Controversy Over the Trans Fat Ban.
There does not appear to be a safe level of exposure to trans fat—or to saturated fat or dietary cholesterol, for that matter. See Trans Fat, Saturated Fat, and Cholesterol: Tolerable Upper Intake of Zero.
If you find these videos about industry influence on public policy compelling, check out my many others, including:
Note that the concept of raising or lowering HDL (the so-called good cholesterol) playing a causal role in heart disease has come into question. See Coconut Oil and the Boost in HDL “Good” Cholesterol.
In health,
Michael Greger, M.D.
PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:


nutritionfactsorg--2020-10-22--70% Taking Common Antidepressants Suffer Sexual Side Effects

What ’ s the latest on treating depression with the spice saffron ?
Years ago , I covered a head-to-head comparison of saffron versus Prozac for the treatment of depression in my video Saffron vs. Prozac , and saffron seemed to work just as well as the drug .
In the years since , five other studies have found that saffron beat out placebo or rivaled antidepressant medications .
It may be the spice ’ s red pigment , crocin , since that alone beat out placebo as an adjunct treatment , significantly decreasing symptoms of depression , symptoms of @ @ @ @ @ @ @ Perhaps , its antioxidants played a role in “ preventing free radical-induced damage in the brain.
” The amount of crocin the researchers used was equivalent to about a half teaspoon of saffron a day .
If the spice works as well as the drugs , one could argue that the spice wins , since it doesn ’ t cause sexual dysfunction in the majority of men and women like most prescribed antidepressants do .
SSRI drugs like Prozac , Paxil , and Zoloft cause “ adverse sexual side effects ” in around @ @ @ @ @ @ @ What ’ s more , physicians not only significantly underestimate the occurrence of side effects , but they also tend to underrate how much they impact the lives of their patients .
Not only is this not a problem with saffron , the spice may even be able to treat it , as I explore in my video Best Food for Antidepressant-Induced Sexual Dysfunction .
“ In folk medicine , there is a widely held belief that saffron might have aphrodisiac effects.
” To test this , men with Prozac-induced sexual impairment were @ @ @ @ @ @ @ month .
By week four , the saffron group “ resulted in significantly greater improvement in erectile function…and intercourse satisfaction , ” and more than half of the men in the saffron group regained “ normal erectile function.
” The researchers concluded that saffron is an “ efficacious treatment ” for Prozac-related erectile dysfunction .
It has all been found to be effective for female sexual dysfunction , as well , as you can see at 2:35 in my video .
Female sexual function increased by week four , improving some of the @ @ @ @ @ @ @ So , it may be better to try saffron in the first place for the depression and avoid developing these sexual dysfunction problems , since they sometimes can persist even after stopping the drugs , potentially worsening one ’ s long-term depression prognosis .
This includes unusual side effects , such as genital anesthesia , where you literally lose sensation .
It can happen in men and women .
More rarely , antidepressants can induce a condition called restless genital syndrome .
You ’ ve heard of restless legs syndrome ?
Well , @ @ @ @ @ @ @ These PSSDs , or Post-SSRI Sexual Dysfunctions , meaning dysfunctions that appear or persist after stopping taking these antidepressants , can be so serious that “ prescribing physicians should mention the potential danger of the occurrence of genital ( e.g.
, penile or vaginal ) anesthesia to every patient prior to any SSRI treatment.
” If you ’ re on one of these drugs , did your doctor warn you about that ?
All hope is not lost , though .
Evidently , penile anesthesia responds to low-power laser irradiation .
After 20 @ @ @ @ @ @ @ man , who had lost his penile sensation thanks to the drug Paxil , partially regained his “ penile touch and temperature sensation.
” However , he still couldn ’ t perform to his girlfriend ’ s satisfaction , and she evidently ended up leaving him over it , which certainly didn ’ t help his mood .
But , before you feel too badly for him , compare a little penile light therapy to clitoridectomy , clitoris removal surgery , or another Paxil-related case where a woman ’ s symptoms only improved @ @ @ @ @ @ @ For more on the spice , check out : • None Saffron for the Treatment of PMS Those drug side effects sound devastating , but depression is no walk in the park .
However , when one balances risk and benefit , one assumes that there are actually benefits to taking them .
That ’ s why the shocking science I explored in Do Antidepressant Drugs Really Work ?
is so important .
What else may boost mood ?
A healthy diet and exercise : • None Benefits of Blueberries for Mood and @ @ @ @ @ @ @ Gluten Sensitivity Real ?
& Separating the Wheat from the Chat • None The Best Way to • None A Better Way to • None The Wrong Way to For more on sexual health generally , see : • None Survival of the Firmest : Erectile Dysfunction and Death • None Do Men Who Have More Sex Live Longer ?
• None Are Apples the Best Food for a Better Sex Life in Women ?
• None Why Might Vegetarians Have Less HPV ?
What else can spices do ?
Here ’ s @ @ @ @ @ @ @ you haven ’ t yet , you can subscribe to my free videos here and watch my live presentations : • 2016 : How Not To Die : The Role of Diet in Preventing , Arresting , and Reversing Our Top 15 Killers • 2015 : Food as Medicine : Preventing and Treating the Most Dreaded Diseases with Diet • 2014 : From Table to Able : Combating Disabling Diseases with Food • 2013 : More Than an Apple a Day • 2012 : Uprooting the Leading Causes of Death

What’s the latest on treating depression with the spice saffron? Years ago, I covered a head-to-head comparison of saffron versus Prozac for the treatment of depression in my video Saffron vs. Prozac, and saffron seemed to work just as well as the drug. In the years since, five other studies have found that saffron beat out placebo or rivaled antidepressant medications.
It may be the spice’s red pigment, crocin, since that alone beat out placebo as an adjunct treatment, significantly decreasing symptoms of depression, symptoms of anxiety, and general psychological distress. Perhaps, its antioxidants played a role in “preventing free radical-induced damage in the brain.” The amount of crocin the researchers used was equivalent to about a half teaspoon of saffron a day.
If the spice works as well as the drugs, one could argue that the spice wins, since it doesn’t cause sexual dysfunction in the majority of men and women like most prescribed antidepressants do. SSRI drugs like Prozac, Paxil, and Zoloft cause “adverse sexual side effects” in around 70 percent of people taking them. What’s more, physicians not only significantly underestimate the occurrence of side effects, but they also tend to underrate how much they impact the lives of their patients.
Not only is this not a problem with saffron, the spice may even be able to treat it, as I explore in my video Best Food for Antidepressant-Induced Sexual Dysfunction. “In folk medicine, there is a widely held belief that saffron might have aphrodisiac effects.” To test this, men with Prozac-induced sexual impairment were randomized to saffron or placebo for a month. By week four, the saffron group “resulted in significantly greater improvement in erectile function…and intercourse satisfaction,” and more than half of the men in the saffron group regained “normal erectile function.” The researchers concluded that saffron is an “efficacious treatment” for Prozac-related erectile dysfunction. It has all been found to be effective for female sexual dysfunction, as well, as you can see at 2:35 in my video. Female sexual function increased by week four, improving some of the Prozac-induced sexual problems but not others. So, it may be better to try saffron in the first place for the depression and avoid developing these sexual dysfunction problems, since they sometimes can persist even after stopping the drugs, potentially worsening one’s long-term depression prognosis.
This includes unusual side effects, such as genital anesthesia, where you literally lose sensation. It can happen in men and women. More rarely, antidepressants can induce a condition called restless genital syndrome. You’ve heard of restless legs syndrome? Well, this is a restless between-the-legs syndrome. These PSSDs, or Post-SSRI Sexual Dysfunctions, meaning dysfunctions that appear or persist after stopping taking these antidepressants, can be so serious that “prescribing physicians should mention the potential danger of the occurrence of genital (e.g., penile or vaginal) anesthesia to every patient prior to any SSRI treatment.” If you’re on one of these drugs, did your doctor warn you about that?
All hope is not lost, though. Evidently, penile anesthesia responds to low-power laser irradiation. After 20 laser treatments to his penis, one man, who had lost his penile sensation thanks to the drug Paxil, partially regained his “penile touch and temperature sensation.” However, he still couldn’t perform to his girlfriend’s satisfaction, and she evidently ended up leaving him over it, which certainly didn’t help his mood. But, before you feel too badly for him, compare a little penile light therapy to clitoridectomy, clitoris removal surgery, or another Paxil-related case where a woman’s symptoms only improved after six courses of electroshock therapy.
Pass the paella!
For more on the spice, check out:
Those drug side effects sound devastating, but depression is no walk in the park. However, when one balances risk and benefit, one assumes that there are actually benefits to taking them. That’s why the shocking science I explored in Do Antidepressant Drugs Really Work? is so important.
What else may boost mood? A healthy diet and exercise:
For more on sexual health generally, see:
What else can spices do? Here’s just a taste:
In health,
Michael Greger, M.D.
PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:


nutritionfactsorg--2020-10-27--No Purveyor of Unhealthy Products Wants the Public to Know the Truth

In 2011 , Denmark introduced the world ’ s first tax on saturated fat .
“ After only 15 months , however , the fat tax was abolished , ” due to massive pressure from farming and food company interests .
“ Public health advocates are weak in tackling the issues of corporate power…A well-used approach for alcohol , tobacco , and , more recently , food-related corporate interests is to shift the focus away from health .
This involves reframing a fat or soft drinks tax as an issue of consumer rights and a debate over the role of @ @ @ @ @ @ @ restricting people ’ s choices.
” I discuss this in my video The Food Industry Wants the Public Confused About Nutrition .
“ The ‘ Nanny State ’ is a term that is usually used in a pejorative way to discourage governments from introducing legislation or regulation that might undermine the power or actions of industry or individuals…Public health advocacy work is regularly undermined by the ‘ Nanny State ’ phrase.
” But those complaining about the governmental manipulation of people ’ s choices hypocritically tend to be fine with corporations doing the @ @ @ @ @ @ @ “ public health is being undermined by the ‘ Nanny Industry ’ … [ that ] uses fear of government regulation to maintain its own dominance , to maintain its profits and to do so at a significant financial and social cost to the community and to public health.
” The tobacco industry offers the classic example , touting “ personal responsibility , ” which has a certain philosophical appeal .
As long as people understand the risks , they should be free to do whatever they want with their bodies .
Now @ @ @ @ @ @ @ , but if you have the right to put your own life at risk , shouldn ’ t you have the right to aggrieve your parents , widow your spouse , and orphan your children ?
Then , there ’ s the social cost argument .
People ’ s bad decisions can cost the society as a whole , whose tax dollars may have to care for them .
“ The independent , individualist motorcyclist , helmetless and free on the open road , becomes the most dependent of individuals in the spinal @ @ @ @ @ @ @ sake of argument , let ’ s forget these spillover effects , the so-called externalities .
If someone understands the hazards , shouldn ’ t they be able to do whatever they want ?
Well , “ first , it assumes individuals can access accurate and balanced information relevant to their decisions…but deliberate industry interference has often created situations where consumers have access only to incomplete and inaccurate information…For decades , tobacco companies successfully suppressed or undermined scientific evidence of smoking ’ s dangers and down played the public health concerns to which @ @ @ @ @ @ @ t worry your little head , said the nanny companies .
“ Analyses of documents…have revealed decades of deception and manipulation by the tobacco industry , and confirmed deliberate targeting of…children.
” Indeed , it has “ marketed and sold [ its ] lethal products with zeal…and without regard for the human tragedy….
” “ The tobacco industry ’ s deliberate strategy of challenging scientific evidence undermines smokers ’ ability to understand the harms smoking poses ” and , as such , undermines the whole concept that smoking is a fully informed choice @ @ @ @ @ @ @ truthful information…yet held smokers [ accountable ] for incurring diseases that will cause half of them to die prematurely .
In contexts such as these , government intervention is vital to protect consumers from predatory industries….
” Is the food industry any different ?
“ The public is bombarded with information and it is hard to tell which is true , which is false and which is merely exaggerated .
Foods are sold without clarity about the nutritional content or harmful effects.
” Remember how the food industry spent a billion dollars making @ @ @ @ @ @ @ food , which you can see at 4:26 in my video , never saw the light of day and was replaced by indecipherable labeling ?
That ’ s ten times more money than the drug industry spends on lobbying in the United States .
It ’ s in the food industry ’ s interest to have the public confused about nutrition .
How confused are we about nutrition ?
“ Head Start teachers are responsible for providing nutrition education to over 1 million low-income children annually… ” When 181 Head Start teachers were @ @ @ @ @ @ @ 4 out of the 181 answered at least four of the five nutrition knowledge questions correctly .
Most , for example , could not correctly answer the question , “ What has the most calories : protein , carbohydrate , or fat ?
” Not a single teacher could answer all five nutrition questions correctly .
While they valued nutrition education , 54 percent “ agreed that it was hard to know which nutrition information to believe , ” and the food industry wants to keep it that way .
A quarter of @ @ @ @ @ @ @ or vegetables the previous day , though half did have french fries and soda , and a quarter consumed fried meat the day before .
Not surprisingly , 55 percent of the teachers were not just overweight but obese .
When even the teachers are confused , something must be done .
No purveyor of unhealthy products wants the public to know the truth .
“ An interesting example comes from the US ‘ Fairness Doctrine ’ and the tobacco advertising experience of the 1960s .
Before tobacco advertising was banned from television @ @ @ @ @ @ @ in 1967 required that tobacco companies funded one health ad about smoking for every four tobacco TV advertisements they placed .
Rather than face this corrective advertising , the tobacco industry took their own advertising off television.
” They knew they couldn ’ t compete with the truth .
Just “ the threat of corrective advertising even on a one-to-four basis was sufficient to make the tobacco companies withdraw their own advertising.
” They needed to keep the public in the dark .
The trans fat story is an excellent example of this @ @ @ @ @ @ @ my videos Controversy Over the Trans Fat Ban and Banning Trans Fat in Processed Foods but Not Animal Fat .
Isn ’ t the Fairness Doctrine example amazing ?
Just goes to show how powerful the truth can be .
If you want to support my efforts to spread evidence-based nutrition , you can donate to our 501c3 nonprofit here .
You may also want to support Balanced , an ally organization NutritionFacts.org helped launch to put this evidence into practice .
More tobacco industry parallels can be found in Big Food Using @ @ @ @ @ @ @ Association Complicity with Big Tobacco , and How Smoking in 1959 Is Like Eating in 2016 .
Want to know more about that saturated fat tax idea ?
See Would Taxing Unhealthy Foods Improve Public Health ?
.
• None The Role of the Toxic Food Environment in the Obesity Epidemic • None The Role of Corporate Influence in the Obesity Epidemic • None The Role of Processed Foods in the Obesity Epidemic PS : If you haven ’ t yet , you can subscribe to my free videos here and watch my @ @ @ @ @ @ @ Not To Die : The Role of Diet in Preventing , Arresting , and Reversing Our Top 15 Killers • 2015 : Food as Medicine : Preventing and Treating the Most Dreaded Diseases with Diet • 2014 : From Table to Able : Combating Disabling Diseases with Food • 2013 : More Than an Apple a Day • 2012 : Uprooting the Leading Causes of Death

In 2011, Denmark introduced the world’s first tax on saturated fat. “After only 15 months, however, the fat tax was abolished,” due to massive pressure from farming and food company interests. “Public health advocates are weak in tackling the issues of corporate power…A well-used approach for alcohol, tobacco, and, more recently, food-related corporate interests is to shift the focus away from health. This involves reframing a fat or soft drinks tax as an issue of consumer rights and a debate over the role of the state in ‘nannying’ or restricting people’s choices.” I discuss this in my video The Food Industry Wants the Public Confused About Nutrition.
“The ‘Nanny State’ is a term that is usually used in a pejorative way to discourage governments from introducing legislation or regulation that might undermine the power or actions of industry or individuals…Public health advocacy work is regularly undermined by the ‘Nanny State’ phrase.” But those complaining about the governmental manipulation of people’s choices hypocritically tend to be fine with corporations doing the same thing. One could argue that “public health is being undermined by the ‘Nanny Industry’…[that] uses fear of government regulation to maintain its own dominance, to maintain its profits and to do so at a significant financial and social cost to the community and to public health.”
The tobacco industry offers the classic example, touting “personal responsibility,” which has a certain philosophical appeal. As long as people understand the risks, they should be free to do whatever they want with their bodies. Now, some argue that risk-taking affects others, but if you have the right to put your own life at risk, shouldn’t you have the right to aggrieve your parents, widow your spouse, and orphan your children? Then, there’s the social cost argument. People’s bad decisions can cost the society as a whole, whose tax dollars may have to care for them. “The independent, individualist motorcyclist, helmetless and free on the open road, becomes the most dependent of individuals in the spinal injury ward.”
But, for the sake of argument, let’s forget these spillover effects, the so-called externalities. If someone understands the hazards, shouldn’t they be able to do whatever they want? Well, “first, it assumes individuals can access accurate and balanced information relevant to their decisions…but deliberate industry interference has often created situations where consumers have access only to incomplete and inaccurate information…For decades, tobacco companies successfully suppressed or undermined scientific evidence of smoking’s dangers and down played the public health concerns to which this information gave rise.” Don’t worry your little head, said the nanny companies. “Analyses of documents…have revealed decades of deception and manipulation by the tobacco industry, and confirmed deliberate targeting of…children.” Indeed, it has “marketed and sold [its] lethal products with zeal…and without regard for the human tragedy….”
“The tobacco industry’s deliberate strategy of challenging scientific evidence undermines smokers’ ability to understand the harms smoking poses” and, as such, undermines the whole concept that smoking is a fully informed choice. “Tobacco companies have denied smokers truthful information…yet held smokers [accountable] for incurring diseases that will cause half of them to die prematurely. In contexts such as these, government intervention is vital to protect consumers from predatory industries….”
Is the food industry any different? “The public is bombarded with information and it is hard to tell which is true, which is false and which is merely exaggerated. Foods are sold without clarity about the nutritional content or harmful effects.” Remember how the food industry spent a billion dollars making sure the easy-to-understand traffic-light labeling system on food, which you can see at 4:26 in my video, never saw the light of day and was replaced by indecipherable labeling? That’s ten times more money than the drug industry spends on lobbying in the United States. It’s in the food industry’s interest to have the public confused about nutrition.
How confused are we about nutrition? “Head Start teachers are responsible for providing nutrition education to over 1 million low-income children annually…” When 181 Head Start teachers were put to the test, only about 4 out of the 181 answered at least four of the five nutrition knowledge questions correctly. Most, for example, could not correctly answer the question, “What has the most calories: protein, carbohydrate, or fat?” Not a single teacher could answer all five nutrition questions correctly. While they valued nutrition education, 54 percent “agreed that it was hard to know which nutrition information to believe,” and the food industry wants to keep it that way. A quarter of the teachers did not consume any fruits or vegetables the previous day, though half did have french fries and soda, and a quarter consumed fried meat the day before. Not surprisingly, 55 percent of the teachers were not just overweight but obese.
When even the teachers are confused, something must be done. No purveyor of unhealthy products wants the public to know the truth. “An interesting example comes from the US ‘Fairness Doctrine’ and the tobacco advertising experience of the 1960s. Before tobacco advertising was banned from television in the US, a court ruling in 1967 required that tobacco companies funded one health ad about smoking for every four tobacco TV advertisements they placed. Rather than face this corrective advertising, the tobacco industry took their own advertising off television.” They knew they couldn’t compete with the truth. Just “the threat of corrective advertising even on a one-to-four basis was sufficient to make the tobacco companies withdraw their own advertising.” They needed to keep the public in the dark.
The trans fat story is an excellent example of this. For more on that, see my videos Controversy Over the Trans Fat Ban and Banning Trans Fat in Processed Foods but Not Animal Fat.
Isn’t the Fairness Doctrine example amazing? Just goes to show how powerful the truth can be. If you want to support my efforts to spread evidence-based nutrition, you can donate to our 501c3 nonprofit here. You may also want to support Balanced, an ally organization NutritionFacts.org helped launch to put this evidence into practice.
More tobacco industry parallels can be found in Big Food Using the Tobacco Industry Playbook, American Medical Association Complicity with Big Tobacco, and How Smoking in 1959 Is Like Eating in 2016.
Want to know more about that saturated fat tax idea? See Would Taxing Unhealthy Foods Improve Public Health?.
Also check:
In health,
Michael Greger, M.D.
PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:


nutritionfactsorg--2020-10-29--What White Blood Cell Count Should We Shoot for?

At the start of my video What Does a Low White Blood Cell Count Mean ?
, you can see what it looks like when you take a drop of blood , smear it between two pieces of glass , and view at it under a microscope : a whole bunch of little , round , red blood cells and a few big , white blood cells .
Red blood cells carry oxygen , while white blood cells are our immune system ’ s foot soldiers .
We may churn out 50 billion new white blood cells a day .
@ @ @ @ @ @ @ that number can shoot up to a 100 billion or more .
In fact , pus is largely composed of : millions and millions of white blood cells .
Testing to find out how many white blood cells we have at any given time is one of the most common laboratory tests doctors order .
It ’ s ordered it hundreds of millions of times a year .
If , for example , you end up in the emergency room with abdominal pain , having a white blood cell count above about 10 @ @ @ @ @ @ @ a sign you have appendicitis .
Most Americans fall between 4.5 and 10 , but most Americans are unhealthy .
Just because 4.5 to 10 is typical doesn ’ t mean it ’ s ideal .
It ’ s like having a “ normal ” cholesterol level in a society where it ’ s normal to die of heart disease , our number-one killer .
The average American is overweight , so if your weight is “ normal , ” that ’ s actually a bad thing .
In fact , having excess @ @ @ @ @ @ @ , so it ’ s no surprise that those who are obese walk around with two billion more white cells per quart of blood .
Given that , perhaps obese individuals should have their own “ normal ” values .
As you can see at 2:06 in my video , if someone with a 47-inch waist walks into the ER with a white blood cell count of 12 , 13 , or even 14 , they may not have appendicitis or an infection .
That may just be their normal baseline level , @ @ @ @ @ @ @ their body from the excess fat .
So , normal levels are not necessarily healthy levels .
It ’ s like smoking .
As you can see at 2:31 in my video , if you test identical twins and one smokes but the other doesn ’ t , the smoker is going to end up with a significantly higher white cell count .
In Japan , for example , as smoking rates have steadily dropped , so has the normal white count range .
In fact , it ’ s dropped such that @ @ @ @ @ @ @ never smoked would now be flagged as having abnormally low white counts if you used a cut-off of 4 .
But , when that cut-off of 4 was set , most people were smoking .
So , maybe 3 would be a better lower limit .
The inflammation caused by smoking may actually be one of the reasons cigarettes increase the risk of heart attacks , strokes , and other inflammatory diseases .
So , do people who have lower white counts have less heart disease , cancer , and overall mortality ?
@ @ @ @ @ @ @ People with lower white blood cell counts live longer .
Even within the normal range , every one point drop may be associated with a 20 percent drop in the risk of premature death .
As you can see at 3:39 in my video , there is an exponential increase in risk in men as white count goes up , even within the so-called normal range , and the same is found for women .
The white blood cell count is a “ stable , well-standardized , widely available and inexpensive measure of @ @ @ @ @ @ @ half of the women around 85 years of age who had started out with white counts under 5.6 were still alive , whereas 80 percent of those who started out over 7 were dead , as you can see at 4:05 in my video—and white blood cell counts of 7 , 8 , 9 , or even 10 would be considered normal .
Being at the high end of the normal range may place one at three times the risk of dying from heart disease compared to being at the lower end .
@ @ @ @ @ @ @ African-American men and women , found for those in middle age , found at age 75 , found at age 85 , and found even in our 20s and 30s : a 17 percent increase in coronary artery disease incidence for each single point higher .
As you can see at 5:00 in my video , the higher your white count , the worse your arterial function may be and the stiffer your arteries may be , so it ’ s no wonder white blood cell count is a useful predictor of high @ @ @ @ @ @ @ heart , brain , legs , and neck .
Even diabetes ?
Yes , even diabetes , based on a compilation of 20 different studies .
In fact , it may be associated with everything from fatty liver disease to having an enlarged prostate .
And , having a higher white blood cell count is also associated with an increased risk of dying from cancer .
So , what would the ideal range be ?
I cover that in my video What Is the Ideal White Blood Cell Count ?
.
A higher @ @ @ @ @ @ @ important predictor for cardiovascular disease incidence and mortality , decline in lung function , cancer mortality , all-cause mortality , heart attacks , strokes , and premature death in general .
This is no surprise , as the number of white blood cells we have circulating in our bloodstreams are a marker of systemic inflammation .
Our bodies produce more white blood cells day to day in response to inflammatory insults .
We ’ ve known about this link between higher white counts and heart attacks since the 1970s , when we found @ @ @ @ @ @ @ with higher white blood cell counts , higher cholesterol levels , and higher blood pressures , as you can see at 0:53 in my video What Is the Ideal White Blood Cell Count ?
.
This has been found in nearly every study done since then .
There are decades of studies involving hundreds of thousands of patients showing dramatically higher mortality rates in those with higher white counts .
But why ?
Why does white blood cell count predict mortality ?
It may be because it ’ s a marker of inflammation @ @ @ @ @ @ @ fact , it may even be a biomarker for how fast we are aging .
It may be more than just an indicator of inflammation—it may also be an active player , contributing directly to disease via a variety of mechanisms , including the actual obstruction of blood flow .
The average diameter of a white blood cell is about seven and a half micrometers , whereas our tiniest vessels are only about five micrometers wide , so the white blood cell has to squish down into a sausage shape in order to @ @ @ @ @ @ @ inflammation present , these cells can get sticky .
As you can see at 2:20 in my video , a white blood cell may plug up a vessel as it exits a small artery and tries to squeeze into a capillary , slowing down or even momentarily stopping blood flow .
And , if it gets stuck there , it can end up releasing all of its internal weaponry , which is normally reserved for microbial invaders , and damage our blood vessels .
This may be why in the days leading up @ @ @ @ @ @ @ you may find a spike in the white cell count .
Whether white count is just a marker of inflammation or an active participant , it ’ s better to be on the low side .
How can we reduce the level of inflammation in our body ?
Staying away from even second-hand smoke can help drop your white count about half of a point .
Those who exercise also appear to have an advantage , but you don ’ t know if it ’ s cause and effect unless you put it @ @ @ @ @ @ @ , two months of Zumba classes—just one or two hours a week—led to about a point and a half drop in white count .
In fact , that may be one of the reasons exercise is so protective .
But is that just because they lost weight ?
Fitness and fatness both appear to play a role .
More than half of obese persons with low fitness—51.5 percent—have white counts above 6.6 , but those who are more fit or who have less fat are less likely to have counts that high , @ @ @ @ @ @ @ my video .
Of course , that could just be because exercisers and leaner individuals are eating healthier , less inflammatory diets .
How do we know excess body fat itself increases inflammation , increases the white count ?
You ’ d have to find some way to get people to lose weight without changing their diet or exercise habit .
How ’ s that possible ?
Liposuction .
If you suck about a quart of fat out of people , you can significantly drop their white count by about a point .
@ @ @ @ @ @ @ the so-called normal reference range for white blood cell counts .
Indeed , maybe we should revise it downward , like we ’ ve done for cholesterol and triglycerides .
Until now , we ’ ve based normal values on people who might be harboring significant background inflammatory disease .
But , if we restrict it to those with normal C-reactive protein , another indicator of inflammation , then instead of “ normal ” being 4.5 to 10 , perhaps we should revise it closer to 3 to 9 .
Where do the @ @ @ @ @ @ @ from the ravages of chronic inflammatory diseases , like heart disease and common cancers ?
Populations eating diets centered around whole plant foods average about 5 , whereas it was closer to 7 or 8 in the United States at the time .
How do we know it isn ’ t just genetic ?
As you can see at 5:38 in my video , if you take those living on traditional rural African diets , who have white blood cell counts down around 4 or 5 , and move them to Britain , @ @ @ @ @ @ @ 7 , or even 8 .
Ironically , the researchers thought this was a good thing , referring to the lower white counts on the “ uncivilized ” diet as neutropenic , meaning having too few white blood cells .
They noted that during an infection or pregnancy , when more white cells are needed , the white count came right up to wherever was necessary .
So , the bone marrow of those eating traditional plant-based diets had the capacity to create as many white cells as needed but “ suffers from @ @ @ @ @ @ @ 6:26 in my video , similar findings were reported in Western plant eaters , with an apparent stepwise drop in white count as diets got more and more plant based , but could there be non-dietary factors , such as lower smoking rates , in those eating more healthfully ?
What we need is an interventional trial to put it to the test , and we got one : Just 21 days of removing meat , eggs , dairy , alcohol , and junk affected a significant drop in white count , even @ @ @ @ @ @ @ 5.7 .
What about patients with rheumatoid arthritis who started out even higher , up around 7 ?
As you can see at 7:03 in my video , there was no change in the control group who didn ’ t change their diet , but there was a 1.5 point drop within one month on whole food plant-based nutrition .
That ’ s a 20 percent drop .
That ’ s more than the drop-in inflammation one might get quitting a 28-year pack-a-day smoking habit .
The most extraordinary drop I ’ ve @ @ @ @ @ @ @ asthmatics .
After four months of a whole food plant-based diet , their average white count dropped nearly 60 percent , from around 12 down to 5 , though there was no control group nor enough patients to achieve statistical significance .
If white blood cell count is such a clear predictor of mortality and is so inexpensive , reliable , and available , why isn ’ t it used more often for diagnosis and prognosis ?
Maybe it ’ s a little too inexpensive .
The industry seems more interested in fancy @ @ @ @ @ @ @ .
I touch on the health of the rural Africans I discussed in How Not to Die from Heart Disease .
For more on fighting inflammation , see : • None The Best Diet for the Inflammation of Aging • None The Effects of Avocados on Inflammation • None Flashback Friday : The Best Foods for PS : If you haven ’ t yet , you can subscribe to my free videos here and watch my live presentations : • 2016 : How Not To Die : The Role of Diet in Preventing @ @ @ @ @ @ @ 15 Killers • 2015 : Food as Medicine : Preventing and Treating the Most Dreaded Diseases with Diet • 2014 : From Table to Able : Combating Disabling Diseases with Food • 2013 : More Than an Apple a Day • 2012 : Uprooting the Leading Causes of Death

At the start of my video What Does a Low White Blood Cell Count Mean?, you can see what it looks like when you take a drop of blood, smear it between two pieces of glass, and view at it under a microscope: a whole bunch of little, round, red blood cells and a few big, white blood cells. Red blood cells carry oxygen, while white blood cells are our immune system’s foot soldiers. We may churn out 50 billion new white blood cells a day. In response to inflammation or infection, that number can shoot up to a 100 billion or more. In fact, pus is largely composed of: millions and millions of white blood cells.
Testing to find out how many white blood cells we have at any given time is one of the most common laboratory tests doctors order. It’s ordered it hundreds of millions of times a year. If, for example, you end up in the emergency room with abdominal pain, having a white blood cell count above about 10 billion per quart of blood may be a sign you have appendicitis. Most Americans fall between 4.5 and 10, but most Americans are unhealthy. Just because 4.5 to 10 is typical doesn’t mean it’s ideal. It’s like having a “normal” cholesterol level in a society where it’s normal to die of heart disease, our number-one killer. The average American is overweight, so if your weight is “normal,” that’s actually a bad thing.
In fact, having excess fat itself causes inflammation within the body, so it’s no surprise that those who are obese walk around with two billion more white cells per quart of blood. Given that, perhaps obese individuals should have their own “normal” values. As you can see at 2:06 in my video, if someone with a 47-inch waist walks into the ER with a white blood cell count of 12, 13, or even 14, they may not have appendicitis or an infection. That may just be their normal baseline level, given all the inflammation they have in their body from the excess fat. So, normal levels are not necessarily healthy levels.
It’s like smoking. As you can see at 2:31 in my video, if you test identical twins and one smokes but the other doesn’t, the smoker is going to end up with a significantly higher white cell count. In Japan, for example, as smoking rates have steadily dropped, so has the normal white count range. In fact, it’s dropped such that about 8 percent of men who have never smoked would now be flagged as having abnormally low white counts if you used a cut-off of 4. But, when that cut-off of 4 was set, most people were smoking. So, maybe 3 would be a better lower limit. The inflammation caused by smoking may actually be one of the reasons cigarettes increase the risk of heart attacks, strokes, and other inflammatory diseases. So, do people who have lower white counts have less heart disease, cancer, and overall mortality? Yes, yes, and yes. People with lower white blood cell counts live longer. Even within the normal range, every one point drop may be associated with a 20 percent drop in the risk of premature death.
As you can see at 3:39 in my video, there is an exponential increase in risk in men as white count goes up, even within the so-called normal range, and the same is found for women. The white blood cell count is a “stable, well-standardized, widely available and inexpensive measure of systemic inflammation.” In one study, half of the women around 85 years of age who had started out with white counts under 5.6 were still alive, whereas 80 percent of those who started out over 7 were dead, as you can see at 4:05 in my video—and white blood cell counts of 7, 8, 9, or even 10 would be considered normal. Being at the high end of the normal range may place one at three times the risk of dying from heart disease compared to being at the lower end.
The same link has been found for African-American men and women, found for those in middle age, found at age 75, found at age 85, and found even in our 20s and 30s: a 17 percent increase in coronary artery disease incidence for each single point higher.
As you can see at 5:00 in my video, the higher your white count, the worse your arterial function may be and the stiffer your arteries may be, so it’s no wonder white blood cell count is a useful predictor of high blood pressure and artery disease in your heart, brain, legs, and neck. Even diabetes? Yes, even diabetes, based on a compilation of 20 different studies. In fact, it may be associated with everything from fatty liver disease to having an enlarged prostate. And, having a higher white blood cell count is also associated with an increased risk of dying from cancer. So, what would the ideal range be? I cover that in my video What Is the Ideal White Blood Cell Count?.
A higher white blood cell count may be an important predictor for cardiovascular disease incidence and mortality, decline in lung function, cancer mortality, all-cause mortality, heart attacks, strokes, and premature death in general. This is no surprise, as the number of white blood cells we have circulating in our bloodstreams are a marker of systemic inflammation. Our bodies produce more white blood cells day to day in response to inflammatory insults.
We’ve known about this link between higher white counts and heart attacks since the 1970s, when we found that higher heart attack risk was associated with higher white blood cell counts, higher cholesterol levels, and higher blood pressures, as you can see at 0:53 in my video What Is the Ideal White Blood Cell Count?. This has been found in nearly every study done since then. There are decades of studies involving hundreds of thousands of patients showing dramatically higher mortality rates in those with higher white counts. But why? Why does white blood cell count predict mortality? It may be because it’s a marker of inflammation and oxidation in the body. In fact, it may even be a biomarker for how fast we are aging. It may be more than just an indicator of inflammation—it may also be an active player, contributing directly to disease via a variety of mechanisms, including the actual obstruction of blood flow.
The average diameter of a white blood cell is about seven and a half micrometers, whereas our tiniest vessels are only about five micrometers wide, so the white blood cell has to squish down into a sausage shape in order to squeeze through. When there’s inflammation present, these cells can get sticky. As you can see at 2:20 in my video, a white blood cell may plug up a vessel as it exits a small artery and tries to squeeze into a capillary, slowing down or even momentarily stopping blood flow. And, if it gets stuck there, it can end up releasing all of its internal weaponry, which is normally reserved for microbial invaders, and damage our blood vessels. This may be why in the days leading up to a stroke or heart attack, you may find a spike in the white cell count.
Whether white count is just a marker of inflammation or an active participant, it’s better to be on the low side. How can we reduce the level of inflammation in our body? Staying away from even second-hand smoke can help drop your white count about half of a point. Those who exercise also appear to have an advantage, but you don’t know if it’s cause and effect unless you put it to the test. In one study, two months of Zumba classes—just one or two hours a week—led to about a point and a half drop in white count. In fact, that may be one of the reasons exercise is so protective. But is that just because they lost weight?
Fitness and fatness both appear to play a role. More than half of obese persons with low fitness—51.5 percent—have white counts above 6.6, but those who are more fit or who have less fat are less likely to have counts that high, as you can see at 3:47 in my video. Of course, that could just be because exercisers and leaner individuals are eating healthier, less inflammatory diets. How do we know excess body fat itself increases inflammation, increases the white count? You’d have to find some way to get people to lose weight without changing their diet or exercise habit. How’s that possible? Liposuction. If you suck about a quart of fat out of people, you can significantly drop their white count by about a point. Perhaps this should get us to rethink the so-called normal reference range for white blood cell counts. Indeed, maybe we should revise it downward, like we’ve done for cholesterol and triglycerides.
Until now, we’ve based normal values on people who might be harboring significant background inflammatory disease. But, if we restrict it to those with normal C-reactive protein, another indicator of inflammation, then instead of “normal” being 4.5 to 10, perhaps we should revise it closer to 3 to 9.
Where do the healthiest populations fall, those not suffering from the ravages of chronic inflammatory diseases, like heart disease and common cancers? Populations eating diets centered around whole plant foods average about 5, whereas it was closer to 7 or 8 in the United States at the time. How do we know it isn’t just genetic? As you can see at 5:38 in my video, if you take those living on traditional rural African diets, who have white blood cell counts down around 4 or 5, and move them to Britain, they end up closer to 6, 7, or even 8. Ironically, the researchers thought this was a good thing, referring to the lower white counts on the “uncivilized” diet as neutropenic, meaning having too few white blood cells. They noted that during an infection or pregnancy, when more white cells are needed, the white count came right up to wherever was necessary. So, the bone marrow of those eating traditional plant-based diets had the capacity to create as many white cells as needed but “suffers from understimulation.”
As you can see at 6:26 in my video, similar findings were reported in Western plant eaters, with an apparent stepwise drop in white count as diets got more and more plant based, but could there be non-dietary factors, such as lower smoking rates, in those eating more healthfully? What we need is an interventional trial to put it to the test, and we got one: Just 21 days of removing meat, eggs, dairy, alcohol, and junk affected a significant drop in white count, even in people who started out down at 5.7.
What about patients with rheumatoid arthritis who started out even higher, up around 7? As you can see at 7:03 in my video, there was no change in the control group who didn’t change their diet, but there was a 1.5 point drop within one month on whole food plant-based nutrition. That’s a 20 percent drop. That’s more than the drop-in inflammation one might get quitting a 28-year pack-a-day smoking habit. The most extraordinary drop I’ve seen was in a study of 35 asthmatics. After four months of a whole food plant-based diet, their average white count dropped nearly 60 percent, from around 12 down to 5, though there was no control group nor enough patients to achieve statistical significance.
If white blood cell count is such a clear predictor of mortality and is so inexpensive, reliable, and available, why isn’t it used more often for diagnosis and prognosis? Maybe it’s a little too inexpensive. The industry seems more interested in fancy new risk factors it can bill for.
I touch on the health of the rural Africans I discussed in How Not to Die from Heart Disease.
For more on fighting inflammation, 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 presentations:


nutritionfactsorg--2020-11-03--2400 Units of Vitamin D a Day for Fibromyalgia

Fibromyalgia , one of the most common joint and muscle diseases , afflicting millions of Americans , is characterized by widespread musculoskeletal pain , often accompanied by other symptoms , such as fatigue .
The medical profession used to think it was all in people ’ s heads , “ but today there is irrefutable evidence ” that it is indeed a disorder of the body and not just the mind .
Back in 2003 , an influential paper was published out of the Mayo Clinic in which a shocking 93 percent of fibromyalgia-type patients were found to be vitamin @ @ @ @ @ @ @ that all such patients are at high risk of severe vitamin D deficiency .
Wait a second , said the skeptics .
There was no control group , and where ’ s the Mayo Clinic located ?
Minnesota .
Maybe 90 percent of everyone in Minnesota is deficient in vitamin D. When controlled studies were done , some did indeed find that those suffering from these kinds of pain syndromes were significantly more likely to be D deficient , but other studies did not find this .
Even if all the studies did @ @ @ @ @ @ @ that doesn ’ t mean that low vitamin D levels cause fibromyalgia .
Maybe chronic , widespread pain disorders like fibromyalgia cause low vitamin D. After all , it ’ s the sunshine vitamin , and perhaps fibromyalgia patients aren ’ t running around outside as much as healthy controls .
To know if vitamin D is contributing to the disease , you have to put it to the test .
Various studies found that the majority of those with pain syndromes and low D levels appeared to benefit from vitamin D supplementation @ @ @ @ @ @ @ up to 90 percent of patients .
But these studies weren ’ t controlled either .
Maybe the subjects would have gotten better on their own without the supplements , or maybe it was the placebo effect .
There are many examples in the medical literature of treatments that looked great in uncontrolled trials , like hyperbaric oxygen therapy for multiple sclerosis , but when put to the test in randomized controlled trials , they failed miserably .
And , that ’ s what seemed to happen in the first randomized controlled trial @ @ @ @ @ @ @ in 2008 .
As you can see at 2:55 in my video The Best Supplement for Fibromyalgia , researchers saw no significant difference in pain scores , though the study only lasted three months , and , in that time , the treatment was only able to get the vitamin D blood levels up to about 30 .
Unfortunately , no controlled study had ever been done pushing levels any higher , until 2014 .
As you can see at 3:23 in my video , fibromyalgia patients were given up to 2400 units @ @ @ @ @ @ @ weeks and their D levels rose up to about 50 .
Then , once they stopped the vitamin D , their levels came back down to match the placebo .
That was reflected in their pain scores : a significant drop in pain severity while they were on the D and then back to baseline when they came off of it .
The researchers concluded “ that this economical [ in fact , over-the-counter ] therapy with a low side effect profile may well be considered in patients with FMS [ fibromyalgia syndrome @ @ @ @ @ @ @ diet may help combat fibromyalgia ?
See my videos Fibromyalgia vs. Vegetarian and Raw Vegan Diets and Fibromyalgia vs. Mostly Raw & Mostly Vegetarian Diets .
What else can vitamin D supplements do ?
Check out : • Flashback Friday : Will You Live Longer if You Take Vitamin D Supplements & How Much Should You Take ?
• None Do Vitamin D Supplements Help with Diabetes , Weight Loss , and Blood Pressure • Do Vitamin D Supplements Reduce the Risk of Dying from Cancer ?
• None Should Vitamin D Supplements @ @ @ @ @ @ @ Elderly ?
What ’ s the best way to get vitamin D ?
See : • None How Much Vitamin D Should You Take ?
• None The Optimal Dose of Vitamin D Based on Natural Levels • None The Best Way to Get Vitamin D : Sun , Supplements , or Salons ?
• None The Risks and Benefits of Sensible Sun Exposure PS : If you haven ’ t yet , you can subscribe to my free videos here and watch my live presentations : • 2016 : How Not To @ @ @ @ @ @ @ Preventing , Arresting , and Reversing Our Top 15 Killers • 2015 : Food as Medicine : Preventing and Treating the Most Dreaded Diseases with Diet • 2014 : From Table to Able : Combating Disabling Diseases with Food • 2013 : More Than an Apple a Day • 2012 : Uprooting the Leading Causes of Death

Fibromyalgia, one of the most common joint and muscle diseases, afflicting millions of Americans, is characterized by widespread musculoskeletal pain, often accompanied by other symptoms, such as fatigue. The medical profession used to think it was all in people’s heads, “but today there is irrefutable evidence” that it is indeed a disorder of the body and not just the mind.
Back in 2003, an influential paper was published out of the Mayo Clinic in which a shocking 93 percent of fibromyalgia-type patients were found to be vitamin D deficient, so the researchers concluded that all such patients are at high risk of severe vitamin D deficiency. Wait a second, said the skeptics. There was no control group, and where’s the Mayo Clinic located? Minnesota. Maybe 90 percent of everyone in Minnesota is deficient in vitamin D.
When controlled studies were done, some did indeed find that those suffering from these kinds of pain syndromes were significantly more likely to be D deficient, but other studies did not find this. Even if all the studies did have the same findings, though, that doesn’t mean that low vitamin D levels cause fibromyalgia. Maybe chronic, widespread pain disorders like fibromyalgia cause low vitamin D. After all, it’s the sunshine vitamin, and perhaps fibromyalgia patients aren’t running around outside as much as healthy controls. To know if vitamin D is contributing to the disease, you have to put it to the test.
Various studies found that the majority of those with pain syndromes and low D levels appeared to benefit from vitamin D supplementation, and clinical improvement was evident in up to 90 percent of patients. But these studies weren’t controlled either. Maybe the subjects would have gotten better on their own without the supplements, or maybe it was the placebo effect. There are many examples in the medical literature of treatments that looked great in uncontrolled trials, like hyperbaric oxygen therapy for multiple sclerosis, but when put to the test in randomized controlled trials, they failed miserably.
And, that’s what seemed to happen in the first randomized controlled trial of vitamin D for a fibromyalgia-type syndrome in 2008. As you can see at 2:55 in my video The Best Supplement for Fibromyalgia, researchers saw no significant difference in pain scores, though the study only lasted three months, and, in that time, the treatment was only able to get the vitamin D blood levels up to about 30. Unfortunately, no controlled study had ever been done pushing levels any higher, until 2014. As you can see at 3:23 in my video, fibromyalgia patients were given up to 2400 units of vitamin D a day for 20 weeks and their D levels rose up to about 50. Then, once they stopped the vitamin D, their levels came back down to match the placebo. That was reflected in their pain scores: a significant drop in pain severity while they were on the D and then back to baseline when they came off of it. The researchers concluded “that this economical [in fact, over-the-counter] therapy with a low side effect profile may well be considered in patients with FMS [fibromyalgia syndrome].”
What changes in our diet may help combat fibromyalgia? See my videos Fibromyalgia vs. Vegetarian and Raw Vegan Diets and Fibromyalgia vs. Mostly Raw & Mostly Vegetarian Diets.
What else can vitamin D supplements do? Check out:
What’s the best way to get vitamin D? 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 presentations:


nutritionfactsorg--2020-11-05--Fermented or Unfermented Soy?

Fermented or Unfermented Soy?

As you can see at the start of my video Fermented or Unfermented Soy Foods for Prostate Cancer Prevention ?
, there is an enormous variation in the rates of prostate cancer around the globe , with among the highest rates in the United States and lowest rates in Asia—though that may be changing .
The largest increase in prostate cancer rates in the world in recent decades has been in South Korea , for example : a 13-fold increase in prostate cancer deaths nationwide .
Researchers suggested the increase in animal foods may have played a role , since @ @ @ @ @ @ @ diet over that period , with nearly an 850 percent increase .
This is consistent with what we know in general about foods and the prevention and management of prostate cancer .
Tomatoes , cruciferous vegetables like broccoli , and soy foods appear to decrease risk , there ’ s no clear benefit from fish , but there is an increased risk associated with meat and dairy , as you can see at 0:52 in my video .
This may be because a diet based around whole plant foods “ may effectively reduce @ @ @ @ @ @ @ also a genetic factor .
If you have a first-degree relative with prostate cancer , you may be at three-fold higher risk , but non-genetic factors may increase your risk 300-fold .
How do we know the low rates in Asia aren ’ t genetic ?
Because when Asians move to the United States , their rates shoot up , “ and by the second generation , the incidence rate [ is ] already approaching that of average Americans.
” This may be because of more Burger Kings and Dairy Queens , but @ @ @ @ @ @ @ protective foods , such as soy .
A systematic review of all soy and prostate cancer population studies to date confirmed that soy foods are associated with lower the risk , but that ’ s a relatively broad category .
There are all sorts of soy foods .
There are fermented soy foods , like miso and tempeh , and unfermented ones , like tofu and soy milk .
Which are more protective ?
Researchers sifted through the studies , and it turns out that only the unfermented soy seemed to help .
@ @ @ @ @ @ @ with about a 30 percent reduction in risk , whereas there didn ’ t appear to be any protection linked to fermented soy foods .
What about other healthy plant foods , like broccoli and turmeric ?
See what they can do in Best Supplements for Prostate Cancer .
Dean Ornish and his colleagues got amazing results , apparently reversing the progression of prostate cancer with a plant-based diet and lifestyle program .
Do you think it could be because of the soy ?
It wasn ’ t just a vegan diet , @ @ @ @ @ @ @ daily serving of tofu and a soy protein isolate powder .
Find out in The Role of Soy Foods in Prostate Cancer Prevention and Treatment .
More on the number-one cancer among men : What about soy and breast cancer ?
I ’ m glad you asked !
• Should Women at High Risk for Breast Cancer Avoid Soy ?
• Why Do Asian Women Have Less Breast Cancer ?
Who Shouldn ’ t Eat Soy ?
Watch the video to find out !
PS : If you haven ’ t yet , @ @ @ @ @ @ @ here and watch my live presentations : • 2016 : How Not To Die : The Role of Diet in Preventing , Arresting , and Reversing Our Top 15 Killers • 2015 : Food as Medicine : Preventing and Treating the Most Dreaded Diseases with Diet • 2014 : From Table to Able : Combating Disabling Diseases with Food • 2013 : More Than an Apple a Day • 2012 : Uprooting the Leading Causes of Death

As you can see at the start of my video Fermented or Unfermented Soy Foods for Prostate Cancer Prevention?, there is an enormous variation in the rates of prostate cancer around the globe, with among the highest rates in the United States and lowest rates in Asia—though that may be changing. The largest increase in prostate cancer rates in the world in recent decades has been in South Korea, for example: a 13-fold increase in prostate cancer deaths nationwide. Researchers suggested the increase in animal foods may have played a role, since that was the biggest change in their diet over that period, with nearly an 850 percent increase.
This is consistent with what we know in general about foods and the prevention and management of prostate cancer. Tomatoes, cruciferous vegetables like broccoli, and soy foods appear to decrease risk, there’s no clear benefit from fish, but there is an increased risk associated with meat and dairy, as you can see at 0:52 in my video. This may be because a diet based around whole plant foods “may effectively reduce inflammation in the body.”
There is also a genetic factor. If you have a first-degree relative with prostate cancer, you may be at three-fold higher risk, but non-genetic factors may increase your risk 300-fold. How do we know the low rates in Asia aren’t genetic? Because when Asians move to the United States, their rates shoot up, “and by the second generation, the incidence rate [is] already approaching that of average Americans.” This may be because of more Burger Kings and Dairy Queens, but could also be because of eating fewer protective foods, such as soy.
A systematic review of all soy and prostate cancer population studies to date confirmed that soy foods are associated with lower the risk, but that’s a relatively broad category. There are all sorts of soy foods. There are fermented soy foods, like miso and tempeh, and unfermented ones, like tofu and soy milk. Which are more protective? Researchers sifted through the studies, and it turns out that only the unfermented soy seemed to help. Tofu and soy milk consumption was associated with about a 30 percent reduction in risk, whereas there didn’t appear to be any protection linked to fermented soy foods.
What about other healthy plant foods, like broccoli and turmeric? See what they can do in Best Supplements for Prostate Cancer.
Dean Ornish and his colleagues got amazing results, apparently reversing the progression of prostate cancer with a plant-based diet and lifestyle program. Do you think it could be because of the soy? It wasn’t just a vegan diet, but a vegan diet supplemented with a daily serving of tofu and a soy protein isolate powder. Find out in The Role of Soy Foods in Prostate Cancer Prevention and Treatment.
More on the number-one cancer among men:
What about soy and breast cancer? I’m glad you asked!
Who Shouldn’t Eat Soy? Watch the video to find out!
In health,
Michael Greger, M.D.
PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:


nutritionfactsorg--2020-11-10--Can Soy Prevent and Treat Prostate Cancer?

As I discuss in my video The Role of Soy Foods in Prostate Cancer Prevention and Treatment , a compilation of 13 observational studies on soy food consumption and the risk of prostate cancer found that soy foods appear to be “ protective.
” What are observational studies ?
As opposed to interventional studies , in observational studies , researchers observe what people are eating but don ’ t intervene and try to change their diets .
In these studies , they observed that men who ate more soy foods had lower rates of prostate cancer , but the problem @ @ @ @ @ @ @ be confounding factors .
For example , “ people who choose to eat soy also make other lifestyle decisions that lower the risk of cancer ( e.g.
, lower fat intake , higher vegetable and fruit intake , more frequent exercise ) , ” maybe that is why they have less cancer .
Most of the studies tried to control for these other lifestyle factors , but you can ’ t control for everything .
What ’ s more , most of the studies were done in Asia , so maybe tofu consumption @ @ @ @ @ @ @ more traditional diet .
Is it possible that the reason non-tofu consumers got more cancer is that they had abandoned their traditional diet ?
If only we could look at a Western population that ate a lot of soy .
We can : the Seventh-Day Adventists .
In the 1970s , more than 12,000 Adventist men were asked about their use of soy milk and then were followed for up to 16 years to see who got cancer and who did not .
So , what did they find ?
Frequent consumption of @ @ @ @ @ @ @ 70 percent reduction of the risk of prostate cancer , as you can see at 1:33 in my video .
Similarly , in a multiethnic study that involved a number of groups , soy intake appeared protective in Latinos , too .
Prostate cells carry beta type estrogen receptors , which appear to act as a tumor suppressor , a kind of “ gatekeeper…inhibiting invasion , proliferation and…preventing ” the prostate cells from turning cancerous .
And , those are the receptors targeted by the phytoestrogens in soy , like genistein , which @ @ @ @ @ @ @ in a petri dish at the kind of levels one might get consuming soy foods .
The prevention of metastases is critical , as death from prostate cancer isn ’ t caused by the original tumor , but its spread throughout the body , which explains why it “ is recommended that men with prostate cancer consume soy foods , such as soybeans , tofu , miso and tempeh.
” Wait a moment .
Dean Ornish and his colleagues got amazing results , apparently reversing the progression of prostate cancer with a plant-based @ @ @ @ @ @ @ because of the soy ?
Their study didn ’ t just include a vegan diet , but a vegan diet supplemented with a daily serving of tofu and a soy protein isolate powder .
There have been studies showing that men given soy protein powders develop less prostate cancer than the control group , but what was the control group getting ?
Milk protein powder .
Those randomized to the milk group got six times more prostate cancer than the soy group , but was that due to the beneficial effects of soy @ @ @ @ @ @ @ ?
Dairy products are not just associated with getting prostate cancer , but also with dying from prostate cancer .
Men diagnosed with prostate cancer who then ate more dairy tended to die sooner , and “ both low-fat and high-fat dairy consumption were positively associated with an increased risk of fatal outcome.
” The best study we have on soy protein powder supplementation for prostate cancer patients found no significant benefit , and neither did a series of soy phytoestrogen dietary supplements .
But , perhaps that ’ s because they used @ @ @ @ @ @ @ soy food .
“ Taking the whole-food approach may be more efficacious , ” but it can be hard to do controlled studies with whole foods : You can make fake pills , but how do you give people placebo tofu ?
A group of Australian researchers creatively came up with a specially manufactured bread containing soy grits to compare to a placebo regular bread and gave slices to men diagnosed with prostate cancer awaiting surgery .
As you can see at 4:31 in my video , they saw a remarkable difference in @ @ @ @ @ @ @ was the first study to show that a diet incorporating a whole soy food could favorably affect prostate cancer markers , but you can ’ t just go out and buy soy grit bread .
Another study was a little more practical .
Twenty men with prostate cancer who had been treated with radiation or surgery but seemed to be relapsing were asked to drink three cups of regular soy milk a day .
The PSA levels in each of the 20 patients were all rising before they started the soy milk , @ @ @ @ @ @ @ growing inside of them .
However , during a year drinking soy milk , 6 out of the 20 subjects got better , 2 got worse , and the remaining 12 remained unchanged , as you can see from 5:02 in my video .
So , they concluded that soy food may help in a subset of patients .
Based on all these studies , the results Ornish and his colleagues got were probably due to more than just the soy .
Similarly , the low prostate cancer rates in Asia are probably @ @ @ @ @ @ @ , since the lowest rates are also found in parts of Africa , where I don ’ t think they ’ re eating a lot of tofu .
Indeed , in the multiethnic study , other types of beans besides soy also appeared protective for Latinos and all the groups put together , when looking at the most aggressive forms of prostate cancer .
So , the protection associated with plant-based diets may be due to eating a variety of healthy foods .
That soy milk stat from the Adventist study is astounding @ @ @ @ @ @ @ though ?
That was the subject of Fermented or Unfermented Soy Foods for Prostate Cancer Prevention ?
.
Reversing the progression of cancer ?
See How Not to Die from Cancer .
Given the power of diet , it ’ s amazing to me how difficult Changing a Man ’ s Diet After a Prostate Cancer Diagnosis can be .
It ’ s not all or nothing , though .
Check out Prostate Cancer Survival : The A/V Ratio .
For soy and breast cancer survival , see Is Soy Healthy for Breast @ @ @ @ @ @ @ you haven ’ t yet , you can subscribe to my free videos here and watch my live presentations : • 2016 : How Not To Die : The Role of Diet in Preventing , Arresting , and Reversing Our Top 15 Killers • 2015 : Food as Medicine : Preventing and Treating the Most Dreaded Diseases with Diet • 2014 : From Table to Able : Combating Disabling Diseases with Food • 2013 : More Than an Apple a Day • 2012 : Uprooting the Leading Causes of Death

As I discuss in my video The Role of Soy Foods in Prostate Cancer Prevention and Treatment, a compilation of 13 observational studies on soy food consumption and the risk of prostate cancer found that soy foods appear to be “protective.” What are observational studies? As opposed to interventional studies, in observational studies, researchers observe what people are eating but don’t intervene and try to change their diets. In these studies, they observed that men who ate more soy foods had lower rates of prostate cancer, but the problem with observational studies is that there could be confounding factors. For example, “people who choose to eat soy also make other lifestyle decisions that lower the risk of cancer (e.g., lower fat intake, higher vegetable and fruit intake, more frequent exercise),” maybe that is why they have less cancer. Most of the studies tried to control for these other lifestyle factors, but you can’t control for everything. What’s more, most of the studies were done in Asia, so maybe tofu consumption is just a sign of eating a more traditional diet. Is it possible that the reason non-tofu consumers got more cancer is that they had abandoned their traditional diet? If only we could look at a Western population that ate a lot of soy. We can: the Seventh-Day Adventists.
In the 1970s, more than 12,000 Adventist men were asked about their use of soy milk and then were followed for up to 16 years to see who got cancer and who did not. So, what did they find? Frequent consumption of soy milk was associated with a whopping 70 percent reduction of the risk of prostate cancer, as you can see at 1:33 in my video. Similarly, in a multiethnic study that involved a number of groups, soy intake appeared protective in Latinos, too.
Prostate cells carry beta type estrogen receptors, which appear to act as a tumor suppressor, a kind of “gatekeeper…inhibiting invasion, proliferation and…preventing” the prostate cells from turning cancerous. And, those are the receptors targeted by the phytoestrogens in soy, like genistein, which inhibits prostate cancer cell invasion and spread in a petri dish at the kind of levels one might get consuming soy foods. The prevention of metastases is critical, as death from prostate cancer isn’t caused by the original tumor, but its spread throughout the body, which explains why it “is recommended that men with prostate cancer consume soy foods, such as soybeans, tofu, miso and tempeh.”
Wait a moment. Dean Ornish and his colleagues got amazing results, apparently reversing the progression of prostate cancer with a plant-based diet and lifestyle program. Was it because of the soy? Their study didn’t just include a vegan diet, but a vegan diet supplemented with a daily serving of tofu and a soy protein isolate powder. There have been studies showing that men given soy protein powders develop less prostate cancer than the control group, but what was the control group getting? Milk protein powder. Those randomized to the milk group got six times more prostate cancer than the soy group, but was that due to the beneficial effects of soy or the deleterious effects of the dairy? Dairy products are not just associated with getting prostate cancer, but also with dying from prostate cancer. Men diagnosed with prostate cancer who then ate more dairy tended to die sooner, and “both low-fat and high-fat dairy consumption were positively associated with an increased risk of fatal outcome.”
The best study we have on soy protein powder supplementation for prostate cancer patients found no significant benefit, and neither did a series of soy phytoestrogen dietary supplements. But, perhaps that’s because they used isolated soy components rather than a whole soy food. “Taking the whole-food approach may be more efficacious,” but it can be hard to do controlled studies with whole foods: You can make fake pills, but how do you give people placebo tofu?
A group of Australian researchers creatively came up with a specially manufactured bread containing soy grits to compare to a placebo regular bread and gave slices to men diagnosed with prostate cancer awaiting surgery. As you can see at 4:31 in my video, they saw a remarkable difference in just about three weeks time. It was the first study to show that a diet incorporating a whole soy food could favorably affect prostate cancer markers, but you can’t just go out and buy soy grit bread. Another study was a little more practical. Twenty men with prostate cancer who had been treated with radiation or surgery but seemed to be relapsing were asked to drink three cups of regular soy milk a day. The PSA levels in each of the 20 patients were all rising before they started the soy milk, suggesting they had relapsing or metastatic cancer growing inside of them. However, during a year drinking soy milk, 6 out of the 20 subjects got better, 2 got worse, and the remaining 12 remained unchanged, as you can see from 5:02 in my video. So, they concluded that soy food may help in a subset of patients.
Based on all these studies, the results Ornish and his colleagues got were probably due to more than just the soy. Similarly, the low prostate cancer rates in Asia are probably because of more than just the soy, since the lowest rates are also found in parts of Africa, where I don’t think they’re eating a lot of tofu. Indeed, in the multiethnic study, other types of beans besides soy also appeared protective for Latinos and all the groups put together, when looking at the most aggressive forms of prostate cancer. So, the protection associated with plant-based diets may be due to eating a variety of healthy foods.
That soy milk stat from the Adventist study is astounding. What about fermented soy foods, though? That was the subject of Fermented or Unfermented Soy Foods for Prostate Cancer Prevention?.
Reversing the progression of cancer? See How Not to Die from Cancer.
Given the power of diet, it’s amazing to me how difficult Changing a Man’s Diet After a Prostate Cancer Diagnosis can be. It’s not all or nothing, though. Check out Prostate Cancer Survival: The A/V Ratio.
For soy and breast cancer survival, see Is Soy Healthy for Breast Cancer Survivors?.
In health,
Michael Greger, M.D.
PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:


nutritionfactsorg--2020-11-12--Kidney Toxins Created by Meat Consumption

As I discuss in my video How to Treat Heart Failure and Kidney Failure with Diet , one way a diet rich in animal-sourced foods like meat , eggs , and cheese may contribute to heart disease , stroke , and death is through the production of an atherosclerosis-inducing substance called TMAO .
With the help of certain gut bacteria , the choline and carnitine found concentrated in animal products can get converted into TMAO .
But , wait a second .
I thought atherosclerosis , or hardening of the arteries , was about the buildup of cholesterol .
Is @ @ @ @ @ @ @ is still king , ” but TMAO appears to accelerate the process .
It seems that TMAO appears to increase the ability of inflammatory cells within the atherosclerotic plaque in the artery walls to bind to bad LDL cholesterol , “ which makes the cells more prone to gobble up cholesterol.
” So TMAO is just “ another piece to the puzzle of how cholesterol causes heart disease.
” What ’ s more , TMAO doesn ’ t just appear to worsen atherosclerosis , contributing to strokes and heart attacks .
It also @ @ @ @ @ @ @ If you look at diabetics after a heart attack , a really high-risk group , nearly all who started out with the most TMAO in their bloodstream went on to develop heart failure within 2,000 days , or about five years .
In comparison , only about 20 percent of those starting out with medium TMAO levels in the blood went into heart failure and none at all in the low TMAO group , as you can see at 1:21 in my video .
So , those with heart failure have higher levels @ @ @ @ @ @ @ with worse heart failure have higher levels than those with lesser stage heart disease .
If you follow people with heart failure over time , within six years , half of those who started out with the highest TMAO levels were dead .
This finding has since been replicated in two other independent populations of heart failure patients .
The question is , why ?
It ’ s probably unlikely to just be additional atherosclerosis , since that takes years .
For most who die of heart failure , their heart muscle just @ @ @ @ @ @ @ fatal heart rhythm .
Maybe TMAO has toxic effects beyond just the accelerated buildup of cholesterol .
What about kidney failure ?
People with chronic kidney disease are at a particularly “ increased risk for the development of cardiovascular disease , ” thought to be because of a diverse array of uremic toxins .
These are toxins that would normally be filtered out by the kidneys into the urine but may build up in the bloodstream as kidney function declines .
When we think of uremic toxins , we usually think of the @ @ @ @ @ @ @ gut , which is why specially formulated plant-based diets have been used for decades to treat chronic kidney failure .
Indeed , those who eat vegetarian diets form less than half of these uremic toxins .
Those aren ’ t the only uremic toxins , though .
TMAO , which , as we ’ ve discussed , comes from the breakdown of choline and carnitine found mostly in meat and eggs , may be increasing heart disease risk in kidney patients as well .
How ?
“ The cardiovascular implication of TMAO seems @ @ @ @ @ @ @ reverse cholesterol transport , ” meaning it subverts our own body ’ s attempts at pulling cholesterol out of our arteries .
And , indeed , the worse our kidney function gets , the higher our TMAO levels rise , and those elevated levels correlate with the amount of plaque clogging up their arteries in their heart .
But once the kidney is working again with a transplant , your TMAO levels can drop right back down .
So , TMAO was thought to be a kind of biomarker for declining kidney function—until @ @ @ @ @ @ @ Heart Study , which found that “ elevated choline and TMAO levels among individuals with normal renal [ kidney ] function predicted increased risk for incident development of CKD , ” chronic kidney disease .
This suggests that TMAO is both a biomarker and itself a kidney toxin .
Indeed , when you follow kidney patients over time and assess their freedom from death , those with higher TMAO , even controlling for kidney function , lived significantly shorter lives , as you can see at 4:44 in my video .
This indicates @ @ @ @ @ @ @ kidney scarring and dysfunction , “ strongly implying the need to focus preventive efforts on dietary modulation , ” but what might that look like ?
Well , maybe we should reduce “ dietary sources of TMAO generation , such as some species of deep-sea fish , eggs , and meat.
” It also depends on what kind of gut bacteria you have .
You can feed a vegan a steak , and they still don ’ t really make any TMAO because they haven ’ t been fostering the carnitine-eating bacteria .
@ @ @ @ @ @ @ one day , they ’ ll find a way to replicate “ the effects of the vegetarian diet…by selective prebiotic , probiotic , or pharmacologic therapies.
” For more on this revolutionary TMAO story , see : • None Flashback Friday : How to Reduce Your TMAO Levels • None How Our Gut Bacteria Can Use Eggs to Accelerate Cancer • None Microbiome : We Are What They Eat For more on kidney failure , see Preventing Kidney Failure Through Diet and Treating Kidney Failure Through Diet .
PS : If you haven @ @ @ @ @ @ @ to my free videos here and watch my live presentations : • 2016 : How Not To Die : The Role of Diet in Preventing , Arresting , and Reversing Our Top 15 Killers • 2015 : Food as Medicine : Preventing and Treating the Most Dreaded Diseases with Diet • 2014 : From Table to Able : Combating Disabling Diseases with Food • 2013 : More Than an Apple a Day • 2012 : Uprooting the Leading Causes of Death

As I discuss in my video How to Treat Heart Failure and Kidney Failure with Diet, one way a diet rich in animal-sourced foods like meat, eggs, and cheese may contribute to heart disease, stroke, and death is through the production of an atherosclerosis-inducing substance called TMAO. With the help of certain gut bacteria, the choline and carnitine found concentrated in animal products can get converted into TMAO. But, wait a second. I thought atherosclerosis, or hardening of the arteries, was about the buildup of cholesterol. Is that not the case?
“Cholesterol is still king,” but TMAO appears to accelerate the process. It seems that TMAO appears to increase the ability of inflammatory cells within the atherosclerotic plaque in the artery walls to bind to bad LDL cholesterol, “which makes the cells more prone to gobble up cholesterol.” So TMAO is just “another piece to the puzzle of how cholesterol causes heart disease.”
What’s more, TMAO doesn’t just appear to worsen atherosclerosis, contributing to strokes and heart attacks. It also contributes to heart and kidney failure. If you look at diabetics after a heart attack, a really high-risk group, nearly all who started out with the most TMAO in their bloodstream went on to develop heart failure within 2,000 days, or about five years. In comparison, only about 20 percent of those starting out with medium TMAO levels in the blood went into heart failure and none at all in the low TMAO group, as you can see at 1:21 in my video.
So, those with heart failure have higher levels of TMAO than controls, and those with worse heart failure have higher levels than those with lesser stage heart disease. If you follow people with heart failure over time, within six years, half of those who started out with the highest TMAO levels were dead. This finding has since been replicated in two other independent populations of heart failure patients.
The question is, why? It’s probably unlikely to just be additional atherosclerosis, since that takes years. For most who die of heart failure, their heart muscle just conks out or there’s a fatal heart rhythm. Maybe TMAO has toxic effects beyond just the accelerated buildup of cholesterol.
What about kidney failure? People with chronic kidney disease are at a particularly “increased risk for the development of cardiovascular disease,” thought to be because of a diverse array of uremic toxins. These are toxins that would normally be filtered out by the kidneys into the urine but may build up in the bloodstream as kidney function declines. When we think of uremic toxins, we usually think of the toxic byproducts of protein putrefying in our gut, which is why specially formulated plant-based diets have been used for decades to treat chronic kidney failure. Indeed, those who eat vegetarian diets form less than half of these uremic toxins.
Those aren’t the only uremic toxins, though. TMAO, which, as we’ve discussed, comes from the breakdown of choline and carnitine found mostly in meat and eggs, may be increasing heart disease risk in kidney patients as well. How? “The cardiovascular implication of TMAO seems to be due to the downregulation of reverse cholesterol transport,” meaning it subverts our own body’s attempts at pulling cholesterol out of our arteries.
And, indeed, the worse our kidney function gets, the higher our TMAO levels rise, and those elevated levels correlate with the amount of plaque clogging up their arteries in their heart. But once the kidney is working again with a transplant, your TMAO levels can drop right back down. So, TMAO was thought to be a kind of biomarker for declining kidney function—until a paper was published from the Framingham Heart Study, which found that “elevated choline and TMAO levels among individuals with normal renal [kidney] function predicted increased risk for incident development of CKD,” chronic kidney disease. This suggests that TMAO is both a biomarker and itself a kidney toxin.
Indeed, when you follow kidney patients over time and assess their freedom from death, those with higher TMAO, even controlling for kidney function, lived significantly shorter lives, as you can see at 4:44 in my video. This indicates this is a diet-induced mechanism for progressive kidney scarring and dysfunction, “strongly implying the need to focus preventive efforts on dietary modulation,” but what might that look like? Well, maybe we should reduce “dietary sources of TMAO generation, such as some species of deep-sea fish, eggs, and meat.”
It also depends on what kind of gut bacteria you have. You can feed a vegan a steak, and they still don’t really make any TMAO because they haven’t been fostering the carnitine-eating bacteria. Researchers are hoping, though, that one day, they’ll find a way to replicate “the effects of the vegetarian diet…by selective prebiotic, probiotic, or pharmacologic therapies.”
For more on this revolutionary TMAO story, see:
For more on kidney failure, see Preventing Kidney Failure Through Diet and Treating Kidney Failure 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 presentations: