The Latest in Nutrition Research Thu, 30 Nov 2023 15:52:49 +0000 en-US hourly 1 Can You Lose Weight on a Keto Diet? Thu, 30 Nov 2023 13:00:23 +0000 Let’s dive into ketogenic diets and their $33-billion gimmick.

The carbohydrate–insulin model of obesity, the underlying theory that ketogenic diets have some sort of metabolic advantage, has been experimentally falsified. Keto diet proponents’ own studies showed the exact opposite: Ketogenic diets actually put you at a metabolic disadvantage and slow the loss of body fat. How much does fat loss slow down on a low-carb diet?  

As I discuss in my video Keto Diet Results for Weight Loss, if you cut about 800 calories of carbohydrates from your diet a day, you lose 53 grams of body fat a day. But if you cut the same number of fat calories, you lose 89 grams of fat a day. Same number of calories cut, but nine butter pats’ worth of extra fat melting off your body each day on a low-fat diet, compared to a low-carb one. Same number of calories, but about 80 percent more fat loss when you cut down on fat instead of carbs. You can see a graph of these results below and at 1:07 in my video. The title of the study speaks for itself: “Calorie for Calorie, Dietary Fat Restriction Results in More Body Fat Loss Than Carbohydrate Restriction in People with Obesity.” 

Just looking at the bathroom scale, though, would mislead you into thinking the opposite. After six days on the low-carb diet, study subjects lost four pounds. On the low-fat diet, they lost less than three pounds, as you can see in the graph below and at 1:40 in my video. So, according to the scale, it looked like the low-carb diet wins hands down. You can see why low-carb diets are so popular. What was happening inside their bodies, however, tells the real story. The low-carb group was losing mostly lean mass—water and protein. This loss of water weight helps explain why low-carb diets have “been such a persistent theme for authors of diet books and such ‘cash cows’ for publishers,” going back more than the last 150 years. That’s their secret. As one weight-loss expert noted, “Rapid water loss is the $33-billion diet gimmick.” 

When you eat carbohydrates, your body bulks up your muscles with glycogen for quick energy. Eat a high-carbohydrate diet for three days, and you may add about three pounds of muscle mass onto your arms and legs, as you can see below and at 2:34 in my video. Those glycogen stores drain away on a low-carb diet and pull water out with it. (The ketones also need to be flushed out of the kidneys, pulling out even more water.) On the scale, that can manifest as four more pounds coming off within ten days, but that “was all accounted for by losses in total body water”—that is water loss. 

The bottom line: Keto diets just don’t hold water. 

The thrill of seeing the pounds come off so quickly on the scale keeps many coming back to the low-carb altar. When the diet fails, the dieters often blame themselves, but the intoxication of that initial, rapid weight loss may tempt them back, like getting drunk again after forgetting how terrible the last hangover was. This has been dubbed the “false hope syndrome.” “The diet industry thrives for two reasons—big promises and repeat customers,” something low-carb diets were built for, given that initial, rapid water loss. 

What we care about is body fat. In six days, the low-fat diet extracted a total of 80 percent more fat from the body than the low-carb diet. It’s not just one study either. As you can see below and at 3:54 in my video, you can look at all of the controlled feeding trials where researchers compared low-carb diets to low-fat ones, swapping the same number of carb calories for fat calories or vice versa. If a calorie is just a calorie, then all of the studies should have crossed that zero line in the middle, straddling “favors low-fat diet” and “favors low-carb diet,” and indeed six did. One study showed more fat loss on a low-carb diet, but every other study favored the low-fat diet—more loss of body fat eating the same number of calories. When you put all of the studies together, we’re talking 16 more grams of daily body fat lost on the low-fat diets. That’s like four more pats of butter melting off your body on a daily basis. Less fat in the mouth means less fat on the hips, even when you’re taking in the same number of calories. 

This is the third installment of my seven-part series on keto diets. 

This keto research came from the deep dive I took for my book How Not to Diet. (All proceeds I receive from my books are donated to charity.) You can learn more about How Not to Diet and order it here. Also please feel free to check out some of my popular weight-loss videos in related videos below. 

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Testing the Keto Diet Theory Tue, 28 Nov 2023 13:00:07 +0000 Do low-carb and ketogenic diets have a metabolic advantage for weight loss? 

When you don’t eat enough carbohydrates, you force your body to burn more fat. “However, this rise in fat oxidation [burning] is often misconstrued as a greater rate of net FM [fat-mass] reduction” in the body, ignoring the fact that, on a ketogenic diet, your fat intake shoots up, too. What happens to your overall body fat balance? You can’t empty a tub by widening the drain if you’re opening the faucet at the same time. Low-carb advocates had a theory, though, the “carbohydrate–insulin model of obesity,” which I discuss in my video Keto Diet Theory Put to the Test 

Proponents of low-carb diets, whether a ketogenic diet or a more relaxed form of carbohydrate restriction, suggested that decreased insulin secretion would lead to less fat storage, so even if you were eating more fat, less of it would stick to your frame. We’d burn more and store less, the perfect combination for fat loss—or so the theory went. To their credit, instead of just speculating about it, they decided to put it to the test. 

Gary Taubes formed the Nutrition Science Initiative (NuSI) to sponsor research to validate the carbohydrate–insulin model. He’s the journalist who wrote the controversial 2002 New York Times Magazine article “What If It’s All Been a Big Fat Lie?” which attempted to turn nutrition dogma on its head by arguing in favor of the Atkins diet with its bunless bacon cheeseburgers based on the carbohydrate–insulin model. (Much of Nina Teicholz’s book The Big Fat Surprise is simply recycled from Taubes’ earlier work.)  

In response, some of the very researchers Taubes cited to support his thesis accused him of twisting their words. One said, “The article was incredibly misleading…I was horrified.” Said another, “He took this weird little idea and blew it up, and people believed him…What a disaster.” It doesn’t matter what people say, though. All that matters is the science. 

Taubes attracted $40 million in committed funding for his Nutrition Science Initiative to prove to the world that you could lose more body fat on a ketogenic diet. NuSI contracted noted researcher Kevin Hall from the National Institutes of Health to perform the study. Seventeen overweight or obese men were effectively locked in what’s called a metabolic ward for two months to allow researchers total control over their diets. For the first month, they were placed on a typical high-carbohydrate diet (50 percent carbs, 35 percent fat, 15 percent protein), then were switched to a low-carb ketogenic diet (only 5 percent of calories from carbohydrates and 80 percent fat) for the second month. Both diets had the same number of daily calories. So, if a calorie is a calorie when it comes to weight loss, there should be no difference in body fat loss on the regular diet versus the ketogenic diet. If Taubes was right, though, if fat calories were somehow less fattening, then body fat loss would become accelerated on a keto diet. Instead, in the very study funded by the Nutrition Science Initiative, researchers found that body fat loss slowed during the ketogenic diet. 

Why do people think the keto diet works if it actually slows fat loss? Well, as you can see in the graph below and at 3:40 in my video, if you looked only at the readings on bathroom scales, the ketogenic diet would seem like a smashing success. Participants went from losing less than a pound a week on the regular diet during the first two weeks of the study to losing three and a half pounds within seven days after switching to the ketogenic diet. What was happening inside their bodies, however, told a totally different story: Their rate of body fat loss was slowed by more than half. So, most of what they were losing was just water weight. It’s presumed the reason they started burning less fat on a ketogenic diet was because, without the preferred fuel of carbohydrates, their bodies started burning more of their own protein—and that’s exactly what happened. Switching to a ketogenic diet made them lose less fat mass and more fat-free mass. Indeed, they lost more lean mass. That may help explain why the leg muscles of CrossFit trainees placed on a ketogenic diet may shrink as much as 8 percent. The vast lateralis, the biggest quad muscle in your leg, shrunk in thickness by 8 percent on a ketogenic diet. 

Yes, the study subjects started burning more fat on the ketogenic diet, but they were also eating so much more fat on the keto diet that they ended up retaining more fat in their body, despite the lower insulin levels. This is “diametrically opposite” to what the keto crowd predicted, and this is from the guy Nutrition Science Initiative paid to support its theory. In science-speak, “the carbohydrate–insulin model failed experimental interrogation.” 

In light of this “experimental falsification” of the low-carb theory, the Nutrition Science Initiative effectively collapsed but, based on its tax returns, not before Taubes and his co-founder personally pocketed millions of dollars in compensation. 

This is the second installment in my seven-part series on keto diets. In case you missed them, check out the other related videos below.  

The more things change, the more they stay the same. I created a whole website about the Atkins Diet, but, sadly, people keep falling into the low-carb trap. You can find some of my older videos on low-carb diets listed below. 

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Keto Diet to Effectively Fight Cancer? Thu, 23 Nov 2023 13:00:30 +0000 What does the science say about the clinical use of ketogenic diets for epilepsy and cancer? 

Blood sugar, also known as blood glucose, is the universal go-to fuel for the cells throughout our bodies. Our brain burns through a quarter pound of sugar a day because “glucose is the preferred metabolic fuel.” We can break down proteins and make glucose from scratch, but most comes from our diet in the form of sugars and starches. If we stop eating carbohydrates (or stop eating altogether), most of our cells switch over to burning fat. Fat has difficulty getting through the blood-brain barrier, though, and our brain has a constant, massive need for fuel. Just that one organ accounts for up to half of our energy needs. Without it, the lights go out…permanently. 

To make that much sugar from scratch, our body would need to break down about half a pound of protein a day. That means we’d cannibalize ourselves to death within two weeks, but people can fast for months. What’s going on? The answer to the puzzle was discovered in 1967. Harvard researchers famously stuck catheters into the brains of obese subjects who had been fasting for more than a month and discovered that ketones had replaced glucose as the preferred fuel for the brain. Our liver can turn fat into ketones, which can then breach the blood-brain barrier and sustain our brain if we aren’t getting enough carbohydrates. Switching fuels has such an effect on brain activity that it has been used to treat epilepsy since antiquity. 

In fact, the prescription of fasting for the treatment of epileptic seizures dates back to Hippocrates. In the Bible, even Jesus seems to have concurred. To this day, it’s unclear why switching from blood sugar to ketones as a primary fuel source has such a dampening effect on brain overactivity. How long can one fast? To prolong the fasting therapy, in 1921, a distinguished physician scientist at the Mayo Clinic suggested trying what he called “ketogenic diets,” high-fat diets designed to be so deficient in carbohydrates that they could effectively mimic the fasting state. “Remarkable improvement” was noted the first time it was put to the test, efficacy that was later confirmed in randomized, controlled trials. Ketogenic diets started to fall out of favor in 1938 with the discovery of the anti-seizure drug that would become known as Dilantin, but they’re still being used today as a third- or fourth-line treatment for drug-refractory epilepsy in children. 

Oddly, the success of ketogenic diets against pediatric epilepsy seems to get conflated by “keto diet” proponents into suggesting a ketogenic diet is beneficial for everyone. Know what else sometimes works for intractable epilepsy? Brain surgery, but I don’t hear people clamoring to get their skulls sawed open. Since when do medical therapies translate into healthy lifestyle choices? Scrambling brain activity with electroshock therapy can be helpful in some cases of major depression, so should we get out the electrodes? Ketogenic diets are also being tested to see if they can slow the growth of certain brain tumors. Even if they work, you know what else can help slow cancer growth? Chemotherapy. So why go keto when you can just go chemo? 

Promoters of ketogenic diets for cancer are paid by so-called ketone technology companies that offer to send you salted caramel bone broth powder for a hundred bucks a pound or companies that market ketogenic meals and report “extraordinary” anecdotal responses in some cancer patients. But more concrete evidence is simply lacking, and even the theoretical underpinnings may be questionable. A common refrain is that “cancer feeds on sugar.” But all cells feed on sugar. Advocating ketogenic diets for cancer is like saying Hitler breathed air so we should boycott oxygen. 

Cancer can feed on ketones, too. Ketones have been found to fuel human breast cancer growth and drive metastases in an experimental model, more than doubling tumor growth. Some have even speculated that this may be why breast cancer often metastasizes to the liver, the main site of ketone production. As you can see below and at 4:59 in my video Is Keto an Effective Cancer-Fighting Diet?, if you drip ketones directly onto breast cancer cells in a petri dish, the genes that get turned on and off make for much more aggressive cancer, associated with significantly lower five-year survival in breast cancer patients, as you can see in the following graph and at 5:05 in my video. Researchers are even considering designing ketone-blocking drugs to prevent further cancer growth by halting ketone production.  

Let’s also think about what eating a ketogenic diet might entail. High animal fat intake may increase the mortality risk among breast cancer survivors and potentially play a role in the development of breast cancer in the first place through oxidative stress, hormone disruption, or inflammation. This applies to men, too. “A strong association” has been found “between saturated fat intake and prostate cancer progression and survival.” Those in the top third of consumption of these kinds of fat-rich animal foods appeared to triple their risk of dying from prostate cancer. This isn’t necessarily fat in general either. No difference has been found in breast cancer death rates based on total fat intake. However saturated fat intake specifically may negatively impact breast cancer survival, increasing the risk of dying from it by 50 percent. There’s a reason the official American Cancer Society and American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline recommend a dietary pattern for breast cancer patients that’s essentially the opposite of a ketogenic diet. It calls for a diet that’s “high in vegetables, fruits, whole grains, and legumes [beans, split peas, chickpeas, and lentils]; low in saturated fats; and limited in alcohol consumption.” 

“To date, not a single clinical study has shown a measurable benefit from a ketogenic diet in any human cancer.” There are currently at least a dozen trials underway, however, and the hope is that at least some cancer types will respond. Still, even then, that wouldn’t serve as a basis for recommending ketogenic diets for the general population any more than recommending everyone get radiation, surgery, and chemo just for kicks. 

“Keto” has been the most-searched keyword on for months, and I didn’t have much specific to offer…until now. Check out my other videos on the topic in related videos below. 

 For an overview of my cancer work, watch How Not to Die from Cancer. 

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Explore Native American Cuisine with Chef Lois Ellen Frank Tue, 21 Nov 2023 13:00:09 +0000 Meet Chef Lois Ellen Frank, Ph.D. We had the pleasure of talking with her about food history, health, and culture. Read on and enjoy her recipe for Three Sisters Stew.

Tell us a little about your work.

Chef Walter Whitewater and I are based in Santa Fe, New Mexico, at Red Mesa Cuisine, a catering company specializing in the revitalization of ancestral Native American cuisine with a modern twist, using ingredients and preparing foods focused on health and wellness.

Together, we have worked with Native American communities in the Southwest of the United States for more than 30 years. I was honored to be the recipient of the Local Hero Olla Award, which recognizes an exceptional individual for the work they do to create healthy, innovative, vibrant, and resilient local sustainable food systems in New Mexico. Chef Walter and I work with the New Mexico Department of Health by providing training to cooks who work in Native communities. We also work with the Physicians Committee for Responsible Medicine (PCRM) on The Power to Heal Diabetes: Food for Life in Indian Country program. See for more.

What are the Three Sisters, and what significance do they have for Native Americans?

The Three Sisters are corn, beans, and squash. They are believed by a number of tribes to be gifts from the great spirit. The way these vegetables grow in the garden exemplifies the notion of interconnectedness, as do the nutrients they provide. They are three ingredients that Chef Walter and I use regularly and a foundation to a healthy ancestral Native American diet.

We recently learned about the “Magic Eight” from you. Could you describe what the “Magic Eight” foods are and their history?

The Magic Eight are corn, beans, squash, chiles, tomatoes, potatoes, vanilla, and cacao. They are eight foods that did not exist anywhere outside of the Americas prior to European contact in 1492. If we deconstruct that, it means that the Italians did not have the tomato, the Irish did not have the potato, there were no chiles in any Asian, East Indian, or African cuisine, and there was no confection using either vanilla or chocolate. These are truly indigenous Native American foods that were given to the rest of the world and are now woven into the identities of so many cuisines. The Magic Eight are the focus of our cookbook, Seed to Plate, Soil to Sky: Modern Plant-Based Recipe Using Native American Ingredients, which was published by Hachette Book Group this summer.

What are your go-to favorite whole food, plant-based, oil-free meals? 

Yesterday, I made a Three Sisters enchilada. I combined savory refried pinto beans with zucchini squash and corn kernels, which I put into a corn tortilla and topped with a red chile sauce, green onions, and some of the sautéed squash and corn. It was delicious. Another favorite is a poblano chile stuffed with quinoa, mushroom, and spinach, which I serve with an heirloom tomato sauce that I can myself every year so I can use it throughout the winter months. Chef Walter loves to use corn and makes a traditional dish called Navajo Kneel Down Bread (Nitsidigo’i), which is sweet corn baked inside a fresh or dried corn husk. Chef Walter’s modern version adds dried currants, raisins, and fresh apples, foods that are readily accessible on the Navajo Nation in his community of Pinon, where he grew up.

Can you please tell us a little bit about your work with PCRM and its Native Food for Life program?

We have done a lot of work over the years with PCRM and its Native Food for Life program. Under its Native American resources, there are plant-based recipe booklets by Chef Walter and myself, as well as a lot of videos, other information, and recipes on healthy foods that are easy to make.

What message do you have for the Native American population regarding reclaiming their health through heritage?

I think that we all—all nations, all ethnicities, and all people—need to reclaim our health and wellness. In Native American communities, there is a movement to re-indigenize, reclaim, and revitalize the ancestral diet for health and wellness. This is a good thing, because when you eat the Magic Eight and other foods from the region of your own ancestors, you revitalize everything associated with those foods, including the land, techniques surrounding the foods, and agricultural practices, so that the knowledge surrounding these practices can be passed on from generation to generation.

Three Sisters Stew

makes 4 to 6 servings

Chef Walter and I originally made this recipe on the Navajo Reservation in the town of Pinon, Arizona, where he was raised. It has been made for numerous family gatherings and ceremonies. For this version, I’ve added zucchini instead of meat. The squash makes this stew hearty without being heavy. This recipe is great because you can make it to feed four to six people, or you can add to it and make enough to feed sixty to six hundred.

1 tablespoon bean juice
½ large yellow onion, chopped (approximately 1 cup)
½ green bell pepper, seeded and chopped (approximately ½ cup)
1 zucchini, cut into small cubes (approximately 1½ cups)
2 teaspoons blackened garlic
1 can (14.5 ounces) diced tomatoes,
no salt added if possible
1½ cups cooked organic dark red kidney beans (or one 15-ounce can)
1½ cups cooked organic pinto beans (or one 15-ounce can)
1 cup corn kernels, fresh or frozen
1½ tablespoons New Mexico red chile powder, mild
1 teaspoon New Mexico red chile powder, medium (optional, for a slightly hotter stew)
¼ teaspoon black pepper, or to taste
¼ teaspoon dried thyme
¼ teaspoon dried oregano
4 cups water or bean juice

Preheat a cast-iron soup pot or heavy bottomed metal soup pot over medium-high heat. Add the bean juice and heat until hot. Add the onions, sauté for approximately 3 minutes until translucent, stirring to prevent burning. Add the bell pepper and sauté for another 3 minutes, stirring to prevent burning. 

Add the zucchini and sauté for another 3 minutes. You want the vegetables to caramelize and begin to turn brown. The bottom of the pan may begin to turn brown, but this is part of the caramelization process. Add the garlic and cook for another minute, stirring to prevent burning and to incorporate into the other ingredients.

Add the tomatoes. Cook for another 2 minutes, stirring constantly. Add the kidney beans, pinto beans, corn, mild chile powder, and medium chile powder (if you want a spicier stew), black pepper, thyme, and oregano, then mix well. Add the water, bring to a boil, then reduce heat and let simmer for 25 minutes, stirring occasionally. Taste and adjust seasonings, if desired. Remove from heat and serve immediately.

Note: Fresh thyme and fresh oregano can be used if available. Simply double the amount from ¼ teaspoon of each to ½ teaspoon of each. I usually buy herbs fresh if they are available, and if I have leftover herbs from whatever I am cooking, I dry them on a sheet tray in my pantry and then put them into glass jars for future use.

Excerpted from Seed to Plate, Soil to Sky: Modern Plant-Based Recipes Using Native American Ingredients by Lois Ellen Frank. Copyright © 2023. Available from Hachette Go, an imprint of Hachette Book Group, Inc.

You can find Chef Lois Ellen Frank here.

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Can You Lose Weight with Pills? Thu, 16 Nov 2023 13:00:17 +0000 Studies show that many doctors either tend to overestimate the amount of weight that can be lost with obesity drugs or are simply clueless.

Current options for weight-loss medications include the ridiculously named Qsymia, a combination of phentermine (the phen in fen-phen) and topiramate, a drug that can cause seizures if you stop it abruptly. Qsymia was “explicitly rejected multiple times for safety reasons in Europe “because of concerns about the medicine’s long-term effects on the heart and blood vessels” but, at the time of making my video Are Weight Loss Pills Effective?, remains available for sale in the United States. Belviq is in a similar boat—allowed in the United States but not in Europe due to “concerns about possible cancers, psychiatric disorders, and heart valve problems…”  

Belviq is sold in the United States for about $200 a month. If you think that’s a lot, there’s Saxenda, which requires daily injections and is listed at the low, low price of only $1,281.96 for a 30-day supply. It carries a black box warning, the FDA’s strictest caution about potentially life-threatening hazards, for thyroid cancer risk. Paid consultants and employees of the company that makes it argue the greater number of breast tumors found among drug recipients may be due to “enhanced ascertainment,” meaning easier breast cancer detection just due to the drug’s effectiveness. 

Contrave is another option if you ignore its black box warning about a potential increase in suicidal thoughts. Then there’s Alli, the drug that causes fat malabsorption, thereby resulting in side effects “including fecal urgency, oily stool, flatus with discharge, and fecal incontinence”—Alli can be your ally in anal leakage. The drug evidently “forces the patient to use diapers and to know the location of all the bathrooms in the neighborhood in an attempt to limit the consequences of urgent leakage of oily fecal matter.” A Freedom of Information Act exposé found that although company-sponsored studies claimed that “all adverse events were recorded,” one trial apparently conveniently failed to mention 1,318 of them. 

What’s a little bowel leakage, though, compared to the ravages of obesity? As with anything in life, it’s all about risks versus benefits. However, in an analysis of more than a hundred clinical trials of anti-obesity medications that lasted up to 47 weeks, drug-induced weight loss never exceeded more than nine pounds. That’s a lot of money and a lot of risk for just a few pounds. Since you aren’t treating the underlying cause—a fattening diet—when people stop taking these drugs, the weight tends to come right back, so you’d have to take them every day for the rest of your life. But people do stop taking them. Using pharmacy data from a million people, most Alli users stopped after the very first purchase and most Meridia users didn’t even make it three months. Taking weight-loss meds is so disagreeable that 98 percent of users stopped taking them within the first year. 

Studies show that many doctors tend to overestimate the amount of weight that can be lost with these drugs or are simply clueless. One reason may be that some clinical practice guidelines go out of their way to advocate prescribing medications for obesity. Are they seriously recommending drugging a third of Americans—more than 100 million people? You may not be surprised to learn that the principal author of the guidelines has a “significant financial interest or leadership position” in six separate pharmaceutical companies that all (coincidently) work on obesity drugs. In contrast, independent expert panels, like the Canadian Task Force on Preventive Health Care, explicitly recommend against weight-loss drugs, given their poor track record of safety and efficacy. 

In case you missed my related video, check out Are Weight Loss Pills Safe?.

As with all lifestyle diseases, it’s better to treat the underlying cause, which, in the case of obesity, is a fattening diet. For an example of what’s possible with a healthy diet intervention, see Flashback Friday: The Weight Loss Program That Got Better with Time. 

Check out the related videos below for more about weight loss. 

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Is It Safe to Take Weight-Loss Pills? Tue, 14 Nov 2023 13:00:33 +0000 Why don’t more people take the weight-loss medications currently on the market? 

Despite the myriad menus of FDA-approved medications for weight loss, they’ve only been prescribed for about 1 in 50 patients with obesity. We tend to worship medical magic bullets in the United States, so what gives? As I discuss in my video Friday Favorites: Are Weight-Loss Supplements Safe and Effective?, one of the reasons anti-obesity drugs are so “highly stigmatized is that, historically, they’ve been anything but magical and the bullets have been blanks—or worse.

To date, most weight-loss drugs that were initially approved as safe have since been pulled from the market for unforeseen side effects that turned them into a “threat to public health.” As you may remember from my video Brown Fat: Losing Weight Through Thermogenesis, it all started with DNP, a pesticide with a promise to safely melt away fat that melted away people’s eyesight instead. (That actually helped lead to the passage of the landmark Food, Drug, and Cosmetic Act in 1938.) Thanks to the internet, DNP has made a comeback with “predictably lethal results.” 

Then came the amphetamines. Currently, more than half a million Americans may be addicted to amphetamines like crystal meth, but the “original amphetamine epidemic was generated by the pharmaceutical industry and medical profession.” By the 1960s, drug companies were churning out about 80,000 kilos of amphetamines a year, which is nearly enough for a weekly dose for every man, woman, and child in the United States. Billions of doses a year were prescribed for weight loss, and weight-loss clinics were raking in huge profits. A dispensing diet doctor could buy 100,000 amphetamine tablets for less than $100, then turn around and sell them to patients for $12,000.  

At a 1970 Senate Hearing, Senator Thomas Dodd (father of “Dodd-Frank” Senator Chris Dodd) suggested that America’s speed freak problem “was no by means an ‘accidental development’: ‘Multihundred million dollar advertising budgets, frequently the most costly ingredient in the price of a pill, have, pill by pill, led, coaxed and seduced post-World War II generations into the ‘freaked-out’ drug culture…’” I’ll leave drawing the Big Pharma parallels to the current opioid crisis as an exercise for the viewer.  

Aminorex was a widely-prescribed appetite suppressant before it was pulled for causing lung damage. Eighteen million Americans were on fen-phen before it was pulled from the market for causing severe damage to heart valves. Meridia was pulled for heart attacks and strokes, Acomplia was pulled for psychiatric side effects, including suicide, and the list goes on, as you can see below and at 2:51 in my video. 

The fen-phen debacle resulted in “some of the largest litigation pay-outs ever seen in the pharmaceutical industry, with individual amounts of up to US$200,000 and a total value of ~US$14 billion,” but that’s all baked into the formula. If you read the journal PharmacoEconomics (and who doesn’t!), you may be aware that a new weight-loss drug may injure and kill so many that “expected litigation cost” could exceed $80 million, but Big Pharma consultants estimate that if it’s successful, the drug could bring in more than $100 million, so do the math. 

What does work for weight loss? I dive deep into that and more in How Not to Diet.  For more of my videos on weight loss, check out the related videos below. 

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Tap, Filtered, or Bottled Water? Thu, 09 Nov 2023 13:00:44 +0000 There are disinfection byproducts in tap water. What happened when Brita, PUR, ZeroWater, and refrigerator water filters were put to the test? 

Though many distrust the safety of tap water, a study of 35 brands of bottled water did not find them to be necessarily safer, cleaner, or of a higher quality than water straight out of the faucet. How much is that saying, though? Two studies published in the 1970s “changed forever the earlier perspective that drinking water safety was only about waterborne disease.” In fact, it was our fight against microbial contaminants that led to a new kind of contamination—in the form of disinfection byproducts.  

The two landmark papers in 1974 solved the mystery of the source of chloroform in drinking water: We met the enemy, and he is us. The chlorination of drinking water—“disinfection [that] is crucial for maintaining the microbiological safety of water”—was interacting with natural organic matter from the water’s source and creating chlorinated compounds that can not only result in off-flavors and smells but also pose a potential public health risk. More than 600 disinfection byproducts have been identified so far. 

After decades of research into the matter, it appears that the life-long ingestion of chlorinated drinking water results in “clear excess risk” for bladder cancer. There is also some evidence of increased risk of certain types of birth defects, but most of the concern has focused on the bladder cancer link. Forty years of exposure may increase your odds of bladder cancer by 27 percent. The Environmental Protection Agency estimated that 2 to 17 percent of bladder cancer cases in the United States are due to these disinfection byproducts in drinking water. However, this assumes the link is one of cause and effect, which has yet to be firmly established. 

The best way to reduce risk is to treat the cause. Countries could prevent the formation of disinfection byproducts in the first place through the better initial removal of source water’s “natural organic matter” (what my grandmother would have called schmutz). Some countries in Europe, such as Switzerland, the Netherlands, Austria, and Germany, have newer, well-maintained drinking water systems that can distribute tap water free from residual disinfectants, but the cost to upgrade the infrastructure of even a small city in the United States could run in the tens of millions of dollars. As the tragedy in Flint, Michigan, revealed, we seem to have trouble keeping even frank toxins out of the tap. 

Nearly 40 percent of Americans use some sort of water purification device. I look at the comparisons of these devices in my video Is It Best to Drink Tap, Filtered, or Bottled Water?. Tap water from Tucson, Arizona, was pitted head-to-head against two of the most common purification approaches—pour-through pitchers and refrigerator filters. As you can see in the graph below and at 2:53 in my video, both fridge filters (GE and Whirlpool) did similarly well, removing more than 96 percent of trace organic contaminants, and edging out the three pitcher filters. ZeroWater caught 93 percent, and PUR pitchers got 84 percent. By the time the filters needed to be replaced, Brita was only catching 50 percent. A similar discrepancy was found between filters from PUR and Brita tested specifically against disinfection byproducts. They both started out about the same at the beginning, but by the end of the filter’s life, PUR appeared to do better, as you can see below and at 3:15 in my video. Reverse osmosis systems can work even better, but the cost, water waste, and loss of trace minerals don’t seem worth it.  

As you can see below and at 3:40 in my video, the annual cost for purifying your water with a pitcher or fridge filter was calculated to be about the same, at only around a penny per cup—with the exception of the ZeroWater brand, which is up to four times more expensive. 

I always figured the “change by” dates on filters were just company scams to get you to buy more replacements, but I was wrong. Because I drink filtered water mostly just for taste, I used to wait until the water started tasting funky. Bad idea. Not only do the filters eventually lose some of their removal capacity, but bacterial growth can build up inside them, resulting in your “filtered” water having higher bacterial counts than water straight out of the tap. You’d be actually making your water dirtier rather than cleaner, so it is important to replace filters regularly. 

As an aside, I used to think the same about the advice to change your toothbrush every three months. Which Big Brush executive thought that one up? But, no, I was wrong again. Toothbrushes can build up biofilms of tooth decay bacteria or become breeding grounds for bacteria to flume into the air with each toilet flush before going back into our mouths. Fun fact: A single flush can spew up “millions of bacteria into the atmosphere” that can settle on your nice, moist toothbrush. The good news is that rather than buying new brushes, you can disinfect the head of your toothbrush with as little as a ten-minute soak in white vinegar or, even more frugally, vinegar diluted by half with water.  

Hydration is important. See related videos below for more information. 

Avoiding waterborne pollutants if possible is also important. See my videos Lead in Drinking Water and Friday Favorites: Benefits of Turmeric for Arsenic Exposure. 

How Many Glasses of Water Should We Drink a Day? Watch the video to find out. 

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Say No to Fish for Five Years Before Pregnancy Tue, 07 Nov 2023 13:00:19 +0000 Advisories telling pregnant women to cut down on fish consumption may be too late for certain persistent pollutants.

If you intentionally expose people to mercury by feeding them fish (like tuna) for 14 weeks, the level of mercury in their bloodstream goes up, as you can see in the graph below and at 0:14 in my video Avoiding Fish for Five Years Before Pregnancy. As soon as they stop eating fish, it drops back down such that they can detox by half in about 100 days. (So, the half-life of total mercury in our blood is approximately 100 days.) Even if you eat a lot of fish, within a few months of stopping, you can clear much of the mercury out of your blood. But what about your brain? 

The results from modeling studies are all over the place, providing “some extreme estimates (69 days vs. 22 years).” When put to the test, though, autopsy findings suggest the half-life may be even longer still at 27.4 years. Once mercury gets in our brains, it can be decades before our body can get rid of even half of it. So, better than detoxing is not “toxing” in the first place. 

That’s the problem with advisories that tell pregnant women to cut down on fish intake. For pollutants with long half-lives, such as PCBs and dioxins, “temporary fish advisory-related decreases in daily contaminant intake will not necessarily translate to appreciable decreases in maternal POP [persistent organic pollutant] body burdens,” which help determine the dose the baby gets. 

Consider this: As you can see in the graph below and at 1:32 in my video, an infant may be exposed to a tumor-promoting pollutant called PCB 153 if their mom ate fish. But if mom ate only half the fish or no fish at all for one year, levels wouldn’t budge much. A substantial drop in infant exposure levels may only be seen if the mom had cut out all fish for five years before getting pregnant. That is the “fish consumption caveat.” “[T]he only scenarios that produced a significant impact on children’s exposures required mothers to eliminate fish from their diets for 5 years before their children were conceived. The model predicted that substituting produce for fish would reduce prenatal and breastfeeding exposures by 37% each and subsequent childhood exposures by 23%.” So, “a complete ban on fish consumption may be preferable to targeted, life stage–based fish consumption advisories…” 

If you are going to eat fish, though, which is less polluted—wild-caught or farmed fish? In a recent study, researchers measured the levels of pesticides, such as DDT, PCBs, polycyclic aromatic hydrocarbons, and toxic elements, such as mercury and lead, in a large sample of farmed and wild-caught seafood. In general, they found that farmed fish were worse. Think of the suspect as farmed and dangerous. The measured levels of most organic and many inorganic pollutants were higher in the farmed seafood products and, consequently, so were the intake levels for the consumer if such products were consumed. For example, as you can see in the graphs below and at 3:09 in my video, there was significantly more contamination by polycyclic hydrocarbons, persistent pesticides, and PCBs in all of the farmed fish samples, including the salmon and seabass (though it didn’t seem to matter for crayfish), and the wild-caught mussels were actually worse. If you split adult and child consumers into those only eating farmed seafood or only eating wild-caught seafood, the level of pollutant exposure was significantly worse with the farmed seafood.  

Overall, the researchers, who were Spanish, investigated a total of 59 pollutants and toxic elements. They concluded: “Taking all these data as a whole, and based on the rates of consumption of fish and seafood of the Spanish population, our results indicate that a theoretical consumer who chose to consume only aquaculture [farmed] products would be exposed to levels of pollutants investigated about twice higher than if this theoretical consumer had chosen only products from extractive fisheries [wild-caught fish].” So, when it comes to pollutants, you could eat twice the amount of fish if you stuck to wild-caught. That’s easier said than done, though. Mislabeling rates for fish and other seafood in the United States are between 30 and 38 percent, so the average fraud rate is around one in three.  

In my previous video on this topic, How Long to Detox from Fish Before Pregnancy, I mentioned a study that suggests detoxing from fish for one year to lower mercury levels, but other pollutants take longer to leave our system. 

For optimum brain development, consider a pollutant-free source of omega-3 fatty acids. Check out Should Vegan Women Supplement with DHA during Pregnancy?. 

Aside from pollutants, there are other reasons we may want to avoid excessive amounts of animal protein. See Flashback Friday: The Effect of Animal Protein on Stress Hormones, Testosterone, and Pregnancy.

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Does Chewing Gum Burn Calories? Thu, 02 Nov 2023 12:00:11 +0000 What are the effects of chewing gum on hunger and appetite?  

“Horace Fletcher,” proclaimed one of his obituaries in 1919, “taught the world to chew.” Also known as the “Great Masticator,” Fletcher was a health reformer who popularized the idea of chewing each mouthful more than 32 times—“once for every tooth.” It wasn’t put to the test, though, until nearly a century later. In that study, participants were told to eat pasta until they felt “comfortably full” and were randomized to chew each mouthful either 10 times or 35 times before swallowing. The subjects were told the study was about the effects of chewing on mood, but that was just a ruse. The researchers really wanted to know whether prolonged chewing reduced food intake. And, as it turned out, those who chewed more felt full earlier than those who chewed less, such that they ended up eating about a third of a cup less pasta overall. 

If chewing suppresses the appetite in some way, what about chewing gum as a weight-loss strategy? As I discuss in my video How Many Calories Do You Burn Chewing Gum?, an article entitled “Benefits of Chewing Gum” suggested as much by saying that it “may be a useful behavior modification tool in appetite control and weight management,” but it was co-written by the executive director of The Wrigley Science Institute and a senior manager at the Wm Wrigley Jr Company. Why don’t we see what the unbiased science says? 

Big Gum likes to point to a letter published in 1999 in The New England Journal of Medicine. In it, Mayo Clinic researchers claimed that chewing gum could burn 11 calories an hour. Critics pointed to the fact that they didn’t really test “typical” gum chewing; they instead tested chewing the equivalent of four sticks of gum “at a very rapid cadence.” Specifically, the participants were told to chew at a frequency of exactly 100 Hertz (Hz) “with the aid of a metronome” for 12 minutes. That seemed to burn 2.2 calories, hence, potentially 11 calories an hour. 

One might have had more confidence in the Mayo scientists’ conclusion had they not lacked a fundamental understanding of basic units. As defined by Merriam-Webster, hertz is a unit of frequency equal to one cycle per second, so 100 Hz would mean 100 chews per second. (That would be a very rapid cadence!) If it’s true that 11 calories may be burned an hour, though, that means you could burn more calories actively chewing gum while sitting in a chair than you would if you weren’t chewing gum while upright at a standing desk. 

In fact, as you can see in the graph below and at 2:24 in my video, chewing one small piece of gum at your own pace may only burn about three calories an hour, which would approximate the calorie content of the sugar-free gum itself. However, chewing off the calories of a piece of sugar-sweetened gum might take all day. What about the purported appetite-suppressing effect of all that chewing, though? 

The results from studies on the effects of chewing gum on hunger are all over the place. For example, as you can see in the graph below and at 2:50 in my video, one showed decreased appetite, another showed no effect, and yet another even showed significantly increased hunger in women after chewing gum. The more important question, though, is whether there are any changes in subsequent calorie intake. Again, the findings are mixed. 

One study, as you can see in the graph below and at 3:12 in my video, even found that while chewing gum didn’t impact M&M consumption much, it did appear to decrease the consumption of healthy snacks. Interesting, but the researchers used mint gum, and the healthy snacks included mandarin orange slices. So, that may have just been an orange juice-after-tooth-brushing effect.  

It can take an hour before the residual taste effect of mint toothpaste dissipates. This is bad if it cuts your fruit intake, but what about harnessing this power against Pringles? An international group of researchers had people eat Pringles potato chips for 12 minutes, interrupting them every 3 minutes to swish with a menthol mouthwash. As you can see in the graph below and at 3:50 in my video, compared to those in the control groups (swishing with water or nothing at all), the minty mouthwash group cut their consumption by 29 percent. The researchers concluded: “If a consumer finds themselves snacking on too many crisps [potato chips] during a given eating occasion, one potential strategy could be intervening by having a peppermint tea, menthol flavoured chewing gum, or brushing their teeth, to slow down or stop snacking.” 

What we’re wondering about, though, is weight loss. Even if a little tweak like chewing gum can affect the consumption of a single snack, your body could just compensate by eating more later in the day. The only way to know for sure if chewing gum can be used as a weight-loss hack is to put it to the test, which I cover in my video Does Chewing Gum Help with Weight Loss? 

For more information on calories and weight loss, check out related videos below. 

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Cannabis on Fertility and Pregnancy Tue, 31 Oct 2023 12:00:04 +0000 Pregnant and breastfeeding women should probably be advised to either decrease or, when possible, cease cannabis use entirely, and couples trying to conceive may also want to consider cutting down. 

Approximately one in six couples “are unable to conceive after a year and are labeled infertile, with a male factor identified in up to half of all cases.” Several lifestyle factors have been associated with diminished sperm production, such as smoking cigarettes, but what about smoking cannabis? 

“Regular marijuana smoking more than once per week was associated with a 28%…lower sperm concentration,” as well as a lower total sperm count based on a study of more than a thousand men, but “no adverse association was found for irregular use” of less than once a week.  

As I discuss in my video The Effects of Marijuana on Fertility and Pregnancy, this wasn’t a randomized study, so other factors that go along with regular marijuana use may have been to blame. Researchers did take into account cigarettes, alcohol, other drugs, STDs, and things like that, but there’s always a possibility there was something else for which they didn’t control. 

Findings were similar for women. Hundreds of infertile couples were studied in California, and, just as men had about a quarter fewer sperm, a quarter fewer eggs were retrieved from women who used cannabis more than 90 times in their lifetime or had been using the year before. Again, there could have been confounding factors, but until we know more, couples who are trying to conceive may want to make the joint decision to turn over a new leaf.  

What about during pregnancy? As you can see below and at 1:39 in my video, medical authorities recommend that “women who are pregnant or contemplating pregnancy should be encouraged to discontinue marijuana use” and not use it during pregnancy or lactation, though the Academy of Breastfeeding Medicine suggests the known benefits of breastmilk currently outweigh any potential harms for women who continue to smoke it. Despite these warnings from authorities, marijuana use has increased among pregnant women in recent years, going up by more than 60 percent, but that’s only from about 2.5 percent up to less than 4 percent, which is less than half the frequency of nonpregnant women. 

Why are OB/GYNs so down on getting high? Scary articles appear in the American Journal of Obstetrics and Gynecology, like one making claims that a “large study conducted by the US National Birth Defects Prevention Center documented a significantly increased risk for anencephaly [a serious birth defect] when the fetus is exposed to marijuana during the first month of gestation.” But, if you don’t just take their word for it and pull up the actual study, you’ll see that the association wasn’t statistically significant after all. As one letter to the editor was titled, “Marijuana and Pregnancy: Objective Education Is Good, but Biased Education Is Not.”  

Some risks have been identified: Infants “were more likely to be anemic, and…have lower birth weight and to require placement in neonatal intensive care than infants of mothers who did not use marijuana.” However, it’s “difficult to determine the direct effects of maternal cannabis use on the developing fetus” because of a variety of confounding factors for which studies may not be able to completely control. 

Studies also show links between prenatal marijuana exposure and learning problems later in life—manifesting years later in school—and that’s where the greater concern lies, on the potential long-term effects on brain development. So, even after “weeding out the myths,” there is enough concern that “pregnant and breastfeeding cannabis users should be identified early and advised to either decrease or where possible cease cannabis use entirely.” 

When do I mean by cut down “when possible?” Check out my video Natural Treatments for Morning Sickness to see how marijuana use during pregnancy can sometimes be a lifesaver. 

I originally released several videos on cannabis in a webinar and downloadable digital DVD. If you missed any of them, they are listed in the related videos below.  

For more on fertility, check out Male Fertility and Diet and Dairy Estrogen and Male Fertility. 

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Chewing Gum for Weight Loss? Thu, 26 Oct 2023 12:00:18 +0000 If extra chewing is effective in suppressing your appetite when it comes to food, what about chewing gum as a weight-loss strategy? 

As I discuss in my video Does Chewing Gum Help with Weight Loss?, chewing gum may only burn about three calories an hour, but the calorie expenditure isn’t only working your little jaw muscles. For some reason, chewing gum revs up your heart rate as much as 12 extra beats per minute after chewing two sticks of gum, even if you’re just sitting quietly, as you can see in the graph below and at 0:21 in my video. It also works while walking, increasing your heart rate by about three more beats per minute (and proving scientifically that people can indeed walk and chew gum at the same time). 

Does this translate into weight loss? Researchers at the University of Buffalo asked study participants to either chew gum before every single eating occasion or not chew any gum at all for a number of weeks. On the gum-chewing weeks, the subjects didn’t just have to chew gum before each meal, but also before each snack or drink that contained any calories. That may have been too much, so the participants actually ended up eating on fewer occasions, switching from four meals a day on average down closer to three. They ended up eating more calories at each of those fewer meals, though, and had no overall significant change in caloric intake and, no surprise, had no change in weight. See the charts below and at 1:08 in my video. 

University of Alabama researchers tried a different tack, randomizing people to chew gum after and between meals. After two months, compared to those randomized to avoid gum entirely, no improvements were noted in weight, body mass index (BMI), or waist circumference. However, some studies have suggested that chewing gum has an appetite-suppressing effect. For example, as you can see below and at 1:51 in my video, in one study, people ate 68 fewer calories of pasta at lunch after 20 minutes of chewing gum, but other studies have shown differently. 

Whenever there are conflicting findings, instead of just throwing up our hands, it can be useful to try to tease out any study differences that could potentially account for the disparate results. The obvious consideration is the funding source. That failed University of Alabama weight-loss study was funded by a gum company, so the outcomes are not necessarily predetermined. 

As well, different types of gum using different sweeteners may have contributed to the diversity of findings. As you can see in the graphs below and at 2:35 in my video, a study that found that chewing gum may actually increase appetite was done with aspartame-sweetened gum. People reported feeling hungrier after chewing the sweetened gum—and not only compared to no gum, but compared to chewing the same gum with no added aspartame. It’s true that not one randomized controlled trial has ever shown a benefit to “chewing gum as a strategy for weight loss,” but they all used gum containing artificial sweeteners.

There was a landmark study that showed that the size of a sip matters when it comes to reducing the intake of sweet beverages. When study participants took one sip every two seconds or a quadruple-sized gulp every eight seconds, but with the same ingestion rate of 150 grams per minute, the smaller sip group won out, satiating after about one-and-a-half cups compared to two cups when taking larger gulps, as you can see in the graph below and at 3:13 in my video. This is thought to be because of increased oro-sensory exposure, so our brain picks up the more frequent pulses of flavor and calories. But repeat the experiment with an artificially sweetened diet drink, and the effect appears to be blunted, as you can see in the graph below and at 3:38 in my video. So, might a different type of gum have a different effect? The positive pasta study I discussed earlier was performed using gum sweetened mainly with sorbitol, a sweet compound that’s found naturally in foods like prunes, and, like prunes, can have a laxative effect.

Case reports like “An Air Stewardess with Puzzling Diarrhea” unveil what can happen when you have 60 sticks of sorbitol-sweetened sugar-free gum a day. Another report was entitled “Severe Weight Loss Caused by Chewing Gum.” A 21-year-old woman ended up malnourished after suffering up to a dozen bouts of diarrhea a day for eight months due to the 30 grams of sorbitol she was getting chewing sugar-free gum and candies every day. Most people suffer gas and bloating at 10 daily grams of sorbitol, which is about eight sticks of sorbitol-sweetened gum, and, at 20 grams, most get cramps and diarrhea. So, you want to be careful how much you get. 

The bottom line is that we have no good science showing that chewing gum results in weight loss. Could that be because the studies used artificial sweeteners that “may have counteracted” any benefits? Maybe, but the most obvious explanation for the results to date “is that chewing gum simply is not an efficacious weight-loss strategy”—and that’s coming from researchers funded by the gum company itself. 

How Many Calories Do You Burn Chewing Gum? Watch the video to find out. For information on both artificial and natural low-calorie sweeteners, check out the related videos below.

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Diabetes Associations Recognize Plant-Based Diets Tue, 24 Oct 2023 12:00:42 +0000 Plant-based diets are the single most important—yet underutilized—opportunity to reverse the pending obesity and diabetes-induced epidemic of disease and death.

Dr. Kim Williams, immediate past president of the American College of Cardiology, started out an editorial on plant-based diets with the classic Schopenhauer quote: “All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident.” In 2013, plant-based diets for diabetes were in the “ridiculed” stage in the official endocrinology practice guidelines and placed in the “Fad Diets” section. The guidelines acknowledged that strictly plant-based diets “have been shown to reduce the risk for T2DM [type 2 diabetes] and improve management of T2DM” better than the American Diabetes Association recommendations, then inexplicably went on to say that it “does not support the use of one type of diet over another” with respect to diabetes or in general. “The best approach for a healthy lifestyle is simply the ‘amelioration of unhealthy choices’”—whatever that means. 

But, by 2015, the clinical practice guidelines from the same professional associations explicitly endorsed a plant-based diet as its general recommendation for diabetic patients. The times they are a-changin’! 

As I discuss in my video Plant-Based Diets Recognized by Diabetes Associations, the American Diabetes Association itself is also now on board, listing plant-based eating as one of the dietary patterns acceptable for the management of the condition. The Canadian Diabetes Association, however, has really taken the lead. “Type 2 diabetes mellitus is considered one of the fastest growing diseases in Canada, representing a serious public health concern,” so it isn’t messing around and recommends plant-based diets for disease management “because of their potential to improve body weight and A1C [blood sugar control], LDL-cholesterol, total cholesterol and non-HDL-cholesterol levels, in addition to reducing the need for diabetes medications.” The Canadian Diabetes Association uses the Kaiser Permanente definition for that eating pattern: “a regimen that encourages whole, plant-based foods and discourages meats, dairy products and eggs, as well as all refined and processed foods,” that is, junk. 

It recommends that diabetes education centers in Canada “improve patients’ perceptions of PBDs [plant-based diets] by developing PBD-focused educational and support as well as providing individualized counseling sessions addressing barriers to change.” The biggest obstacle identified to eating plant-based was ignorance. Nearly nine out of ten patients interviewed “had not heard of using a plant-based diet to treat or manage T2DM.” Why is that? “Patient awareness of (and interest in) the benefits of a plant-based diet for the management of diabetes…may be “influenced by the perception of diabetes educators and clinicians.” Indeed, most of the staff were aware of the benefits of plant-based eating for treating diabetes, yet only about one in three were recommending it to their patients.  

Why? One of the common reasons given was they didn’t think their patients would eat plant-based, so they didn’t even bring it up, but “[t]his notion is contrary to the patient survey results that almost two-thirds of patients were willing” to at least give it a try. The researchers cite the PCRM Geico studies I’ve covered in other videos, in which strictly plant-based diets were “well accepted with over 95% adherence rate,” presumably because the study participants just felt so much better, reporting “increased energy level, better digestion, better sleep, and increased satisfaction when compared with the control group.” 

A number of staff members also expressed they were unclear about the supportive scientific evidence as their second reason for not recommending this diet, but it’s been shown to be more effective than an American Diabetes Association–recommended diet at reducing the use of diabetes medications, long-term blood sugar control, and cholesterol. It’s therefore possible that the diabetes educators were simply behind the times, as there is “a lag-time” in the dissemination of new scientific findings from the literature to the clinician and finally to the patient. Speeding up this process is one of the reasons I started 

As Dr. Williams put it, “the ‘truth’ (i.e., evidence) for the benefits of plant-based nutrition continues to mount. This now includes lower rates of stroke, hypertension, diabetes mellitus, obesity, myocardial infarction, and mortality [heart attacks and cardiac death], as well as many non-cardiac issues that affect our patients in cardiology, ranging from cancer to a variety of inflammatory conditions.” We’ve got the science. The bigger challenge is overcoming the “inertia, culture, habit, and widespread marketing of unhealthy foods.” He concludes, “Reading the existing literature and evaluating the impact of plant-based nutrition, it clearly represents the single most important yet underutilized opportunity to reverse the pending obesity and diabetes-induced epidemic of morbidity and mortality,” disease and death. 

I highlighted the PCRM Geico studies in my videos Slimming the Gecko and Plant-Based Workplace Intervention. 

Aren’t plant-based diets high in carbs? Get the “skinny” by checking out my video Flashback Friday: Benefits of a Macrobiotic Diet for Diabetes. 

To learn more about diet’s effect on type 2 diabetes, see the related videos below. 

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Can We Stop Tooth Decay? Thu, 19 Oct 2023 12:00:55 +0000 If sugar consumption is considered to be the one and only cause of cavities, can we have any sugar? How much is too much? 

Dental cavities may be humanity’s most prevalent disease, affecting 35 percent of the global population. The average number of decayed, missing, and filled teeth has been estimated at more than two by the age of 12. In the United States, the oral health of our elderly may also be in a state of decay, with one in four missing all of their teeth. “In terms of economic costs,” it is estimated that $100 billion is spent on dental diseases due to sugar consumption.  

As I discuss in my video How to Stop Tooth Decay, sugar consumption is considered to be the one and only cause of cavities. It is often referred to as a multifactorial condition, with other factors including bacteria, plaque, saliva, brushing, and flossing. However, those factors appear to have only mitigating influences. All of those other factors simply modify the speed by which sugar causes cavities. “Without sugars, the chain of causation is broken, so the disease does not occur.” 

“Numerous studies from decades ago showed that in countries where sugar consumption was very low, dental caries [cavities] was almost non-existent,” and “new analyses show that the life-long burden of caries increases as sugar intakes increase from 0%E [zero]…The most comprehensive national data are from…Japan…before, during and after World War II,” where the incidence of cavities tracked per capita sugar intake as it dropped from about 8 percent of calories down to just 0.1 percent, which is less than a teaspoon a week, before rebounding up to about 14 percent. Such studies show that cavities continued to occur even when sugar intake comprised only 2 to 3 percent of caloric intake. Given that more extensive disease in adults doesn’t appear to manifest if sugar intakes are limited to less than 3 percent of caloric intake, a public health goal to limit sugar intake to below 3 percent has been recommended. This led to the suggestion that traffic-light food labels be used to mark anything above 2.5 percent added sugars as “high.” That would make even comparatively low-sugar breakfast cereals such as Cheerios “red-light” foods. 

The recommended 3 percent cap on total daily intake of added sugars wouldn’t even allow for young children to have a single average serving of any of the top ten breakfast cereals most heavily advertised to them, which you can see below and at 2:21 in my video. Obviously, soda is off the table. One can of soda has nearly two days’ worth of added sugar. 

The American Academy of Pediatric Dentistry adopted the more pragmatic goal of recommending sugar intake stay below 5 percent for children and adolescents, matching the World Health Organization’s conditional recommendations for both children and adults. That’s about where added sugar consumption dropped in Iraq when they were under sanctions, and cavity rates were cut in half within just a few years. Of course, the sanctions may have cut other things, too, like the lifespan of children, though that was apparently fake news—a consequence of the “government of Iraq cleverly manipulating survey data to fool the international community.” 

If we were really interested in minimizing disease, the ideal goal would be to drop the intake of free sugars (meaning added sugars) to zero. These are not the sugars naturally found in breast milk or the intrinsic sugars in fruits. When it comes to the intake of added sugars, there does not seem to be a “threshold for sugars below which there are no adverse effects.” An exponential increase in cavity rates can begin for sugar intakes starting as low as 1 percent.  

A Kellogg’s-funded researcher agreed that we might be able to get rid of cavities if there was no sugar in the diet, but suggested that “this ideal is impractical.” The “dictatorial use of foods ‘friendly to the teeth’…might promote a philosophy of dietary celibacy…[that] would not be applicable or acceptable to all individuals.”  

“Instead of recommending draconian reductions in the amount of sugars intake,” the sugar industry responded that “attention would be better focused on…fluoride toothpaste.”  

That’s the perfect metaphor for medicine’s approach to lifestyle diseases in general. Why treat the cause when you can just treat the consequences? Why eat more healthfully to prevent and treat heart disease when we have all of these statins and stents? 

Not all sugars are created equal. To explore this topic, see my videos Flashback Friday: If Fructose Is Bad, What About Fruit? and Flashback Friday How Much Fruit Is Too Much?.

To gain a sense of how powerful the sugar industry is, check out my video Big Sugar Takes on the World Health Organization. 

For more on dental and oral health, see the related videos below. 

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Eating for Stroke Prevention Tue, 17 Oct 2023 12:00:38 +0000 Strokes are one of the leading causes of death and disability in the world. They are the most common cause of seizures in the elderly, the second most common cause of dementia, and a frequent cause of major depression. In short, stroke is a burdensome—but preventable––brain disorder.


What Causes a Stroke?

Strokes can kill instantly and without warning. Most can be thought of as “brain attacks”—like heart attacks, but with the rupturing plaques in our arteries cutting off blood flow to parts of the brain rather than parts of the heart.

Nearly 90 percent of strokes are ischemic, from the Latin ischaemia, meaning “stopping blood.” Blood flow to part of the brain gets cut off, depriving it of oxygen and killing off the part fed by the clogged artery. A small minority of strokes are hemorrhagic, caused by bleeding into the brain when a blood vessel bursts. People who experience a brief stroke may only contend with arm or leg weakness, while those who suffer a major stroke may develop paralysis, lose the ability to speak, or die.

The blood clot may last only a moment—not long enough to notice but still long enough to kill off a tiny portion of our brain. These “silent strokes” can multiply and slowly reduce cognitive function until dementia fully develops.


How to Prevent a Stroke

According to the Global Burden of Disease Study, the largest study of risk factors for human disease in history, funded in part by the Bill and Melinda Gates Foundation, more than 90 percent of the stroke burden is attributable to modifiable risk factors. For example, about 10 percent of all healthy years of life lost due to stroke may be due to ambient air pollution. Moving away from a city to a more rural area with cleaner air is an option to modify that risk factor, but it may be easier to quit smoking, which accounts for 18 percent of the stroke death and disability. As I discuss in my video What to Eat for Stroke Prevention, diets high in salt are as bad as smoking when it comes to stroke burden, but not as harmful as inadequate fruit and vegetable consumption. Other factors, like sedentary lifestyles, are at play, but they aren’t as bad as not eating enough whole grains, for instance.

As with heart disease, a plant-based diet can reduce stroke risk by reducing cholesterol and blood pressure, while improving blood flow and antioxidant capacity. Most of the studies on plant-based dietary patterns have found a protective effect against stroke, whereas those looking at Westernized eating habits based more on animal foods, added sugars, and fats have found a detrimental effect.

Yes, wrote the director of the Stroke Prevention & Atherosclerosis Research Centre, “learning to make vegetarian meals every other day is a tall order for most North Americans, but is feasible given tasty recipes and a positive attitude.”


What Foods Prevent a Stroke?

Fruit and vegetable consumption is associated with lower risk of about a dozen different diseases, including stroke. There appears to be a linear dose-response relationship, a straight-line association between eating more fruits and vegetables and lowering stroke risk. Researchers have suggested that the risk of stroke decreases by 32 percent for every 200-gram increase in fruit consumption, which is about one apple a day, and by 11 percent for each equivalent amount of vegetables eaten. Particularly potent are citrus fruits, apples, pears, and dark green leafy veggies, including one you can drink: the green leaves of green tea. Drinking three cups of green tea a day is associated with an 18 percent lower stroke risk.

graphs showing decrease in stroke risk with increase in fruit and vegetable intake

Garlic was tested head-to-head against a sugar pill and beat out placebo for preventing CIMT progression, the thickening of the major artery walls in the neck going up to the brain, a key predictor of stroke risk. For those in the placebo group, it continued to worsen, but not so for study participants in the garlic group who had been taking just a quarter teaspoon of garlic powder a day, which costs about a penny.

What about nuts? The original PREDIMED study found that an ounce a day of nuts, which is what I recommend in my Daily Dozen, helped to cut stroke risk nearly in half. When it was republished (after correcting for some irregularities in their randomization procedures), the reanalysis found the same results—the same 46 percent fall in stroke risk in the added nuts group, dropping the ten-year risk of stroke from about 6 percent down to 3 percent.

High fiber intake may also help ward off stroke. Fiber is naturally concentrated in only one place: whole plant foods. Processed foods have less, and animal-derived foods have no fiber at all. Increasing fiber intake by just seven grams a day may be associated with a 7 percent reduction in stroke risk.

Though stroke is considered an older person’s disease, risk factors may begin accumulating in childhood. Hundreds of kids were followed for 24 years, from junior high school to adulthood, and low fiber intake early on was associated with stiffening of the arteries leading up to the brain—a key risk factor.


Foods to Avoid to Prevent a Stroke

As I discuss in my video What Not to Eat for Stroke Prevention, when it comes to stroke risk, the worst foods appear to be meat and soda. Eating two sausage links for breakfast, a burger for lunch, and a pork chop for dinner and drinking a 20-ounce bottle of soda may increase stroke risk by 60 percent. Reviewers suggest the meat effect may be its saturated fat, cholesterol, iron-mediated oxidized fat, salt, or the TMAO. The carnitine in meat and the choline in dairy, seafood, and especially eggs are converted by our gut bacteria into trimethylamine, which is oxidized by our liver into TMAO, which may then contribute to heart attacks, stroke, and death.

graphs showing relationship between daily intake of red meat, processed meat, and sugar sweetened beverages and stroke risk

A 2019 study published in the Journal of the American Medical Association following tens of thousands of Americans for a median of about 17 years up to a maximum of 31 years found that “higher consumption of dietary cholesterol or eggs was significantly associated with higher risk of incident CVD [cardiovascular disease] and all-cause mortality, in a dose-response manner.” Those who ate more eggs or consumed more cholesterol in general appeared to live significantly shorter lives, on average, and the more eggs eaten, the worse it was, including for stroke risk.

And dairy? The bottom line is that dairy fat may be better than other animal fats, such as those found in meat, but something like whole grains would be better still. But you wouldn’t be doing yourself many favors if you simply swapped out dairy in favor of refined grains or added sugar. When it comes to stroke risk, vegetable fat is better than dairy fat, meat fat is the worst, whole grains are better, and fish fat, added sugars, or refined grains are statistically about the same.


Food for Thought

The good news is that stroke risk can be reduced substantially by an active lifestyle, cessation of smoking, and a healthy diet. All we have to do now is educate and convince people about the benefits that can be expected from healthy lifestyle and nutrition.

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Exploring Hispanic Cuisine with Sylvia Klinger Thu, 12 Oct 2023 12:00:15 +0000 Meet Sylvia Klinger. We had the pleasure of interviewing her about food history and culture. Read on and enjoy her recipe for Jicama Mango Salad.  


As an expert in cross-cultural Hispanic nutrition and health issues, how have you found food to tell a story and shape culture?
In our Hispanic culture, food is the essence of our life. It is what keeps us together. We are obsessed with the flavors, colors, and textures of our cuisine. Although our typical Hispanic cuisine includes different preparation and cooking methods, and ingredients and flavors vary from county to country, we quickly adapt and love all of the variations.

How do you inform people about the intersection of food, history, health, and culture?
I love teaching families and health professionals in the community how to cook our favorite dishes. It helps me to share the history of our cuisine and demonstrate the nutritional value of the foods we love. I teach them how to incorporate our favorite foods in a way that combines flavors and nutrition in quantities (portion sizes) for our age, gender, and activity level. 

What are some plant-based foods that are the foundations of Hispanic food traditions?
Plant-based foods are the foundation to our Latin foods, including all types of beans (for example, black, pinto, garbanzo, red, pigeon pea), vegetables (yuca, calabaza or pumpkin, zucchini, plantains, corn, tomatoes), fruits (tropical fruits, citrus fruits, passion fruit, coconut), grains (corn, amaranth, rice, tortillas), and nuts. It is my job as a dietitian-nutritionist to teach our communities about the amazing health benefits of our foods and the roles they play in the prevention of chronic disease. It’s easy, healthful, and delicious to season savory Latin foods with more onions, garlic, chiles, and fresh herbs instead of too much salt, and to flavor Latin desserts with more “canela” (cinnamon), vanilla, ginger, and citrus juices instead of adding too much sugar.

Do these foods or dishes have any significant meaning or history?
Absolutely! Many of our staple ingredients originated in Latin countries. Corn was first domesticated in Mexico by their native indigenous people hundreds of years ago, and chocolate’s history also began in Mexico, where the first cacao plants were found. No wonder many of the famous dishes in Mexico and neighboring countries have corn and chocolate! 

What do you envision as the way forward to encourage people to eat more fruits and vegetables and, in the West especially, return to traditional Hispanic eating patterns?
My mission is to encourage my Hispanic communities to continue eating the foods they love since a lot of them are highly nutritious and to add the foods and nutrients they are lacking. For example, Mexicans love fruits and vegetables, and even their snacks consist of fresh fruits and veggies. 

Please tell us a little bit about your work and career.
I am a dynamic global nutrition expert and a sought-after bilingual consultant, international speaker, communications professional, business owner, award-winning author, mentor, and board advisor for several associations and Fortune 500 companies. I am driven to empower communities toward better health outcomes through professional relationship building, health/nutrition program development, and strategic planning.

I have a relentless passion for understanding dietary behaviors, diet quality, and dietary patterns, as well as generating science-based evidence to develop timely strategies that promote a healthy lifestyle through dissemination of culturally relevant nutrition and health education programs for disease prevention and management. I draw my energy from my compassionate, family focus to help low-income communities establish healthy eating habits within their budget. 

Please tell us a little bit about your books.
I’ve published two books on providing a tasty, healthy, culturally-appropriate lifestyle for Hispanic populations, who face mounting health problems today. The award-winning Hispanic Family Nutrition: Complete Counseling Tool Kit for the Academy of Nutrition and Dietetics provides optimal wellness and nutrition counseling tools, and The Little Book of Simple Eating is filled with practical tips in both English and Spanish for achieving everyday optimal health.  

Jicama Mango Salad

1 garlic clove, minced
¼ cup fresh lemon juice
½ cup cilantro, chopped
2 cups jicama, peeled and julienned
3 cups mangos, peeled and sliced
1 jalapeno, seeded and diced
1 cup red onion, peeled and minced
Zest of 1 orange
Orange pieces to taste
Lemon zest to taste
Lemon pepper to taste
Black pepper to taste
Sliced radishes (optional garnish)


  1. Mix the garlic, lemon juice, and cilantro. Season with lemon pepper and black pepper to taste.
  2. Add the remaining ingredients, toss lightly, and serve. Garnish with sliced radishes, if desired.

Servings: 4 – 8 people


You can find Sylvia on her website here and Instagram here.

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What Is the Best Diet for Preventing Colon Cancer? Tue, 10 Oct 2023 12:00:37 +0000 What would happen within just two weeks after swapping the diets of Americans with those of healthier eaters? 

Colon cancer is our second leading cancer killer, but some places, like rural Africa, have more than ten times lower rates than we do in the United States. How do we know it isn’t genetic? “Migrant studies, such as those in Japanese Hawaiians, have demonstrated that it only takes one generation for the immigrant population to assume the colon cancer incidence of the host western population.” The change in diet is considered “most probably responsible for this,” but all sorts of changes occur when you move from one culture to another. “For example, cigarettes, chemicals, infections, and antibiotics might be equally responsible for the change in colon cancer risk.” You don’t know if it’s the diet until you put it to the test.

It’s rare that I do a whole video on a single study, but I think you’ll agree the one that I cover in The Best Diet for Colon Cancer Prevention is worth it. An international group of researchers was trying to figure out why colon cancer rates were an order of magnitude higher in African Americans and Caucasians in the United States than in rural South Africans. As you can see below and at 1:09 in my video, if you look at American colons, they’re a mess with polyps and diverticulosis, not to mention hemorrhoids, whereas the African colons were “remarkably pristine.” And more importantly, the Africans had sevenfold lower colonic epithelial proliferation rates, a characteristic of precancerous conditions. The researchers measured everything the study participants were eating and concluded that the higher colorectal cancer risk and proliferation rates in African Americans were most closely “associated with higher dietary intakes of animal products and higher colonic populations of potentially toxic hydrogen [acid] and secondary bile-salt-producing bacteria.”  

When put to the test, higher rates of colon cancer were indeed found to be associated with higher intake of animal protein and animal fat, lower fiber consumption, more of those bad bile acids, less of those good short-chain fatty acids like butyrate, and higher mucosal proliferation. But how do we know the diet is what’s mucking things up? We don’t—until an interventional study is performed.  

How about we just swap their diets? Feed the Americans a high-fiber African-style diet, and give the rural Africans the standard American diet. On day one of the experiment, the rural Africans were given sausage and white flour pancakes for breakfast, a burger and fries for lunch, and some meatloaf and white rice for supper, whereas the African Americans ate fruits, vegetables, corn, and beans. To help with compliance, the researchers included some more familiar foods like veggie dogs. Note, though, that it was not a vegan diet, just generally plant-based. You can see the day one menu below and at 2:31 in my video. 

Also, note that the food exchanges weren’t for years. They only swapped for two weeks. Could changes be seen that fast? Indeed, the dietary changes “resulted in remarkable reciprocal changes” in the lining of the participants’ colons in terms of cancer risk and their microbiome. Switching to a more plant-based diet boosted their fiber fermentation and suppressed their carcinogenic bile acid synthesis. The researchers took biopsies and looked under a microscope at the colon lining of African Americans. Before the diet swap, their colon lining was in overdrive with rapidly dividing cells, a sign of premalignancy that is a risk factor for cancer. But, after just two weeks of eating a healthier diet, their colons calmed right down. You can see some before and after pictures below and at 3:07 in my video. The brown dots in the before photo for the African Americans represent dividing cells. In the after photo, they’re nearly gone. In contrast, the rural Africans started out with some proliferation, but it got worse on the American diet. 

Below and at 3:44 in my video, you can also see a different marker measuring inflammation. Each of the brown dots represents an inflammatory cell. In the African Americans, there was rife inflammation on their typical diet that calmed way down after just two weeks on a healthier one, and the opposite happened for the rural Africans who switched to the standard American diet.  

We know that when our friendly flora ferment fiber, they produce beneficial compounds like butyrate, which is anti-inflammatory and anti-cancer. “Impressively, ‘Africanization’ of the diet” more than doubled butyrate production, increasing total quantities, “whereas ‘westernization’ reduced quantities by half.” And in terms of toxic metabolites, there was a significant drop in the healthier diet, whereas the “meatloafy” standard American diet increased the levels of these carcinogens by 400 percent within just two weeks. So, the bottom line is that just by changing the food you eat, you can remarkably change your risk. In fact, that’s how the lead investigator put it. “O’Keefe’s advice is simple, ‘change your diet, change your cancer risk!’” It may never be too late to start eating healthier. 

Based on these kinds of data, “adopting a whole-food vegan or near-vegan diet rich in fruits and vegetables, exercising regularly, and avoiding tobacco, could have a stunningly positive impact on the cancer risks not only of black Americans but of all peoples.” The researchers concluded: “While it would be unrealistic to expect rapid and profound lifestyle changes in the general population, it is gratifying to have sound, effective advice to offer to those who are willing to take the steps needed to optimize their healthful longevity.” 

This is the follow-up to Best Foods for Colon Cancer Prevention. As I mentioned, it’s rare I do a whole video on a single study, but I hope you’ll agree this one is worth it. For more on keeping our colonic colleagues thriving, check out the related videos below.   

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What Are the Best Foods for Preventing Colon Cancer? Thu, 05 Oct 2023 12:00:52 +0000 A low-fiber diet is a key driver of microbiome depletion, the disappearance of diversity in our good gut flora. 

We have a hundred trillion microorganisms residing in our gut, give or take a few trillion, but the “spread of the Western lifestyle has been accompanied by microbial changes,” which may be contributing to our epidemics of chronic disease. The problem is that we’re eating meat-sweet diets, “characterized by a high intake of animal products and sugars, the use of preservatives, and a low intake of plant-based foods, such as fruits, vegetables, and whole grain cereals.” 

Contrary to the fermentation of the carbohydrates that make it down to our colon, where the fiber and resistant starch benefit us through the generation of magical short-chain fatty acids like butyrate, when excess protein is consumed, “microbial protein fermentation generates potentially toxic and pro-carcinogenic metabolites involved in CRC,” colorectal cancer. So, what we eat can cause an imbalance in our gut microbiome and potentially create “a ‘recipe’ for colorectal cancer,” where a high-fat, high-meat, high-processed food diet tips the scale towards dysbiosis and colorectal cancer, as you can see below and at 1:04 in my video Best Foods for Colon Cancer Prevention. On the other hand, a high-fiber and starch, lower-meat diet can pull you back into symbiosis with your friendly flora and away from cancer. 

“Evidence from recent dietary intervention studies suggest adopting a plant-based, minimally processed high-fiber diet may rapidly reverse the effects of meat-based diets on the gut microbiome.” So, what may be “a new form of personalized (gut microbiome) medicine for chronic diseases”? It’s called food, which can “rapidly and reproducibly” alter the human gut microbiome. As shown in the graph below and at 1:52 in my video, if you switch people between a whole food, plant-based diet to more of an animal-based diet, you can see dramatic shifts within two days, resulting in toxic metabolites. 

And, after switching to an animal-based diet, levels go up of deoxycholic acid, a secondary bile acid known to promote DNA damage and liver cancers. Why do levels go up? Because the bad bacteria that produce it triple in just two days, as you can see in the graph below and at 2:10 in my video. 

Over time, the richness of the microbial diversity in our gut has been disappearing. Below and at 2:22 in my video, you can see a graphic of our bacterial tree of life and how it’s being depleted. Why is this happening? It is because of “The Fiber Gap.” “A low-fiber diet is a key driver of microbiome depletion.” Sure, there are factors like antibiotics, cesarean sections, and indoor plumbing that have contributed to the gut microbiome diversity decline, but “the only factor that has been empirically shown to be important is a diet low in microbiota-accessible carbohydrates (MACs),” not Big Macs. That’s just a fancy name for fiber found in whole plant foods and resistant starch found mostly in beans, peas, lentils, and whole grains. 

Our intake of dietary fiber and whole plant foods “is negligibly low in the Western world” when compared to what we evolved to eat over millions of years. “Such a low-fiber diet provides insufficient nutrients for the gut microbes,” which leads not only to the loss of bacterial diversity and richness but also to a reduction in the production of those beneficial fermentation end products that they make with the fiber. We are, in effect, “starving our microbial self.”  

What are we going to do about the “deleterious consequences” of a diet deficient in whole plant foods? Create new-fangled “functional foods,” of course, and supplements and drugs—prebiotics, probiotics, synbiotics. Think how much money there is to be made! Or, we can just eat the way our bodies were meant to eat, but what kind of value is that going to earn your stockholders? Don’t you know probiotic pills may be “the next big source of income” for Big Pharma?  

Why eat healthfully when you can just have someone else eat healthfully for you, then get a fecal transplant from a vegan? Researchers compared the microbiomes of vegans versus omnivores and found the vegans’ friendly flora were churning out more of the good stuff, showing that a plant-based diet may result in more beneficial metabolites in the bloodstream and less of the bad stuff like TMAO. But while the impact of a vegan diet on what the bacteria were making was large, “its effect on the composition of the gut microbiome [was] surprisingly modest.” The researchers only found “slight differences between the gut microbiota of omnivores and vegans.” Really? “The very modest difference between the gut microbiota of omnivores relative to vegans juxtaposed to the significantly enhanced dietary consumption of fermentable plant-based foods” was a shocker to the researchers. The vegans were eating nearly twice the fiber. Can anyone guess the problem here? The vegans just barely made the minimum daily intake of fiber. Why? Because Oreos are vegan. Cocoa Pebbles are vegan. French fries, Coke, potato chips. There are vegan Doritos and Pop-Tarts. You can eat a terrible vegan diet.  

Burkitt showed that we need to get at least 50 grams of fiber a day to prevent colon cancer, and that’s only half of what our bodies were designed to get. We evolved getting about 100 grams a day, which is the amount you see in modern populations immune to epidemic colorectal cancer. So, instead of feeding people a vegan diet, what if you just fed people that kind of diet, one centered around whole plant foods? For an answer to that, check out my video The Best Diet for Colon Cancer Prevention. 

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The Political Power of the Food Industry Tue, 03 Oct 2023 12:00:28 +0000 What can millions of dollars in the hands of the lobbying industry do to shut down efforts to protect children?  

For nearly half a century, there have been calls to ban the advertising of sugary cereals to children, a product that Harvard nutrition professor Jean Mayer referred to as “sugar-coated nothings.” In a Senate hearing on nutrition education, he said, “Properly speaking, they ought to be called cereal-flavored candy, rather than sugar-covered cereals.” 

As I discuss in my video A Political Lesson on the Power of the Food Industry, the Senate committee invited the major manufacturers of children’s cereals to testify, and they initially said yes—until they heard what kinds of questions were going to be asked. One cereal industry representative candidly admitted why the decision was made to boycott the hearing: They simply didn’t have “persuasive answers” to why they were trying to sell kids breakfast candy. 

In the Mad Men age before the consumer movement was in bloom, ad “company executives were more willing to talk frankly about the purpose of their ads and how they felt about aiming the ads at the ‘child market.’” Said an executive of the Kellogg’s ad firm: “Our primary goal is to sell products to children, not educate them. When you sell a woman on a product and she goes into the store and finds your brand isn’t in stock, she’ll probably forget about it. But when you sell a kid on your product, if he can’t get it, he will throw himself on the floor, stamp his feet and cry. You can’t get a reaction like that out of an adult.”  

Sugary cereals are the number one food advertised to kids, but don’t worry—the industry will just self-regulate. “In response to public health concerns about the amount of marketing for nutritionally poor food directed to children, the Council of Better Business Bureaus launched the Children’s Food and Beverage Advertising Initiative” in which all the big cereal companies “pledged to market only healthier dietary choices in child-directed advertising.” The candy industry signed on, too. Despite pledging not to advertise to kids, after the initiative went into effect, kids actually saw more candy ads. Take Hershey, for example. It doubled its advertising to children “at the same time it pledged to not advertise to children.”  

The cereal companies got to decide for themselves their own definitions of “healthier dietary choices.” That should give us a sense of how serious they are at protecting children. For example, they classified “Froot Loops and Reese’s Peanut Butter Puffs consisting of up to 44% sugar by weight…as ‘healthier dietary choices.’” In that case, what are their unhealthy choices? It seems that the Children’s Food and Beverage Advertising Initiative basically just “based its maximal nutrient levels more on the current products marketed by its members than on a judgment about what was best for children.”  

Now, they’ve since revised that to allow only cereals that are 38 percent sugar by weight. But even if they are only one-third sugar, that means kids are effectively eating “one spoonful of sugar in every three spoons of cereal”—not exactly a healthier dietary choice. 

The Federal Trade Commission tried stepping in back in 1978, but the industry poured in so many millions of dollars in lobbying might that Congress basically threatened to yank the entire agency’s funding should the FTC mess with Big Cereal, demonstrating just “how powerful market forces are compared to those that can be mobilized on behalf of children.” The political “post-traumatic stress induced by the aggressive attacks on the FTC led to a twenty-five-year hiatus in federal efforts to rein in food marketing aimed at children.”  

Finally, enter the Interagency Working Group with members from four federal agencies—the FTC, CDC, FDA, and USDA. The group developed a set of “voluntary principles [that] are designed to encourage stronger and more meaningful self-regulation by the food industry and to support parents’ efforts to get their kids to eat healthier foods.” It proposed the radical suggestion of not marketing to children cereals that are more than 26 percent pure sugar.  

As you can see below and at 4:02 in my video, the top ten breakfast cereals marketed to children are Cinnamon Toast Crunch, Lucky Charms, Honey Nut Cheerios, Froot Loops, Reese’s Puffs, Trix, Frosted Flakes, Fruity Pebbles, Cocoa Puffs, and Cookie Crisp—and not a single one would meet that standard. General Mills shot back: “The Proposal’s nutrition standards are arbitrary, capricious, and fundamentally flawed.” No surprise since “literally all cereals marketed by General Mills would be barred from advertising”—not a single one would make the cut. To suggest voluntary standards “unconstitutionally restrains commercial speech in violation of the First Amendment,” to which the FTC basically replied: Let me get you a dictionary. How could suggesting voluntary guidelines violate the Constitution? But that’s how freaked out the industry is at even the notion of meaningful guidelines. One grocer’s association actually called the proposed nutrition principles the “most bizarre and unconscionable” it had ever seen. 

So, what happened? Again, agency funding was jeopardized, so the FTC called off the interagency proposal.  

“At every level of government, the food and beverage industries won fight after fight….They have never lost a significant political battle in the United States…” Said a director of one of the child advocacy organizations: “We just got beat. Money wins.” And it took a lot of money—$175 million of Big Food lobbying funds. It was apparently enough to buy the White House’s silence as the interagency proposal got killed off. As one Obama advisor put it, “You can tell someone to eat less fat, consume more fiber, more fruits and vegetables, and less sugar. But if you start naming foods, you cross the line.”  

“‘I’m upset with the White House,’ said Senator Tom Harkin (D-Iowa), chairman of the Senate Health Committee. ‘They went wobbly in the knees, and when it comes to kids’ health, they shouldn’t go wobbly in the knees.’”  

For more on breakfast cereals, click here. And click here for more on sugar.  

I am all in favor of Taking Personal Responsibility for Your Health, but the strong-arm tobacco-style tactics of the multitrillion-dollar food industry are contributing to the deaths of an estimated 14 million people every year. 

On a brighter note, check out How We Won the Fight to Ban Trans Fat. 

For more on sugar specifically, see Flashback Friday: Sugar Industry Attempts to Manipulate the Science. 

Check out my other videos on breakfast cereals: Flashback Friday: The Worst Food for Tooth Decay and How to Stop Tooth Decay. Are there any healthy cereals? A few make the cut. See Flashback Friday: The Five-to-One Fiber Rule. 

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Are Nutrients Preserved by Pressure Cooking? Thu, 28 Sep 2023 12:00:38 +0000 How does Dr. Greger pressure steam his greens? 

In a review of more than one hundred articles about the effects of cooking on vegetables, researchers tried to find the sweet spot. On the one hand, heat can destroy certain nutrients, but on the other hand, softening the tissues can make them more bioavailable. Researchers settled upon steaming as the best cooking method to preserve the most nutrition because the vegetable isn’t dunked in water or oil where the nutrients can leach out and excessive dry-heat temperatures aren’t reached either. They acknowledge, however, that of all of the common cooking methods, we know the least about pressure cooking, as you can see in the graph below and at 0:37 in my video Does Pressure Cooking Preserve Nutrients?.

There are all sorts of fancy electric pressure cookers, like the Instant Pot. They’re great for quickly cooking dried beans with just a touch of a button, but what happens to the nutrition? Let’s look at black beans. (See the chart below and at 1:01 in my video.) The antioxidant content of presoaked black beans boiled for about an hour, a usual cooking time, is high, but it’s even higher when pressure cooked for 15 minutes. In fact, researchers found six times the antioxidant levels in the pressure-cooked beans. I’ve been pressure-cooking beans just because I like their texture better (the canned ones can be a bit mushy for me) and dried beans are so cheap compared to canned ones. But now we know they’re tastier, cheaper, and healthier. That’s quite the triple threat. 

What about pressure-cooking vegetables? As you can see below and at 1:35 in my video, vitamin C is one of the more heat-sensitive nutrients. Researchers found that sautéing spinach or amaranth leaves in a pan for 30 minutes destroyed about 95 percent of the vitamin C, whereas ten minutes in a pressure cooker wiped out only about 90 percent. But who pressure cooks spinach for ten minutes or sautés it for half an hour? Regardless, even then, not many effects were found either way on beta-carotene levels. 

Vitamin C is but one of many antioxidants, though. What about the effects of pressure cooking on overall antioxidant capacity? At 2:07 in my video and below, you can see a table of different cooking methods researchers compared—for example, 12 minutes of boiling, 5 minutes of pressure cooking, and 6 minutes of microwaving carrots. The researchers found that cooking carrots increased their antioxidant potential and pressure cooking nearly doubled their antioxidant value. In contrast, no matter how peas were cooked, their antioxidant capacities took a hit.  

What about greens? Chard wasn’t affected much across the board, but for spinach, microwaving beat out both pressure cooking and boiling, and pressure cooking beat out boiling—even though pressure cooking is actually boiling, but in less time and at a higher temperature. However, the cooking time appeared to trump the temperature; the researchers saw significantly less nutrient loss when pressure-cooking spinach for three and a half minutes compared to boiling for eight. 

The researchers found the same thing with those magical cancer-fighting glucosinolate compounds in cruciferous greens, which are the healthiest ones, including kale, collards, and turnip greens. As you can see in the graph below and at 3:08 in my video, they had the highest nutrient levels when they were raw. Three-quarters were wiped out by boiling, but less than half were eliminated by pressure cooking. Steaming beat both methods, retaining more nutrients than boiling or pressure cooking, because the greens weren’t dunked in water, which can leach out the nutrients. But, even though the pressure-cooked greens were immersed just as much as the boiled greens were, there were only half the nutrient losses, presumably because it was only half the cooking time—seven minutes pressure cooking compared to 15 minutes boiling. 

What if you cut down that time even more by pressure steaming, for instance, by adding a layer of water at the bottom of an electric pressure cooker, dropping it in a metal steaming basket, then putting in the greens and steaming them under pressure? That’s how I cook the greens I eat every day. I’ve always loved collards, especially in Southern-inspired cooking or Ethiopian cuisine, and I found I could get that same melt-in-your-mouth texture simply by steaming them under pressure for zero minutes. Zero minutes? Yes. Just set the pressure cooker to zero so it shuts off as soon as it reaches the cooking pressure, then immediately open the quick-release valve to release the steam. The greens turn out tender, a bright emerald, and cooked to perfection. Give it a try, and let me know what you think. 

I love covering practical topics—ones we may need to consider day-to-day when making decisions. Check out some of my other videos, including some cooking ones, in the Related Videos below. 

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Treating Reflux in Kids with Diet Tue, 26 Sep 2023 12:00:12 +0000 Even those who test negative for cow’s milk allergy may have hypersensitivity reactions to dairy products.

Excessive spitting up and vomiting in infants may be treated by putting them down on their left side after meals—of course, never when sleeping. It’s always face-up to wake up to reduce the risk of crib death. Also, as I discuss in my video How to Treat Reflux in Children with Diet, you can try smaller, more frequent feedings, thickening or changing formulas, and in breastfed infants, which is ideally how all babies should be fed, eliminating cow’s milk and eggs from the mother’s diet. 

You may recall that, in my video Treating Reflux in Babies with Diet, I talk about how more than 40 percent of infants with reflux can be successfully treated with cow’s milk removal. It can also affect them on the other end, too, as cow’s milk allergy can be a major contributor to diaper rash and also contribute to chronic constipation in 80 percent of affected kids. In one study, however, only a single kid tested positive for having an actual allergy to cow’s milk, so it seems to be a kind of sensitivity reaction that can really only be diagnosed by giving a cow’s milk-free diet a try. Anal fissures in infants may be practically pathognomonic for cow’s milk allergy, meaning so characteristic of the condition that it could be used as a diagnostic sign, with no allergy testing required. 

It’s like when cow’s milk hypersensitivity was demonstrated in 10 of 17 children with severe reflux. In the majority of patients, the hypersensitivity to cow’s milk was identified only by eliminating it and then re-challenging to confirm. Researchers did endoscopies, measuring the acid that gurgled up before and after milk consumption, then verified by repeating milk exposure with double-blind placebo-controlled challenges when necessary. Yet, all but one of the children proven to have this adverse reaction to dairy tested negative on allergy tests. So, the kids tested negative for a cow’s milk allergy, but they still got better by cutting out the cow’s milk. “In conclusion, an association of cow milk hypersensitivity and severe GERD [reflux] was observed not only in infants but also in preschool/school children.”  

Another disease that can be cured with cow’s milk elimination is eosinophilic esophagitis, a chronic inflammatory disorder of the esophagus, the tube that connects your mouth to your stomach. To figure out what’s causing the inflammation, an elimination diet is prescribed, where you basically remove everything, then each time you add back a food, doctors insert an endoscope down your throat and take biopsies to see if that particular food made things worse. How many freaking foods are there?! You can imagine how difficult, costly, invasive, confusing, and frustrating that may be for families. So, researchers at Northwestern figured why not just see what happens if you remove just one food from their diet instead of making them go through all that. Their finding? Eliminating cow’s milk induced remission in 65 percent of the children they tried it on. Normally, doctors would have to try to coat their patients’ throats with steroids to knock down their immune response. Doing so then sets the stage for infections like thrush, though, and of course, as soon as the steroids are stopped, the esophageal inflammation comes raging back because you aren’t treating the underlying cause. But steroids are considered the standard of care. Too bad there’s never been a head-to-head test of cow’s milk elimination versus steroids…until now. 

As you can see in the graph below and at 3:40 in my video, researchers conducted a comparative effectiveness trial of cow’s milk elimination versus a swallowed steroid and found they both appeared to work just as well, which is to say the cow’s milk elimination worked better because there are no side effects and you’re treating the actual cause. They concluded, “Our results suggest that cow’s milk elimination is an effective treatment option that should be considered as a first-line therapy…” 

In adolescence, cow’s milk protein intolerance can contribute to chronic fatigue syndrome, evidently a common problem in young people with chronic fatigue and most importantly “a treatable contributor to their symptoms.” But again, most were unaware that dairy was a problem, possibly because it can take hours between milk ingestion and when you start feeling worse, so people don’t make the connection. So, even those who report no problems after milk ingestion may still be suffering problems after consuming dairy. 

Finally, what about adults? Well, there’s lactose intolerance. Most people on Earth are lactose-intolerant after weaning, with the exception of some human populations that developed lactose tolerance about 10,000 years ago, thanks to a mutation in the lactase gene that enabled adult humans to digest lactose (milk sugar). As you can see below and at 4:53 in my video, they were mostly select European populations, whereas most Hispanics, Africans, and Asians remain intolerant, which may be a good thing, since acid regurgitation, reflux, and heartburn is so common among adults in the Western world. Food intolerance may play a role in adults as well. Milk was found to be the leading culprit, but researchers were using what’s called a leucocytotoxic test, where you see how someone’s white blood cells react to individual foods in a petri dish. 

This test is frowned upon by professional allergy associations as not being sufficiently sensitive and specific. It can’t hurt, though, to put it to the test. A double-blind, randomized, controlled trial was performed in 38 reflux patients for which proton pump inhibitor drugs failed to completely control their symptoms. What happened when the diet was given a try? As you can see in the graph below and at 5:48 in my video, researchers randomized people to either a diet in which they excluded foods they tested sensitive to (most often dairy) or one that instead excluded foods for which they didn’t test positive to control for the placebo effect. A month later, the symptoms in the control group dropped, but the symptoms in the true diet exclusion group dropped significantly further. The researchers kind of felt bad for the control group, so they switched those participants to the right diet, too, and two months later, everyone was feeling better. 

I covered the effects of maternal diets on breastfed babies in Treating Infant Colic by Changing Mom’s Diet and Infant Seizures Linked to Mother’s Spirulina Use. Breast is best, but you may also be interested in The Best Baby Formula and Formula for Childhood Obesity. 

For more on dairy and child health, check out the Related Videos below. 

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When Is the Best Time to Floss? Thu, 21 Sep 2023 12:00:31 +0000 How good is the evidence that flossing is effective? According to randomized controlled trials, what is the optimal toothbrushing and flossing sequence? 

“Over the years, it has been generally accepted that the use of dental floss has a positive effect on removing plaque. The American Dental Association (ADA) even reports that up to 80% of plaque may be removed by this method.” How do we know? You can use what’s called a split-mouth design, where each person can act as their own control—for example, by flossing only one-quarter of their mouth. Researchers asked study participants to stop brushing their lower jaw so that plaque would build up, then they were randomized to floss half and leave the other half as the non-flossed control. As you can see below and at 0:37 in my video Should You Floss Before or After You Brush?, not only did flossing cut plaque by about 60 percent after just three weeks, more importantly, it also halved gingivitis signs—bleeding on probing and another index of gum inflammation. Note, though, that this compared flossing to doing nothing. The study subjects weren’t allowed to brush their lower jaw. So, flossing is better than nothing, but is flossing plus brushing better than just brushing alone? 

“The advocacy of floss as an interdental cleaning device hinges, in large part, on common sense,” but common sense doesn’t go very far as a form of evidence. You don’t really know until you put it to the test. What’s the efficacy of dental floss in addition to a toothbrush? Surprisingly, only 3 out of the 11 studies the researchers looked at found a significant added benefit. 

The anti-flossers were positively giddy, comparing dentists who continued to advocate flossing in the face of the data to flat-earthers. Dentistry is a profession “in denial,” they wrote. “Over 80% do not floss regularly and it is hard to accept that these ‘the great unflossed’ were right and we, ‘the highly educated intelligencia’ may actually have been wrong…Flossing doesn’t work—get over it!” 

So, you’ve heard of the tooth fairy. Is flossing just some tooth fairy tale? The review showing that only 3 out of 11 studies found a significant benefit to flossing in addition to brushing was published back in 2008. Since then, more studies have found that while the evidence on additional plaque reduction is weak, there is at least some evidence that flossing with toothbrushing helps with gingivitis, which is a primary reason you want to reduce plaque anyway. Why might they not have found stronger evidence? “Trials were of poor quality and conclusions must be viewed as unreliable,” so basically, we don’t have good evidence either way because good studies really haven’t been done.  

Why not? Why wouldn’t Big Floss fund the studies? It appears that all floss works the same. If you compare unwaxed to woven to shred-resistant floss, they all have about the same plaque-removal efficacy, something all such studies appear to have found. So, why would a floss company fund a study to show that flossing in general is good if it can’t show that its product is better than another? You might just buy its competitor’s floss. 

Where do we stand today? “Although technically the evidence for flossing is weak, more importantly, the methodology and rigor of the studies examining flossing effectiveness are also weak.” For example, the studies didn’t assess the frequency or quality of people’s flossing. (You can see an incorrect way of flossing below and at 3:18 in my video.) The bottom line is that the American Dental Association continues to recommend brushing and flossing every day. But what’s the proper sequence? Should you floss before or after you brush? 

“Some dentists argue that flossing should come first because you stir up the particles and plaque that the toothbrush can brush away subsequently. The fluoride from your toothpaste is also more likely to reach the interdental areas [the spaces between teeth] if food wedged in between the teeth is removed before brushing.” Others, however, “recommend brushing be done first and their rationale is that brushing teeth first removes the bulk of the particles on the teeth and flossing afterward can remove interdental plaque better. It could also force the remaining bit of fluoride that is left on the teeth from toothpaste into the interdental spaces.” You don’t know until you put it to the test. 

An article titled “The Eect of Toothbrushing and Flossing Sequence on Interdental Plaque Reduction and Fluoride Retention: A Randomized Controlled Clinical Trial” reported that flossing first won—both in terms of getting rid of significantly more plaque, as well as getting more of the fluoride between the teeth. “When we use dental floss after brushing, much of the particles that are removed by dental floss would stay in place.” The bottom line is that flossing followed by brushing is preferred. 

What about oil pulling? Short answer: Don’t do it. Long answer: You’ll find out in my four-part video series listed below in Related Videos.  

Treating the cause of cavities by reducing added sugar intake is the most important thing for protecting your teeth, but is there anything else we can do to improve our oral health? See below. 

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Fighting Inflammation and Treating Osteoarthritis with Berries Tue, 19 Sep 2023 12:00:20 +0000 What did double-blind, randomized, placebo-controlled trials on berries and the first clinical study on the effects of berries on arthritis find? 

How might berries improve human health, healthy aging, and quality of life? It may be due to their anti-inflammatory effects, since inflammation can be an underlying contributing factor in the “development, progression, and complication” of a number of chronic diseases. 

As I discuss in my video Berries for Inflammation and Osteoarthritis Treatment, higher intake of anthocyanins—the brightly colored pigments in berries—has been associated with anti-inflammatory effects, which “may be a key component” underlying the associated reduction in chronic disease risk. But these are all just associations. You can’t prove cause and effect until you put it to the test. 

A double-blind, randomized, placebo-controlled trial found that blueberry smoothies could turn off inflammation genes. At 0:48 in my video and below, you can see a graph measuring the expression of pro-inflammatory genes in white blood cells taken from individuals before and after six weeks of drinking placebo smoothies without any blueberries. Those study participants in the placebo group got worse over time; six weeks later, more inflammatory chemicals were pouring out. In contrast, the blueberry group started out about the same at week zero, but after six weeks of daily blueberries, their expression of inflammatory genes went down. 

Wrote the researchers, “In addition to attenuating inflammation, our findings from this study demonstrate that blueberry consumption was able to significantly decrease the levels of free radicals in the whole blood,” the bloodstream. There was no change in the placebo group, but after six weeks of blueberry smoothies, the amount of free radicals in their blood was extinguished by half, as you can see in the graph below and at 1:27 in my video. Does all of that antioxidant and anti-inflammatory power actually translate into clinical benefits? For example, what is the effect of blueberry consumption on recovery after excessive weight lifting–induced muscle damage? 

In a randomized cross-over study, participants were given either a blueberry smoothie or an antioxidant-matched placebo smoothie 5 and 10 hours before and again 12 and 36 hours after exercise-induced muscle damage. The smoothies were either about a cup and a half of frozen blueberries, a banana, and apple juice, or, for the placebo version, they were made without the berries but with added dextrose and vitamin C to match it for calories and antioxidant power. Even so, the blueberries worked better at mopping up free radicals. As you can see in the graph below and at 2:16 in my video, the oxidative stress without the blueberries went up and stayed up, but it came right down with the blueberries. Great, but we care about the recovery of muscle strength so we can jump right back into training. On blueberries, there was the same drop in peak torque 12 hours later, but a day later, there was a significantly faster restoration of peak muscle strength, demonstrating that the ingestion of blueberries can accelerate recovery, which may be especially relevant to athletes who compete over successive days. 

That’s all well and good, but what about using berries to treat inflammatory diseases like arthritis? Yes, they may have protective effects against arthritis in a rat, significantly reducing “paw volume”—how swollen their paws get when injected with some inflammatory irritant, as you can see in the graph below and at 3:06 in my video—but there had never been any human arthritis berry studies until now. 

Remember that amazing study that showed that strawberries alone could reverse the progression of precancerous lesions? The strawberries were dramatically downregulating pro-inflammatory genes, as you can see in the graph below and at 3:27 in my video. Give strawberries for six weeks to people with diabetes, and not only does their diabetes get better, but their level of C-reactive protein, which is a marker of systemic inflammation, also drops by 18 percent, as you can see at 3:32 in my video

Even a single meal can help. As you can see below and at 3:46 in my video, if people eat a largely unhealthy breakfast, their level of inflammatory markers goes up over the next six hours—but less so if just five large strawberries are added to the meal.  

So, can strawberries improve pain and inflammation in confirmed knee osteoarthritis? Osteoarthritis patients were randomized to get about a pint and a half of strawberries a day for 12 weeks, and certain inflammatory markers plummeted, as you can see below and at 4:16 in my video. Did they actually feel any better, though? There were significant reductions in constant pain, intermittent pain, and total pain. The first clinical study on the effects of berries on human arthritis found that a “simple dietary intervention, i.e., the addition of berries, may have a significant impact on pain, inflammation, and overall quality of life in obese adults with OA [osteoarthritis].”  

In my Daily Dozen, I recommend eating at least one serving of berries every day—either ½ cup fresh or frozen. What else can berries do? Check out the Related Videos below. 

And, for more on arthritis and inflammation, see below. 

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High Oxalate Greens and Kidney Stones Thu, 14 Sep 2023 12:00:40 +0000 Given their oxalate content, how much is too much spinach, chard, beet greens, chaga mushroom powder, almonds, cashews, star fruit, and instant tea? 

There was a tragic case in which a “green smoothie cleanse” shut down the kidneys of a woman who had had two cups of spinach a day for just ten days. Complicating the matter, she had had gastric bypass surgery and was on prolonged antibiotics, both of which can increase the absorption of the oxalates in spinach. So, too, can taking mega-doses of vitamin C: A man juicing spinach and beet greens went into kidney failure, but he was also taking about 2,000 mg of vitamin C each day. Vitamin C is metabolized into oxalate inside the body and likely played a role in his oxalate overload. In both of these cases, the individuals were getting more than 1,200 mg of oxalate a day just from their juicing. As you can see in the graph below and at 0:50 in my video Kidney Stones and Spinach, Chard, and Beet Greens: Don’t Eat Too Much, that’s easy to do with spinach—it takes only two cups of spinach a day—but it’s practically impossible with most other greens. Kale, for instance, requires more than six hundred cups a day. 

There is one case, however, of apparent dietary oxalate overload–induced kidney failure uncomplicated by surgery, antibiotics, or vitamin C: a man who had lost about 80 pounds eating a diet of berries, nuts, and greens, including spinach, six times a day. Tragically, his kidney function never recovered. 

Remember that study that purported to show a “massive” load of dietary oxalate didn’t have much of an effect on urine levels? As you can see in the graph below and at 1:30 in my video, that study went up to 250 mg of oxalates a day. That is massive if you’re talking about most greens. For instance, to get 250 mg of oxalates, you’d need to eat 25 cups of collard greens, 60 cups of mustard greens, 125 cups of kale, or 250 cups of bok choy at a time, but less than half a cup of spinach. 

Spinach really is an outlier. Even though there are small amounts of oxalates found throughout the food supply, spinach alone may account for 40 percent of oxalate intake in the United States. The Harvard cohorts found that men and older women who ate spinach eight or more times a month had about a 30 percent higher risk of developing kidney stones.  

What if you cook the greens? Oxalates are water-soluble so, for example, blanching collard greens can reduce oxalate levels by up to a third. So, to reach 250 mg of oxalates, instead of 25 cups of collards at a time, it’s 33 cups! For low-oxalate greens, though, it doesn’t matter whether they’re cooked or not, since they’re so low to begin with.  

As you can see below and at 2:33 in my video, steaming spinach reduces oxalate levels by 30 percent, and boiling cuts oxalate levels by more than half. Boiling any of the three high-oxalate greens—spinach, beet greens, and Swiss chard—results in 60 percent of the oxalates leaching into the cooking water. But, those greens start out so high that even when they’re cooked, they would contain hundreds of times more than low-oxalate greens like kale. For high-oxalate greens, though, it doesn’t matter whether they’re cooked or not, since they’re so high to begin with. 

The bottom line is that anyone with a history of kidney stones, is otherwise at high risk, or eats cups a day should probably avoid the three high-oxalate greens. This is especially important for those who juice or blend their greens, as oxalates appear to be absorbed more rapidly in liquid than solid form.  

Another reason to give preference to low-oxalate greens is that they are less stingy with their calcium. As you can see in the graph below and at 3:27 in my video, while less than a third of the calcium in milk may be bioavailable (whether from a cow or a plant), most of the calcium in low-oxalate vegetables is absorbed. The calcium bioavailability in some greens doubles that of milk, but the oxalates in spinach, chard, and beet greens bind to the calcium, preventing the absorption. 

Other high-oxalate foods that have been associated with kidney problems at high enough doses include chaga mushroom powder. Four to five teaspoons a day, and you can end up on dialysis. Four cups a day of rhubarb is also not a good idea, nor is more than a cup a day of almonds or eating that many cashews. Then there is star fruit. (You may have seen my video Neurotoxicity Effects of Star Fruit.) Consuming a single dose of about a cup and a quarter (300 mL) of star fruit juice, which is just four to six fruit, can lead to problems. Excessive intake of tea can also be a problem, especially instant tea, which boosts urine oxalate nearly four times higher than brewed tea. Two cases of kidney damage have been reported, both of which were attributed to drinking a gallon of iced tea a day. Tea, like spinach, is super healthy—just don’t overdo it. 

If you missed it, be sure to check out my video Oxalates in Spinach and Kidney Stones: Should We Be Concerned?.

To be clear, I encourage everyone to eat huge amounts of dark green leafy vegetables every day, as they are the healthiest foods on the planet. But if you follow this advice—and I hope you do—choose a variety of greens, not only spinach, beet greens, and chard. If you only eat typical amounts of greens, like just one serving a day, then it doesn’t matter which ones you choose. I eat spinach, beet greens, and chard all the time, but it’s possible to overdo those three. When I’m trying to hit my pound-a-day green leafy quota, I mostly eat kale, collards, and arugula, which also happen to have the added benefit of being cruciferocious!

How are greens so good for us? How aren’t they?! Check the Related Videos below for more on this.

Also, look below for some tips on how you might prep them for maximum benefit.

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Do the Oxalates in Spinach Cause Kidney Stones? Tue, 12 Sep 2023 12:00:16 +0000 Even though dietary oxalates may have a limited effect on the risk of kidney stones in most people, there are some predisposing factors that can put anyone at risk.

Kidney stones affect as many as one in ten people in their lifetime and can cause excruciating pain. (It makes me cross my legs just thinking about them.) Oxalate stones are the most common type, forming when the oxalate concentration in your urine gets so high it basically crystallizes out of solution like rock candy. Some foods, like spinach, have a lot of oxalates in them, as you can see below and in the table shown at 0:29 in my video Oxalates in Spinach and Kidney Stones: Should We Be Concerned?. Should we try to reduce our intake of oxalates to lower our risk? It turns out that people who do get stones don’t seem to eat any more oxalates on average than people who don’t get stones. It may be less what you eat and more what you absorb. People who are predisposed to kidney stones just appear to be born with a higher intestinal oxalate absorption. Their guts just really suck it up. “People who have hyperoxaluria—so-called ‘super absorbers’—can absorb 50% more oxalate than non–stone formers.” 

Overall, the impact of typical dietary oxalate on the amounts of oxalates that end up in the urine “appears to be small.” In fact, even a “massive” dose of dietary oxalates typically only “results in a relatively mild increase” in the amount that makes it into your urine, as you can see in the graph below and at 1:21 in my video. A 25-fold increase in oxalate consumption doesn’t even double the concentration of oxalates flowing through your kidneys, so it is “indeed determined more frequently by genetic than environmental factors,” like diet. Still, until you get your first kidney stone, how do you know if you’re a super absorber or not? Is it safer just to generally avoid higher oxalate fruits and vegetables? People who eat more fruits and veggies may actually tend to get fewer kidney stones. 

When researchers put it to the test and removed produce from people’s diets, their kidney stone risk went up. Removing fruits and veggies can make your dietary oxalate intake go down, but your body produces its own oxalate internally as a waste product that you may have more difficulty getting rid of without the alkalizing effects of fruits and vegetables on your urine pH. This may help explain why those eating plant-based get fewer kidney stones, but it also may be due to them cutting their intake of animal protein, which can have an acid-forming effect on the kidneys. We’ve known this for 40 years. Just a single can of tuna fish a day can increase your risk of forming kidney stones by 250 percent, whereas just cutting back on animal protein may help slash that risk in half. 

Surely there’s some level of oxalate intake that could put people at risk regardless. There have been a few rare cases reported of people who drink green juices and smoothies getting oxalate kidney stones, though most had extenuating circumstances. In one case, however, a woman’s kidneys shut down after a ten-day juice cleanse, which included two cups of spinach a day. Normally, we might not expect a cup or two of spinach to cause such a violent reaction, but she had two aggravating factors: She had had gastric bypass surgery, which can increase oxalate absorption, and a history of prolonged antibiotic use. There’s actually a friendly bacterium called oxalobacter that we want in our colon because it eats oxalate for breakfast, leaving even less for us to absorb, but it can get wiped out by long-term, broad-spectrum antibiotic use.  

Even with those two aggravating factors, she probably wouldn’t have run into a problem if she had used something other than spinach (or beet greens or swiss chard) when making the smoothies for her cleanse. As you can see in the graph below and at 3:53 in my video, compared to that trifecta of high-oxalate greens, kale has hundreds of times fewer oxalates than all three. She would have had to have juiced in excess of 650 cups of kale every day to get a comparable dose—more than 6,000 cups of kale over the ten days of her cleanse.  

Are the three high-oxalate greens only a problem for people with extenuating circumstances or who are otherwise at high risk? What if you cook the greens? And, how much is too much? I answer all of those questions in my video Kidney Stones and Spinach, Chard, and Beet Greens: Don’t Eat Too Much. 

It takes a while for videos to be made, so when I discover something like this in the research, I immediately go to our social media channels to alert people, as I did with this cautionary note on high-oxalate greens. So you don’t miss any critical “heads-up” info like this in the future, follow us on Facebook, Instagram, or Twitter, and subscribe to our free monthly newsletter. 

For more information on kidney stones, see my videos Flashback Friday: How to Prevent and Treat Kidney Stones with Diet.

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Preorder How Not to Age Today Thu, 07 Sep 2023 12:00:34 +0000 I’m thrilled to announce that preorders are now open for How Not to Age, my new book coming out in December after three years in the making. There was so much juicy research on the many aspects of aging and longevity—more than 13,000 citations’ worth!—that I couldn’t even fit it all in. So, throughout the book, you will find links to special videos I made just for How Not to Age to provide you with even more life-changing, life-saving information.

Preorders are available now. If you plan to buy How Not to Age, please do me the favor of preordering. All preorders count towards first week sales, which factor into the New York Times Best Sellers list calculations. So, the more preorders How Not to Age receives, the more likely it will make the list, which could help expose millions to the message of healthy eating. In fact, the book lands on December 5—perfect timing for holiday gifts for everyone in your life you want to live long and healthy lives! Please consider getting some of your holiday shopping done early by ordering a whole stack of them! 

Preorder and Immediately Receive a Chapter

We are also offering a gift! Everyone who preorders a copy of How Not to Age can immediately receive the Preserving Your Bones chapter from the book. After you place your order, enter your order number on this page to receive your free chapter. Be among the first to get this sneak peek into the book by preordering now. 

As always, all proceeds I receive from all of my books are donated directly to charity. 

P.S. In a few weeks I will be announcing an upcoming webinar where I will share my brand-new How Not to Age presentation before opening it up for questions. Keep your eyes out for that email at the end of September.

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The Best Way to Cook Greens Tue, 05 Sep 2023 12:00:01 +0000 What is the best way to prepare dark green leafy vegetables, the most nutrient-dense foods on the planet? 

“The main purpose of cooking is to make vegetables more edible, palatable, and digestible…The downside is that cooking may adversely affect the levels of nutrients and bioactive compounds, especially the heat-sensitive and water-soluble ones.” But, as you can see in the graph below and at 0:19 in my video Flashback Friday: How to Cook Greens, even if you boil greens for ten minutes, the drop in antioxidant capacity, which is a rough proxy for phytonutrient retention, isn’t that much. Yes, there’s a significant 15 to 20 percent drop in each case, but most of the antioxidant power is retained. The single nutrient that drops the most is probably vitamin C, but data show that collard greens start out so rich in vitamin C that even when they’re boiled for ten minutes, they have twice as much vitamin C as raw broccoli.  

However, the vitamin C in spinach really takes a hit during cooking. Even blanching for just five minutes can cut vitamin C levels by more than half, with more than 90 percent dissolving into the water after 15 minutes, as you can see below and at 0:58 in my video. Most of the beta-carotene, which is fat soluble, tends to stay in the leaves, though. Keeping spinach in a regular plastic bag (like you may find in the produce aisle at your local market) can protect it. Refrigeration is important, too. Even when stored in a bag, a hot day can wipe out nearly 50 percent of the vitamin C in spinach. Drying is especially damaging, eliminating up to 90 percent of the vitamin C, which suggests that kale chips may pale in comparison to fresh kale. Vitamin C is particularly sensitive, whereas other nutrients, like beta-carotene, are less affected across the board. 

Microwaving and steaming watercress, for example, preserve more nutrients than boiling does. As you can see in the graph below and at 1:42 in my video, steaming or microwaving has little impact when compared to raw, though boiling for even two minutes may cut antioxidant levels nearly in half. Watercress is a cruciferous vegetable, a member of the cabbage and broccoli family, so it’s prized for its glucosinolate, which turns into the magical compound sulforaphane. What does cooking do to glucosinolate levels? As you can see below and at 2:06 in my video, while fresh is best, the data show that steaming has the least impact, microwaving comes in second, and stir-frying and boiling result in the most significant loss. The glucosinolates in other cruciferous vegetables are also significantly affected by boiling. Researchers have concluded that red cabbage is best consumed fresh. As I shared in my book How Not to Die, I always keep a red or purple cabbage in my crisper to cruciferize my meals, slicing off shreds and putting them on basically anything and everything. But if you are going to cook it, steaming may be the best bet “so as to retain the optimum benefits of the health-promoting compounds.”  

Other nutrients we look to greens for are eyesight-preserving nutrients like lutein and folate. Folate is particularly important for women of childbearing age, and vegetables are the main natural source. It’s been estimated that approximately half of the folate is lost during cooking, which may be true for boiling broccoli or stir-frying spinach or mustard greens, as you can see below and at 3:01 in my video. But, the folate in stir-fried kale holds up better, only losing about a quarter, similar to steamed broccoli florets. However, broccoli starts out so high in folate that even boiled broccoli has more folate than raw spinach. Broccoli leaves are an interesting case: Not only do they start out with among the highest levels of folate, but their levels actually go up a bit when you cook them. Prior to this study, no one had ever looked at the folate concentration in broccoli leaves. They’re commonly just cut off and thrown away, but since they contribute “great concentrations of this vitamin,” we should make sure to eat them. 

Researchers also compared thinly sliced kale to kale torn into larger pieces to determine if a larger surface area of exposure would promote greater losses of folate, but no effects were found, so slice away. This study just looked at stir-frying, though. What about the effect of other cooking methods on kale? There have been many studies on cooking cabbage and broccoli; however, very little information has been available on the “queen of greens”—until recently. 

First of all, the study compared fresh versus frozen. “The freezing process is generally regarded as destructive to antioxidant compounds. Frozen samples are assumed to have a lower antioxidant capacity compared to fresh ones,” but kale breaks all of the rules. The frozen kale showed 60 percent more antioxidant capacity than fresh! But what happens when you cook it? As you can see in the graph below and at 4:43 in my video, if you normalize the starting levels at 100 percent, blanching and steaming actually boost the antioxidant content, whereas microwaving or even boiling doesn’t have much negative impact. Therefore, you can boil kale without losing its antioxidant punch. I told you kale’s a rule breaker! 

The heat associated with blanching and steaming can disrupt the plant cell walls and all of the little subcellular compartments and spill out extra antioxidant compounds that may have been hiding. Now that’s usually counterbalanced by losses caused by high temperatures, but the kale compounds look pretty cruciferocious by standing their ground. 

I often get questions about how to prepare certain foods to maximize their benefits, so I love it when I can bring you videos like this one and Flashback Friday: Best Way to Cook Vegetables. For more on optimum cooking methods and why it’s so important to eat greens every day, check the Related Videos below. 

If you have any concerns with microwaving, you may find my video Flashback Friday: Are Microwaves Safe? & The Effects of Radiation Leaking from Microwave Ovens informative. 

If you eat multiple cups of dark green leafy vegetables a day—as I hope we all do—it’s probably best to stick to low-oxalate ones to avoid the risk of kidney stones. Low-oxalate greens are basically any greens other than spinach, swiss chard, and beet greens. See my video Kidney Stones and Spinach, Chard, and Beet Greens: Don’t Eat Too Much to learn more. 

What about pressure cooking? (I’m looking at your Instant Pot.) Does Pressure Cooking Preserve Nutrients? 

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Are There Any Benefits of Flaxseed for Weight Loss? Thu, 31 Aug 2023 12:00:09 +0000 Were the flaxseed studies showing 20 pounds of weight loss just flukes? 

Canada now allows a health claim on the labels of products with flaxseeds, saying that we know with sufficient certainty that flaxseeds do indeed help lower cholesterol levels. The products must contain at least two tablespoons of ground flax and be relatively healthy in the first place, so they can’t boast about the cholesterol-lowering effects of flaxseed-enriched meatballs or something.

Such claims are based on studies like one that I review in my video Benefits of Flaxseed Meal for Weight Loss: a double-blind, randomized, placebo-controlled trial that supplemented research subjects’ diets with flaxseeds. How do you come up with placebo food? There are placebo sugar pills for drugs, but how can you slip spoonsful of flax past someone? The researchers made special products—snack bars, muffins, bagels, and more—so the study participants would unknowingly be getting tablespoons of either ground flaxseeds or the control, whole wheat. And they did this for a year. No one knew who got which until the code was broken at the end. Their findings? The dietary flaxseed group saw a 15 percent reduction in LDL cholesterol as early as one month into the trial, but it only fell significantly lower than the whole-wheat group in those on cholesterol-lowering drugs. In whole-wheat group participants not on drugs, their cholesterol went down, too, diminishing the efficacy of the flax in comparison. You can see charts at 1:12 in my video. That’s why food placebos are so hard. 

In another trial, the researchers conducted an “open label” study, where the participants were aware they were eating flaxseeds, because they couldn’t come up with an inert placebo for flaxseed. Whole-wheat flour is a whole grain and could be beneficial in its own right, for instance, whereas white flour could make the control group look even worse. So, for this study, the researchers randomly assigned overweight participants to receive either lifestyle advice and daily ground flaxseeds or just the lifestyle advice alone as the control group. And, not surprisingly, body weight, waist circumference, and body mass index decreased significantly in both groups. (Even without lifestyle advice, simply enrolling people in a study where they know they’re going to keep getting weighed can get them to lose weight.) However, there was “a significantly greater reduction in [the] flaxseed group in comparison with controls.” And not just by a little. As you can see at 2:21 in my video, the control group that just got lifestyle advice lost nearly seven pounds and about an inch off their waist, while the group receiving the same advice plus spoonsful of flax a day—so, in effect, given more food to eat—lost more than 20 pounds on average and cut nearly four inches off their waist over the same period. Those are extraordinary numbers for an intervention that added rather than actively removed calories from the diet. Was it just a fluke? 

How about using flaxseed supplementation for non-alcoholic fatty liver disease? Thanks to the obesity epidemic, “it is the most common liver disease and now recognized as a major public health problem in contemporary society around the world.” The most common cause is a high-fat diet, but flaxseed fat may be better, compared to lard. Lard? Well, that’s not very helpful. Let’s put it to the test. 

As with the last study, participants received lifestyle modification advice with or without flaxseeds. They were told to mix the flaxseeds with water and juice and drink it down after breakfast. And? Their body weight went down, along with liver inflammation, and scarring and fat inside the liver in both groups, but the results were better in the flaxseed group. And again, there was that extraordinary 20-pound weight loss for the subjects told to add something (flaxseeds) to their diet, as you can see at 3:36 in my video. So, maybe that first study wasn’t a fluke—or maybe they both were. 

There have been dozens of randomized, placebo-controlled trials of flaxseeds and weight loss, and, as you can see in the graphic below and at 3.54 in my video, most were more equivocal. Those two recent 20-pound weight-loss studies appear to be the outliers. But still, after putting all of the studies together, you do see a significant reduction in body weight, BMI, and waistlines following flaxseed supplementation in randomized controlled trials, though one should expect more like 2 pounds of weight loss rather than 20 pounds. 

What else can flaxseeds do? So much! Check out the Related Videos below. 

What about the cyanide? Cyanide? See Friday Favorites: How Well Does Cooking Destroy the Cyanide in Flaxseeds and Should We Be Concerned About It?.

For more on weight loss, based on my book How Not to Diet, see the topic page here and the list of videos below. 

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The Best Duct Tape for Wart Removal Tue, 29 Aug 2023 12:00:34 +0000 Why do some experiments show that duct tape is ineffective for treating warts? 

In 1978, a new approach for the treatment of warts was described, complete with compelling before-and-after pictures, as you can see below and at 0:13 in my video Which Type of Duct Tape Is Best for Wart Removal?. What was it? The application of adhesive tape was put to the test in a head-to-head trial of duct tape versus cryotherapy to resounding success.

Even though it was a randomized, controlled study, it wasn’t a double-blinded one. “Patients in the duct tape group were instructed to remove all tape prior to making a return clinic visit,” so the nurses measuring the wart changes wouldn’t be biased one way or the other. Cryotherapy can cause redness, skin discoloration, crusting, and blisters, though, so the nurses may have had an idea which study participant was in which group, which may have biased them. 

So, ideally, there would be a double-blind, randomized, controlled trial, and here we go. Researchers disguised the duct tape so no one knew which study subject was in which group. Transparent duct tape was applied to the underside of moleskin, an opaque adhesive pad, and the control group got the moleskin without the duct tape. On the outside, both treatments looked the same, but half of the warts were exposed to duct tape and the other half were not. So, if there was something special about the duct tape adhesive, the duct tape group would triumph and the moleskin-only group would fail. If there was nothing special about duct tape and the remarkable success of that other study was simply due to covering warts with something sticky, then both groups would triumph. Instead, they both failed. Neither one did any better than placebo. 

The first double-blind, placebo-controlled trial investigating duct tape for the treatment of warts failed—in adults. Was that the problem? The subjects in the original duct tape study were mostly children, average age of 9, whereas in this study, the average age was 54. Warts in younger populations may be more amenable to treatment, so is it possible the reason duct tape worked in the first study but not the second, is that duct tape only works on kids and not adults? To determine that, you’d have to repeat the same kind of study with children as the subjects. 

Researchers randomized about a hundred schoolchildren to either duct tape applied to the wart or a corn pad placed around the wart as a placebo. Each group did something, but only one group had duct tape on their warts. In this case, the researchers used that same transparent duct tape so it wouldn’t be recognized. The result? After six weeks, the duct tape failed. “In this 6-week study, duct tape was no more effective than placebo.” 

And that’s where the medical community left it. If you look at recent reviews on whether it’s better to burn warts, freeze them, or duct tape them, duct tape is dismissed as being totally ineffective, which is totally understandable. No matter how good some original results are, if you duplicate the test in a bigger, better study and can’t replicate the results, then you have to assume the first study was just a fluke. 

But, did the researchers put the same thing to the test? Maybe adults weren’t the critical factor here. Maybe it was the transparent tape. In fact, “clear duct tape is not duct tape.” It turns out that “clear duct tape and moleskin both contain an acrylic-based adhesive, whereas standard silver duct tape contains a rubber-based adhesive,” which is totally different. “It is likely that the success of traditional duct tape is associated with the rubber-based adhesive that comes in direct contact with the wart during treatment.” After the two clear tape studies came out, it appears there is something unique in duct tape beyond just merely covering up a wart. And indeed, the latest addition to the body of evidence found that using actual duct tape was 80 percent effective versus cryotherapy’s 60 percent effectiveness. However, in this case, superglue was used so the duct tape would stick better. 

In conclusion, “odd as it may sound, duct tape is a legitimate and often effective treatment for common warts.” 

Don’t you love it when there are cheap, safe, side-effect-free solutions to common medical problems? One of the reasons I started was to unearth all of the amazing medical knowledge that may languish in the scientific literature because there isn’t a hefty corporate budget driving its promotion. Everything we do here is free. No ads, no corporate sponsorships, no selling you anything. If you’d like to support our nonprofit work and help expand our team of researchers, please consider donating here. 

This video was the conclusion to a three-part series on duct tape and warts. If the missed the first two, see Duct Tape and Wart Removal and Can You Really Remove Warts with Duct Tape?. 

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Should We Remove Warts with Duct Tape? Thu, 24 Aug 2023 12:00:23 +0000 Duct tape beat out ten other wart treatments for cost and effectiveness, so why isn’t it standard practice? 

One of the “unusual, innovative, and long-forgotten remedies” noted in a dermatology journal article was the use of duct tape to cure warts. It was finally put to the test. There are all sorts of conventional therapies, from acid to cryosurgery to lasers, but most are “expensive, painful, or labor intensive,” whereas the simple application of duct tape is none of those and may even be more effective than trying to freeze off the warts. 

As I discuss in my video Can You Really Remove Warts with Duct Tape?, some doctors lauded the study, noting they had been using duct tape as a “painless, yet effective, therapy for several decades,” instead of “surgery and other destructive therapies.” Said one physician, “Sometimes, when I’ve mentioned this type of therapeutic option to a patient, they will look at me as if I’ve lost my mind! When the treatment works, however, they appreciate the wisdom of my advice and my ‘minimal discomfort and fuss’ philosophy.”

Other doctors were not so amused. After spending money on all sorts of fancy equipment, along comes duct tape? Studies like that “could damage the reputation of cryosurgery,” wrote one physician, who also complained that the ten-second application of liquid nitrogen used in the study was too short, so it was an unfair comparison. And, evidently, you really have to get in there and freeze until there is a blistering reaction. It’s painful, but too bad. The doctor even joked and made light of a poor child who, before each freezing treatment session, vomited out of fear of the pain! 

Did he have a point, though, about the ten seconds? In the trial comparing duct tape to cryotherapy, those ten-second cryotherapy treatments worked 60 percent of the time, which is actually better than the results of most cryotherapy studies that only seemed to cure about 50 percent. In fact, typical cryotherapy for warts works so poorly that, statistically, it didn’t even beat out placebo, so all of that pain may have been for nothing, though aggressive cryotherapy does seem to work better. 

What they should have done, wrote another doctor in response to the duct tape trial, is take a scalpel to the wart and really blister it before going back a week later and trying to cut and crater it out. Maybe even go back a third time. ”If the procedure I detailed had been followed, the resolution rate would have been closer to 90%”—but at what cost? In the duct tape trial, one patient “lost his study wart in a trampoline toe-amputation accident.” (Amputation—a 100 percent effective treatment!) But, at what cost? In this study, 85 percent of the duct tape patients were cured without any pain or tissue damage, whereas aggressive cryotherapy may require lidocaine injection nerve blocks, “taking the cry out of cryotherapy.” It can also cause permanent tissue damage. As you can see below and at 2:48 in my video, you can end up with big, necrotic, frostbite lesions. In one sense, tissue damage is the whole point of freezing warts, but you can end up causing deep burns, rupturing tendons, which can cause permanent disability, or causing extensive scarring in rare cases. Just the psychological stress of having to keep going back for such a painful procedure may ironically impair our ability to fight off the wart viruses in the first place. 

So, “even if the effectiveness of duct tape occlusion is shown to be merely equivalent to that of cryotherapy,” duct tape would be better. And it was shown to be even more effective than cryotherapy; in fact, duct tape may be the most effective treatment. As you can see in the graph below and at 3:25 in my video, compared to ten other wart treatments, duct tape beat them all in terms of effectiveness and cost. It was cheaper than all but the “DN” option, with DN standing for Do Nothing. Compared to the most cost-effective prescription treatments available, over-the-counter duct tape is ten times cheaper. “It is an unusual and welcome event in health care when a common ailment is proven equally amenable to an inexpensive, tolerable, and safe alternative therapy.” 

Hold on. If you look at the latest Cochrane review, which many consider to be the gold standard of evidence-based reviews, it acknowledges that cryotherapy “is less convenient, more painful, and also more expensive,” but despite being excited about the effectiveness of duct tape in an earlier review, in two subsequent studies, duct tape seemed to totally flop. So, should we give up on duct tape for warts, or is there another side of the story? You can find out the thrilling conclusion in Which Type of Duct Tape Is Best for Wart Removal?, the next and final video in this three-part series. 

This is the second video in my three-part series. If you missed the first video, check out Duct Tape and Wart Removal. 

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Removing Warts with Duct Tape? Tue, 22 Aug 2023 12:00:26 +0000 Duct tape beat out cryotherapy (freezing) for treating warts in a randomized, controlled, head-to-head trial. 

When I was reviewing “The Science Behind Common Over-the-Counter Remedies Used in Dermatology,” such as tea tree oil for acne or nail fungus, I was surprised to see a section on duct tape on the same page. Duct tape? The only time I remember seeing duct tape used in a medical study was for identifying the gases responsible for the odor of human farts. That study involved a “collection system” comprised of “gas tight pantaloons” sealed to the skin with duct tape to assess the wind-breaking ability of a cushion called the Toot Trapper. 

In this case, the dermatology journal was talking about warts. As I discuss in my video Duct Tape and Wart Removal, “Duct tape brings out our inventive, slightly kooky side…Given this versatility, it wasn’t so surprising a few years ago when a group of doctors…reported that duct tape could get rid of warts.” As I noted in my previous video on warts, Benefits of Tea Tree Oil for Warts and Cold Sores, all sorts of strange things are purported to cure warts—because most warts go away on their own. Researchers followed a thousand kids for two years, and two-thirds of their warts disappeared without doing a thing. So, maybe we should just leave them alone, “although…there are cases which may warrant treatment…” Otherwise, we can just let our own body take care of them. 

Warts are caused by wart viruses, so spontaneous wart disappearance is thought to be an immune response where our body finally wakes up and takes notice. This assumption is based on studies where foreign proteins were injected into the wart itself. In one such study, researchers injected a measles-mumps-rubella (MMR) vaccine directly into the wart, which, compared to placebo, appeared to accelerate the immune clearance process. The problem is that injections hurt, of course, and 30 percent of the kids who got their warts injected with the vaccine suffered a flu-like syndrome. Yikes. Okay, scratch that. What else can we do? 

Within a few months, any placebo treatment will work in about a quarter of the cases, so it wouldn’t mean much if you put duct tape on 100 warts and 23 went away. The traditional medical therapies of acid treatments and freezing treatments bump up the cure rate to about 50 percent, so, if you were really serious about testing the efficacy of duct tape, you would pit it head-to-head against one of those two treatments, which is exactly what researchers did in “The Efficacy of Duct Tape vs Cryotherapy in the Treatment of Verruca Vulgaris (the Common Wart).” (Cryotherapy is one of the current treatments of choice for many pediatricians.) 

“Objective: To determine if application of duct tape is as effective as cryotherapy in the treatment of common warts.” Patients were randomized to receive either liquid nitrogen applied to each wart or “duct tape occlusion (applied directly to the wart).” When I heard about treating warts with duct tape, I had an image where duct tape was used to try to rip off the warts, but that wasn’t the case. A little circle of duct tape was applied to the wart every week or so.  

Although there had been a few anecdotal reports of using tape, no prospective, randomized, controlled trial had been performed until this study. Researchers found that the duct tape “is not only equal to but exceeds the efficacy of cryotherapy in the treatment of the common wart.” Cryotherapy worked in 60 percent of the cases, but 85 percent of the duct-taped patients were cured. The researchers concluded: “Duct tape occlusion therapy was significantly more effective than cryotherapy for treatment of the common wart.” More effective and with fewer side effects. “The only adverse effect observed in the duct tape group during our study was a minimal amount of local irritation and erythema,” or redness, whereas cryotherapy hurts. 

Do you want to hear the saddest thing? One young child actually vomited in fear of pain before each cryotherapy session. It was as though the poor kid was being tortured. Cryotherapy can not only cause pain, but bloody blisters that can get infected, and it can mess up your nail bed, too. 

So, duct tape: more effective, fewer side effects, and more convenient. Compare applying a little duct tape at home to making multiple clinic visits every two weeks or so. With duct tape, it’s win-win-win. 

Duct tape “can now be offered as a nonthreatening, painless, and inexpensive technique for the treatment of warts in children.” How much does a little piece of duct tape even cost? Win-win-win-win! Of course, the money you save is the money the doctor loses, and there’s no way the medical profession is going to let this go unchallenged. Further studies were performed and failed to show an effect. So, we end up with conclusions like this in the medical literature: “Is duct tape effective for treating warts?… No.” What? Is duct tape really ineffective after all, or was there some kind of critical design flaw in the follow-up studies? You can find out in my follow-up video Can You Really Remove Warts with Duct Tape?. 

This video is the first in a three-part series on duct tape for wart removal. The others are Can You Really Remove Warts with Duct Tape? and Which Type of Duct Tape Is Best for Wart Removal?. 

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