Ask the Doctor: Q&A with Michael Greger, M.D. (#17)

This is another sampling of the more than 800 comments and questions I’ve responded to on the site (so far!). Please feel free to leave any follow-up questions here or on any of the hundreds of videos on the more than a thousand topics covered on NutritionFacts.org. And remember, there’s a new video posted every weekday, so to make sure you don’t miss any:

OmarLittle asked on Ask the Doctor (#16)Do you have any advice on which plant foods or beverages can help prevent cavities and gum disease?

Normally we just hear about things to avoid to protect our teeth and gums (like candy, acidic juices, smoking, etc.) but what about things we should be eating? Last year an Italian review actually looked at the “anti-cariogenic” (cavity-fighting) properties of polyphenol phytonutrients (read full-text here). Polyphenols are found in all flowering plants and have been ascribed anti-inflammatory, anti-oxidant and anti-cancer properties. There are thought to be more than 8,000 types. In the plant kingdom they serve a defensive role, including fighting off bacterial infections. Since cavities are primarily caused by bacteria eating away our tooth surfaces, researchers started looking into the potential of polyphenols to protect against cavities. And indeed they found that this class of phytonutrients could directly inhibit the growth of plaque bacteria and their ability to attach to teeth, produce acid, and produce the sticky “biofilm” we call plaque. My only caution is to hold off brushing your teeth for a half hour after eating acidic foods like berries, citrus, and vinegars to cut down on dental erosion.

patmcneill asked on Better than green tea?  According to the USDA Database, an 8 fl oz (237g) serving of hibiscus tea has 20.48 mg of Iron, while the RDA for a male is 8 mg with an upper limit of 45 mg. Furthermore, apparently the Vitamin C in the drink itself or added to increase the antioxidant content tends to increase the absorption of Iron by the body. Will a few glasses of hibiscus tea a day be a few too many from the perspective of potentially developing an Iron Overdose, and especially in males?

I love the USDA Nutrient Database! (accessible here). That’s where the data for videos like The Best NutThe Best Bean, and The Best Apple came from. I can see how you could get confused, though. I know it says “fluid ounce” but they’re just multiplying their 100 g portion by 2.37. So what they’re referring to is 237 grams of the dried bulk petals (the ash and fiber content can tip you off). So even if you chew and swallow the hibiscus flowers after you drink your tea (or do what I do: blend them in with a high speed blender), it would take about 400 cups to reach that 20 mg, so no need to worry!

rosaleah asked on Dried apples versus cholesterolI eat dried fruits (prunes, raisins, apricots and now apples) daily. Please tell me your thoughts about what may be the cumulative effects on an aging body of sulphur dioxide preservatives used in processing fruits for drying.

35 years ago studies started implicating sulphur dioxide preservatives in the exacerbation of asthma. This so-called “sulfite-sensitivity” seems to affect only about 1 in 2000 people, but if you have asthma I would recommend avoiding it whenever possible. For more on preservatives, please check out my videos Is Sodium Benzoate Harmful?Is Potassium Sorbate Bad For You?Is Citric Acid Harmful?, and Diet & Hyperactivity. And for more on asthma, Preventing Childhood AllergiesPreventing Allergies in Adulthood, and Inflammatory Remarks About Arachidonic Acid.

Evan Brand asked on Antioxidants in a pinch: Does the anti-oxi value decrease with age of spice (or berry)? If so, how much? Second, how much is “toxic”? I heard taking more than 1-2 tbsns of cinnamon a day could be toxic. Is one hurting oneself if one takes 2 tbs of all the above mentioned spices a day?

Please see my video Oxalates in Cinnamon in terms of dosing. I have a video coming up comparing the safety of the four common types of cinnamon:

  • Cinnamomum verum (“True cinnamon,” Sri Lanka cinnamon or Ceylon cinnamon)
  • Cinnamomum burmannii (Korintje or Indonesian cinnamon)
  • Cinnamomum loureiroi (Saigon cinnamon or Vietnamese cinnamon)
  • Cinnamomum aromaticum (cassia or Chinese cinnamon)

I’ll go through how you can tell which is which to choose the safest, but just wanted to give you the heads up to make sure you’re using Ceylon (not cassia cinnamon).

soupy commented on Amla: Indian gooseberries vs. cancer, diabetes, and cholesterol:  I stirred 1 teaspoon of powdered amla into my daily glass of V8 juice, along with a sprinkle of black pepper and 1/2 teaspoon turmeric – tasted OK.

That’s an even better idea than you might know! I’m working on a new video on food synergy, documenting evidence that when certain foods are eaten together the sum of nutritive value may be greater than the parts. And there is indeed an amazing reaction that takes place between the phytonutrients in black pepper and turmeric. Eating black pepper at the same time as turmeric boosts the bioavailability of curcumin–the chief purported cancer fighter in turmeric–by (you sitting down?) 2000%! My only suggestion would be to choose the low-salt V8, as there is new evidence on just how bad sodium may be for the heart. See also my video Salt OK if Blood Pressure is OK?

-Michael Greger, M.D.

  • David Schmidt

    For the person drinking Low Sodium V8, there may be a better choice. Knudsens is only 35mg of Sodium and its Organic!
    http://www.rwknudsenfamily.com/products/very-veggie/very-veggie-organic-low-sodium/

    GD Star Rating
    loading...
  • http://www.facebook.com/lkarlan Lisa Karlan

    About a year ago, I began putting “a pinky finger’s worth” of the fresh rhyzome, turmeric, into my green smoothie each morning. About 5 months ago, I had my first kidney stone ever. Then, 3 months later, I had another kidney stone. My physician never made the connection…..you did in your video blog about soluble and insoluble oxalates! I was obviously ingesting too much on a daily basis. Would you recommend completely avoiding this amazing compound or if it would be reasonable to begin using about 10% of the amount I used in the past?

    GD Star Rating
    loading...
  • jht

    The link to the full paper on (cavity-fighting) properties of polyphenol phytonutrients is broken.

    GD Star Rating
    loading...
    • Michael Greger M.D.

      Sorry you’re having problems! It works for me. Anyone else having problems with it? The full text is at: http://www.mdpi.com/1420-3049/16/2/1486/pdf

      GD Star Rating
      loading...
      • jht

        Sorry, I tried again and it works fine for me now.
        Thanks for checking.

        GD Star Rating
        loading...
  • soupy

    Some more thoughts on how to consume amla: I added a defrosted Indian gooseberry (need to remove the pit) to my smoothie and it was not good, with my daughter informing me that it tastes like dirty water. The candied amla is delightful, but the sugar probably reduces it’s value. I’m sticking with the powdered amla, which is fine in a smoothie or small glass of V8 juice.

    GD Star Rating
    loading...
  • http://www.veg-soc.org MarkB

    Dear Dr Greger

    Has any research been done on the relative benefits (or otherwise) of astaxanthin as an antioxidant?

    Thank you.

    MarkB

    GD Star Rating
    loading...
  • mikesnyder

    I’ve just seen you video from a year ago, “forgo fat free dressing”. Amazing! I ‘ve been following Dr McDougall, Dr Barnard, Dr Esselstyn, and Dr Campbell: low fat, Vegan diet for diabetes, cholesterol, etc. They all say no olive oil, few or no nuts or seeds, but this video seems to say we need some fat with veggies? Is a little olive oil OK? What’s the update? thank….Mike

    GD Star Rating
    loading...
    • Thea

      mikesnyder: I don’t have an absolute answer for you, but I can say that I asked something of a similar question on another page on this site. Dr. Greger suggested that it probably wouldn’t take much, say just a small amount of nuts, to meet that fat requirement for getting the nutrients out of greens.

      My interpretation of all of this is that the general advice from sources such as the Dr.’s you listed is still good. You probably don’t want a lot of of the processed oils. However, natural foods with relatively high amounts of fats, such as nuts and seeds, can be an important part of your diet, especially when eating greens. So, you can have your favorite delicious fat-free dressing and add some nuts to your salad and you end up with a super healthy dish that your body can absorb.

      That’s how I put it together in my head anyway. Good luck with your nutritional research.

      GD Star Rating
      loading...
  • GeorgeI

    I’ve seen a number of blog posts about some food scientists stating that if you avoid ANY food, canned tomato products and non-organic root vegetables should be at the top of your list?

    Do you know anything about these statements? Is it just the opinion of a few researchers or is there a lot of weight behind the recommendation to avoid those products?

    GD Star Rating
    loading...
    • Michael Greger M.D.

      Did they offer any rationale? With canned tomato products are they concerned about the BPA? (see my video Which Plastics are Harmful?). A recent study found that it was canned tuna that had the highest levels, whereas concentrations in canned vegetables was relatively low. And pesticides in root vegetables? Only one even made it into the Environmental Working Group’s top twenty list. If I had to pick a worst food it would probably be Crisco, processed meat, or some of the mentions in my blog post about Paula Deen.

      GD Star Rating
      loading...
      • Thea

        Dr Greger – I clicked on the link to the Environmental Working Group’s top 20 list. Potatoes are number 9. That’s a “root vegetable”, right? So, maybe there is something to staying away from non-organic root vegetables?

        Interestingly enough, sweet potatoes comes out at 41. I wonder why the difference.

        GD Star Rating
        loading...
        • Michael Greger M.D.

          Oh, you’re totally right about white potatoes! I’ll edit my comment–thanks Thea!

          GD Star Rating
          loading...
  • rrkim

    Is there a natural remedy for breast fibrosis associated with hormonal fluctuations? I’ve tried cutting down caffeine but I didn’t have much to begin with so all that I’ve changed has been going from first brew green tea to second brew green tea and from cacao to carob. I’m not sure that this has helped as my breasts are incredibly tender right before menstruation each month. My gyno said it was something that may just go away on its own, but I’ve had this discomfort for six months now. I’m 25, and my menstruation cycle is very regular.

    GD Star Rating
    loading...
  • http://www.facebook.com/profile.php?id=604652331 Grant Lucas

    I had a couple of questions.
    What is a good oil to cook with?
    Is soya milk good or bad for you?
    Thanks for the help
    Grant

    GD Star Rating
    loading...
    • Toxins

      Hello Grant,

      Oil is not a healthy food and should be avoided. There is no such thing as a healthy oil. The only difference is between ratios of fat. Otherwise they are the definition of empty calories, fat without nutrition, and also the most calorie dense food on the planet.

      If your looking for frying food, it is best to stay away from frying.
      http://nutritionfacts.org/videos/deep-frying-toxins/

      As for oil itself, what is the harm?

      Dr. Vogel conducted a study that compared different fats and oils (olive oil, canola oil, and salmon) and how they impaired our endothelial cells. Our endothelial cells are within our blood vessels lining their walls. They keep clots from forming and keep our blood running smoothly. It also helps our blood vessels dilate and contract when needed. The participants of the study ate a meal containing 3.5 tablespoons of olive oil and the examiners measured their arterial damage after 3 hours. “Contrary to part of our hypothesis, our study found that omega-9 (oleic acid)-rich olive oil impairs endothelial function postprandially.” They also make note that “In terms of their postprandial effect on endothelial function, the beneficial components of the Mediterranean and Lyon Diet Heart Study diets appear to be antioxidant-rich foods, including vegetables [and] fruits”
      http://content.onlinejacc.org/cgi/content/full/36/5/1455

      It was even noted that “In a clinical study, olive oil was shown to activate coagulation factor VII to the same extent as does butter. Thus, olive oil does not have a clearly beneficial effect on vascular function.”
      http://www.ncbi.nlm.nih.gov/pubmed/9409274

      Another study looked at different oils (olive, soybean and palm oils). They had their patients eat a potato soup. The soup either had 3 tablespoons of each oil OR they fried the potatoes in the oil. They too examined the extent of damage on the volunteers’ arteries. this is what they found “All the vegetable oils, fresh and deep-fried, produced an increase in the triglyceride plasma levels in healthy subjects.”
      http://www.ncbi.nlm.nih.gov/pubmed/17174226

      This 2 year study looked at coronary artery lesions of the heart after consuming different types of fat. Polyunsaturated fat (omega 3 type of fat) Monounsaturated fat (75% of which makes up olive oil) and Saturated fat (the kind found in mostly animal products). They looked at angiograms a year apart after intervening with increasing one type of fat in each group. All 3 fats were associated with a significant increase in new atherosclerosis lesions. Most importantly, the growth of these lesions did not stop when polyunsaturated fats and monounsaturated fats were substituted for saturated fats. Only by decreasing all fat intake including the polyunsaturated and monounsaturated fats did the lesions stop growing.
      http://jama.ama-assn.org/content/263/12/1646.abstract?sid=47d1d016-3c15-43f4-a013-0d10144ef8e3

      In conclusion, there are health risks associated with consuming oil. Moderation is easy to talk about but sometimes moderation can be too much.

      Experiment cooking with water instead of oil ( I do it and I don’t notice a significant taste difference). If baking healthy vegan pastries, try using apple sauce instead of oil.

      Soya milk is fine just be aware that it should be a small part of your diet and not a meal replacement but a condiment to whatever your consuming. Soy milk has benefits but it is also not entirely a whole plant food and is processed. Also, when consuming soy milk with tea or coffee be aware that the antioxidants will be absorbed and unavailable for you to use.
      http://nutritionfacts.org/videos/soymilk-suppression/

      GD Star Rating
      loading...
      • Thea

        Toxins: Your reply about the unhealthy nature of oils is ***extremely***. I know people who insist that olive oil is healthy. I will be saving your post and passing it on. Thanks!

        GD Star Rating
        loading...
        • Toxins

          No problem! Myth busting is always a favorite hobby of mine. I know people who insist olive oil is healthy too.

          Just some extra information, the study that really set olive oil in motion as a “health food” was this one.
          http://www.ncbi.nlm.nih.gov/pubmed/16954359

          Except there is one flaw in this study that I believe is significant enough. Spoken outright in the limitations.
          “The olive oil may have interacted with other dietary components, participants’ dietary intake was self-reported, and the intervention periods were short.”

          GD Star Rating
          loading...
  • Elvin

    Dr Greger: What is the optimal ratio (either by weight or volume) of turmeric to black pepper? (I am not a fan of black pepper but since reading what you write about the combination, I have been using 1/4 level teaspoon of each in my almost 1 kilo of steamed vegetables at lunch. I would not happily bear more black pepper than that.)

    GD Star Rating
    loading...