Ask the Doctor: Q&A with Michael Greger, M.D. (#18)

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:

CapeBreton asked on Evolutionary argument for optimal vitamin D levelI assume the lifeguards were caucasian? With a “built in” SPF of 15 what blood level of Vit D does the lifeguard of African descent attain? Perhaps that is a better clue for evolutionary “normal”.

You’re absolutely right, CapeBreton. Considering the average vitamin D levels of clothed high latitude office workers “normal” for our species doesn’t make much sense and though lifeguards are at least outside all day and half naked, they were still both Caucasian and Missourian. A more representative normal level of the “sunshine vitamin” could be gleaned measuring levels in those with black skin who live scantily clad in equatorial Africa. The problem is that such a study has never been done–until now.

This month researchers published results from the Maasai and the Hadzaben and the title says it all: “Traditionally living populations in East Africa have a mean serum 25-hydroxyvitamin D concentration of 115 nmol/l.” So lower than the pale St. Louisans, but still nearly twice the levels found in most Americans. No change to my recommendations, though, summarized in the culmination of my two week vitamin D series: Resolving the vitamin D-bate.

Toxins asked on Ask the Doctor (#16)Dr. Greger, I have heard some talk about the dangers of fluoride. When I research this all I stumble upon are propagandists websites without scientific backing. Is there any truth to these claims that fluoride in our water supply and toothpaste is damaging our health?

The proposed EPA changes to water fluoridation have sparked a resurgence of many of the old anti-fluoridation arguments, which as far as I can tell were successfully debunked over 50 years ago. According to the CDC, fluoridation of drinking water joins vaccination (another unjustly vilified practice) as one of the greatest public health achievements in the last last century.

MarkB asked on Dragon’s bloodIs any research available on astaxanthin which seems to be touted as a wonderful antioxidant?

Astaxanthin is the reason flamingos are pink (or at least flamingos in the wild; in the zoo they may be fed artificial dyes like farmed salmon–see my video Artificial Coloring in Fish). Astaxanthin is also the reason some crustacean shells turn red when boiled. One need not eat flamingo feathers or lobster exoskeletons, though. You can go right to the source and get it from green algae such as chlorella (I recommend against blue-grean algae and spirulina–see for example my videos Is blue-green algae good for you? and Another Update on Spirulina). A review last month suggests a wide range of beneficial effects, though one should note the author is listed as a dietary supplement industry consultant. With a few exceptions, I recommend against taking supplements as they have been found in some cases to be less effective (see, for example, my Produce Not Pills) or even deleterious (see Is vitamin D the new vitamin E? and my other 60 videos on supplements).

Georgel asked on Ask the Doctor (#17):  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?

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.

Joanne Irwin asked on Ask the Doctor (#16)Class participant heard that celery should be avoided for colon cancer patients. Only thing I’ve read about celery is to consume only ‘organic’ as conventional grown veggie is extremely high in pesticides. Do you know any other reason it should be avoided?  Thanks.

Celery avoidance makes no sense to me. In fact celery may have a “strong protective effect against colorectal cancer.” And in terms of for people already fighting the disease, a study was just published a few weeks ago elucidating the mechanism by which one of the key phytonutrients in celery (luteolin) arrests the growth of human colon cancer cells in vitro. For a comparison of the anti-cancer activity of a variety of vegetables, see my videos Veggies vs. Cancer and the follow-up, #1 Anticancer Vegetable.

For some reason the subject of nutrition appears especially wrought with myths, exaggerations, and baseless opinions. That’s in fact one of the reasons NutritionFacts.org was started. When it comes to what we put in our bodies, critical thinking is, well, critical. Any time anyone hears anything like that I would encourage you to ask what their source was for their information. If there really is science backing up their assertions I’d be happy to review it and offer my thoughts.

-Michael Greger, M.D.

  • Michael Greger M.D.

    Please feel free to post any ask-the-doctor type questions here in the comments section and I’d be happy to try to answer them.

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  • streetester

    What is your opinion of the theory of Cardiologist William Davis that wheat is unhealthy for humans? In the book, Wheat Belly, he claims that “scientific studies” prove his argument.

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  • Patek

    I am confused about fluoride!
    I found this http://www.atsdr.cdc.gov/toxprofiles/tp11.pdf and this http://tv.naturalnews.com/v.asp?v=42652E035A1B1BAAAE1F340B54694975
    ??

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  • Patek

    Also interesting http://www.ewg.org/node/21001

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  • jaycee

    Dr.Greger, is it possible to have coronary artery disease in an young patient without high cholesterol levels?

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  • Patek

    Dr. Greger, does fluoride increase risk of osteosarcoma ?

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  • Toxins

    Hello Dr. Greger. Latest in nutrition Volume 8 was a fantastic DVD. It was very informative and applicable to my lifestyle. I especially liked the healthy ice cream idea, I’m going to try that!

    I don’t want to pester you with an email, so I thought id post it here.

    In regards to creatine, you mentioned that most creatine supplements are contaminated with heavy metals, yet consuming a creatine supplement as a vegetarian has markedly increased cognitive function. Now my question to you is this.

    1. Is there any safe creatine supplement and if there was one, would you recommend consuming it?

    2. If there was a safe supplement and you did recommend it, wouldn’t constant consumption of creatine create a down regulation of production within the body similar to meat eaters?

    Also in reference to caffeine, you mentioned it has positive health benefits. This study shows that the caffeine in coffee caused impaired endothelial function. I know Dr. Essyslten also brings up this study. What are your thoughts?
    http://www.clinsci.org/cs/109/0055/1090055.pdf

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    • Michael Greger M.D.

      I’m so glad you liked it! (note: volume 8 won’t be available publicly until March; I’m still rolling out volume 7). So everyone understands the context, I’ll leave the creatine question until the video airs (sometime in early May), but let me address the caffeine question, since I’ve been such an outspoken advocate of green tea consumption (see, for example, The Healthiest Beverage and Dietary Brain Wave Alteration). As I detailed in my video The Power of NO, endothelial dysfunction is the first step towards atherosclerosis–our #1 killer–and so we need to keep the inner lining of our arteries healthy by any means necessary. Last year, a study entitled “Impact of Acute Caffeine Ingestion on Endothelial Function in Subjects With and Without Coronary Artery Disease” was published in the American Journal of Cardiology. They performed the most rigorous investigation to date, a randomized, double-blind, placebo-controlled cross-over study that found that caffeine significantly improved endothelial function. They concluded “In conclusion, acute caffeine ingestion significantly improved endothelial function assessed by brachial artery FMD in subjects with and without CAD and was associated with lower plasma markers of inflammation.” That was for the amount of caffeine found in about 2 cups of coffee, 4 cups of black tea, or 8 cups of green. Similar benefits were found previously at a higher dose (3, 6, and 12 cups respectively). So why do studies on brewed coffee, espresso, and energy drinks show negative effects? Well, there are a lot of other substances in these beverages besides caffeine, some of which may also be removed in the decaffeination process. Since there appear to be compounds in coffee that both impair and improve endothelial function (whereas in tea, both green and black, it appears to be all improvement), one might turn to epidemiological studies to look at overall risk and benefit of coffee consumption (see, for example, my Update on Coffee). Though filtered coffee may be good, the evidence supporting the benefits of green tea are much stronger and more consistent. So I continue to recommend people drink tea instead of coffee, not because coffee is bad for you, but because green tea appears to be much better.

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      • Toxins

        Thanks for your thorough reply and links to the studies. I am glad this is finally cleared up for me! I was always hearing the benefits of caffeinated products (i.e. tea and coffee) yet in the back of my mind thinking “what about impaired endothelial function?”. Is there a certain method to preparing coffee that will not cause endothelial damage? You mentioned filtered coffee is better but brewed coffee has been shown to cause damage (via studies linked) but isn’t this the same preparation? I will be looking forward to your response to creatine in May. Thanks.

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