NutritionFacts.org

Health Topics

  1. #
  2. A
  3. B
  4. C
  5. D
  6. E
  7. F
  8. G
  9. H
  10. I
  11. J
  12. K
  13. L
  14. M
  15. N
  16. O
  17. P
  18. Q
  19. R
  20. S
  21. T
  22. U
  23. V
  24. W
  25. X
  26. Y
  27. Z
Browse All Topics

Turmeric Curcumin and Rheumatoid Arthritis

Randomized controlled trial comparing the safety and efficacy of drugs versus curcumin, the yellow pigment in the spice turmeric, for the treatment of autoimmune inflammatory rheumatoid arthritis.

January 15, 2014 |
GD Star Rating
loading...

Topics

Supplementary Info

Can't view the video above? Try it on Vimeo!
View Turmeric Curcumin and Rheumatoid Arthritis on Vimeo

Sources Cited

Y. Henrotin, A. L. Clutterbuck, D. Allaway, E. M. Lodwig, P. Harris, M. Mathy-Hartert, M. Shakibaei, A. Mobasheri. Biological actions of curcumin on articular chondrocytes. Osteoarthr. Cartil. 2010 18(2):141 - 149.

S. K. Yadav, A. K. Sah, R. K. Jha, P. Sah, D. K. Shah. Turmeric (curcumin) remedies gastroprotective action. Pharmacogn Rev. 2013 7(13):42 - 46.

B. Chandran, A. Goel. A randomized, pilot study to assess the efficacy and safety of curcumin in patients with active rheumatoid arthritis. Phytother Res. 2012 26(11):1719 - 1725.

P. Anand, C. Sundaram, S. Jhurani, A. B. Kunnumakkara, B. B. Aggarwal. Curcumin and cancer: An old-age disease with an age-old solution. Cancer Lett. 2008 267(1):133 - 164.

A. Shehzad, J. Lee, Y. S. Lee. Curcumin in various cancers. Biofactors. 2013 39(1):56 - 68.

S. Saha, A. Adhikary, P. Bhattacharyya, T. Das, G. Sa. Death by design: Where curcumin sensitizes drug-resistant tumours. Anticancer Res. 2012 32(7):2567 - 2584.

A. Goel, A. B. Kunnumakkara, B. B. Aggarwal. Curcumin as Curecumin: From kitchen to clinic. Biochem. Pharmacol. 2008 75(4):787 - 809.

R. A. Sharma, A. J. Gescher, W. P. Steward. Curcumin: The story so far. Eur. J. Cancer 2005 41(13):1955 - 1968.

S. C. Gupta, S. Patchva, B. B. Aggarwal. Therapeutic roles of curcumin: Lessons learned from clinical trials. AAPS J. 2013 15(1):195 - 218.

S. Shishodia. Molecular mechanisms of curcumin action: Gene expression. Biofactors. 2013 39(1):37 - 55.

S. C. Gupta, G. Kismali, B. B. Aggarwal. Curcumin, a component of turmeric: From farm to pharmacy. Biofactors. 2013 39(1):2 - 13.

S. Shishodia, G. Sethi, B. B. Aggarwal. Curcumin: Getting back to the roots. Ann. N.Y. Acad. Sci. 2005 1056(NA):206 - 217

S. Salvioli, E. Sikora, E. L. Cooper, C. Franceschi. Curcumin in cell death processes: A challenge for CAM of age-related pathologies. Evid Based Complement Alternat Med. 2007 4(2):181 - 190.

M. S. Baliga, N. Joseph, M. V. Venkataranganna, A. Saxena, V. Ponemone, R. Fayad. Curcumin, an active component of turmeric in the prevention and treatment of ulcerative colitis: Preclinical and clinical observations. Food Funct. 2012 3(11):1109 - 1117.

A. Shehzad, G. Rehman, Y. S. Lee. Curcumin in inflammatory diseases. Biofactors. 2013 39(1):69 - 77.

J. H. Kim, S. C. Gupta, B. Park, V. R. Yadav, B. B. Aggarwal. Turmeric (Curcuma longa) inhibits inflammatory nuclear factor (NF)-κB and NF-κB-regulated gene products and induces death receptors leading to suppressed proliferation, induced chemosensitization, and suppressed osteoclastogenesis. Mol Nutr Food Res. 2012 56(3):454 - 465.

B. B. Aggarwal, W. Yuan, S. Li, S. C. Gupta. Curcumin-free turmeric exhibits anti-inflammatory and anticancer activities: Identification of novel components of turmeric. Mol Nutr Food Res. 2013 57(9):1529 - 1542.

W. H. Inman. Study of fatal bone marrow depression with special reference to phenylbutazone and oxyphenbutazone. Br Med J. 1977 1(6075):1500 - 1505.

L. Baum, C. W. K. Lam, S. K.-K. Cheung, T. Kwok, V. Lui, J. Tsoh, L. Lam, V. Leung, E. Hui, C. Ng, J. Woo, H. F. K. Chiu, W. B. Goggins, B. C.-Y. Zee, K. F. Cheng, C. Y. S. Fong, A. Wong, H. Mok, M. S. S. Chow, P. C. Ho, S. P. Ip, C. S. Ho, X. W. Yu, C. Y. L. Lai, M.-H. Chan, S. Szeto, I. H. S. Chan, V. Mok. Six-month randomized, placebo-controlled, double-blind, pilot clinical trial of curcumin in patients with Alzheimer disease. J Clin Psychopharmacol. 2008 28(1):110 - 113.

S. Bengmark, M. D. Mesa, A. Gil. Plant-derived health: The effects of turmeric and curcuminoids. Nutr Hosp. 2009 24(3):273 - 281.

S. D. Deodhar, R. Sethi, R. C. Srimal. Preliminary study on antirheumatic activity of curcumin (diferuloyl methane). Indian J. Med. Res. 1980 71:632 - 634.

Acknowledgements

Images thanks to Qnr via Flickr. Thanks to Ellen Reid for her image-finding expertise and Jeff Thomas for his Keynote help.

Transcript

According to the World Health Organization, 80% of the Earth’s inhabitants (seven billion) rely upon traditional medicine for their primary health-care needs, in part due to high cost of Western pharmaceuticals. Medicines derived from plants have played a pivotal role in the health care of both ancient and modern cultures. One of the prime sources of plant-derived medicines is spices. Turmeric is one such spice that has been consumed over the years around the world. Turmeric is known around the world by different names, my favorite of which is probably zard-choobag.

Turmeric is the dried powdered root stalks of the turmeric plant—a member of the ginger family—from which the orangish-yellow pigment curcumin can be extracted. The spice turmeric is what makes curry powder yellow, and curcumin is what makes turmeric yellow. The molecule even looks cool. I always thought it kind of looked like crab.

In recent years, more than 5000 articles have been published in the medical literature about curcumin. Many sport impressive looking diagrams suggesting curcumin can benefit a multitude of conditions via a dizzying array of mechanisms.

Curcumin was first isolated more than a century ago, but out of the thousands of experiments, just a handful in the 20th century were clinical studies, involving actual human participants, but since the turn-of-the-century more than 50 clinical trials have been done, testing curcumin against a variety of diseases, with 84 more on the way.

But most of the 5,000 were just in vitro lab studies, which I've resisted covering until they moved more out of the petri dish and into the person. But this study got my attention.

Rheumatoid arthritis is a chronic systemic inflammatory disorder that causes progressive destruction of the cartilage and bone of joints. The long-term prognosis of RA is poor with as much as 80% of patients affected becoming disabled with a reduction of years in life expectancy. There're lots of drugs one can take, but unfortunately they're often associated with severe side effects including blood loss, bone loss, bone marrow suppression, and toxicity to the liver and eyes.

Efficacy was first demonstrated over 30 years ago in a double-blind crossover study: curcumin versus phenylbutazone, a powerful anti-inflammatory they use in race horses. Both groups showed significant improvement in morning stiffness, walking time, and joint swelling, with the complete absence of any side effects in the curcumin group, which is more than can be said for phenylbutazone, which was pulled from the market three years later for wiping out people's immune systems, and their lives.

Forty-five patients diagnosed with rheumatoid arthritis were randomized into three groups: curcumin, the standard of care drug, or both. The primary endpoint was a reduction in disease activity, as well as a reduction in joint tenderness and swelling. All three groups got better but interestingly the curcumin groups showed the highest percentage of improvement, significantly better than those in the drug group. The findings are significant and demonstrate that curcumin alone was not only safe and effective, but surprisingly more effective in alleviating pain compared to the leading drug of choice, all without any adverse side effects. In fact curcumin appeared protective, given that there were more adverse reactions in the drug group than in the combined drug and curcumin group. In contrast to nonsteroidal anti-inflammatory drugs, curcumin has no gastrointestinal side effects, and can even protect the lining of the stomach.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Ariel Levitsky.

To help out on the site please email volunteer@nutritionfacts.org.

Dr. Michael Greger

Doctor's Note

Did you guess that that’s what was on the cover of my latest DVD? Hard to appreciate the gorgeous color of fresh turmeric root unless you see it for yourself. You should be able to find it at any large Asian store. I incorporate it into my Natural Nausea Remedy Recipe. The inner color is almost fluorescent!

I’m afraid followers of NutritionFacts.org are going to get sick of turmeric, but there’s a lot of important new research I felt I needed to cover. Next I’ll cover Turmeric Curcumin and Osteoarthritis, then move to Boosting the Bioavailability of Curcumin, and end (for now!) with a video on Who Shouldn’t Consume Curcumin or Turmeric.

I’ve talked about treating autoimmune joint inflammation with diets full of plants in Diet & Rheumatoid Arthritis and Potassium and Autoimmune Disease.

If phenylbutazone sounds vaguely familiar, maybe you read my Q&A Is horse meat safe to eat?

If you haven't yet, you can subscribe to my videos for free by clicking here.

  • Iain Wetherell

    Hi Dr Greger, Iain here. Hope you are well. Turmeric is one of the few foods I can’t get on with – is it ok to take it as a supplement? If so, are there any you would recommend? Many thanks for your fantastic work.

    • http://nutritionfacts.org/ Michael Greger M.D.

      Cheapest way would be to fill one’s our capsules, since in bulk it’s just pennies. If you were going to buy premade supplements, with some exceptions I’d suggest whole turmeric powder, not isolated curcumin, for reasons I’ll explain in upcoming videos.

      • Randall

        That would be terrific if you would elaborate Dr Gregor on the benefits or possible disadvantages of taking full Turmeric versus a supplement of Curcumin. There appears to be quite a bit of confusion.

        Personally, I employ whole Turmeric, as I usually consider the more natural–nature made–product the best for all around use. There are usually hidden benefits from phytonutrients that are frequently overlooked from a narrow minded view. Some Black Pepper is added to increase absorbtion.

  • Hillary Rettig

    thanks! i know someone who can really use this info -

  • Cam Leviticus Gb

    Does mustard have significant amount.?

    • Darryl

      This recipe mimicking French’s suggests common yellow mustard just over 1% turmeric (⅛ tsp in ¼ cup).

  • Rachel

    Thanks so much for sharing this great information!! Now I need to know how to implement it! Can you please do a video or a post on how to best add Turmeric Curcumin to your diet to get all these benefits?

    For EXAMPE: What are the best ways to add Turmeric Curcumin into your diet? Do you chop up the root and eat the root? Juice the root? Buy the spice and add it to your soups and other dishes?
    Take a supplement?

    How much should you consume each day? I suffer with chronic inflammation so I would really love to know more.

    Thank you!

  • stephanie Lester

    Hi! How do we consume Tumeric & in what amounts? Is it available as a tea? Capsule? Recently diagnosed with RA & eager to find natural relief. Thanks!

  • Tobias Brown

    Thanks for this report which confirms your earlier reports on turmeric. Thankfully, I’ve finally taken the lead from a vegan friend and started preparing DAL as a food I’ve started eating almost daily, which covers me for legume department (though I have a weakness for fresh sweet peas too). The best thing is that the recipes calls for several of the GREATS in the short list of foods that are really good for us: Cooked onion, garlic, tomatoes, ginger and… TUMERIC. Though I still can make it as well as my friend, batches lasting few days can be made in a pressure cooker in less than 20 minutes.

    • Darryl

      For those with an South Asian market nearby with black mustard/rai (AITC), asafoetida/hing (many compounds), curry leaves (mahanine), fenugreek leaf/methi (diosgenin), I never seem to tire of this South Indian dal. Prepared garlic/ginger paste at South Asian markets is a real time saver, too.

      • Tobias Brown

        The recipe link here leads to the page on mahanine.

        • Darryl

          ooops. fixed.

      • Tobias Brown

        Do you do the frying, or “tempering” part? I do this however I skip the oil. Anyway. Thanks for this reference. I’ll try it, though not until I perfect my Dal Tadka recipe, which I literally eat every day (though only for the past couple of weeks, as it’s still a novelty for me.)

        • Darryl

          Frying in minimal oil is necessary to extract the flavor compounds from whole mustard and cumin seeds (you’ll hear them pop and fly across the kitchen). Some added oil will also help with absorption of carotenoids from the tomatoes. Ghee is traditional and as an animal product high in saturated fat, in my opinion unwelcome, but any other cooking oil will do. Mustard oil is an authentic alternative. Dals, and legume dishes in general, require a lot less oil than recipes often call for – I double that recipe while halving the oil so its still < 15% fat.

          • Tobias Brown

            Yeah, a little bit of oil… But I recall Dr Esselstyn shouting “No oils.” Anyway. Will look into mustard oil. Can’t see that using a bit could be harmful, but I’m not a researcher.

          • Darryl

            Dr. Esselstyn is trying to stabilize coronary plaques, and many fats are both directly and indirectly inflammatory (trans > SFA > MUFA > ω-6 > ω-3). Having an absolute rule like his makes sense for his patients and others with plaques that could burst and cause a heart attack at any moment, who would otherwise be adding not-so “heart-healthy” 12% SFA 78% MUFA olive oil.

            A vegan diet with no nuts and added fats can be as low as 10% fat, compared to the 35% American average. My goal is a bit more moderate: I aim for 15% of caloric intake from fats, avoid trans and saturated fats where ever possible, and choose fatty foods like nuts or minimal cooking/salad oil with the highest ω-3:ω-6 ratio (it doesn’t leave much: canola & mustard oils, walnuts, flax seeds, and wheat germ).

          • Coacervate

            I am in that “no oil” group, been there for 2.5 years now. Heart attack (“mild”) 10 years ago…IS THERE a period of time on the strict NO OIL Essy diet after which you could say the plaques have stabilized? Any data on that? I keep wondering what those “pimples” are doing in there.

          • Darryl

            Ornish and Esselstyn’s work suggests plaques stabilize in weeks, and regress in years, but I haven’t encountered any good guides to a “safe” level of dietary fats for secondary prevention. In the big studies with moderate fat substitutions, people in the experimental arms still have plenty of coronary events, and there isn’t much work in the range between Pritikin/Ornish/Essylstyn pilot-scale studies (< 12% fats, < 5% saturated) and the larger cohort studies (~30% fats, ~10% saturated). There’s perhaps no “safe” threshold: every increment of trans, SFAs, and even MUFAs increase endothelial inflammation somewhat, and every higher ratios of ω-6:ω-3 intake makes signalling eicosanoids more inflammatory.

            I picked 15% because it was just achievable in my diet (calculated using Cron-O-meter) while permitting a daily 2 Tbsp flaxseed, 2 Tbsp walnuts, and a Tbsp added oil, and its roughly the amount consumed by rural Chinese in the China study. But Esselstyn’s record speaks for itself in secondary prevention.

          • VegAtHeart

            What is your take on health value/risk associated with a higher fat whole foods vegan diet, say roughly 30% of calories from fat including using a variety of nuts and seeds, soy, avocado and olives? I am curious in part because Dr. Greger has consistently argued in favour of eating nuts with seemingly no upper limit. In one video, he went so far as to argue that heart disease risk was halved by eating a handful of nuts per day.

          • Darryl

            The health benefit of nuts added to Western diets is usually attributed to phytosterols, tocopherols, magnesium, potassium, and (in walnuts) a fair ω-3:ω-6 ratio. The phytosterols, which interfere with cholesterol absorption, might not benefit cholesterol-free vegan diets. The tocopherols (including vitamin E and gamma tocopherol, also appear other seeds (and seed oils), including wheat germ and soy. There are other good sources for potassium (tomatoes, potatoes, wheat germ/bran, greens). And wheat germ/bran is a better source for magnesium. Western diets tend to be deficient in tocopherols, potassium, and magnesium, but it appears wheat germ/bran may be just as good at providing these, per calorie or per gram of saturated fat (at least for the 95% of us without a gluten sensitivity).

            Looking at the diets of howler monkeys and mountain gorillas, perhaps we can infer that our ancestors spent most of the last 40 million years eating a diet with 14-18% fats, 4-8% being saturated. Fat intakes among the low heart attack risk rural Chinese in the China study fall into this range (15% fats, 4% saturated), while the very low heart attack risk Tarahumara are a bit lower (12% fats, 3% saturated). I think these are good starting points, with higher fat intakes requiring good justification. For comparison the U.S. diet averages 33% fat, 11% of which is saturated, and the #1 killer remains cardiovascular disease.

            There’s a 5 lb bag of shelled walnuts in my kitchen, and my evening snack is 5 of them. I had to give up some tasty salad dressings to fit them into the fat budget.

          • Wegan

            i hope the bag is in the fridge, at that rate they will go rancid before you’re done. I don’t have that kind of self control.

          • VegAtHeart

            Thank you for providing your reasoning. Interesting argument, although I am never quite convinced by dietary evolution arguments as compared with those that are based on controlled humans studies/trials.

            The Institute of Medicine provides this chart indicating the Acceptable Macronutrient Distribution Range (AMDR) for fat as 20-35% for most people. What do you think?

          • Darryl

            As with all the NIM/NRC nutrition recommendations, a perusal of the justifications for their recommendations is worthwhile. Most study for lower requirements is addressed to infants and children, where formula feeding and school meals are important priorities. For adults, the rationale for a 20% minimum requirement appears to be drawn from the the fact that 99% consume more than 19.8% of calories from fat, without evident deficiencies. Specific named concerns for low-fat diets in adults were: inadequate calorie intake, high triglycerides, and inadequate n-6 & n-3 intake. Among developed world adults (without anorexia or digestive diseases), inadequate calorie intake isn’t common. In the context of low LDL levels (achieved with low fat diets), slightly elevated triglycerides like those of the Tarahumara indians don’t seem to matter. And actual requirements for the two essential fatty acids (linoleic and α-linolenic acid) determined from intravenous feeding are remarkably small:

            Total fat: The amount of total energy as fat in the diet can vary from 10 to 50 percent without differing effects on short-term health…there are insufficient data, however, to identify a definde intake level for fat based on maintaining fat balance or on the prevention of chronic diseases, therefore, neither an AI nor and EAR and RDA are set. Strong evidence that low fat diets actually predispose to either CHD or diabetes does not exist. In fact, some populations that consume low fat diets and in which habitual energy intake is relatively high have a low prevalence these chronic diseases… Available prospective studies have not concluded whether low fat, high carbohydrate diets provide a heath risk in the North American population.

            n-6: Studies on patients receiving total parenteral nutrution have shown that linoleic acid intakces of as little as 7.4g/d reverses the symptoms of deficiency…A AI for n-6 is set based on the median intake of linoleic acid in the United states where the presence of an n-6 fatty acid eficiency is basically nonexistent in the free living population.

            n-3: Intakes as low as 0.3 g/d (of α-linolenic acid) prevented the symptoms of deficiency…an AI is set based on the highest median intake of α-linolenic acid by adults in the United States where a deficiency is basically non-existent in noninstututionalized populations.

            So, while one can look at the headline 20% minimum recommendation as the final word, the actual text suggest adults need on the order of 10 g LA and 1 g ALA. Personally, I’d think 10 + 10 + some EPA/DHA is better to dilute inflammatory eicosanoids, but even that’s only about 10% of calories.

          • DH

            I’ve always found your guidance to readers to be incredibly wise. I’m having a hard time reducing my omega-6 intake (the latter decision made in light of the re-analysis and meta-analysis involving the Sydney Diet Heart Trial — http://www.bmj.com/content/346/bmj.e8707 ).

            I consume omega-6 in the form of large quantities of nuts and pumpkin seeds (though I’ve cut back on whole sesame seeds and cut down on brazil nuts, which are SFA-rich and increased cholesterol and apoB in one randomized trial); I also eat tahini as a salad dressing (crushed sesame paste), use a very small amount of olive oil without cooking it, and eat store-bought hummus (which is enriched with canola oil) as a condiment at most meals. Processed tofu-based meat analogues also seem to contain a lot of high oleic acid safflower or sunflower oil, which adds further omega-6 to my dietary burden.

            Do you think omega-6 intake is something to be worried about?

          • Darryl

            For the following: LA = ω-6 linoleic acid,
            ALA = ω-3 α-linolenic acid, AA ω-6 arachidonic acid, EPA ω-3 eicosapentanoic acid.

            The increased 5 year mortality (17.2% vs. 11.4%) from Sydney definitely threw a spanner in the works, though is worth noting that its results were just barely statistically significant, its intervention group had a high attrition rate, and used safflower margarine of unknown composition, possibly including trans fats. Their meta-analysis perhaps conveniently excludes larger studies (LA Veterans, MRC Soy) which include soy oil (51% LA & 7% ALA), which is as far as I’m concerned is still a high ω-6 fat. See their prior meta-analysis for details on the other studies. Still I think the evidence from the meta-analysis is sufficient to say oils with a lot of LA and negligible ALA (corn oil and safflower oil) are not heart healthy.

            The mechanistic concern with LA is two-fold: like ALA, its more likely to oxidize than more saturated fats; and its elongation product AA gives rise to more inflammatory eicosanoids than the competing EPA elongation product from ALA. The LDL oxidation concern is a favorite for paleo advocates, but as oxidizable ALA is cardioprotective, I don’t think oxidized LDL is that important a mechanism, leaving the ω-6 derived eicosanoids as the major issue. The conventional wisdom for reducing the proportion of ω-6 derived eicosanoids is choosing fats with a low ω-6:ω-3 ratio (flax, canola, and mustard oils, walnuts) or negligible amounts of ω-6 (high oleic sunflower oil, chia), eliminating AA (mostly in animal products), and supplementing with EPA (algal or fish oil). Note that in Western diets with ample preformed AA, LA intake doesn’t seem to effect plasma AA much, but in vegetarians, a low LA:ALA ratio does reduce the proportion of plasma AA.

          • DH

            LA Veterans study used mostly corn and soybean oil (with some safflower and cottonseed) and if I recall correctly, showed double the rate of deaths from cancer in the intervention arm, and half the rate of deaths from coronary disease in the intervention arm, with neutral effect on overall death. I am surprised that they would have excluded these studies in their latest meta-analysis, since they separately subclassified trials with mixed w-6:w-3 interventions. Still this seems to me to be a major scientific error and possibly investigator bias.

          • Darryl

            Investigator bias? Two of the authors have contributed to papers embraced by paleo-diet advocates:

            Dietary fat quality and coronary heart disease prevention: a unified theory based on evolutionary, historical, global, and modern perspectives

            Omega-3 fats in depressive disorders and violence: the context of evolution and cardiovascular health

            Still, axe-grinding can also lead to insight. That’s fascinating about the increased cancer mortality in L.A. Vets – the sort of thing one might expect from increased systemic inflammation.

          • DH

            Darryl, that’s an excellent point (re: axe-grinding).

            I have been reading the Mark McLarty document that you so kindly referred me to in one of your earlier postings. It is brilliant. I take issue with only a tiny bit of it (particularly the emphasis on supplements that have only biomarker data – I thought we had learned our lesson from the colossal antioxidant trial failures, but I have not yet gotten to Appendix B where he apparently discusses this in detail, perhaps on the basis that spirulina is a whole food). My main confusion comes down to the “very low fat” part of the diet (everything else I completely concur with). What is your take on it? I am perfectly willing to abandon all of my favorite fats (e.g. canola oil, tahina, nuts, seeds, nut butters, etc) and just go as low fat as possible (with a DHA supplement). But he also talks about monounsaturates being somewhat beneficial, so I am a bit confused as to the overall message. Ornish, Esselstyn, McDougall and others with hard data use a very low fat vegan diet, but one could also cite data suggesting that some fats are beneficial: Lyon Heart Trial (canola), PREDIMED (extra virgin olive oil), nuts (in various epidemiological studies and biomarker-based trials, as well as PREDIMED). In fact he recommends almonds and hazelnuts, which are oleate-rich but also contain other beneficial compounds, fiber, etc.

            So which is it – moderate fat vegan diet or as low fat vegan diet as possible? By using balsamic vinegar as a salad dressing and replacing the commercially bought tahini (containing canola oil) with homemade tahini, I could easily drop more fat from my diet.

            This to me seems to be the most intense controversy within veganism (low vs moderate fat).

          • Darryl

            McCarty runs a tiny supplement firm, so his advocacy for his pet ideas (spirulina, berberine, high dose folic acid, etc.) perhaps should be taken with a grain of salt. Low-Fat, Low-Salt, Whole-Food Vegan is actually his least pill-happy “Medline synopsis”, see Full-Spectrum Antioxidant Therapy for the other side of his thinking. I happen to think a select few supplements (none being common or having strong human evidence) are really intriguing, but I’ve avoided discussing them on this forum.

            I happen to disagree with McCarty on monounsaturates. In this meta-analysis, substituting MUFAs for SFAs had no effect on CVD deaths; in a 30 year study of serum fatty acids, MUFA levels were positively associated with coronary and all-cause death, and in better controlled animal studies, even plant-based MUFAs offered no protection against atherosclerosis compared to SFAs. That’s more than enough evidence to call into question the in vitro supported hypothesis that LDL cholesterol oxidation (which MUFAs should reduce) is a primary cause of vascular disease.

            I’ve now read around 50 papers on fats, and the only definite conclusions I’ve arrived at is that the only “good” fats are ω-3 PUFAs, trans fats are terrible, SFAs and MUFAs aren’t much better, and ω-6 PUFAs have a great big question mark hanging over them. That suggests to me the beneficial nutrients in nuts, aren’t the fats at all. I’d love to see a head-to-head study of nuts vs wheat germ or bran, which have 3-fold the tocopherol/fat and 5-fold the magnesium/fat content of nuts, and have ample studies in their “diluted” whole grain form demonstrating CVD benefits. Or at least a study that examined whether nuts had as much benefit in those eating whole grains exclusively.

          • DH

            I agree with that. Bear in mind also that the STARS trial found major reductions in cardiovascular events and reduction of plaque with a diet that replaced SFA with PUFA (both omega-3 and omega-6) and was very rich in fiber, amylopectin, etc. If you want this paper, hit me with a line and I will email it to you (dhackam@uwo.ca).

          • VegAtHeart

            Thank you for your detailed response and thorough analysis. If you haven’t already come across it, you will enjoy this tour de force of a paper on the lower limit of fat intake.

          • Coacervate

            Thanks for a straight answer. I’m on track.

    • Theresa

      What is the recipe? I love Dal but don’t make it very often. Would love to have recipe.

    • ifyoucareenough

      You don’t find straight turmeric to be too bitter? I’ve tried a few recipes that called for turmeric and didn’t like them as much as using curry powder.

  • B

    Thot I’d share some ways I incorporate turmeric into my diet. First, I buy it in bulk at a co-op or in large bags at the local Asian/Indian grocery store. Much less expensive than buying a regular spice bottle. I put it in all my smoothies/juices and the taste is mild. I also add it to curries and rice. It colors rice nicely and has only a mild nutty flavor. It can also be added to sauces and gravies (I make a vegan gravy with roasted eggplant)…the taste is mild enough to have minimal or complimentary flavoring. Finally, I bought a $12 capsule loader (for size 00 caps) and 1000 large empty capsules (about $15) and load them myself. That’s around a year’s supply. Then, if I’m not having it in my smoothies or food, just take a couple caps and get some as a natural supplement.

    • Coacervate

      Thanks, been thinking about the cap’s myself. Do you know if ground clove in a 00 cap would be tolerated by most people? Cloves seem so powerful to me.

      • Amanda Steele

        Thanks for the informative videos, Dr. Greger. I nominated you for a MacArthur Genius Award, but they wrote back & said they have their own committees. I have a question about the safety of Indian turmeric. Does it contain heavy metals. I am nervous now about green tea from China & Japan & spices from India. Please advise. Thanks too everyone for your comments & suggestions.

      • Lawrence

        Coacervate, here’s something to consider: I create a mixture of 3 parts turmeric powder, 1/2 part black pepper and 1 part clove powder (Frontier brand from Amazon) in a stainless steel bowl. I use size “0″ vegcaps and fill the capsules by hand (without a fancy loader device). I’ll take two capsules with food once a day. The black pepper aids absorption of turmeric, and the cloves are for a potent antioxidant kick and maybe blood sugar stabilization. I don’t really like turmeric as a spice because it stains so well, but I like using it as a supplement. No stomach upset experienced. Mixture ratios are just a ‘swag’ that seems right to me.

        • Coacervate

          Thanks for the TEK Lawrence. Getting late here. Reminds me of Richard Pryor: “…One day I was having cookies and milk. I mixed some 2 percent with some half n half, I stuck my cookie in the milk and the sh*t blew up.” Man i have to laugh. I mean the chemicals I used to put into my body, not me I mean SWIM…then you know, job, marriage, kids – straightsville…now its like I’m mainlining chems all over again…Hey man, got any shrooms? Yeah man, Upgrade’s got some marinaded portobellos that are oozing with curcumin, like totally rad kicking. We’re talking Orac dude, dig?

          I don’t know how to say…what a long strange trip its been. “….woke last night to the sound of thunder. How far off I sat and wondered. Ain’t it funny how the night moves?”

  • Vegamaniac

    For those who are prone to kidney stone formation, you may want to read this before dousing yourself with tumeric. Would love to have Dr. Greger’s take on this study. http://ajcn.nutrition.org/content/87/5/1262.full

  • jazgottt

    hi. My Mother has glioblastoma multiformae. She eats turmeric every day since almost all survirors of this deadly cancer say they ate turmeric or curcumin. we started to cook turmeric now of coursdo you know about research that

    • jazgottt

      I wrote prev message from smartphone and it is not complete. I wanted to ask if someone know about research about turmeric and glioblastoma or brain cancers in general. I have heard that curcumin crosses brain/blood barrier but am not sure if it is true.
      Usually I try to not rely on anegdotal data but in situation we as family are now we have no choice. I discovered that one of drugs tested as chemosensitiver is a substance that was originally found in saffron so I added also saffron as my Mother’s standard spice.

  • Jill

    Dr. G- What amount of Turmeric was taken in the study? Thanks!

    • Darryl

      The study.

      500 mg of BCM-95 / Bio-curcumin, a solvent extract of turmeric that’s 95% curcumin, with some essential oils added back in for bioavailability. As dried turmeric spice is 3.2% curcumin and 4.5% total curcuminoids, 500 mg BCM-95 is perhaps equivalent to 10 grams (1.5 Tbsp) of turmeric spice.

  • Shelly Young

    Dr. Greger:
    I know that Tumeric is not supposed to cause GI upset but it does with me. The first time I got a stomach ache from it. This time it has given me some bowel disturbances. It has very much helped my arthritis and would like to continue. Do you know what the minimum effective amount per day might be?
    Thank you for all that you do!

    • Susan

      I take 400 to 600 mg of extracts (capsules) as directed on product to reduce pain caused by arthritis and physical therapy. Currently, I only need it once a day, and that helps me prevent heart burn which I receive when taking more of the product. This is regardless of the product I take.

      When I made a fresh herb turmeric tea from the turmeric root and sipped the tea all day, I never had heart burn.

  • DH

    I would like to know if pickle achar is healthy. It contains mango, canola oil, salt, vinegar (acetic acid), spices, and potassium sorbate as a preservative. I dab it with a paper towel to soak up as much as the canola oil as possible.

  • Melody

    My grandmother contracted rheumatoid arthritis from a contaminated blood transfusion decades ago. Her doctor at the time predicted she would soon be wheelchair bound, but she is still incredibly active in her late seventies. She has managed her condition with various supplements, some of which are most likely helpful, and some of which are dubious (she is not interested in changing her diet).

    I have been convincing her to trade in mega-doses of vitamins for herbal supplements with well-documented benefits and low toxicity. She is already taking ginger, and now I am going to get her turmeric pills as well, so thank you!

  • veggieballs

    Dr.Greger, Thank you for all your awesome work! I recall a video where
    you cautioned us all on the dangers of too much turmeric, am I missing
    something here? Also, I’m an endurance (vegan) athlete and I’m
    out-of-commission with patellofemoral syndrome in my right knee- you
    think the turmeric will help out speeding up the healing process? Thank
    you for your time and hard work!

  • Tan

    Another amazing Dr. Greger video. Great food, awesome news.

  • Brian Thornton

    I have a liquid Mediherb Turmeric supplement made by Standard Process. On the label it says that it is Turmeric rhizome 1:1 extract from Curcuma long rhizome 5.0g. I have to drink it with juice because the taste in just nasty.

  • ifyoucareenough

    I have a fluctuatingly high ESR and have been diagnosed with Polymalgia Rheumatica (also have fibromyalgia, and at 60 I’m sure I have arthritis somewhere in my body … hard to tell what’s what I’ve had chronic pain for so long. (CRP has always been normal.)

    Anyway, do you think curcumin would help with my symptoms, maybe even bring my ESR back to normal?

    Hopefully one day you’ll have some info on PMR here. Thanks in advance Dr. G.

  • Susan

    I am now taking turmeric in supplemental form, which I am buying from Dr Weil VitaminAdvisor.com and am taking as Herbal Tissue Support with a full glass of water with or after breakfast, to reduce side effects of heart burn, which I experienced both with this, and with other turmeric supplements which contained black pepper. I am taking this supplement once a day.
    It helped me get through physical therapy with minimal pain, and even better, reduce the pain and inflammation that occurred after I was accidentally bumped two years ago, on the side on my lower leg. I had experienced severe bruising with a lot of pain that no pharmaceutical ever relieved. But, taking this supplement alleviated both the inflammation and pain completely, although the discoloration is still there from the bruising.
    An x-ray found nothing broken, yet the bruising remains since the onset of the injury. Would a MRI show what was wrong?