Flashback Friday: Amla vs. Drugs for Cholesterol, Inflammation, & Blood-Thinning

Flashback Friday: Amla vs. Drugs for Cholesterol, Inflammation, & Blood-Thinning
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Extracts of amla (Indian gooseberry) were pitted head-to-head against cholesterol-lowering statin drugs and the blood thinners aspirin and Plavix.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Indian gooseberries, otherwise known as amla, have been touted as everything from a cancer fighter to a “hair tonic” to a “refrigerant,” whatever that means—what, like freon? Not to mention, a “snake venom detoxifier.” Complete with fancy diagrams, but based on what kind of research?

Yes, “[d]ietary intake of [both turmeric and amla] increases the life span [of fruit flies].” But, do we really care about the effects of amla on the life span, or the “sexual behavior” for that matter, of fruit flies? How do you even study the sexual behavior of fruit flies? Why, obviously, you just introduce “a virgin female and [a] bachelor male…into an “Elens-Wattiaux mating chamber.” Can you imagine having an insect-mating chamber named after you? And, it looks like there were two fighting over naming rights; so, they had to go with both!

Then, it’s just a matter of getting out a stopwatch. Twenty minutes is the average duration, but almost a half-hour on amla, the studly beast, and it dropped the mating latency, the time between when they were introduced to one another in the chamber, and when they started getting busy from ten down to seven…seconds! They don’t mess around. Well, actually, they do mess around—and quite rapidly.

And, on amla, they lay more eggs, and more hatched into larvae. But, just like when you hear amla is “the best medicine to increase…lifespan,” you’re probably not thinking about flies. When you read about amla may be a “potent aphrodisiac”, you’re probably not thinking, “More maggots!”

Now, there was this study that found extraordinary improvements in total cholesterol and LDL cholesterol—in actual humans, but that was compared to placebo. What about compared to simvastatin, a leading cholesterol-lowering drug, sold as Zocor? Treatment with the drug “produced significant reduction[s]” in cholesterol, as one would expect. But, so did the amla. In fact, you could hardly tell which was which. Now note, this was only about a 10 to 15% drop in total and LDL cholesterol. In this study, the amla dose was only 500 milligrams, which is like a tenth of a teaspoon. So, smaller than the eighth of a teaspoon a day. And, it wasn’t just the powdered fruit, but the powdered juice of the fruit, which may have made a difference.

How about versus Lipitor, the cholesterol-lowering drug known as atorvastatin? No effect of taking placebos, but significant improvements for the drug, and significant improvements for two amla doses—but again, only about 15% or so. Did they just use the juice again? No, worse; some patented extract of amla. So, instead of five cents a day, it’s 50 cents a day, and doesn’t seem to work as well. But, because there’s this proprietary version, at least there’s someone willing to pony up the funds to do the research.

It’s like the cancer story. “For [Indian gooseberries] to become relevant clinically,” they’re praying that “patentable derivatives [be] synthesized. Without the possibility of patents, the pharmaceutical industry [isn’t going to] invest” in the research; their shareholders wouldn’t let them. It’s patents over patients. But, without that research, how can we ever prove its worth—or worthlessness, for that matter?

So, drug and supplement industry interest in patenting natural food product remedies is a double-edged sword. Without it, there would never have been this study—showing not only benefits for cholesterol, but also arterial function: reducing artery stiffness in the two amla-extract groups and the drug group, but not placebo, as well as a dramatic drop in inflammation; C-reactive protein levels cut in half.

So, amla—or at least amla extracts—”may be a good therapeutic alternative to statins in diabetic patients with [artery] dysfunction because it has [many of] the beneficial effects of the statins but without the well known [potential] adverse [side-]effects of [the drugs]”—including muscle damage or liver dysfunction.

The amla extract was also compared to the blood-thinning drugs, aspirin and Plavix, often prescribed after heart attacks, and achieved about three-quarters of the same platelet aggregation-inhibiting effect as the drugs; significantly increasing the “bleeding and clotting time,” where they poke you with a needle, and see how many seconds it takes you to stop dripping. So, that’s actually a good thing, if you have a stent or something that you don’t want to clog up. But, it didn’t thin the blood outside the normal range, and so it may not unduly raise the risk of major bleeding.

It also appears to decrease the effects of stress on the heart. They had people plunge their hand into ice water, and keep it there until the pain became “unbearable.” This causes your arteries to constrict and blood pressure to go up—but not as much if you’re taking amla extract. Good to know for your next ice bucket challenge.

Please consider volunteering to help out on the site.

Icons created by Parkjisun from The Noun Project.

Image credit: Kristina DeMuth. Image has been modified.

Motion graphics by Avocado Video.

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Indian gooseberries, otherwise known as amla, have been touted as everything from a cancer fighter to a “hair tonic” to a “refrigerant,” whatever that means—what, like freon? Not to mention, a “snake venom detoxifier.” Complete with fancy diagrams, but based on what kind of research?

Yes, “[d]ietary intake of [both turmeric and amla] increases the life span [of fruit flies].” But, do we really care about the effects of amla on the life span, or the “sexual behavior” for that matter, of fruit flies? How do you even study the sexual behavior of fruit flies? Why, obviously, you just introduce “a virgin female and [a] bachelor male…into an “Elens-Wattiaux mating chamber.” Can you imagine having an insect-mating chamber named after you? And, it looks like there were two fighting over naming rights; so, they had to go with both!

Then, it’s just a matter of getting out a stopwatch. Twenty minutes is the average duration, but almost a half-hour on amla, the studly beast, and it dropped the mating latency, the time between when they were introduced to one another in the chamber, and when they started getting busy from ten down to seven…seconds! They don’t mess around. Well, actually, they do mess around—and quite rapidly.

And, on amla, they lay more eggs, and more hatched into larvae. But, just like when you hear amla is “the best medicine to increase…lifespan,” you’re probably not thinking about flies. When you read about amla may be a “potent aphrodisiac”, you’re probably not thinking, “More maggots!”

Now, there was this study that found extraordinary improvements in total cholesterol and LDL cholesterol—in actual humans, but that was compared to placebo. What about compared to simvastatin, a leading cholesterol-lowering drug, sold as Zocor? Treatment with the drug “produced significant reduction[s]” in cholesterol, as one would expect. But, so did the amla. In fact, you could hardly tell which was which. Now note, this was only about a 10 to 15% drop in total and LDL cholesterol. In this study, the amla dose was only 500 milligrams, which is like a tenth of a teaspoon. So, smaller than the eighth of a teaspoon a day. And, it wasn’t just the powdered fruit, but the powdered juice of the fruit, which may have made a difference.

How about versus Lipitor, the cholesterol-lowering drug known as atorvastatin? No effect of taking placebos, but significant improvements for the drug, and significant improvements for two amla doses—but again, only about 15% or so. Did they just use the juice again? No, worse; some patented extract of amla. So, instead of five cents a day, it’s 50 cents a day, and doesn’t seem to work as well. But, because there’s this proprietary version, at least there’s someone willing to pony up the funds to do the research.

It’s like the cancer story. “For [Indian gooseberries] to become relevant clinically,” they’re praying that “patentable derivatives [be] synthesized. Without the possibility of patents, the pharmaceutical industry [isn’t going to] invest” in the research; their shareholders wouldn’t let them. It’s patents over patients. But, without that research, how can we ever prove its worth—or worthlessness, for that matter?

So, drug and supplement industry interest in patenting natural food product remedies is a double-edged sword. Without it, there would never have been this study—showing not only benefits for cholesterol, but also arterial function: reducing artery stiffness in the two amla-extract groups and the drug group, but not placebo, as well as a dramatic drop in inflammation; C-reactive protein levels cut in half.

So, amla—or at least amla extracts—”may be a good therapeutic alternative to statins in diabetic patients with [artery] dysfunction because it has [many of] the beneficial effects of the statins but without the well known [potential] adverse [side-]effects of [the drugs]”—including muscle damage or liver dysfunction.

The amla extract was also compared to the blood-thinning drugs, aspirin and Plavix, often prescribed after heart attacks, and achieved about three-quarters of the same platelet aggregation-inhibiting effect as the drugs; significantly increasing the “bleeding and clotting time,” where they poke you with a needle, and see how many seconds it takes you to stop dripping. So, that’s actually a good thing, if you have a stent or something that you don’t want to clog up. But, it didn’t thin the blood outside the normal range, and so it may not unduly raise the risk of major bleeding.

It also appears to decrease the effects of stress on the heart. They had people plunge their hand into ice water, and keep it there until the pain became “unbearable.” This causes your arteries to constrict and blood pressure to go up—but not as much if you’re taking amla extract. Good to know for your next ice bucket challenge.

Please consider volunteering to help out on the site.

Icons created by Parkjisun from The Noun Project.

Image credit: Kristina DeMuth. Image has been modified.

Motion graphics by Avocado Video.

Doctor's Note

I profile the study that used the whole fruit in my video, The Best Food for High Cholesterol.

For more on amla, see:

The double-edged sword of patenting natural substances comes up over and over. See, for example, Plants as Intellectual Property: Patently Wrong?.

With a healthier diet, neither drugs nor supplements may be necessary:

For all of my videos on the latest research on cholesterol, visit our Cholesterol topic page.

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

The original video aired on October 30th 2017.

200 responses to “Flashback Friday: Amla vs. Drugs for Cholesterol, Inflammation, & Blood-Thinning

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  1. Not sure if Amla goes in the category of “Super-food” or not, like Kale, turmeric, and blueberries…

    I have a question for the forum, unrelated to the video today: They’re talking about having a Covid-19 vaccine available by November now – for the First Responders and high-risk populations first, then for the rest of us eventually. How many of you will go out and get the vaccine when it becomes available to the general public, say this winter? I’m curious.

    My apologies, if this has already been addressed elsewhere; Sometimes I miss things.

    1. Not me. I’m rural and have limited contact with tainted populations. Rushed vaccines have a very troubled history as well. Maybe in ten years when proper development has had time to pass and possibly they’ve learned how to avoid toxicity in vaccines.

      I’ll have some amla instead.

          1. So if Covid induced a heart attack or respiratory failure, that’s not really a Covid death? Only 6% deaths counted are Covid caused? Must be all hoax to get stopTrump’s re-election.
            That is the latest crazy conspiracy theory….
            PS How many deaths are attributed to ‘Old Age’.

            1. I feel it is VERY important to understand health factors that affect outcomes and even likelihood to become infected because those are things we can actually do something about. Since this is a health oriented website it seems obvious that people here would be interested in how health maintenance may help with general well being including covid amelioration. It is sad that technical issues have become so politically charged. Covid aside, surely if one is obese and has a heart attack then the cause of death will be properly described as a heart attack but people can still understand the role of obesity in negative health outcomes.
              That said, I wouldn’t rush to get a vaccine as I live in a relatively low infection rate area(fact). And I actually have the wildly optimistic hope that people will wake up and wear masks thereby reducing the basic reproductive number below zero which by definition will result eventually in no infections if kept below 1. The targeting of vaccine IF ACTUALLY PROPERLY TECHNICALLY TARGETED should also be significant in reducing the basic reproductive number as it will end transmission among the groups at greatest risk of infection.
              But I am grateful for the many efforts providing information about lifestyle and health maintenance that may help people avoid some degree of suffering due to this virus.

    2. dr cobalt,

      I tend to prefer older and well tested drugs; there are often too many undetected problems with newer drugs when they first appear on the market. In fact, I wish we had better drug registries, to record possible adverse effects of drugs once they hit the markets.

      That said, I prefer not to take drugs at all.

      As for the vaccine, I can’t believe that it will have been sufficiently tested in time to act as political propaganda for the election. Nonetheless, I worry about my daughter, who is a hospital nurse, being required to get one. I worry about everybody who is required to get early vaccines as part of their jobs.

      1. Dr. J,

        [I wish we had better drug registries, to record possible adverse effects of drugs…]

        You’re probably talking about registries that are beyond the reach of the general public. However, one website that I have found useful for basic information about drugs is rxlist.com. Have you browsed that one? They have tabs at the top for Professionals and Consumers (presumably a dumbed down version for the laity) and sub-categories for Description, Dosage, Interactions, Warnings/Precautions, Contraindications, Clinical Pharmacology, and Medication Guide.

        Whenever my mom had to go into the hospital as an inpatient, I always used that website to investigate the array of drugs she was assigned during her stay. Sometimes I garnered enough information to dialogue with her attending physician about my concerns.

        1. Dr. Cobalt,

          I am not decided yet about the vaccine.

          Not against them developing it. Not against using it.

          Just not in a rush to be the first group to get one.

          From experience, they will run out.

          I was picking up medicines for my step-mother recently and there were so many people getting flu shots and shingles shots and one said about the shingles shot, “You are always out.” But she came earlier in the year this year.

          1. I think part of the COVID vaccine question will be how things go with my father and cousin.
            My father is in the hospital now and had looked like he was improving until last night.
            Currently, he looks exactly like he looked when we brought him in.

            If he stays this weak and sickly, I will get one.

            1. Is Covid like the flu? There are articles on pubmed on using bran to treat hemmerhoids, and bran and psilium fiber have silicon in them. SIlicon is in Bananas, Potatoes, Mint, Stinging nettle, and horsetail weed. People who take Vitamin D3 survive covid better. I have some SIlicon gel from Britain. They say it is for oily skin though. Did you know grounding is good for the lungs? Electrons from earthing or grounding help the lungs, if covid is like the flu.

              1. Hi Mathew thanks for your comment about vitamin D and grounding. Vitamin D is a very important nutrient for immunity and as for grounding yes there has been studies on this topic as well.
                In the below review article, indicates that mounting evidence suggests that the Earth’s negative potential can create a stable internal bioelectrical environment for the normal functioning of all body systems. Moreover, oscillations of the intensity of the Earth’s potential may be important for setting the biological clocks regulating diurnal body rhythms, such as cortisol secretion [3].

                It is also well established that electrons from antioxidant molecules neutralize reactive oxygen species (ROS, or in popular terms, free radicals) involved in the body’s immune and inflammatory responses. It is assumed that the influx of free electrons absorbed into the body through direct contact with the Earth likely neutralize ROS and thereby reduce acute and chronic inflammation [4].
                https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3265077/

    3. Dr cobalt, in answer to your question about the coronavirus vaccine, no, I will not be getting it. I will be refusing the flu vaccine also. The only years I ever got the flu were the years I got the flu vaccine. Often I got the flu twice.

      1. Barb,

        I have been thinking about your experiences with flu vaccinations for some time.

        Superimposed upon the Coronavirus situation.

        What to do, what to do, what to do . . .

        I will certainly not try to talk you out of your decision.

        Were it myself – my thoughts change every day.

        Six of one . . .

        I hope that you will keep an exceptionally low profile for the duration of the current pandemic.

        All the best –

        Vivamus

    4. There are three types of vaccines… killed, DNA and RNA… we have never licensed or have experience with the latter two. So I would want to find out what type it is. The next two questions are safety and effectiveness. It has taken over a year in the past to do safety and efficacy testing for previous vaccines. I am concerned about the “rush” to get a vaccine out especially with an election coming up. Don’t get me wrong I think if we can “learn” how to produce a vaccine faster given new pandemics that would be good. The last question is will it be effective. We have had some success with flu vaccines in the past but no success with developing vaccines against corona viruses as in common cold. We know very little about “novel corona” viruses. The other variable is what population the safety and effectiveness testing is done on. At 72 years old I am in a “high risk” population so I’m interested but need more information to make a decision. My guess is that this “pandemic” will work through the population as they all do. We have to guard against the tendency to give “credit” to a vaccine when natural course of pandemic might be the main reason for effectiveness. I’m optimistic that we can learn from this pandemic and adequately prepare for the next one but given the past performance of gov’t and medical industry I am not hopeful. I am much more likely to get the flu shot when it becomes available for the upcoming season. I hope this perspective is useful… too many unknowns at this point for me to make a decision.

      1. If only people would leave the critters alone, we would not have pandemics – plant-based vegan is the way of the future if we want a future. Has anyone studied the effect the virus has on vegans as opposed the those on the typical western diet?

      2. I largely concur with Dr. Forrester’s thoughts. No disagreements.

        Excellent post – as per usual.

        I would like to add a perspective from this side of the kaleidoscope.

        In my experience this conversation is not generally engaged in by those who are accustomed to making these kind of decisions on the Physician level. The answer is clear. If the subject is brought up, it is dismissed with a wry comment or a gesture. No need to waste time.

        I have – a number of times – seen this conversation initiated by ancillary personnel. They smell a fish – they need affirmation.

        The question is generally asked with blank affect – as a poker player conceals his cards.

        I ask a few questions to allow the person to vent – then I tell the following story:

        (The following is from memory – corrections are welcome)

        Around a week after 9/11 (2001), the anthrax scare began. One of our government’s responses was to get an anthrax vaccine out to the doctors ASAP.

        It was a multidose vaccine. Military. Experimental to some degree – not fully vetted – special permit required to allow it to be used outside of normal channels. Efficacy? Effectiveness? Duration of immunity? I do not know.

        I am not sure that anyone knew. I mean – how do you test an anthrax vaccine on humans?

        Where are all those “prisoner volunteers” when you need them?

        Th idea was: E.R. Docs first. Then the rest in line.

        Funny thing was – the Docs wouldn’t take the vaccine.

        In the survey I saw – up on a screen during a conference – JAMA? – 98% of doctors stated that they would refuse to take the vaccine. 99% stated that they would refuse the vaccine for members of their family.

        They’d rather face Anthrax.

        Huh?

        Why?

        Because doctors understand vaccines.

        And they understand risk/benefit ratios.

        So the whole idea died.

        Well – no. No – the whole idea didn’t die.

        You know those wild and crazy vaccine guys.

        If they couldn’t foist it off on the doctors – they would foist it off on someone else.

        Never give a sucker and even break.

        Enter – the military.

        Oh – you could refuse to be vaccinated. No problem.

        But if you did – you were cashiered out of the military.

        Fifteen years in on your twenty?

        So much wasted time.

        What would you have done?

        When Gulf War Syndrome hit – people wondered. Spontaneously.

        I doubt that there is any causal link – if there was, you can be sure we would have heard about it.

        But people wondered.

        This time around – 2020 – I expect something like last time around. Not identical, certainly. But recognizable similarities.

        At that point I rest. And the inquirer speaks: What do I do if they say I have to take it?

        Well – I tell them – a man always has a choice.

        They nod. Silently.

        ———————————

        Dr. Forrester.

        If I may ask – what are your memories of the anthrax vaccine?

        Does this feel at all familiar?

        Best regards,

        Vivamus

        1. Vivamus,

          I was reading PubMed about the anthrax vaccine and Gulf War syndrome and, it seems like if there is an association, they would need to look for a different theory to link it.

          I read:

          The balance of immunological studies that have directly addressed Th2 bias of the immune response as an explanation for Gulf War-related illness appears to favour rejection of the hypothesis. We conclude that multiple vaccination, or the perception of it, could have favoured illness as an outcome of the post-deployment era, but that this has little to do with any putative effects on the immune system.

          1. People who investigated it for 20 years concluded that it was toxic exposure such as exposure to pesticides and ingestion of pyridostigmine bromide pills intended to protect troops against the effects of possible nerve gas—are “causally associated with GWI and the neurological dysfunction in Gulf War veterans.” They also decided that there was a link between neurological problems and exposure to the nerve-gas agents and oil well fire emissions.

            https://www.bu.edu/sph/2016/01/25/toxic-exposures-caused-illness-in-gulf-war-veterans/

          2. Deb,

            “We conclude that multiple vaccination, or the perception of it, could have favoured illness as an outcome of the post-deployment era, but that this has little to do with any putative effects on the immune system.”

            Are they saying that there is an association with multiple vaccinations and illness – but they cannot explain it physiologically?

            Steering the reader to infer that it’s all in their head?

            Hmmm . . .

            I am always cautious when I encounter such implications.

            I had always figured that there was probably no association between vaccinations and Gulf War Syndrome at all.

            Mildly interesting – but not really an area of interest for me.

            War is not my cup of tea.

            I prefer gardening.

            Deb.

            All the best –

            Vivamus

            1. Vivamus,

              I believe they were saying that the vaccines was one theory at the beginning of the process but that the theory had stated a mechanism and that mechanism wasn’t likely. So the theory wasn’t likely.

              Nobody else came up with another theory of how the vaccines could have caused it.

              Plus, the soldiers were exposed to so many other things and those things looked more promising.

      3. Dr. Forrester,

        Thank you for sharing your thoughts.

        My own thoughts are similar.

        The only thing that moves me toward the vaccine is that I have so many very elderly people who I help.

        Aside from them, I wouldn’t be standing in line to be first.

        Except that I do know that altruistically, people have stood in line to be first to help humanity.

        I have watched videos on that from history.

    5. I am an Emergency Department RN and I will not get the vaccine. Too much rush. There are many others willing to accept the risk of a brand new vaccine. I want to see how they do first.

      1. Julie,

        Prudent caution makes sense.

        But what are you going if do when your employer mandates the vaccination? (please see second article, below)

        The following makes sense to me:

        Two-thirds of Americans say they won’t get COVID-19 vaccine when it’s first available, USA TODAY/ Suffolk Poll shows
        https://www.usatoday.com/story/news/politics/2020/09/04/covid-19-two-thirds-us-wont-take-vaccine-right-away-poll-shows/5696982002/

        —————————–

        Then there’s the vaccine guy’s viewpoint. You can never say “no” to these people – they won’t let you.

        They have a product to sell. Willing or not – YOU are the customer.

        Can you hear the stirring patriotic music in the background?

        Defeat COVID-19 by requiring vaccination for all. It’s not un-American, it’s patriotic.
        https://www.usatoday.com/story/opinion/2020/08/06/stop-coronavirus-compulsory-universal-vaccination-column/3289948001/

        —————————–

        My own take:

        I will be very happy if everyone in America rushes out and gets the newly minted vaccine the first day that it is out – like people standing in long lines to be the first in America to get a fresh copy of the newly minted Windows Millennium. Or Windows Vista. Or Windows 8.

        I happy for everyone who enjoys beta testing new, untried technology.

        Except – of course – my own family, my friends, and myself.

        Our crew will be more than happy to watch from the sidelines – until the storm has dies down – and people actually understand what they are doing.

        Months? Years?

        Whatever it takes.

        And as time passes – we will evaluate and re-evaluate the evidence and make our decisions as appropriate.

        Hey – most of us (who needed to) have lost weight – 15 pounds here, 20 pounds there – and are eating a whole lot healthier – since we have stopped eating any restaurant food. Cholesterol, triglyceride, serum glucose, PSA – reports are coming down everywhere you look.

        And we have more money in our pockets, to boot.

        And more time to spend on cookin’.

        We have adapted – fine – to the new reality.

        Reality is good.

        There are hares and there are tortoises.

        To the tortoise goes this race.

        Julie.

        Be well –

        Vivamus

    6. I am not inclined to avail myself of the vaccine.

      I asked one doctor about my having a flu injection. He advised against it.

      Another doctor offered me a flu injection which I declined. I expected a stern lecture but he just laughed.

      1. Me too. I take amla berry powder and would love to hear a recommended dose ? Currently I am taking 1 teaspoon a day. It is very tolerable to mix with water.

    7. I probably will if it gets even worse. I live in Canada and we have keep it under control better than many countries but I do have to travel a lot. I probably won’t be the first in line and it will be the date it comes out and from where..that sound horrid but it is true. I think if anything it might be put out as placebo type vaccine, hopefully a vaccine without many side effects. I’ve never taken a flu shot or any vaccine that I did not need to get into another country. I’m not anti vaccine just relied heavily on immune system

    8. I don’t trust any drug rushed to market and trump is putting major pressure on the pharmaceuticals by offering mega dollars to whomever gets a vaccine first. So many drugs today are placed on the market only to be pulled a few months later due to severe side effects or death. I will not be taking any vaccine rushed like that.

    9. I would say given the incredible data so far collected on amla, it is definitely a “superfood.” Not to mention it’s the second highest antioxidant food known, second to triphala but that’s actually a combination of 3 foods which includes amla. If memory serves, dragon’s blood (an exotic tree sap) has the most, but harmed healthy cells in a Petri dish.

      1. Oh and triphala tested very high in mercury for some reason so Dr. Greger advises against it… I think it was mercury… maybe lead though, there’s a video.

    10. I would have the vaccine depending from origin.i think the one developed at Oxford would be the better one,as my concern with the US based ones is there is a lot riding on Trump to get it out and like Putin it has become politicized.UK standards are impervious to such high level of crass interference. Being a DNA vaccine one does not worry about picking up Covid 19 and as far as what has been suggested,the antibody responses appear adequate.

    11. I absolutely WILL NOT. Don’t trust what’s in that vaccine!!!! Rumors are elitists want population control and this is how they plan on it. Some pros have said approx one year after taking people will become very ill and parish.

  2. One of my thoughts is that flu vaccines may have a placebo affect. Kind of like taking a red pill or being given a trash can lid shield and a plastic sword to go fight the villians. I got a tetanus shot last year and noticed they piggy backed a flu vaccine in with it (& charged more). Do I think the flu vaccine did anything? It’s good for fighting the dragons with my trash can lid shield and plastic sword. Part of my skepticism is that science doesn’t support it.

    1. Dan C,

      There are studies for flu vaccines. When they get it right, and choose viruses that are similar to circulating flu viruses, flu vaccine has been shown to reduce the risk of having to go to the doctor with flu by 40 percent to 60 percent and hospitalizations by 40%. Plus, it reduces the risk of going to an ICU by 82 percent for adults and 74% for children.

      On top of that, even when you do get the flu with it, having had the vaccine lowers the rate of cardiac events and COPD/lung problems associated with the flu.

      It lessens the severity of the hospitalizations in people who do get hospitalized and it lowers the number of days the person spends in the ICU in patients who go to the ICU and lowers the number of days in the hospital by 4 and lowers the mortality risk of children.

      If that is all placebo effect that is still pretty good.

      Some years they miss and choose the wrong virus pool.

      1. Deb,
        Great statistics. It seems there is more to flu vaccines than I’ve given credit. Admittly, I’ve focused on more of the miss than the hits. To be truthful, I got the flu vaccine for many years, partly because I remember my last flu event from maybe 20 years ago. It was a religious experience. It seems the C-19 vaccines are being rushed and old pros, in the field, have their doubts. Russia is citing a Sputnik event with their vaccine and the U.S. version may be ready by election time. Dr. Greger has said the usual time frame for development is ten years. It’s a game of darts guessing what variant of the flu will be in season, and which vaccine to roll out. Good nutrition and health measures are more of a sure thing.

    2. Dan C –
      By definition a flu vaccine can be or have a placebo effect. They are mutually exclusive.
      A background in science would make this plain and clear.

        1. R,
          I’ve had some science classes. Sadly, as much as I admire science, it is not one of my strong suits. I could easily be off on my use of the term placebo. I do wonder if antibotics are still given for flu viruses. Antibiotics do not kill viruses. They do kill helpful gut flora. Were antibiotics used for the red pill effect?

      1. Mr Fumblefingers,

        That was the FDA line of 6/30/2020.

        That may not be the same FDA line of the upcoming election period – considering that the FDA is overseen by our Executive Branch.

        The CDC has already very much switched from Science to the Administration line.

        Can one expect the FDA to hold out much better than did the CDC?

        Your call?

        Realistically –

        Vivamus

        1. The answer to that question depends on your politics I suppose. Fortunately, not being American, it’s an academic question as far as I am concerned.

          However, requiring a vaccine to demonstrate 50% improved effectiveness over a placebo seems sensible. Expecting vaccine manufacturers to monitor and report vaccine safety does not. That is where governments, or at least independent agencies, need to be active. Underfunding regulatory agencies is one way of favouring profits over safety while still keeping clean hands.

  3. AMLA IS NASTY, the only decent and easy way to take it regularly is how Desi people eat it, in Chyavanprash, aka Ayurvedic amla jam. Most brands have ghee in them but there are vegan brands. It tastes like spiced apple butter.

    1. RB,
      I am willing to try amla, but have not found it where I shop. I’ve never heard of Desi people or Chyavanprash. Definitely from India where amla is grown. I suspect it has an acidic taste. I’ve looked online for it but probably thought it is pricey.

      1. I found powdered amla did absolutely nothing for me, but then I have been eating wfpb a long long time. I struggle with high cholesterol, but the amla has zero impact. Maybe for people eating the typical western diet it might have some effect, idk.

        Vit c (heck of a lot cheaper) may have as much effect if I remember correctly. Amla here is about $25 for 200 gm. and like RB says, it’s the worst tasting thing ever. I include it in cocktail of powders in the a.m.

          1. hi George, I get organic amla powder here. I have never seen the whole fruit but I must visit an asian market soon to explore all the great things. It was much lower price befor How Not to Die was published lol, but that’s ehat publicity does I guess. Demand increased overnight, and prices went up. I still use it every day as a shelf stable whole food vit c and antioxidant source… excellent for that.

        1. Barb,
          I’ve wondered if Amla is a pricey version of Vitamin C. I would like to think it has something special about it. So you have a cholesterol issue. As close as you watch your health I think there would be some give.
          I recently did a moving dismount off my mountain bike. I’ve become more flexible with a robust stretching routine that I do seven days a week. I’m also arthritis jogging my neighborhood lane and doing hill running every day. I pushed a couch out away from a wall and put some exercise mats down. I’m able to sit cross legged again.

          1. Dan, you are doing so great! You must be thrilled with your progress. I admit there are many mornings I could have just sat around and drank coffee instead of bike riding, but for me too, consistency has been key. I look forward to start swimming again too, though for now, swimming in the river near here is wonderful .

            Yes my cholesterol is high, and it went higher after menopause. Yesterday I was stuck in emergency dept at the hospital for 6 hrs suffering a gall bladder attack. Im ok today though and back on the bike this morning. Little scared to eat anything though lol …

    2. Glad you pointed that out. Amla has no discernable culinary value but I have it daily (just in case I get bit by a cobra since it’s reputed to be a venom detox). I put it in my oat bran cereal every morning along with a bunch of other spices. However, I mask the bad taste with coco powder. That will cover lots o culinary sins.
      However, spiced apple butter is a favorite of mine.

    3. I eat amla each and every day. Its not nasty, its very tart. Very, very, tart.

      Do you eat oatmeal? With bananas, nuts, blueberries, cinnamon, ground flax seed?

      Yum. Knock out several daily dozens and tweaks right there. (I often add tumeric , black cumin seeds, and ginger as well so that even more of the daily dozen/21 tweaks is taken care of)

      Step 1:
      Add the recommended (small) amount of amla.

      *Done.*

      I challenge you to taste it in this “wild” non-desi concoction.

      So disaster and fear and mystery and annoyance and difficulty = solved.

      Yay.

    4. I’ve looked for amla locally at a Desi market, and the only place I’ve found it it is as an Indian pickle/achar. For those unfamiliar, Indian pickles are very different from European ones, very salty and spicy and to be used in moderation, but just a little can transform a bowl of rice or spice up other dishes.

    5. Reality bites: Chyavanprash contains a lot of sugar too, in the form of honey, juggary, or plain old cane sugar. I’m Asian; I’m used to the extremely sour taste of amla. My problem is dried amla powder aggravate sinus problems. So I take triphala, which in small amounts I can tolerate.

  4. I’ve used Amla powder to brush my teeth. OH how they remain slick and clean for so long after! But I’ve gotten out of that habit. Tastes no worse than conventional toothpastes. I don’t use it for flavor.

    Buy a bag online, is the only way I could source it.

    1. Wade, I haven’t tested the ph of amla powder mixed with a little water, but I don’t think I would brush my teeth with it until I did. My hunch is that it’s very acidic, though I could be wrong. Rolls of ph testing paper are quite inexpensive.

  5. I took amla for more than a year after hearing about it here. It was not effective in lowering cholesterol number.
    Had several lipid profiles to check for efficacy. Now taking 5mg of Rosuvastatin with good results.
    It was a waste of time and bad taste every day for me.
    Thanks,
    Fred

  6. I put it in my Green Smoothies. The taste is covered up by the fruit. Also put turmeric and black pepper in the Smoothie. I buy it online for $20.00 for a lb. bag.

  7. I have purchased it at an Indian grocery store in the Seattle area. I mix it with turmeric an black pepper in a few ounces of water. I don’t know if it’s helping, but it seems it can’t hurt. It was quite inexpensive, but it’s just powdered berries, not from juice.

  8. It sounds too good to be true for someone like me with high cholesterol and high blood pressure. So I am disappointed that it did nothing for some of the people that mentioned it on the forum here. I also wish that Dr. Gregor had included some cautions against taking if you are already on baby aspirin and BP meds

  9. The amla supplements I found in California have a Proposition 65 warning regarding chemicals that may cause cancer or reproductive harm.

    1. It’s almost impossible to find any product in California that does not have a prop 65 warning. I tried to order a temperature sensor for my car on Amazon but they would not send it to because it might cause cancer.

  10. 2016 at age 73 I was diagnosed as diabetic. A1c was 7,2. Was told by to read the book “How Not To Die”. Bought the book. read it and changed my ways. Also was told to consider amla and started taking it shortly thereafter.. One hundred days later my A1c was 5.9. I take amla with hot oat bran for breakfast,

    So does amla work or not I can’t say. But whatever I am doing is keeping me off diabetes meds so I will continue to use it.

    Most recent blood work this June showed an A1c of 6.1, HDL 45 LDL 48, Trig 48 and overall cholesterol of 105.

        1. Spring03
          Thank you for your reply. Do you think that it would be OK to use it as an adjunct to my daily baby aspirin and my BP meds? Or should it really be used in place of. I would ask my doctor but I suspect she would not know the answer because she does not seem to be into any nutritional supplements

          1. Hi Webster, thanks for your quick reply. I would send you the link to the complete article that Dr Greger has included as reference for your own further reading.
            Please consult with your Dr regarding your medication and BP. Please note as a health professional I cannot prescribe a supplement without discussion with your physician.

            If you brought your research information regarding alma to your Dr that could be helpful to your Dr to guide you further on that. I hope that is useful to you.
            http://www.phcogres.com/article.asp?issn=0974-8490;year=2014;volume=6;issue=1;spage=29;epage=35;aulast=Fatima.

      1. Webster:

        I mix 1/2+ teaspoon of powdered amla in bubbly oat bran along with a teaspoon of cinnamon, about two tablespoons of ground flaxseed and toss in about a cup of frozen wild blueberries. I use stevia to sweeten.

        1. @Wolf.

          Ditto, same exact breakfast, except I cook dates in with my oatmeal. I’m actually not sure what oat bran is, but I get the whole groats. Looks like a cross between brown rice and barley.

          The dates make is sweet enough for me and I also add some almond butter or pecans and half a super ripe banana so I dont miss swerve or stevia. I tried the sweeteners but found Dr. G’s example of sweetening with fruits, like dates seems to be fine..For dates, I feel that the Mejdool are awesome and the ones from Qataar (doha) are delectible.

  11. I’ve been taking 1MG of Propecia or Finasteride for 15 years hoping that it keeps me from losing hair. If I took a natural blood thinner like Amla would that work and do the same thing? And how much Amla Would I take?

  12. Based on your original series on amla I’ve given it to a handful of patients including my son. Unfortunately not a single one experienced any improvement in lipids.

    1. I purchased the tincture, power, and the dried berries and the only benefit that I’ve notice is excelerated wound healing. It seems to me that the tincture would benefit individuals suffering from extreme dry skin and excema.

  13. I seem to recall an earlier video by Doctor G testing for substances that were high in antioxidants. And as I recall amla dwarfed most competitors in that respect but even higher was a substance called triphala which is a powder containing amla with a couple of other berries found in India. So I decided to give it a try but I was worried about heavy metals re. some of the concerns I’ve heard about things used as Ayurvedic medicine such as triphala. I found a couple of places that sell organic triphala and they said that that meant heavy metal free as well. I decided to declare victory at that point re. further research but I’m not really sure about that claim. Lastly, I used to cover up the taste like other commenters suggest by mixing it into something else, e.g. a smoothie. But then I read somewhere that in Ayurvedic medicine, experiencing the bitterness can actually be considered therapeutic. Whether or not that’s BS I now have my morning stoic exercise re. a spoon of triphala…

    1. Karl, Dr Greger has a couple of videos on amla and triphala that might interest you. Amla is his first choice. The organic designation (as far as I know.. I could be wrong) does not mean it is heavy-metal contamination free. You could call the supplier and ask if they test every batch. ( Rose mountain herbs tests herbs and spices.. I am not affiliated with them whatsoever).

      Triphala is known to assist with constipation so beware – more may not be better :)

    2. “organic triphala and they said that that meant heavy metal free as well.”

      It doesn’t mean that at all.

      Sometimes heavy metals are deliberately added to Ayurvedic products and sometimes they contaminate the products as a result of manufacturing processes. As Barb has written, it’s safer to find a supplier that can provide current certificates for heavy metal testing.

    3. Karl,
      Unfortunately organic does NOT mean acceptable levels of heavy metals. Examples are brown rice and many spices and herbs from India. My organic turmeric has a level of arsenic slightly above acceptable but I’m not worried as I could actually find this brand with a number for various heavy metals and the only high level was arsenic. But the consumed amount of arsenic by myself would be miniscule compared to a single serving of Bismati rice.

  14. Hi Matthew Smith, thanks for you question. Yes, in the lil you provided to the study indicates that the powerful effect of three nuts are due to macronutrients, micronutrients, and phytochemical which affect several pathways in AD pathogenesis such as amyloidogenesis, tau phosphorylation, oxidative stress, cholinergic pathways, and some non-target mechanisms including cholesterol lowering and anti-inflammatory properties, as well as effect on neurogenesis. Thank you.

  15. Amla is one option, but there is a simpler, and far more pleasant way of obtaining the beneficial statin effect. Milk and cocoa drink (hot chocolate). Stick to raw (non-alkalized cocoa, not processed ‘Dutch’ cocoa).

    Heiss et al, 2007 found consumption of a high-flavanol, dairy-based cocoa drink produced sustained reversal of endothelial dysfunction at a level similar to statins. Incidentally, this contradicts Dr Greger’s claim that milk ‘completely blunts’ the FMD benefits of tea polyphenols (I will address this false claim when I find the time).

    ‘In the chronic 1 wk study (Figure 1), subjects consumed high-flavanol cocoa drinks (dry dairy-based beverage mix made with cocoa powder containing 306 mg of flavanols mixed in 100 mL of water) 3 times daily, totalling 918 mg of daily flavanol intake’

    https://www.chococru.com/wp-content/uploads/2017/11/Heiss-et-al.-2007.pdf

    also Heiss et al, 2010

    https://www.sciencedirect.com/science/article/pii/S0735109710017365

    I have been consuming dairy/cocoa (hot chocolate) for 25 years because of its potential to improve endothelial dysfunction. The improvement in FMD (a complex and fascinating subject I will post on sometime soon), is modest. But perhaps in the same league as statins. Tea probably less so than cocoa (another long story). The effect probably enhanced with full cream dairy, rather than skim (yet another long story). Either way, the improvement is not in the same league as controlled exercise. Especially high intensity training. Which, by comparison may deliver very high improvements, at least in men:

    ‘An eight-week program of brisk walking resulted in a 50% increase in brachial artery FMD in middle-aged and older men, but failed to produce this benefit in estrogen-deficient post-menopausal women’.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4157159/

    https://en.wikipedia.org/wiki/Flow-mediated_dilation

    …. ‘a meta-analysis of 182 participants demonstrated twice the improvement in FMD following high intensity training (HIIT)’

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6518096/

    1. ‘ Incidentally, this contradicts Dr Greger’s claim that milk ‘completely blunts’ the FMD benefits of tea polyphenols’

      Of course it doesn’t Pete. You have been making similar assertions for ages now and have failed to prove your claim on every occasion.

      How can a cocoa drink experiment contradict a tea drink experiment? In any case, you appear to be confusing the effects of black tea on FMD and the effect of milk on tea polyphenol absorption. The two might ultimately be linked but the trials concerned stand on their own.

      Also, the flavonol content of cocoa is many times higher than the polyphenol content of tea infusions. A simple head to head comparison would therefore be misleading. Furthermore no milk was consumed in the cocoa study you linked. It was a study of two MARS products mixed with water to produce a drink. The actual MARS powders/products concerned may well have contained dairy of some kind but I have no idea what and the study does not, unlike you, describe the drinks as dairy based beverages. To make the claim that you are trying to make, the study would have had to compare a drink made with milk/dairy versus a drink made without. It didn’t. In fact, I don’t recall the words ‘milk’ or ‘dairy’ being mentioned even once in that study.

      As for your habit of drinking hot chocolate, you may be wasting your time since, as the MARS company itself acknowledges

      ‘In the traditional processes for making cocoa or chocolate products, the flavanols can be easily destroyed. While cocoa flavanols are naturally present in cocoa beans, many products available today contain minimal amounts of active cocoa flavanols due to manufacturing processes that destroy them, including the use of extreme heat, oxidation, pH changes and isomerization (change in chemical structure). It is important to recognize that the destruction of flavanols begins from the time that the cocoa beans are harvested. Therefore, using a higher percentage of cocoa, which may have little or no flavanols present, is not a reliable way to ensure a high level of cocoa flavanols in a product.’
      https://www.marscocoascience.com/research/cocoa-science/cocoapro

      Thanks for the link though. Very interesting. I would add that it seems to be a study of MARS products. There were no financial disclosures provided with the article but it wouldn’t be unreasonable to assume the study was funded by MARS (which appears to have a substantial ‘research’ budget).
      https://www.marscocoascience.com/research

        1. First, there was no milk added to the cocoa drink.
          Second, cocoa is not tea.
          Third, there are no ‘tea polyphenols’ in cocoa
          Fourth, the study did not test a drink made without dairy versus a drink made with dairy.
          Fifth, ‘blunt’ means to make less sharp not to destroy the edge completely
          Sixth, the study nowhere mentions ‘milk’

          Your statement represents a VERY imaginative interpretation of the article concerned.

          1. Incidentally, this contradicts Dr Greger’s claim that milk ‘completely blunts’ the FMD benefits of tea polyphenols’

            ———————————————————–

            Of course it doesn’t Pete. You have been making similar assertions for ages now and have failed to prove your claim on every occasion.

            ———————————————————-

            Tom, even you will come to realise you have been mislead. Please be patient, all will be revealed.

            ———————————————————————-

            How can a cocoa drink experiment contradict a tea drink experiment?

            ———————————————-

            Because of what they have in common. The claimed FMD benefit is derived from polyphenols in the food matrix. For example, tea, coffee or cocoa polyphenols. Dr Greger claims that milk (but not soy) ‘completely blunts’ the potential bioavailability these polyphenols, and thereby completely blunts the FMD benefit. Yet the cocoa study I quoted demonstrated that FMD was not ‘completely blunted’ by milk. I am demonstrating the inconsistency between Dr Greger’s claim that milk ‘completely blunts’ polyphenol bioavailability/FMD, and the study I referenced – which found otherwise. Indeed, milk was intentionally added to the cocoa polyphenols, obviously without ‘completely blunting’ its polyphenol bioavailability. Its no surprise when you have read all the studies, including Lorenz et al, Felberg, and Zhang et al, but it requires a long answer, not a short one. .

            ————————————————————–

            In any case, you appear to be confusing the effects of black tea on FMD and the effect of milk on tea polyphenol absorption. The two might ultimately be linked but the trials concerned stand on their own.

            ———————————————————————–

            No, I am not confusing them. They are inextricably linked. Black tea polyphenols are supposed to enhance FMD, and according to Dr Greger milk is supposed to irreversibly blunt this benefit. By irreversibly binding (complexing) milk proteins with polyphenols ….making them indigestible. However, according to EFSA, black tea polyphenols have no influence on FMD. So, that’s the end of Dr Greger’s argument there and then. That is, its impossible for milk to ‘completely blunt’ the FMD benefits of polyphenols, if the benefit is non-existent. In reality, there may be a benefit, but its unproven, and its very small if it does exist.

            Unfortunately, Dr Greger ‘cherry picked’ Lorenz et al 2007 as his reference study. Lorenz et al thought they were conducting an in-vivo study, but unwittingly conducted an in-vitro study. That is, they measured polyphenol bioavailability prior to the completion of digestion. Failing to take into account that bindings (complexes) formed between milk and polyphenols significantly delay polyphenol digestion. A fundamental scientific error or judgement which made their ‘completely blunted’ claims completely erroneous. As it eventuates, this is a reference to a pre-digestive state, not post-digestive state. Moreover, the ‘significant’ FMD benefit of polyphenols (ex-milk) was only 3.5%. Hardly earth-shattering. But worse was to come. Ultimately, EFSA did not agree they had demonstrated that (ex-milk) polyphenols were responsible for any FMD benefit. Milk cannot extinguish a non-existent benefit. So, both their principal findings were invalid. Lorenz et al, 2007 is an example of a completely botched study. Lorenz et al 2009 would not bring Dr Greger any joy as well. They found that soy milk has the same effect on polyphenols as cows milk (pre-digestive complexing between milk and polyphenols). To be fair, the complexing of polyphenols by either soy or cows milk are reversed during their delayed digestion. But we are getting the ‘alternative truth’ from Dr Greger.

            ———————————————————————

            Also, the flavonol content of cocoa is many times higher than the polyphenol content of tea infusions. A simple head to head comparison would therefore be misleading.

            ———————————————————————–

            What is misleading is selectively quoting a discredited study, ignoring the subsequent public mea-culpa of the authors, as well as 30 studies (still counting) which demonstrate milk does not diminish polyphenol bioavailability. It goes deeper, but I will save that for next time.

            ————————————————————————————————

            Furthermore no milk was consumed in the cocoa study you linked. It was a study of two MARS products mixed with water to produce a drink.

            ———————————————————————————————

            The Mars product (cocoa) was added to milk powder and water. That is, milk proteins were added to cocoa.

            ———————————————————————————————–

            The actual MARS powders/products concerned may well have contained dairy of some kind but I have no idea what and the study does not, unlike you, describe the drinks as dairy based beverages. To make the claim that you are trying to make, the study would have had to compare a drink made with milk/dairy versus a drink made without. It didn’t. In fact, I don’t recall the words ‘milk’ or ‘dairy’ being mentioned even once in that study.

            ———————————————————————————

            Milk proteins are added to cocoa polyphenols:

            ‘In the chronic 1 wk study (Figure 1), subjects consumed high-flavanol cocoa drinks (dry dairy-based beverage mix made with cocoa powder)’

            https://www.chococru.com/wp-content/uploads/2017/11/Heiss-et-al.-2007.pdf

            Note: ‘dry dairy-based beverage’

            ———
            Pre digestion: Bioaccessible chlorogenic acid (CGA) of coffee = 80.2 μmol/200 mL

            Post Digestion: Without milk = 53 μmol/200 mL

            Post Digestion: With milk = 69.5 μmol/200 mL

            ‘After digestion, bioaccessible CGAs decreased from 80.2 to 53.0 and 69.5 μmol/200 mL in coffee without milk and coffee-whole milk, respectively. When whole, semiskimmed, skimmed, or diluted milk were present, the increase in bioaccessibility was dependent on fat content (r = 0.99, p < 0.001)

            Tagliazucchi et al, 2012:

            You should appreciate this Tom. A large proportion of polyphenols go undigested. Of those remaining, milk, and particularly milk fat increases CGA polyphenol bioavailability

            https://pubs.acs.org/doi/10.1021/jf302694a
            —————————-

            ‘Compared to capsule ingestion, consumption of polyphenol-rich beverages containing either dairy, soy or no proteins had minor to no effect on the bioavailability and excretion of phenolic compounds in plasma (118% ± 9%) and urine (98% ± 2%). We conclude that intake of polyphenols incorporated in protein-rich drinks does not have a major impact on the bioavailability of a range of different polyphenols and phenolic metabolites’

            Tom: Note the word ‘dairy’.

            Draijer et al, 2016

            https://pubmed.ncbi.nlm.nih.gov/27983686/

            ——————————————————–

            As for your habit of drinking hot chocolate, you may be wasting your time since, as the MARS company itself acknowledges

            'In the traditional processes for making cocoa or chocolate products, the flavanols can be easily destroyed’…..
            —————————————————————————

            This is why I consume raw, non-alkalized cocoa. Processing destroys the polyphenols. I principally consume it for its antioxidant, memory and mood effect. The FMD benefit, if it does exist, is minimal. Albeit, Heiss claims it matches statins for endothelial dysfunction protection.

            —————————————————————————–

            Thanks for the link though. Very interesting. I would add that it seems to be a study of MARS products. There were no financial disclosures provided with the article but it wouldn't be unreasonable to assume the study was funded by MARS (which appears to have a substantial 'research' budget).
            https://www.marscocoascience.com/research

            —————————————————————————–

            Sure Tom, it may be funded by Mars. But I dont purchase their expensive product. I get a similar benefit from raw, non-alkalised cocoa at a fraction of the price. And add full-cream milk and stevia.

            Yes, I know you have theorised that milk protein/polyphenol complexes may be reversed, but milk fat prevents this occurring. Actually, milk fat has the opposite effect. You have misinterpreted Zhang et al. I will explain next time.

            ————————————————————

            1. ‘Yes, I know you have theorised that milk protein/polyphenol complexes may be reversed, but milk fat prevents this occurring. Actually, milk fat has the opposite effect. You have misinterpreted Zhang et al. I will explain next time.’

              No theorising, I merely reported what Zhang et al wrote about milk …. not milk protein, not milk protein complexes, not milk fat, not milk protein and fat combined but actual whole milk, For example, the Zhang et al study on milk and jujube juice reports

              ‘The addition of skimmed milk to jujube juice resulted in significant changes in the plasma kinetics profile of phenolics, rather than affecting the overall absorption. Milk fat did not interact with jujube juice phenolics. However, when jujube juice was ingested with whole milk, a significant reduction of the bioavailability of phenolics and the maximum increase in plasma antioxidant capacity was observed.’
              https://onlinelibrary.wiley.com/doi/abs/10.1002/mnfr.201200085

              You just ignore Zhang’s statement about the different effects of whole milk vs milk components/fractions. This why I pointed out last time that you misrepresented the findings of that Zhang et al study you cited last time by ignoring the clear statement made by the authors and insisting that your interpretations of the study’s findings was the correct one – and the authors had misunderstood their own work!

              1. This may be why so many industry funded studies in this area don’t look at the effects of actual milk consumption on bioavailability …. they look instead at the effect of milk proteins and milk fats either separately or combined. They at least can be relied upon to produce results agreeable to the funding sponsor.

                1. now you are talking absolute nonsense Tom. Do you really reckon that what Zhang et al has done? This is your escape argument when you start losing the scientific debate. Somehow blame it on Big Dairy, whilst conveniently ignoring that Dr Greger is propagating Big Vegan. And not very objectively would be the kindest way I could express it. Double standards ? Researchers examine the components because if they do it with just whole milk, they have no idea which component (protein, fats, minerals) is having which effect on polyphenol bioavailability. I thought this would be obvious.

                  1. Then why do you and the industry continually ignore the studies showing that adding whole milk blunts the beneficial effects of tea on arterial function? And ignore studies showing the effect of whole milk on polyphenol absorption?

                    Instead, all the industry does is fund and talk about studies that show that individual milk components appear to have no adverse effects in these areas. It all seems like a calculated attempt to give a misleading impression to me.

                    1. Tom,

                      There are many early studies which found milk and soy proteins bind tea, coffee or cocoa polyphenols in the tea or coffee cup. What most failed to investigate is whether these bindings were reversed during digestion. Sometimes they attempted to ascertain this, but failed to factor in the delayed digestion caused by these bindings (complexing). That is, in ignorance they made their measurements prior to the completion of digestion. Making them meaningless. Dr Greger’s index reference (Lorenz et al, 2007) is a prime example.

                      ‘Flow-mediated dilation (FMD) was measured…. Black tea significantly improved FMD in humans compared with water, whereas addition of milk completely blunted the effects of tea …All (other) effects were completely inhibited by the addition of milk to tea. ‘

                      Lorenz et al, 2007. https://academic.oup.com/eurheartj/article/28/2/219/2887513

                      This is the study you claimed ‘the dairy industry loved to hate’. However, when formally challenged (criticised) by Pfeuffer and Schrezenmeir Lorenz et al subsequently conceded some extremely serious shortcomings in their study:

                      ‘the increase in flow-mediated dilation (FMD) after consumption of black tea in our study (is) just 3.5% above the control response’

                      there is ….‘further doubt whether complexes between catechins and casein, if formed at all in the intestinal tract, would remain once the caseins are broken down to amino acids and peptides. As we have shown in Table 2 of our paper, tea catechins become complexed as soon as milk is added to tea. Whether these complexes are broken down after digestion of the caseins and whether the catechins are subsequently released and absorbed later on represent interesting questions’.

                      Interesting questions? More likely fundamental questions – which Dr Greger (and you Tom) had little interest in exploring, even with the benefit of hindsight !

                      In their response to Pfeuffer and Schrezenmeir, Lorenz et al also concede their findings differ from others, and their readings had been premature:

                      ‘We are also aware of the study by van het Hof et al.,6 who did not observe a difference in plasma catechin concentrations after consumption of black tea with or without milk. This objection needs to be further investigated. A plausible explanation of the fact that we observed an impairment of FMD response after addition of milk to tea may be that the catechins, owing to the longer retention period in the digestive tract, could have been modified and thus rendered physiologically inactive. The suggestion by the authors to measure the vasodilatory response at later time points is an important issue that should be addressed in future studies.’

                      Lorenz et al, 2007
                      https://academic.oup.com/eurheartj/article/28/10/1266/2887455.

                      Tom, you are a bright person, so you will realise the grave significance of these comments. Unbelievably, Dr Greger hung his hat on this study. Lorenz et al, 2007 had conceded 12 YEARS AGO theirs was effectively a completely meaningless study because they had NOT in fact (despite the claims by Dr G) established that ‘milk completely blunted the effects of tea’. Principally because they had failed to allow for delayed digestion of milk/polyphenol complexes. Not that this precludes it (and others like it) being quoted as gospel ever since.

                      Moreover, in 2018 EFSA formally rejected the claim that polyphenols enhance FMD:

                      ‘The (EFSA) Panel concludes that a cause and effect relationship has not been established between the consumption of black tea and maintenance of normal endothelium-dependent vasodilation’
                      https://pubmed.ncbi.nlm.nih.gov/32625684/).

                      This is not to say one shouldn’t consume black, white or green tea. It most probably provides other antioxidant-based benefits, and it is still possible there is a minor FMD benefit – particularly in the elderly. But the benefit (if it does exist) is obviously very modest, and in any event (according to EFSA) it is not diminished by the addition of milk or soy. It is simply delayed. In summary:

                      1. EFSA declares enhancement of FMD by tea polyphenols is unproven.(that is, the finding of several studies, including Lorenz et al, 2007, are rejected by EFSA )
                      2. The FMD benefit claimed by Lorenz et al is minimal (just 3.5%). This is modest to the ~ 50% improvement from brisk walking I have already referenced.
                      3. Due to serious shortcomings in their design, Lorenz et al did NOT (as claimed in their study) find that milk ‘completely blunts’ polyphenol bioavailability.
                      4. It is impossible for added milk to ‘completely blunt’ a medicinal FMD benefit which (according to EFSA) does not even exist
                      5. Up to 30 studies (already provided) demonstrate that milk, and a multitude of dietary proteins, fats and carbohydrates temporarily, but not permanently diminish polyphenol bioavailability.
                      6. These various studies also demonstrate there is no little or no difference between soy and cows milk in terms of their pre-digestive and post-digestive interaction with polyphenols.

                      * An eight-week program of brisk walking resulted in a 50% increase in brachial artery FMD in middle-aged and older men’ – https://en.wikipedia.org/wiki/Flow-mediated_dilation

                      So desperate to malign milk, Dr Greger cherry-picked a redundant, meaningless and discredited study (Lorenz et al, 2007) to convey a set of false assertions. He ignored the fact that Lorenz et al had failed to make allowance for the milk-induced delayed digestion of tea polyphenols. In the circumstances, a rather unforgiveable scientific oversight. Dr Greger also ignored the Lorenz et al, 2007 mea culpa following criticisim by Pfeuffer and Schrezenmeir. Dr Greger also culled up to 30 studies (already provided) demonstrating milk does not diminish net polyphenol bioavailability – and in some notable instances actually increases it.
                      And I have not even begun on Dr Greger’s other reference study (Felberg, et al) – a South American organisation that has developed a soy/coffee beverage which competes with milk/coffee beverages. Surprise, surprise, they found that in (just six subjects) their soy/coffee brew reversed protein complexing, whereas their competitor (milk/coffee brew) did not. Delivering an FMD benefit to their brew, but not their competitors. Dr Greger was all over this, ridiculously claiming it was proof-positive that (unlike milk) soy protein/polyphenol complexes were reversed. Yesterday I Iisted about 8 studies which demonstrate that soy and milk have a similar effect on polyphenols, including a study by Lorenz et al, 2009 – which was conveniently ‘overlooked’ by Dr Greger. As I posted earlier, this video is a real low point for Dr Greger, and he should withdraw it. And, in the name of science, you should also cease defending it Tom.

          2. First, there was no milk added to the cocoa drink.

            ——————————-

            Not so Tom, please read my previous post

            ————————————-

            Second, cocoa is not tea.

            ———————————–

            tea, coffee and cocoa have polyphenols. Dr Greger’s assertion is that milk proteins irreversibly bind to polyphenols, whereas soy proteins do not. There is no distinction made between tea, coffee or cocoa polyphenols.

            —————————————————————

            Third, there are no ‘tea polyphenols’ in cocoa

            ———————————————-

            Obviously not. Each have their own polyphenols.

            ———————————————–
            Fourth, the study did not test a drink made without dairy versus a drink made with dairy.

            ————————————————-

            Polyphenols enhance FMD. The researchers measured FMD in subjects without the dairy/cocoa beverage, and then measured it following the dairy/cocoa beverage. The dairy/cocoa beverage improved their FMD by about double. Conclusions: 1. Polyphenols enhance FMD. 2. Milk obviously did not ‘completely blunt’ polyphenol bioavailability. If it did, there would not have been a FMD improvement, and certainly not a doubling in improvement.

            —————————————————

            Fifth, ‘blunt’ means to make less sharp not to destroy the edge completely

            —————————————————

            In his video, Dr Greger claimed that added milk ‘completely blunted’ polyphenol bioavailability. This was him emphasising the claims made by Lorenz et al, 2007. Claims which they subsequently withdrew because they had prematurely measured bioavailability, that is, prior to completion of digestion. Dr Greger also claimed soy milk completely reversed in-vitro protein/polyphenol complexes, and thereby preserved polyphenol bioavailability. Whereas milk did not reverse complexes.

            ’does it (soy milk) have the same nutrient-blocking effect (as cow milk)? No! The protein-bound chlorogenic acids that are not absorbed in the upper digestive tract seem to be released, metabolised by intestinal bacteria, and excreted in urine after absorption’.

            This embellishment merely describes the everyday digestive breakdown of polyphenols in the gut, as described by Del Rio et al. 2010 (more on this later). Dr Greger has acquired it exclusively for the digestion of soy/polyphenol complexes. Moreover, the evidence suggests soy and milk function much the same with polyphenols:

            Farah et al, 2018 found ‘soy protein and/or other substances present in soymilk also bind chlorogenic acids decreasing their absorption in the upper digestive tract. This corroborates in vitro results on interactions between chlorogenic acids and soy protein.

            Draijer et al, 2016 found ‘dairy, soy or no proteins had minor to no effect on the bioavailability and excretion of phenolic compounds in plasma’.

            Rawel et al, 2017 found ‘soy proteins (amongst many other macronutrients) bind with various polyphenols.

            Lorenz et al. (2009) found that ‘10% plain soy beverage can suppress the vascular antioxidant property of tea, possibly through interactions between proteins, such as β-conglycinin and glycinin, with tea antioxidants’.

            Rashidinejad et al, 2017 found there is ‘a conflicting evidence of the effect of milk addition to tea on antioxidant activity…..(there are) ‘similar effects between soy and bovine milk’.

            Clifford et al, 2017, found ‘milk added to coffee does not diminish its antioxidant potential, whereas soybean/lecithin creamers delay antioxidant absorption’

            Egert et al, 2013 investigated ‘ the influence of dietary proteins (casein, soy protein) and skimmed milk on the plasma kinetics of green tea (GT) catechins. ‘No significant differences in bioavailability of GT catechins were observed between the treatments’

            Lorenz et al. (2009) found that ‘10% plain soy beverage can suppress the vascular antioxidant property of tea, possibly through interactions between proteins, such as β-conglycinin and glycinin, with tea antioxidants’.

            Ryan & Sutherland, 2011, found soy affects total antioxidant activity of tea.

            ————————————

            Sixth, the study nowhere mentions ‘milk’

            ————————————

            I answered this in my previous post.

            ——————————————-

            Your statement represents a VERY imaginative interpretation of the article concerned.

            ———————————–

            Thanks for the complement Tom, but when it comes to comparative imaginations, I concede defeat.

            1. ‘Dr Greger’s assertion is that milk proteins irreversibly bind to polyphenols, whereas soy proteins do not. ‘

              No. My recollection is that Greger reported that both cow’s milk and soy milk blocked tea’s benefits on arterial function.

              ‘The reason cow’s milk blocks the benefits of tea, we think, is because of the milk protein, casein, binding up all the phytonutrients. Since soy milk doesn’t have casein, though, one would assume that adding soy milk to tea is fine; but, you never know until you run the experiment.

              What do you think? Soy milk blocks the benefits of tea: fact or fiction? Let’s look at the data. This is measuring the beneficial effects on arterial cells in a Petri dish. Here’s the control, plain water. Then comes the plain black tea, no creamer, and you can see the spike in beneficial effects that appear to be completely blocked by milk. Then they tried three types of soy milk: sweetened, calcium-enriched, and unsweetened. All of which had the same effect as milk! Fact: vascular effects of tea are suppressed by soy milk.’
              https://nutritionfacts.org/video/soymilk-suppression/

              The particular mechanism by which this effect is caused is less important. The fact is that both cow’s milk and soy milk block tea’s arterial , benefits. Going on about milk protein and milk fat is a distraction. The effect follows consumption of milk, cow’s or soy……. not milk protein or milk fat but milk.

              Incidentally, there is more carbohydrate than either fat or protein in milk (by weight). So focusing on milk protein or milk fat ignores the major macronutrient component of whole milk.

              1. ‘The fact is that both cow’s milk and soy milk block tea’s arterial , benefits’.

                Wrong Tom. Neither of them block tea’s arterial benefits. According to EFSA, there is no benefit anyhow, so how can milk or soy possibly block it? All they do is act similarly to each other.
                Secondly, the blocking effect only occurs in the tea cup or mug, and is reversed during digestion. Therefore, there is no net loss of polyphenol bioavailability. And if there is no net loss of polyphenols, how can milk and soy possibly diminish (these highly questionable) arterial benefits? All that happens is that polyphenol digestion is delayed. Milk fat appears to accelerate and enhance the reversing of this initial protein/polyphenol complexing, unless you believe Zhang’s jujube juice study is applicable more broadly (there is no evidence for this).

                Your ‘milk fat’ reference to Zhang et al relates to jujube juice. Not coffee, tea, or cocoa. I have no idea about the chemistry or digestive chemistry of jujube juice, and don’t much care. All it tells me is to be cautious about adding milk to my jujube juice. If Zhang et al could demonstrate that milk fat had the same effect on tea, coffee or cocoa, then maybe we would add skim milk rather than whole milk to our beverages. But there is no evidence of this. What we do have are Zhang’s overall conclusions, which make it clear milk proteins are not irreversibly bound to polyphenols as Dr Greger claims (https://nutritionfacts.org/video/does-adding-milk-block-the-benefits-of-coffee), as well as about 30 studies which demonstrate milk does not diminish polyphenol bioavailability. So, I am not going to get too excited about just one study relating to the addition of milk to jujube juice. Which seems inconsistent with 30 other studies relating specifically to the addition of milk to tea, coffee and cocoa. When it comes to conclusions, Zhang et al make it perfectly clear neither milk proteins (nor milk fats) diminish the polyphenol bioavailability of tea, coffee or cocoa:

                ‘It has been suggested that polyphenols can bind to milk proteins and subsequently form complexes(166,167). Therefore, the in vivo results may be explained by the formation of protein – polyphenol complexes that remain in the stomach for an extended period of time, thereby delaying the appearance of polyphenols in the blood. Additionally,the absence of an effect on overall polyphenol absorption indicated that polyphenols could be released from the complexes and be absorbed later’.

                Zhang et al, 2013

                Page 6, https://www.researchgate.net/publication/258146452_Interaction_of_plant_phenols_with_food_macronutrients_Characterisation_and_nutritional-physiological_consequences

                ‘Recently, we showed that milk protein–polyphenol complexes lead to significant changes in the plasma kinetics profile but do not affect the absorption and bioactivity of polyphenols both in rats and in human subjects

                Zhang et al, 2014

                https://www.cambridge.org/core/journals/nutrition-research-reviews/article/interaction-of-plant-phenols-with-food-macronutrients-characterisation-and-nutritionalphysiological-consequences

                ‘when plant phenols are consumed along with food macronutrients, the bioavailability and bioactivity of polyphenols can be significantly affected. The protein–polyphenol complexes can significantly change the plasma kinetics profile but do not affect the absorption of polyphenols’

                Zhang et al, https://tinyurl.com/u8hvw9n

                Despite the scant evidence (one study on jujube juice), we can have a legitimate debate about whether or not whole milk functions differently to skim milk, albeit I dont think it will go anywhere until we find studies demonstrating this in tea, coffee or cocoa. They just don’t exist. In fact most demonstrate that milk fat enhances the breakdown of these milk protein/polyphenol complexes. In one study, homogenisation of fat doubles coffee polyphenol (CGA) levels.

                1. Tagliazucchi et al, 2012:

                Pre digestion: Bioaccessible chlorogenic acid (CGA) of coffee = 80.2 μmol/200 mL

                Post Digestion: Without milk = 53 μmol/200 mL

                Post Digestion: With milk = 69.5 μmol/200 mL

                Note: Milk, and particularly milk fat increases CGA polyphenol bioavailability

                ‘After digestion, bioaccessible CGAs decreased from 80.2 to 53.0 and 69.5 μmol/200 mL in coffee without milk and coffee-whole milk, respectively. When whole, semiskimmed, skimmed, or diluted milk were present, the increase in bioaccessibility was dependent on fat content (r = 0.99, p 0.05). The type of milk did not influence TCAT recovery during all digestive stages (p > 0.05). Polyphenol-protein complexes are degraded during digestion. It is very unlikely that consumption of tea with or without milk will result in differences in catechin plasma concentration’.

                Note, the type of milk did not influence catechin recovery.

                https://www.ncbi.nlm.nih.gov/pubmed/21692489

                3. Van der Burg-Koorevaar et al. (2011) –

                ‘Administration of GTPM (green tea polyphenol infused with milk) significantly increased (p < 0.05) the antioxidant index and antioxidant enzyme activities when compared with the placebo group, whereas a concomitant decrease in the levels of lipid peroxidation were noted’.
                Chiu et al, 2016 – https://pubs.rsc.org/en/content/articlelanding/2016/fo/c5fo01271f#!divAbstract

                ‘These in vitro observations are consistent with several clinical studies that have reported milk addition generally does not impact acute absorption of flavan-3-ols from black or green tea in humans’.

                ‘It is very unlikely that consumption of tea with or without milk will result in differences in catechin plasma concentration’.

                https://www.researchgate.net/publication/51237698_Effect_of_Milk_and_Brewing_Method_on_Black_Tea_Catechin_Bioaccessibility

                4.Clifford et al, 2017

                ..’a feeding study by Renouf et al.243 revealed no difference in the pharmacokinetic profiles of plasma acyl-quinic acid metabolites after drinking black coffee with or without 10% whole milk. Thus, although 5-CQA has been reported to bind to certain proteins in vitro, such as albumin and casein,244,245 milk would appear not to have a significant impact on the overall absorption of coffee acyl-quinic acids.

                However, adding a mixture of sugar and non-dairy creamer (these are traditionally made from soybean oil and lecithin, Ed) to the black coffee resulted in lower Cmax values for caffeic acid (3) and isoferulic acid (43) accompanied by longer Tmax times for ferulic acid (4) and isoferulic acid.243 Sugar246 and lipids247 are known to delay gastric emptying and this may have delayed absorption of the coffee acyl-quinic acids resulting in an extended Tmax for two of the three metabolites.

                https://pubs.rsc.org/en/content/articlehtml/2017/np/c7np00030h

                5. Urbanska et al, April 2020:

                ‘Regardless of the decreasing antioxidant reduction potential in vitro studies, in many works,among others, Serafini, et al. [53], Loffredo, et al. [58], and Di Mattia, et al. [1], the same trend is not observed in studies on living organisms. In all these studies, the results of the increase in the occurrence of specific antioxidants in plasma consumed in the vicinity of milk did not differ significantly from those of milk-free counterparts. ….. It follows that lowering the antioxidant character of cocoa in a product with the addition of milk, such as milk chocolate, may be of primarily technological importance’.

                https://www.mdpi.com/2076-3921/9/4/299/pdf.

                6. Rashidinejad et al, 2017

                ..there are ‘similar effects between soy and bovine milk’ –

                ‘There is a conflicting evidence of the effect of milk addition to tea on antioxidant activity. Differences in the type of tea, the composition, type and amount of milk, preparation method of tea-milk infusions, the assays used to measure antioxidant activity, and sampling size likely account for different findings’. (there are) ‘similar effects between soy and bovine milk’.

                https://www.ncbi.nlm.nih.gov/pubmed/26517348

                7. Green et al, 2007 –

                Catechin stability in green tea was poor with <20% total catechins remaining post-digestion. EGC and EGCG were most sensitive with less, not double equals 10% recovery. Teas formulated with 50% bovine, soy, and rice milk increased total catechin recovery significantly to 52, 55, and 69% respectively. Including 30 mg AA in 250 mL of tea beverage significantly (p50%’

                ’Milk presence and HPH also improved α-glucosidase inhibitory capacity of coffee’.

                [Homogenised milk more than doubled chlorogenic acid bioavailability and improved alpha-glucosidase inhibition – which is of particular benefit to diabetics]

                https://www.sciencedirect.com/science/article/abs/pii/S1756464619302415

                10. Draijer et al, 2016

                ‘Compared to capsule ingestion, consumption of polyphenol-rich beverages containing either dairy, soy or no proteins had minor to no effect on the bioavailability and excretion of phenolic compounds in plasma (118% ± 9%) and urine (98% ± 2%). We conclude that intake of polyphenols incorporated in protein-rich drinks does not have a major impact on the bioavailability of a range of different polyphenols and phenolic metabolites’.

                https://www.ncbi.nlm.nih.gov/pubmed/27983686

                11. Mullen et al, 2017.

                ‘Milk decreases urinary excretion but not plasma pharmacokinetics of cocoa flavan-3-ol metabolites in humans.

                https://www.ncbi.nlm.nih.gov/pubmed/19403635

                12. Zhang et al, 2014

                …. ‘when plant phenols are consumed along with food macronutrients, the bioavailability and bioactivity of polyphenols can be significantly affected. The protein–polyphenol complexes can significantly change the plasma kinetics profile but do not affect the absorption of polyphenols’

                https://tinyurl.com/u8hvw9n

                13. Lamothe et al, 2014

                ‘The presence of dairy matrices significantly improved polyphenol stability in the intestinal phase and increased the antioxidant activity by 29% (cheese) to 42% (milk) compared to the control. These results suggest that simultaneous consumption of green tea and dairy products helps to maintain the integrity and antioxidant activity of polyphenols during digestion’.

                https://www.ncbi.nlm.nih.gov/pubmed/25154916

                14. Leenan et al, 2000

                ‘Consumption of a single dose of black or green tea induces a significant rise in plasma antioxidant activity in vivo. Addition of milk to tea does not abolish this increase’.
                ‘A_single_dose_of_tea_with_or_without_milk_increases_plasma_antioxidants_in_humans’

                https://www.researchgate.net/publication/12620409
                https://pubmed.ncbi.nlm.nih.gov/10694777/

                15. Van Het – 1998
                ‘Catechins from green tea and black tea are rapidly absorbed and milk does not impair the bioavailability of tea catechins’.

                https://www.ncbi.nlm.nih.gov/pubmed/9630386

                16. Cebeci et al, 2014

                … ‘it was not possible to detect catechin in mixtures due to milk addition. In vitro digestion method was used to determine potential bioavailability of phenolic compounds. According to in vitro digestion procedure results, whole or skimmed milk did not affect the total phenolic content of the proportion passing to the blood from intestine’.

                https://www.ncbi.nlm.nih.gov/pubmed/23944181/

                17. Neilson et al – 2009

                ‘Areas under the serum concentration−time curve (AUC) were similar among chocolate matrices. However, in-vitro AUCs were significantly increased for sucrose/milk/protein cocoa beverages, and non-nutritive sweetener milk protein cocoa beverages’.

                https://pubs.acs.org/doi/10.1021/jf902919k

                18. Keogh et al. (CSIRO, 2017)

                ‘In conclusion, milk powder did not influence the average concentration of polyphenols. While it slightly accelerated absorption, this is of no physiological significance’.

                https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1750-3841.2007.00314.x

                19. Roura et al, 2008

                ‘The results show that milk does not significantly affect the total amount of (cocoa) metabolites excreted in urine’.
                ‘The matrix in which polyphenols are consumed can affect their metabolism and excretion, and this may affect their biological activity.

                https://www.ncbi.nlm.nih.gov/pubmed/18257943

                20. Roura et al, 2007

                ‘Cocoa powder dissolved in milk as one of the most common ways of cocoa powder consumption seems to have a negative effect on the absorption of polyphenols; however, statistical analyses have shown that milk does not impair the bioavailability of polyphenols and thus their potential beneficial effect in chronic and degenerative disease prevention’.

                https://www.ncbi.nlm.nih.gov/pubmed/18032884

                21. Moser et al, 2014

                ‘These data …suggest that both milk proteins and minerals may alter flavan-3-ol bioaccessibility, but normal GI digestion appears to minimize the impact of specific protein interactions.

                https://www.sciencedirect.com/science/article/abs/pii/S0963996914006188

                22. Khan et al, 2012

                ‘Consumption of cocoa power with milk modulates the lipid profile in high-risk subjects for CHD. In addition, the relationship observed between the urinary excretion of cocoa polyphenol metabolites and plasma HDLc and oxLDL levels suggests a beneficial role for cocoa polyphenols in lipid metabolism’.

                https://www.ncbi.nlm.nih.gov/pubmed/21550218

                23. Renouf et al (2010)

                ‘As a conclusion, adding whole milk did not alter the overall bioavailability of coffee phenolic acids, whereas sugar and nondairy creamer affected the Tmax and Cmax but not the appearance of coffee phenolics in plasma.

                https://academic.oup.com/jn/article/140/2/259/4600297

                24. Farah et al, 2019

                … ‘about one third of the consumed chlorogenic acid from coffee is absorbed in the human gastrointestinal tract’ (that is, about two-thirds of chlorogenic aid is lost during digestion, that is, unrelated to the addition of milk)

                ‘Even in-vitro, higher fat milk added to coffee strongly increases the bioaccessibility of chlorogenic acids.

                ‘the addition of 10% whole milk or a pre-mixed non-dairy (fat rich) creamer with sugar to coffee did not increase or decrease chlorogenic acids area under the curve in plasma, in despite of a delay in chlorogenic acids appearance observed in the creamer test’

                ‘soy protein and/or other substances present in soymilk also bind chlorogenic acids decreasing their absorption in the upper digestive tract. This corroborates in vitro results on interactions between chlorogenic acids and soy protein

                ‘Brazil has implemented an active coffee school programme based on the findings that 20% coffee added to a glass of whole milk helps children perform better in school (ABIC, 2016)’

                https://www.mdpi.com › pdf-vor
                https://pubs.rsc.org/en/content/chapter/9781788015028-00364/978-1-78801-502-8

                25. Reddy et al. (2005) . ‘Addition of Milk Does Not Alter the Antioxidant Activity of Black Tea’

                …..’the results suggest that addition of milk may not obviate the ability of black tea to modulate the antioxidant status of subjects and that consumption of black tea with/without milk prevents oxidative damage in vivo’.

                https://www.karger.com/Article/Abstract/87071

                26. Kyle et al, 2007.

                ‘Six brands of tea demonstrated similar increases in antioxidant capacity and total phenolic and catechin contents with increasing infusion time. These results were unaffected by the addition of milk. Consumption of black tea (400 mL) was associated with significant increases in plasma antioxidant capacity (10%) and concentrations of total phenols (20%), catechins (32%), and the flavonols quercetin (39%) and kaempferol (45%) (all p < 0.01) within 80 min. This was unaffected by adding milk. Infusion time may therefore be a more important determinant in the absorption of polyphenols from black tea.

                https://www.ncbi.nlm.nih.gov/pubmed/17489604

                27. Heiss et al, 2007. ‘subjects consumed high-flavanol cocoa drinks (dry dairy-based beverage mix made with cocoa powder containing 306 mg of flavanols mixed in 100 mL of water) 3 times daily, totalling 918 mg of daily flavanol intake.

                We demonstrated that the daily consumption of a high-flavanol cocoa drink leads to a sustained reversal of endothelial dysfunction, reaching a plateau level of improved FMD at approximately day 5 (Figure 1). The magnitude of sustained vascular effects observed in the present study was in a range similar to that observed after long-term pharmacological approaches with, for example, statins.

                https://www.chococru.com/wp-content/uploads/2017/11/Heiss-et-al.-2007.pdf

                28. Rawel et al, 2017

                ‘Soy glycinin (SG) and soy trypsin inhibitor (STI) were derivatized by chlorogenic- and caffeic acid (cinnamic acids, C(6)-C(3) structure), and by gallic acid representing hydroxybenzoic acids (C(6)-C(1) structure). Further, the flavonoids, flavone, apigenin, kaempferol, quercetin and myricetin (C(6)-C(3)-C(6) structure) were also caused to react with soy proteins’…

                [Soy proteins (amongst many other macronutrients) bind with polyphenols].

                https://www.ncbi.nlm.nih.gov/pubmed/12063116

                29. Weisburger et al, 1997

                ‘black tea with milk exerted a greater protection against colon and breast tumors’. Full-fat milk (4.5% fat) led to an even greater additive effect on the antioxidant property.
                ‘Tea decreases mammary tumor induction, and the production of foci of aberrant crypts in the colon. Milk potentiates these inhibiting effects’.

                https://www.sciencedirect.com/science/article/abs/pii/S0304383597046934

                I have deleted several studies which are unambiguously milk protein, rather than whole milk.

              2. Your comment is awaiting moderation.

                [This usually means my doc may be too large, so I will re-send it in sections]

                Tom: ‘The fact is that both cow’s milk and soy milk block tea’s arterial , benefits’.

                Wrong Tom. Neither of them block tea’s arterial benefits. According to EFSA, there is no benefit anyhow, so how can milk or soy possibly block it? All they do is act similarly to each other.
                Secondly, the blocking effect only occurs in the tea cup or mug, and is reversed during digestion. Therefore, there is no net loss of polyphenol bioavailability. And if there is no net loss of polyphenols, how can milk and soy possibly diminish (these highly questionable) arterial benefits? All that happens is that polyphenol digestion is delayed. Milk fat appears to accelerate and enhance the reversing of this initial protein/polyphenol complexing, unless you believe Zhang’s jujube juice study is applicable more broadly (there is no evidence for this).

                Your ‘milk fat’ reference to Zhang et al relates to jujube juice. Not coffee, tea, or cocoa. I have no idea about the chemistry or digestive chemistry of jujube juice, and don’t much care. All it tells me is to be cautious about adding milk to my jujube juice. If Zhang et al could demonstrate that milk fat had the same effect on tea, coffee or cocoa, then maybe we would add skim milk rather than whole milk to our beverages. But there is no evidence of this. What we do have are Zhang’s overall conclusions, which make it clear milk proteins are not irreversibly bound to polyphenols as Dr Greger claims (https://nutritionfacts.org/video/does-adding-milk-block-the-benefits-of-coffee), as well as about 30 studies which demonstrate milk does not diminish polyphenol bioavailability. So, I am not going to get too excited about just one study relating to the addition of milk to jujube juice. Which seems inconsistent with 30 other studies relating specifically to the addition of milk to tea, coffee and cocoa. When it comes to conclusions, Zhang et al make it perfectly clear neither milk proteins (nor milk fats) diminish the polyphenol bioavailability of tea, coffee or cocoa:

                ‘It has been suggested that polyphenols can bind to milk proteins and subsequently form complexes(166,167). Therefore, the in vivo results may be explained by the formation of protein – polyphenol complexes that remain in the stomach for an extended period of time, thereby delaying the appearance of polyphenols in the blood. Additionally,the absence of an effect on overall polyphenol absorption indicated that polyphenols could be released from the complexes and be absorbed later’.

                Zhang et al, 2013

                Page 6, https://www.researchgate.net/publication/258146452_Interaction_of_plant_phenols_with_food_macronutrients_Characterisation_and_nutritional-physiological_consequences

                ‘Recently, we showed that milk protein–polyphenol complexes lead to significant changes in the plasma kinetics profile but do not affect the absorption and bioactivity of polyphenols both in rats and in human subjects

                Zhang et al, 2014

                https://www.cambridge.org/core/journals/nutrition-research-reviews/article/interaction-of-plant-phenols-with-food-macronutrients-characterisation-and-nutritionalphysiological-consequences

                ‘when plant phenols are consumed along with food macronutrients, the bioavailability and bioactivity of polyphenols can be significantly affected. The protein–polyphenol complexes can significantly change the plasma kinetics profile but do not affect the absorption of polyphenols’

                Zhang et al, https://tinyurl.com/u8hvw9n

                Despite the scant evidence (one study on jujube juice), we can have a legitimate debate about whether or not whole milk functions differently to skim milk, albeit I dont think it will go anywhere until we find studies demonstrating this in tea, coffee or cocoa. They just don’t exist. In fact most demonstrate that milk fat enhances the breakdown of these milk protein/polyphenol complexes. In one study, homogenisation of fat doubles coffee polyphenol (CGA) levels.

                1. Pete

                  You continue to misunderstand what both Greger says and what Zhang et al found.

                  Grgere reported that a study found that whole milk blocked tea absorption of polyphenols. He also reported that the authors of that study speculated that casein might have been responsible. Whether or not casein or milk proteins generally were responsible is irrelevant. What is relevant are the studies showing that milk blocks polyphenol absorption (and beneficial effects on arterial function).

                  Zhang found that ‘milk protein complexes’ etc did not block polyphenol absorption. Fine, no problem there Ditto for milk fats. However, Zhang et al found akso that whole milk did block absorption. That is the point. Posting yards and yards of studies about milk protein and milk fat complexes only swerves to obscure the key issue – the effect of whole milk on arterial health and polyphenol absorption.

              3. 1. Tagliazucchi et al, 2012:

                Pre digestion: Bioaccessible chlorogenic acid (CGA) of coffee = 80.2 μmol/200 mL

                Post Digestion: Without milk = 53 μmol/200 mL

                Post Digestion: With milk = 69.5 μmol/200 mL

                Note: Milk, and particularly milk fat increases CGA polyphenol bioavailability

                ‘After digestion, bioaccessible CGAs decreased from 80.2 to 53.0 and 69.5 μmol/200 mL in coffee without milk and coffee-whole milk, respectively. When whole, semiskimmed, skimmed, or diluted milk were present, the increase in bioaccessibility was dependent on fat content (r = 0.99, p 0.05). The type of milk did not influence TCAT recovery during all digestive stages (p > 0.05). Polyphenol-protein complexes are degraded during digestion. It is very unlikely that consumption of tea with or without milk will result in differences in catechin plasma concentration’.

                Note, the type of milk did not influence catechin recovery.

                https://www.ncbi.nlm.nih.gov/pubmed/21692489

                3. Van der Burg-Koorevaar et al. (2011) –

                ‘Administration of GTPM (green tea polyphenol infused with milk) significantly increased (p < 0.05) the antioxidant index and antioxidant enzyme activities when compared with the placebo group, whereas a concomitant decrease in the levels of lipid peroxidation were noted’.
                Chiu et al, 2016 – https://pubs.rsc.org/en/content/articlelanding/2016/fo/c5fo01271f#!divAbstract

                ‘These in vitro observations are consistent with several clinical studies that have reported milk addition generally does not impact acute absorption of flavan-3-ols from black or green tea in humans’.

                ‘It is very unlikely that consumption of tea with or without milk will result in differences in catechin plasma concentration’.

                https://www.researchgate.net/publication/51237698_Effect_of_Milk_and_Brewing_Method_on_Black_Tea_Catechin_Bioaccessibility

                4.Clifford et al, 2017

                ..’a feeding study by Renouf et al.243 revealed no difference in the pharmacokinetic profiles of plasma acyl-quinic acid metabolites after drinking black coffee with or without 10% whole milk. Thus, although 5-CQA has been reported to bind to certain proteins in vitro, such as albumin and casein,244,245 milk would appear not to have a significant impact on the overall absorption of coffee acyl-quinic acids.

                However, adding a mixture of sugar and non-dairy creamer (these are traditionally made from soybean oil and lecithin, Ed) to the black coffee resulted in lower Cmax values for caffeic acid (3) and isoferulic acid (43) accompanied by longer Tmax times for ferulic acid (4) and isoferulic acid.243 Sugar246 and lipids247 are known to delay gastric emptying and this may have delayed absorption of the coffee acyl-quinic acids resulting in an extended Tmax for two of the three metabolites.

                https://pubs.rsc.org/en/content/articlehtml/2017/np/c7np00030h

                5. Urbanska et al, April 2020:

                ‘Regardless of the decreasing antioxidant reduction potential in vitro studies, in many works,among others, Serafini, et al. [53], Loffredo, et al. [58], and Di Mattia, et al. [1], the same trend is not observed in studies on living organisms. In all these studies, the results of the increase in the occurrence of specific antioxidants in plasma consumed in the vicinity of milk did not differ significantly from those of milk-free counterparts. ….. It follows that lowering the antioxidant character of cocoa in a product with the addition of milk, such as milk chocolate, may be of primarily technological importance’.

                https://www.mdpi.com/2076-3921/9/4/299/pdf.

                6. Rashidinejad et al, 2017

                ..there are ‘similar effects between soy and bovine milk’ –

                ‘There is a conflicting evidence of the effect of milk addition to tea on antioxidant activity. Differences in the type of tea, the composition, type and amount of milk, preparation method of tea-milk infusions, the assays used to measure antioxidant activity, and sampling size likely account for different findings’. (there are) ‘similar effects between soy and bovine milk’.

                https://www.ncbi.nlm.nih.gov/pubmed/26517348

                7. Green et al, 2007 –

                Catechin stability in green tea was poor with <20% total catechins remaining post-digestion. EGC and EGCG were most sensitive with less, not double equals 10% recovery. Teas formulated with 50% bovine, soy, and rice milk increased total catechin recovery significantly to 52, 55, and 69% respectively. Including 30 mg AA in 250 mL of tea beverage significantly (p50%’

                ’Milk presence and HPH also improved α-glucosidase inhibitory capacity of coffee’.

                [Homogenised milk more than doubled chlorogenic acid bioavailability and improved alpha-glucosidase inhibition – which is of particular benefit to diabetics]

                https://www.sciencedirect.com/science/article/abs/pii/S1756464619302415

                10. Draijer et al, 2016

                ‘Compared to capsule ingestion, consumption of polyphenol-rich beverages containing either dairy, soy or no proteins had minor to no effect on the bioavailability and excretion of phenolic compounds in plasma (118% ± 9%) and urine (98% ± 2%). We conclude that intake of polyphenols incorporated in protein-rich drinks does not have a major impact on the bioavailability of a range of different polyphenols and phenolic metabolites’.

                https://www.ncbi.nlm.nih.gov/pubmed/27983686

              4. 11. Mullen et al, 2017.

                ‘Milk decreases urinary excretion but not plasma pharmacokinetics of cocoa flavan-3-ol metabolites in humans.

                https://www.ncbi.nlm.nih.gov/pubmed/19403635

                12. Zhang et al, 2014

                …. ‘when plant phenols are consumed along with food macronutrients, the bioavailability and bioactivity of polyphenols can be significantly affected. The protein–polyphenol complexes can significantly change the plasma kinetics profile but do not affect the absorption of polyphenols’

                https://tinyurl.com/u8hvw9n

                13. Lamothe et al, 2014

                ‘The presence of dairy matrices significantly improved polyphenol stability in the intestinal phase and increased the antioxidant activity by 29% (cheese) to 42% (milk) compared to the control. These results suggest that simultaneous consumption of green tea and dairy products helps to maintain the integrity and antioxidant activity of polyphenols during digestion’.

                https://www.ncbi.nlm.nih.gov/pubmed/25154916

                14. Leenan et al, 2000

                ‘Consumption of a single dose of black or green tea induces a significant rise in plasma antioxidant activity in vivo. Addition of milk to tea does not abolish this increase’.
                ‘A_single_dose_of_tea_with_or_without_milk_increases_plasma_antioxidants_in_humans’

                https://www.researchgate.net/publication/12620409
                https://pubmed.ncbi.nlm.nih.gov/10694777/

                15. Van Het – 1998
                ‘Catechins from green tea and black tea are rapidly absorbed and milk does not impair the bioavailability of tea catechins’.

                https://www.ncbi.nlm.nih.gov/pubmed/9630386

                16. Cebeci et al, 2014

                … ‘it was not possible to detect catechin in mixtures due to milk addition. In vitro digestion method was used to determine potential bioavailability of phenolic compounds. According to in vitro digestion procedure results, whole or skimmed milk did not affect the total phenolic content of the proportion passing to the blood from intestine’.

                https://www.ncbi.nlm.nih.gov/pubmed/23944181/

                17. Neilson et al – 2009

                ‘Areas under the serum concentration−time curve (AUC) were similar among chocolate matrices. However, in-vitro AUCs were significantly increased for sucrose/milk/protein cocoa beverages, and non-nutritive sweetener milk protein cocoa beverages’.

                https://pubs.acs.org/doi/10.1021/jf902919k

                18. Keogh et al. (CSIRO, 2017)

                ‘In conclusion, milk powder did not influence the average concentration of polyphenols. While it slightly accelerated absorption, this is of no physiological significance’.

                https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1750-3841.2007.00314.x

                19. Roura et al, 2008

                ‘The results show that milk does not significantly affect the total amount of (cocoa) metabolites excreted in urine’.
                ‘The matrix in which polyphenols are consumed can affect their metabolism and excretion, and this may affect their biological activity.

                https://www.ncbi.nlm.nih.gov/pubmed/18257943

                20. Roura et al, 2007

                ‘Cocoa powder dissolved in milk as one of the most common ways of cocoa powder consumption seems to have a negative effect on the absorption of polyphenols; however, statistical analyses have shown that milk does not impair the bioavailability of polyphenols and thus their potential beneficial effect in chronic and degenerative disease prevention’.

                https://www.ncbi.nlm.nih.gov/pubmed/18032884

              5. 21. Moser et al, 2014

                ‘These data …suggest that both milk proteins and minerals may alter flavan-3-ol bioaccessibility, but normal GI digestion appears to minimize the impact of specific protein interactions.

                https://www.sciencedirect.com/science/article/abs/pii/S0963996914006188

                22. Khan et al, 2012

                ‘Consumption of cocoa power with milk modulates the lipid profile in high-risk subjects for CHD. In addition, the relationship observed between the urinary excretion of cocoa polyphenol metabolites and plasma HDLc and oxLDL levels suggests a beneficial role for cocoa polyphenols in lipid metabolism’.

                https://www.ncbi.nlm.nih.gov/pubmed/21550218

                23. Renouf et al (2010)

                ‘As a conclusion, adding whole milk did not alter the overall bioavailability of coffee phenolic acids, whereas sugar and nondairy creamer affected the Tmax and Cmax but not the appearance of coffee phenolics in plasma.

                https://academic.oup.com/jn/article/140/2/259/4600297

                24. Farah et al, 2019

                … ‘about one third of the consumed chlorogenic acid from coffee is absorbed in the human gastrointestinal tract’ (that is, about two-thirds of chlorogenic aid is lost during digestion, that is, unrelated to the addition of milk)

                ‘Even in-vitro, higher fat milk added to coffee strongly increases the bioaccessibility of chlorogenic acids.

                ‘the addition of 10% whole milk or a pre-mixed non-dairy (fat rich) creamer with sugar to coffee did not increase or decrease chlorogenic acids area under the curve in plasma, in despite of a delay in chlorogenic acids appearance observed in the creamer test’

                ‘soy protein and/or other substances present in soymilk also bind chlorogenic acids decreasing their absorption in the upper digestive tract. This corroborates in vitro results on interactions between chlorogenic acids and soy protein

                ‘Brazil has implemented an active coffee school programme based on the findings that 20% coffee added to a glass of whole milk helps children perform better in school (ABIC, 2016)’

                https://www.mdpi.com › pdf-vor
                https://pubs.rsc.org/en/content/chapter/9781788015028-00364/978-1-78801-502-8

                25. Reddy et al. (2005) . ‘Addition of Milk Does Not Alter the Antioxidant Activity of Black Tea’

                …..’the results suggest that addition of milk may not obviate the ability of black tea to modulate the antioxidant status of subjects and that consumption of black tea with/without milk prevents oxidative damage in vivo’.

                https://www.karger.com/Article/Abstract/87071

                26. Kyle et al, 2007.

                ‘Six brands of tea demonstrated similar increases in antioxidant capacity and total phenolic and catechin contents with increasing infusion time. These results were unaffected by the addition of milk. Consumption of black tea (400 mL) was associated with significant increases in plasma antioxidant capacity (10%) and concentrations of total phenols (20%), catechins (32%), and the flavonols quercetin (39%) and kaempferol (45%) (all p < 0.01) within 80 min. This was unaffected by adding milk. Infusion time may therefore be a more important determinant in the absorption of polyphenols from black tea.

                https://www.ncbi.nlm.nih.gov/pubmed/17489604

                27. Heiss et al, 2007. ‘subjects consumed high-flavanol cocoa drinks (dry dairy-based beverage mix made with cocoa powder containing 306 mg of flavanols mixed in 100 mL of water) 3 times daily, totalling 918 mg of daily flavanol intake.

                We demonstrated that the daily consumption of a high-flavanol cocoa drink leads to a sustained reversal of endothelial dysfunction, reaching a plateau level of improved FMD at approximately day 5 (Figure 1). The magnitude of sustained vascular effects observed in the present study was in a range similar to that observed after long-term pharmacological approaches with, for example, statins.

                https://www.chococru.com/wp-content/uploads/2017/11/Heiss-et-al.-2007.pdf

                28. Rawel et al, 2017

                ‘Soy glycinin (SG) and soy trypsin inhibitor (STI) were derivatized by chlorogenic- and caffeic acid (cinnamic acids, C(6)-C(3) structure), and by gallic acid representing hydroxybenzoic acids (C(6)-C(1) structure). Further, the flavonoids, flavone, apigenin, kaempferol, quercetin and myricetin (C(6)-C(3)-C(6) structure) were also caused to react with soy proteins’…

                [Soy proteins (amongst many other macronutrients) bind with polyphenols].

                https://www.ncbi.nlm.nih.gov/pubmed/12063116

                29. Weisburger et al, 1997

                ‘black tea with milk exerted a greater protection against colon and breast tumors’. Full-fat milk (4.5% fat) led to an even greater additive effect on the antioxidant property.
                ‘Tea decreases mammary tumor induction, and the production of foci of aberrant crypts in the colon. Milk potentiates these inhibiting effects’.

                https://www.sciencedirect.com/science/article/abs/pii/S0304383597046934

                I have deleted several studies which are unambiguously milk protein, rather than whole milk.
                Tom, debate the issue by al means, but please dont say Pete's 'has never provided any evidence', or 'Pete is just sending selected quotes'. I am sending excerpts from studies which directly address Dr Greger's claims in his video.

            2. ‘First, there was no milk added to the cocoa drink.

              ——————————-

              Not so Tom, please read my previous post’

              Not so Pete. The study says

              ‘ (dry dairy-based beverage mix made with cocoa powder containing 306 mg of flavanols mixed in 100 mL of water)’

              So, no milk. Whatever dairy components were in there, there was no actual milk since the drinks were made with water and no milk was added..

              1. In any case, your argument also fails because that study did not compare a powder including some dairy components against a powder without any dairy components. If the study doesn’t make such a comparison, how can one claim that a drink with dairy doesn’t blunt absorption vis a vis a drink without dairy?

                We’ve already agreed that dairy/milk protein and dairy/milk fat don’t appear to affect absorption. The issue is whether actual milk does. Posting na hundred tangential studies that don’t actually address the issue only kicks up a lot of dust.

                1. Tom,
                  I have posted 30 studies which demonstrate milk does not affect absorption of tea, coffee, cocoa polyphenols. I think about 20 of them use the expression ‘milk’ ….not ‘skim milk’, or ‘milk proteins’. I think this is fairly compelling. You have quoted just one study of jujube juice (Zhang et al) where milk fat interfered with the digestive reversal of milk protein/jujube juice polyphenol complexes. It has nothing to do with tea, coffee or cocoa polyphenols. I note they have had 7 years to do a study to ascertain if the same effect occurs with tea, coffee and cocoa. Which would be far more meaningful. They have not done so. Which suggests to me something else is going on. If I had to guess (and that is all it is) they had a problem with their methodology in that study. Even if they did not, it does not affect tea, coffee and cocoa drinkers. .

  16. Paul Rubin
    Unless I am misunderstanding some facts, maybe Dr. Greger should have added his recommended Amla powder to the list of Oxalate foods to avoid. (My references are listed in parenthesis at the end of each statement and links listed at the end).
    Dr. Greger warned us that other high-oxalate foods that have been associated with kidney problems at high enough doses include a single dose of about a cup and a quarter of star fruit juice, or just 4-6 fruit (1). In his video on star fruit he said, star fruit, which you can often find in the tropical produce section at large supermarkets is harmful enough to shut down our kidneys. Acute oxalate nephropathy, caused by the extraordinarily high oxalate content (2).
    Dr. Greger said he takes a tsp of Amla powder in his smoothies for breakfast (3).
    An article I found on the internet stated that very high levels of total oxalates were measured in 2 imported fruits, Indian gooseberry (Phyllanthus emblica L.) and carambola (Averrhoa carambola L., star fruit), at 7566.5, and 436.1 mg/100 g FW, respectively, and their soluble oxalates were also the highest measured of all the fruits (4). That showed that Indian goose berries had over 17 times as much oxalates as star fruit and since it applied to whole fruit I don’t know if the powdered forms were worse, much worse, or better, I also read that in another report that the reported oxalate content of foods varies by a very wide margin (5), so I don’t know how that would affect any result/conclusion/advice/danger. I leave the whole analysis up to the experts like Dr. Greger and his staff, but I do think the whole subject of the safety of Amla powder should be addressed unless I am misunderstanding something.
    References:
    1. https://youtu.be/Eg5ksHXQavk
    2. https://youtu.be/19jF5eNi2tk
    3. https://youtu.be/N0QbVYoKe5g
    4. https://www.sciencedirect.com/science/article/pii/S0889157513000732
    5. https://www.ncbi.nlm.nih.gov/pubmed/25168533
    Oxalate content of food: a tangled web.
    CONCLUSION:
    Wide variations exist in the reported oxalate content of foods across several Web-based sources and smartphone applications, several of which are substantial and can have a sizable impact on the construction of a low oxalate diet. As dietary counseling has proven benefits, patients and caregivers should be aware of the heterogeneity that exists in the reported oxalate content of foods.

    1. Paul,

      I looked every where I could think to see if there were warnings for a la and kidney stones or kidney shut downs and didn’t find any.

      WebMD didn’t have that as a warning on their amla page.

      A renal doctor telling people what they could eat okayed amla as long as people didn’t overdo it. He didn’t warn against it.

      Some sites recommended using amla to protect the kidneys and some other sites which I didn’t find credible recommended amla to improve kidney stones.

      Dr Gregers video on the oxalate’s in turmeric versus cinnamon comes to mind.
      He said that something like 90% of the oxalates in turmeric get absorbed but only 10% of the oxalates from cinnamon get absorbed.

      When I searched for turmeric and kidney stones there was a warning.

          1. Deb: thank you for the article. The dependence of the oxalate content of food on geography and season makes it impossible to choose low-oxalate food everyday. The easiest thing to do is to avoid all foods known to contain large amounts of oxalate, but then you’ d miss some very healthful foods, like spinach and turmeric, and amla.

    2. Hi, Paul Rubin! Not everyone needs to avoid oxalates, and not all dietary oxalate is absorbed. Oxalate content of a food may also not be the only factor to consider. The most common concerns with regard to oxalates are mineral absorption and kidney stone formation. The first issue is easily resolved by separating intake of mineral-rich foods from high-oxalate foods. The second issue appears not to exist with amla, which may even offer some protection against kidney stone formation, according to this: https://pubmed.ncbi.nlm.nih.gov/29962797/ I hope that helps!

  17. Hello,

    Amla POWDER (in milligrams or ounces) is approximately equivalent to how many average-sized Indian Gooseberries?

    I ask because I would rather eat the whole fruit than the powder as a general rule.

    Can someone please recommend a high-quality, unadulterated brand of Amla powder and where to get it?

    Thank you.

      1. Thanks George! I typed it backwards in my comment about that company this afternoon. I have heard good reports about them, and I like their procedures for testing etc.

    1. Hi, Barryman! We do not endorse specific products or manufacturers here on NutritionFacts. Look for independent third-party testing and open publication of results. I don’t know the exact ratio of fresh to dried amla fruit. The general rule of thumb for fresh to dried plant matter, which will vary depending on the moisture content of the fresh fruit, is 3:1. I hope that helps!

  18. Off-topic post.

    ‘A team of scientists, led by researchers at University of California San Diego School of Medicine, report that a class of drugs used for a broad array of conditions, from allergies and colds to hypertension and urinary incontinence, may be associated with an increased risk of cognitive decline, particularly in older adults at greater risk for Alzheimer’s disease (AD)……………………..
    Anticholinergic drugs are widely used for dozens of conditions, minor and major. Some of these medications require a prescription, while others can be purchased over the counter.’
    https://www.sciencedaily.com/releases/2020/09/200904125116.htm
    https://n.neurology.org/content/early/2020/09/02/WNL.0000000000010643

    1. Mr Fumblefingers,

      I read the Science Daily material posted. I do not have access to the full Neurology article – just the teaser.

      Could you enlighten us as to the specific anticholinergic medications evaluated?

      Thank you,

      Vivamus

      1. Vivamus

        The full study is available for free here.

        https://www.researchgate.net/publication/301481483_Association_Between_Anticholinergic_Medication_Use_and_Cognition_Brain_Metabolism_and_Brain_Atrophy_in_Cognitively_Normal_Older_Adults

        As I understand it, they did not evaluate specific medications. They instead evaluated outcomes for a number of people and found that those taking drugs with medium or high anticholinergetic effects had a higher risk. Here is a list of common anticholinergetic medications

        https://www.healthline.com/health/anticholinergics#drug-list

        Benadryl is probably the best known.

        1. Mr. Fumbelfingers,

          Thank you.

          Time to brush up on my anticholinergics.

          Scopolamine! Scopolamine? Yes, Scopolamine!

          Wow – I had no idea that people were still using it.

          Wisened maternity nurses used to stories ’round the campfire of the days of “Twilight Sleep” obstetrical anesthesia – utilizing Scopolamine.

          Scopolaine does not kill pain – it just kills memory. So the girls giving birth were delirious and thrashing and screaming in pain – but didn’t remember any of it – and thereby experienced painless childbirth.

          Young female zombies walking around Labor and Delivery gibbering with clothes – well – every which way.

          That’s one reason the leather restraining cuffs and straps were built into the obstetric tables (the cause of my original question to the nurses – “what’s this all about?”).

          No pain for the patient with Scopolamine – in memory, anyway. But consider the effect on staff:

          Chasing half-naked zombies in labor around labor and delivery in the wee, wee hours of the morning.

          You wonder why Fathers used to be confined to the waiting room?

          Now you know.

          Labor and delivery nurses have their stories . . .

          You don’t ever want to be one.

          ——————————————

          I know. We all miss the Good ol’ Days!

          ——————————-

          Other uses for Scopolamine – “transdermal patch behind the ear for motion sickness.”

          Yup.

          Brother and his wife did this – as instructed – to ward off seasickness for a sailing expedition.

          They complained of blurred vision – disabling – for one to two weeks afterward. “Never again!” “Don’t ever do this!” “Really –
          don’t ever, ever do this!” They were fairly adamant about it. As adamant as they get.

          OK. I won’t.

          End of story.

          ——————————-

          There are still other uses for Scopolamine. Good. I am sure some uses are perfect.

          Whereas some have – minor issues.

          And there’s a nice long list of other anticholinergics to review.

          Times a-wastin’!

          Mr. Fumblefingers.

          Thanks, again –

          Vivamus

    2. Thanks, Tom.

      Wow, Benadryl. That is something I took for years because of allergies.

      I occasionally took Tylenol PM because of my sleep problems.

      The list of things that harmed my brain gets longer and longer.

  19. Deb,
    I’m not sure what route you went on your power. 1. backup 2. off grid .
    Years ago I considered backup generator, or solar and even ground heat pump. My electric is dirt cheap and it’s been years since it went out for a week. So I’ve decided to be inconveinenced now and then. My next auto may be battery powered and my new set of lawn tools, to include the riding mower. Walmart has all the battery lawn tools now, but not the riding mower. Zheesh, if I went with the push mower, I would get more exercise. I’m so used to sitting on my throne and doing the meditation ride.

    1. Dan,

      I am leaning toward Tesla solar panels with backup battery.

      Sun run wants to send a proposal for their system which they say is the most efficient 55% more efficient and I am letting them quote me because the Tesla, their small system would almost be enough but not quite during the summer.

      I decided that I will go with their medium system.

      But if Sunrun can sell me a small system that generates more kilowatts than Teslas small system, that costs halfway between, Sunrun can suddenly come from behind and win.

      I told Sunrin that I was leaning toward Tesla because they put all of their numbers on the table and aren’t trying to put me through a slick sales process and because Sunrun is 1% right now but all of the companies that were number 1 before them got bought out and Tesla is one of the biggest companies and is likely to still be in business to honor the warranty and market watch people aren’t sure whether Sunrun will follow solar city and vivant into needing rescuing. Plus, Sunrun had some lousy service YouTube videos where Trsla showed up to a man’s house with ladders at 9 PM and fixed his roof even though it wasn’t them who had repaired it wrong. They did it for free. That one man was a pain in the neck to them several times but he was amazed that a human being answered late at night and they showed up faster than AAA.

      1. Deb,
        Looks like you are leaning to Tesla medium. Also that you have been crunching the data. Passive energy and insulation can be significant modifications. Things like draping hot windows in summer can save on AC. Or putting foan board on the same windows in winter saves on the heat bill. Or letting warm sunlight flow through the windows on a sunny but cold day. Weatherstripping an 1/8″ door crack can make a big difference in room comfort. Insulating ceilings to the max. Dressing warmly in winter and keeping the house an average, comfortable temperature.

        1. Dan C,

          Yes, for years I have been refining all of the tricks.

          When I had to fix the house (I had no choice, for insurance reasons) I put in energy star rated insulation in the walls and attic and triple-pane windows with krypton and I put in insulating blinds to go over the insulating windows. My carpenter went around putting in winterizing for my doors (It became so tight a seal that my door broke when the wood expanded with the season change, so it backfired a little.)

          I also got a Vornado to pull the hot air back down from the ceiling. The personal-sized Vornado was perfect for me because it can either be very low watt or higher watt. I also have a heated mattress pad and a down throw and a heated throw for the living room. The downthrow is whisper-light and pretty much enough but if I come in feeling chills to the bone, I put the electric throw on for an hour. That is usually enough.

          Honestly, I worked really hard to get the electric down to $50 to $70 per month and then they doubled the fees and it is suddenly above $150 while my next-door neighbor who was always closer to $150 to $200 is paying $9 per month with her Tesla panels. (Solar City)

          The thing is, my friends have gotten in trouble with utility bills and medical bills and 3 or 4 of them have had their power shut off for a few weeks at a time and a few of them had gone homeless in their early 60’s.

          I don’t have debt and I am trying to make sure that I never have debt and that I would still be okay even if taxes and utilities doubled and even if I lost my job and there was hyper-inflation.

          I guess watching stories of homeless people, so many of their stories go: “And then I had a stroke and couldn’t work and lost my house” or “And then I lost my job” “And then, I re-mortgaged my house to afford medical care”

          I feel peace about getting rid of utilities and it feels almost mischievous that I might also suddenly not have to be as careful with my electric use.

          1. Dan C.,

            I already know that you did the work, too. You use the energy savings logic. Kudos to you.

            I laugh because I know that I sometimes veer off of what the experts say.

            The example I could give was the triple-pane windows. They said, “It will take them 20-years to pay for themselves and they aren’t worth it.” but went on to add a sentence that “They do make the rooms much more comfortable” and I mentally heard, “In 20 years they will have paid for themselves and I will have been more comfortable for the whole 20 years.” But everybody everywhere heard the logic as “Not worth it” and I heard, “Way more comfortable” and they really did help tremendously. I have saved thousands of dollars off my oil bill with them and already don’t have to dress quite as warmly. I can keep my house at 60 to 65 degrees 24/7 but my house gets so much more comfortable with an hour of vornado in the morning and an hour at night.

            I already know that I am going to go for it.

            Yes, I have wiped out so much of my savings preparing for my future but I have learned from friends and family that if you wait until you have medical problems, you can never afford any of it.

            I am almost done.

            The question is whether I will go overboard doing the medium system and then do something crazy like get a Titan anyway just because I don’t trust the utility companies at all.

            Plus, I expect my taxes to raise dramatically next year to pay for re-funding the police. They have already talked about the fact that the new laws mean that it is going to cost twice as much to run the police departments and they aren’t giving back the amounts they defunded them so raising taxes dramatically or getting rid of officers are the only 2 choices. It is going to be taxes and that will be next year.

            I feel like I am the person in the movies with the sand storm coming at them and they are riding their horses as fast as they can.

            1. Deb, rather moved by your comments; cost of living, homelessness.
              Particularly comments relating to financial difficulties because of medical emergencies, sudden unemployment. Post retirement poverty. I understand the political sensitivities of this issue in the US, but by way of comparison, I live in a country where falling ill is not such a profound financial problem. The public health system is available free to everyone. We pay just 2% of our taxable income for life, with low income earners exempt. I just wish Americans could enjoy the same benefit. The conservative political parties in Australia tried to scrap it, but it is so popular they no longer can afford to do so.
              Whilst on this subject, Australia also has a compulsory superannuation scheme. Same deal. The conservatives wanted to scrap it. Fortunately, they have not succeeded.
              Tiny Australia (25 million) now has ‘the Fourth Largest Pension Fund Assets in the World’ https://www.austrade.gov.au/news/economic-analysis/australia-has-the-fourth-largest-pension-fund-assets-in-the-world

              The huge pool of superannuation funds has helped save Australia from the crippling economic impacts of Corona 19. Employers pay a levy, and in exchange, employees get lower pay and smaller raises. In the US they have come to the realisation that employees are also getting lower pay and smaller raises, but without compensatory superannuation.

              Hard to say if America will ever adopt the Australian model, but it should be seriously considered. Politicians need to represent voter’s interests (that’s democracy) rather than the myriad of vested interests. And ‘lighten up’ on the ‘socialism’ bit. Proper superannuation may even help save capitalism:

              ‘Major American investment manager Bill Ackman is calling for the adoption of an Australian-style super system in the US to tackle inequality and protect the capitalist system.

              Writing to investors in his Pershing Square group – which has $US6.75 billion ($A9.28 billion) in the markets – Mr Ackman said that “one of the principal problems with capitalism … is that wage growth has not kept pace with long-term wealth creation.”

              If that situation continues then “more and more Americans will seek changes – potentially radical ones – to the current system or seek an alternative system,” Mr Ackman said.

              A push to “socialism or other alternatives” is likely to be driven by “Americans who have no ownership in the success of capitalism.”

              One solution put forward by Mr Ackman would be mandating employers to set aside funds for workers “similar to the approach used by the highly successful and popular Australian superannuation system, which has created savings of scale for growing generations of its citizens.”

              The Australian super systems has set aside, Mr Ackman observed, $2.7 trillion in retirement savings since it was established in 1991.

              “[That’s] nearly twice the country’s GDP,” he said.

              “Remarkably, Australia has created the fourth-largest pension system in the world, in the 53rd most populous nation.”

              Wages in the United States have effectively been on the decline for much of the last 40 years with the average wage after inflation peaking in 1973 at $US23.24 ($A31.99) an hour.

              Wages did not reach that level again until March 2019.

              “There has been tremendous inequality in the US,” said Professor Simon Jackman, CEO of the United States Study Centre at the University of Sydney.

              “Average wages in areas like computer software and financial services growing dramatically while, at the same time, there has been an oversupply of unskilled workers which has held wages down.” Aussies doing ok

              At the same time real wages in Australia have been growing, according to Mark Wooden, economics professor at the University of Melbourne.

              “If you look at real wage growth levels [wage growth above the inflation rate] they grew at 0.6 per cent in the period between 2001 and 2008,” Professor Wooden said.

              “[They grew at] 0.8 per cent between 2008 and 2013 and then only 0.2 per cent between 2013 and the present,” Professor Wooden said.

              A major difference between the two countries is the award system.

              “While there’s a minimum wage in the US and Australia there are actually hundreds of minimum wages in Australia set by awards,” Professor Wooden said.

              “So we have about 21 per cent of people on award minimums that are above the actual legislated minimum, which is the highest in the world.”

              In the US the growth in low skill employee numbers has held down wage growth and the minimum wage is extremely low at $US7.25 ($A9.97) per hour compared to $19.84 in Australia.
              Super boosts wages

              Superannuation has further improved Australian wages as the current 9.5 per cent of wages paid in by employers is not counted in the measurement of wages in the above chart.

              “The super system is a form of social engineering which grew out of the relationships between Labor governments and the union movement ,” Professor Jackman said.

              By adopting an Australian-type superannuation system, US workers would improve their retirement prospects while also effectively getting a wage rise through employer funded contributions.

              “Ensuring workers have a stake in the growth in capital markets is a vital ingredient in delivering better retirement incomes and combating inequality,” said Industry Super Australia (ISA) in a statement.

              “Isn’t it ironic that while other developed nations look with envy at the difference our super system makes to the lives of ordinary people, some of our own leaders want to tear it to pieces and create the shocking divisions in wealth we observe in those same nations trying to emulate us,” said ISA CEO Bernie Dean.

              “Australia is one of very few OECD countries to have reduced its age pension expenditure as a portion of GDP since 2000, with this positive decline set to continue in the years ahead.”

              These trends are good news for taxpayers, Mr Dean said, and highlight the value of a universal compulsory super system.

              “But we can’t take these things for granted,” he added.

              “We need to protect members from adverse system change that would shatter their retirement balances and be disastrous for the economy, such as cancelling the super rate rise and lumping future generations with tax hikes by cracking open preservation rules.” Hold on a minute

              Professor Jim Stanford of the Centre for Future Work said he thought Mr Ackman was concerned more with the future of the capitalist system than social equality.

              “Adopting the Australian system would not do anything for wages,” he said.

              “America already has a defined benefit pensions system called Social Security which is universal and pays 12.4 per cent, half contributed by workers and half by employers.

              “It’s not invested in the stock market, it’s simpler, less-costly, and more secure for workers,” he said.

              However with half the contributions coming from workers it contributes less to wages than the Australian system.

              https://thenewdaily.com.au/finance/superannuation/2020/09/04/super-us-equality-bill-ackman/

              More at:

              https://www.forbes.com/sites/nextavenue/2013/08/19/to-solve-the-u-s-retirement-crisis-look-to-australia/#46e873fb47b5 https://theconversation.com/our-super-system-isnt-perfect-but-for-a-failure-look-to-the-us-46886

              1. Pete,

                Wow! Just wow!

                How little we know here – where ~50% of bankruptcies are said to be driven by medical bills.

                Those lazy sick people!

                Question – how is Australia doing as far as higher education is concerned?

                Are Australian kids mortgaging their futures – to the tune of multiple tens of thousands of dollars per year of study – to be locked into their dormitories and attend virtual classes online?

                Or have you not followed our lead?

                So much to learn –

                Vivamus

                1. Vivamus,

                  Education is very affordable:

                  *‘University fees* will go up by $2,000 to $3,600 for a four-year course, an increase of 1.8% in 2018, and 7.5% by 2022. From 1 July 2018, the income level at which *HECS* debt repayments start will be reduced, from $55,000 to $42,000’.

                  [The debt is commenced to be paid off once one reaches income of $42,000 pa.]

                  ‘HELP (HECS) debts are administered by the Australian Taxation Office and will be repaid compulsorily over time through the taxation system. If the *HELP Repayment Income* (HRI) of a person with a HELP debt exceeds a certain threshold, which for the 2014/15 financial year is $53,345, a compulsory payments will be deducted from the person’s tax for the year. The HRI is the person’s taxable income plus any net rental loss claimed against that taxable income and adding fringe benefits, reportable superannuation contributions and foreign income received, normally exempt from taxation.

                  Unlike marginal tax rates, the repayment rate applies on the full HRI, so that a person with a HRI below $45,881 in 2019/20 will not need to make a compulsory HELP repayment, but a person with a HRI of $80,000 would make a payment of $4,400. This is 5.5% of the HRI (not taxable income or the debt balance) of $80,000. The compulsory repayment amount cannot exceed the balance of the HELP debt.

                  https://en.wikipedia.org/wiki/Tertiary_education_fees_in_Australia

              2. Pete,

                Minimum wage isn’t that low anymore. Most people can get a job at someplace like Target or Walmart or Amazon for $14 or $15 per hour now. The problem is getting a full-time job with benefits.

                What I would say is that half of the people around me are leisure class with more than one home, multiple cars, multiple everything else and half are falling out the bottom. That side of my family and friends drive Mercedes and Jaguars and Teslas, and Cadillacs and they travel to whichever part of the country has better weather throughout the year and they do not want what you are suggesting at all. They want the poor people to pull themselves up by their bootstraps.

                I am still in the middle – neither rich nor poor. I have never had debt. I have insurance. Plus, as part of my preparation, I have about $12,000 in an account for a medical emergency.

                As far as our system goes, it is much more complex than you know. People do get put temporarily on Medicare if they are unemployed and have no money and multiple of my friends have used that temporary Medicare benefit. Or, if they make too much and don’t qualify for that, they can buy their own insurance and I have friends who only get insurance when they have something happen and those people are doing okay. Strangely enough, it is working people with insurance that have such high deductibles that became a serious problem. People who have medical issues often end up hospitalized more than once and that is hard on a fixed income. Medicines are also high.

                What I know is that people who have skill sets can just do something like make a YouTube channel and I watch a man who went from homeless to paying cash for a house and a Tesla and now he is buying a house for his mother and his sister.

                In some ways, that is the spirit of America. I just know that the middle is being squeezed.

                Low-income housing is the main issue.

                I do wish that we could have a different system for medical care.

                But it would be so hard to change it that mostly I just want a safety net for the ones who fall through.

                The temporary Medicare is a safety net and so is being able to buy insurance on the spot.

                But businesses can’t afford insurance for their workers so the workers get poor insurance and that is where people suddenly fall through the cracks.

                1. Thanks Deb for your (as always) interesting take on things. Its always fraught with danger commenting on other nations, but then again, sometimes you have to be an outsider to provide a different perspective

                  The US was created on that ‘pull themselves up by the bootstraps’ mentality. Australia is similar, but does not have quite the same tolerance for systemic inequality. Which, can be the result of disability, mental illness, a broken marriage, aging, and especially declining opportunity.
                  The latter has occurred as the economic pie has shrunk. This seems to have occurred in the US over the past 40 years:

                  *‘But despite the strong (US) labor market, wage growth has lagged economists’ expectations. In fact, despite some ups and downs over the past several decades, today’s real average wage (that is, the wage after accounting for inflation) has about the same purchasing power it did 40 years ago. And what wage gains there have been have mostly flowed to the highest-paid tier of workers’.*

                  *‘After adjusting for inflation, however, today’s average hourly wage has just about the same purchasing power it did in 1978, following a long slide in the 1980s and early 1990s and bumpy, inconsistent growth since then. In fact, in real terms average hourly earnings peaked more than 45 years ago: The $4.03-an-hour rate recorded in January 1973 had the same purchasing power that $23.68 would today’.*

                  *‘Meanwhile, wage gains have gone largely to the highest earners. Since 2000, usual weekly wages have risen 3% (in real terms) among workers in the lowest tenth of the earnings distribution and 4.3% among the lowest quarter. But among people in the top tenth of the distribution, real wages have risen a cumulative 15.7%, to $2,112 a week – nearly five times the usual weekly earnings of the bottom tenth ($426)’.*

                  https://www.pewresearch.org/fact-tank/2018/08/07/for-most-us-workers-real-wages-have-barely-budged-for-decades/

                  This is not good. Its a somewhat similar (less extreme) situation in Australia, but compensation comes in the form of lower medical care overheads, enhancing medical benefits (Medicare), boosting education services (HECS scheme), and compulsory superannuation. Its a reasonable trade off, particularly as housing is expensive in Australia (a big minus).
                  People ultimately fund these services themselves through their own taxes – unless they are incapable of doing so. In which case the state steps in. It might not be politically correct, but there are advantages to compulsory, collective power. So long as it does not gravitate to the Chinese authoritarian way of doing things.

                  The other aspect to this is the huge cost of medical care in the US, which obviously has a bearing on peoples capacity to pay. Or afford decent insurance:

                  ‘The U.S. spends about $8,745 per capita on health care costs, compared with less than half that — $3,997 per person — in Australia’.

                  https://www.cbsnews.com/news/trump-says-australias-health-care-beats-the-us-hes-right/

                  ‘Australia’s healthcare system has been ranked among the best in the developed world by a team of American researchers who have ranked their own country’s system the worst’.
                  ‘In their study of 11 different national health care models, researchers at the New York-based Commonwealth Fund ranked Australia’s mixed public-private system second best’.

                  https://www.abc.net.au/news/2017-07-17/australian-healthcare-ranked-second-best-in-developed-world/8716326

                  If medical outcomes are better in Australia, there is no good reason for the US medical bill being double that of Australia’s. This just further increases the poverty gap for US citizens. It is a systemic problem which appears to be the consequence of vested interests wielding sufficient political power to block much-needed reform.

              3. Pete,

                I just see the USA as so divided that we can’t fix anything easily.

                Watching the elections and COVID and where the money and power is, we are so divided.

                If we had a Civil War with brother against brother before, we can’t even have one. It isn’t North against South or state against state.

                It is one brother radically conservative about this topic and radically liberal about that subject and radically neutral here and elitist about that and disciplined in these 6 areas of their lives and willy nilly about these 3 things over there.

                1. You don’t understand

                  we are

                  black Lives Matter

                  defund the police

                  Followed by.

                  policeives Matter

                  re-fund the police at a higher level

                  Taxes matter

                  But we can’t put the funding for the police back where it was.

                  NY is having more shootings this year in one month than all of last year

                  Wait people can’t afford taxes
                  Neither can businesses
                  Well tax the wealthy people and they move overseas to avoid it.

                  It is so complicated.

                  1. Deb,

                    You describe the problem so vividly. US is socially polarised, which is very destructive. Conservatism/authoritarianism Vs cultural libertarianism.
                    Conservative authoritarianism from within, and from outside. With the Chinese communist party intent on replacing the free world’s cultural libertarianism with Beijing-controlled authoritarianism. Ironically, those on the conservative side of politics in the US, being far more attuned to the risk than those on the left of politics (takes one to know one).
                    I believe most humans have both a conservative and libertarian side to their personality (yin and yang). They are capable of exhibiting either of these personality traits. Which is a healthy thing. What is very unhealthy is people exclusively (fanatically) locked into one personality extreme or the other. A cohesive nation needs the majority of people to be in the uncertain, vacillating group (centrists) and a minority in each of the extremes. Notwithstanding the centrists will be accused of believing in nothing. That is, being bereft of faith/belief. Its this faith/belief which is at the core of the problem, when it becomes more important than reason and truth for those at the political extremes. It causes enormous chaos and internal conflict. The USA has a habit of righting itself, and those of us in the free world are hanging out for it. We know in Australia that if there were no USA, Australia would already be a sovereign state of China. So, a viable USA is mighty important to us.

          2. Long underwear.

            Turtlenecks.

            Flannel-lined pants!

            Scarves.

            Knit hats.

            Flannel sheets.

            Shearling ankle slippers.

            Fingerless gloves.

            Humidifier.

            I was able to live as low as 55 degrees Fahrenheit during low income / energy crisis times with no problem.

            New normal.

            Without feeling cold – except when just out of the bath. The old house did not have a shower.

            But the towel rack was just over the bathroom forced air heat vent – so the towel was always nice and toasty.

            Excellent 1928 design.

            A thick long hooded terrycloth bathrobe helped. And we had a floor mounted heating vent in the master bedroom – so you could stand over it and get toasty as the heat rose from your feet – heat would fill the whole bathrobe!

            Ahhhhhhhh . . .

            This led to some vertical wrestling at times. But that was OK, too.

            A heated toilet set would have been nice. But that was just an idea in passing – I dunno if they are actually out there.

            The wood set wasn’t that bad. Now – stainless steel would have been something.

            Glass of water at the bedside table – in the morning, it was like it had come straight from the refrigerator.

            ———————-

            I used a simple concept, then – what part of me is currently coldest? Then I would add clothing in that direction..

            Then ask the question again. Rinse and repeat until no cold was left.

            Except – I never did solve the issue of the cold nose.

            The final frontier.

            ——————————————————

            However – there was one fundamental problem: living in a cold house chased the girls away.

            Girls just do not like living in a cold house.

            Simple as that.

            Spring broke. And all was well again.

            Deb.

            Stay warm –

            Vivamus

        2. Sunrun has been texting me.

          The salesman is charming but he won’t just give me numbers.

          He wants to do the whole teaching pitch.

          Tesla will win.

    2. Tesla not being pushy is almost enough to win on it’s own.

      I can get a medium system for slightly more than my electric bill pre-Federal government credit.

      Then, I can use electric heat and so get rid of my oil bill.

      I feel like it is the way to go.

  20. The concept that I could get a small system with a 3 Day battery backup and only pay $35 per month already made it that I am going to do it.

    Tesla had fires when they bought out solar city and Walmart called them cold-hearted but there are some amazing customer service videos.

    Plus, after the fires, they figured out which someonemt was faulty and proactive went around giving panels and inspection them.

    In some ways, I think them doing extra processes now makes me more willing to use them.

    Plus my next four neighbor has Tesla panels.

    I had originally crossed them off because of the fires and their price but they dropped their price by 30% and are doing extra inspections to prevent fire.

    Seems like good timing to go that way.

    1. The small system is just about what I need but the panels would slowly lose efficiency.

      Sun runs should cover the loss in efficiency.

      Tesla’s medium system would be double what I need but I would never have to worry about using the ac or how long the electric heater in the bathroom stays on or whether to hang my clothes or dry them in the dryer or how much electricity the oven uses ever again for the rest of my life.

      I often alternate which room gets best or ac and that wont ever be an issue ever again.

      Plus because it comes with 2 batteries and would be hooked up to my solar panels on the roof, even if the grid went down entirely I wouldn’t be affected.

      That is where my heart is leaning.

      Tesla medium system.

      Never think about utilities ever again.

      Maybe lease electric cars in the future.

      1. Deb,

        I’m holding out for flying cars, myself.

        I know they’ll be here soon.

        Because – well – because it’s time!

        Deb.

        Take care –

        Vivamus

        1. Vivamus,

          Flying cars are for sale in the USA as of 2019.

          If you are insanely wealthy, might as well get one.

          I need to make sure it flies itself so I can close my eyes when I try to fly over a traffic jam.

          1. It is only $600,000.

            So if I figure out some cool YouTube channel to put up, I figure that I could afford one in about 60,000 years.

            I had better eat my blueberries.

  21. Sunrun took a year to repair one persons solar panels.

    Tesla seems to have gotten rid of sales and shored up customer service.

    My final option would be to go to Teslas small system and get a Titan and use that for heating and cooling. I would still get 1 battery from Tesla but I can get a 2 battery Titan for much cheaper than the Tesla medium package.

    It is really hard to figure things out.

    I am still leaning toward the medium system but the Titan is cheaper than Teslas battery backup So that could save another thousand or two.

  22. I started watching the faux meat webinar and paused almost immediately that China is going to cut their meat consumption by 50% within the next ten years.

    Wow.

  23. I was also interested that the meat companies are coming out with products that blended vegetables into the chicken and hamburgers and other meat products to lower the saturated fat by 60%.

    China could just make hamburgers that are blended with 50% plant products and cut their meat intake in half next year without telling anybody and then, they can cut it in half again.

    1. How would they control how much meat there is?

      Nope, you can only eat the sweet and sour chicken every other day.

      No, no, you can’t switch to sweet and sour pork. Can I recommend the sweet and sour tofu?

      Wouldn’t they be better off investing in faux meats and flooding the market with those?

      1. Years ago, when I became allergic to meat, there was a Chinese restaurant that had an extensive vegetarian and possibly vegan menu but they didn’t speak English well and my friend and I were too timid to try vegetarian duck tongue and the other specialties on their menu. Years later, someone re-did their menus and explained the ingredients and I still never tried the vegetarian duck tongue.

  24. Well, I have really enjoyed the faux meat webinar up to about the fecal water. Somehow, you totally lost me there and somehow you have suddenly made liver pate and blood sausage sound appetizing in comparison.

    I honestly am going to have to watch that one 3 or 4 times, I think because the cogs in my brain are saying, “What the heck are they doing? I do not even understand what is being studied at all.” Writing department, I think when you are going way off the wall, you need an extra sentence that is simpler somehow.

    1. The jokes led away from understanding what was happening in the study.

      Humor works better when it increases revelation.

      The use of the words tea and smoothie only belong there if that is what is happening.

      If it isn’t being ingested then the analogies are moving in the wrong direction.

        1. If the point was they were having them do fecal transplants that way, then the jokes were appropriate but the explanation of what was going on was weak.

  25. Did NutritionFacts.org contact the Impossible Burger to suggest that they do a study to see if the soy in the burger counteracts the sodium?

    The best question of the webinar.

    I still don’t understand why it doesn’t work in soy sauce though.

  26. Even if you have heard it all re the coronavirus, this article is worth reading imo. https://www.bluezones.com/2020/06/covid-19-straight-answers-from-top-epidemiologist-who-predicted-the-pandemic/
    Obesity is the number 1 risk factor forr 55 yrs and under group. Healthy diet, exercise/activity, getting outside all important in surviving this, and it’s not going away anytime soon. Interesting bits about vaccines, too. Enjoy.

    This morning another lady called out to me as I rode by that she had felt inspired to dust off her bike and do what I do in riding around the neighbourhood. I feel like I am ten again…. this afternoon, it’s river swimming and inner tubes. :)

    1. Barb,
      Thanks for the interview with Dr. Osterholm. Great to know we are 5% of the way through c-19. At least we know to stay the course. Good to know that being outside is much safer. Happy tubing!

    2. “this afternoon, it’s river swimming and inner tubes. :)”

      Mud squishin’ underfoot.

      Rope tied to a tree limb on the riverbank. Geronimo!

      Don’t step on a bee!

      Skeeter bites!

      Crickets.

      Catchin’ frogs.

      Watermelon seed distance contests.

      Tag.

      Hide-n-seek.

      Hula hoops.

      Pogo sticks.

      Roller skates.

      Skate boards.

      Model planes.

      Paper routes.

      I remember everything.

      ———————————————–

      Ahem.

      The article you referenced.

      Published June 6, 2020. Three months of Pandemic ago.

      Still perfectly fine. Michael Osterholm, PhD, MPH has been at this for a while – his wisdom does not get outdistanced by events.

      That – in itself – is interesting.

      In contrast – think of how may times the CDC has revised it’s recommendations along the way.

      The CDC was once a great Institution. Truly great. Now – now it’s ping-pong ball.

      —————————————————

      One observation of Dr. Osterholm’s really stands out to me:

      “Wearing a cloth mask does not protect you much if you’re in close contact with someone who is COVID-19 contagious. It may give you 20 minutes, instead of 10, to avoid contracting the disease.”

      That says it more clearly than I have seen it expressed anywhere else. Really brings it home.

      Just a reference point as to airborne aerosol protections: PAPR > Respirators (N100, N99, N95) > Surgical Masks (two back ties, .1 micron filtration) > Procedural Masks (ear loops, .6 micron filtration > Cloth Masks.

      I prefer alternatives to cloth masks.

      Good article.

      Stay well –

      Vivamus

  27. Off topic but just came across this… This is a good article on AGE’s and supports, to my mind, my lack of concern over them in healthy plant foods such as peanut butter, toasted nuts, baked tofu, etc. Still I typically stick to raw nuts and nut butters, so I still rarely get them. In any case, here’s the link:

    https://www.alzdiscovery.org/cognitive-vitality/blog/fear-of-ages

    They also point out there are different types but in studies they typically only study one type. Interesting stuff. Personally, I think worrying about them in whole plant foods is too far, but can understand informing about them.

    1. A,

      I might have missed the part where it is safe to eat AGES if it is plant-based but the article had a fabulous sentence that I no.inate as a topic.

      There are things that lower the AGeS in food like lemon juice and vinegar.

  28. S,

    One may find this helpful –

    The advanced glycation end product (AGE) content of 549 foods:

    Advanced Glycation End Products in Foods and a Practical Guide to Their Reduction in the Diet
    J Am Diet Assoc. 2010 Jun; 110(6): 911–16.e12.
    doi: 10.1016/j.jada.2010.03.018
    JAIME URIBARRI, MD, SANDRA WOODRUFF, RD, SUSAN GOODMAN, RD, WEIJING CAI, MD, XUE CHEN, MD, RENATA PYZIK, MA, MS, ANGIE YONG, MPH, GARY E. STRIKER, MD, and HELEN VLASSARA, MD
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3704564/pdf/nihms482555.pdf
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3704564/

    See Table 1 – pages 11-27

    Not to worry. Animal products are the big concern.

    Veggies and fruits are largely fine.

    A few exceptions: Fried anything. Foods cooked at higher temperatures.

    Corrections are welcome:

    As I understand it, Advanced Glycation End Products are produced in the cooking of food when protein, fat and sugar are heated together above 260 degrees Fahrenheit.

    Which describes frying, sautéing, steaming, broiling and roasting.

    It does not apply to boiling, which is limited to 212 degrees. Soups, stews, etc.

    I was focused on lower heat oven cooking, anyway (<300 degrees) to avoid hitting the smoke point of Extra Virgin Olive Oil (typically < 300 degrees). On learning of Advanced Glycation End Products, I just went to cooking at 250 degrees, instead. End of concerns about producing Advanced Glycation End Products during cooking (< 260 degrees).

    Works fine with most things. Whole grains. Roasted vegetables. Roasting nuts (20-25 minutes – with cinnamon! – good smell from the kitchen!). Very lightly toasted bread.

    Advantages – when I burn myself, there is much, much less drama. At a much lower volume.

    Cooking times are very, very forgiving.

    Takes longer – but I am often able to just start meals earlier. And I like to take my time.

    Time is what I value most. Much more important than money.

    And this is cooking time – not pot watching time. I just go off and do other things and respond when I hear the timer.

    And dinner magically appears.

    Plus – I sometimes take the time to cook a large amount of food at once – beans with vegetables, grains, soups, whatever – freeze in one cup jars (as many as 36 at a time – fills most of the freezer) – and reheat later via microwave. So when I need a quick meal in ten minutes – no problem.

    YMMV.

    Vivamus

  29. this is one of the few times i have seen the good Doctor advocate the use of extracts or supplements.the other time was for vitamin b 12 with respect to vegans and stroke risk.can i ask,what is the best extract form of Amla that he advocates ? which company ? i note many times including in his book he suggests that supplements are fraught with dangers as they do not always carry the exact product as no strict regulations apply to companies.this leaves us all a bit in the lurch so to speak ! can he advocate a product line therefore that in these circumstances where extracts and supplements are proposed,have his stamp of endorsement so to speak or at least would be the ones he would take himself !!

  30. What dose of Amla powder should one take?
    What is the best way take it? Many have mentioned taking it with oats and fruit but I’m wondering if absorption of the Amla is reduced by binding to fibre or the pectin in fruit. If this is so, can anyone suggest another method of ingesting it. It is very sour. I tried it as a tea with stevia but still very sour.
    Someone mentioned it is high in oxalates. Again, what dose is safest? 1tsp/day?

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