Why Pepper Boosts Turmeric Blood Levels

Written by: Michael Greger M.D.

“Historians from all around the world have produced evidence to show that apparently all primitive peoples used herbs-often in a sophisticated way. Quinine from Cinchona bark was used to treat the symptoms of malaria long before the disease was identified, and the raw ingredients of a common aspirin tablet have been a popular painkiller for far longer than we have had access to tablet-making machinery. Indeed, today many pharmacological classes of drugs include a natural product prototype that we originally discovered through the study of traditional cures and folk knowledge of indigenous people.”

There’s a plant in South Asia called Adhatoda (from adu meaning “goat,” and thoda meaning “not touch” because it’s so bitter even the goats won’t eat it). It has compounds that help open one’s airways and as such, Adhatoda tea has been used traditionally to treat asthma, where the leaves are steeped with black peppercorns. Leaves steeped with black peppercorns? That sounds gross to me—why would they do that? Because they’re smart. Back in 1928, scientists discovered what the people evidently already knew, that adding pepper increased the anti-asthmatic properties of the leaves. Black pepper alone didn’t work: it was the combination. And now we know why.

Just like approximately 5% of the spice turmeric is composed of an active compound called curcumin, about 5% of black pepper by weight is comprised of this compound called piperine. Curcumin is responsible for the yellow color of turmeric and piperine for the pungent flavor of pepper. Piperine is a potent inhibitor of drug metabolism. One of the ways our liver gets rid of foreign substances is making them water soluble so they can be more easily excreted. But this black pepper molecule inhibits that process.

And it doesn’t take much. If people are given a bunch of turmeric curcumin, within an hour there’s a little bump in the level in their blood stream. We don’t see a large increase because our liver is actively trying to get rid of it. But what if the process is suppressed by taking just a quarter teaspoon’s worth of black pepper? Then you see curcumin levels skyrocket (See Boosting the Bioavailability of Curcumin). The same amount of curcumin consumed, but the bioavailability shoots up 2000%. Even just a little pinch of pepper—1/20^th of a teaspoon—can significantly boost levels. And guess what a common ingredient in curry powder is besides turmeric? Black pepper.

Another way to boost the absorption of curcumin is to consume it in the whole food, turmeric root (fresh or dried as a powder) because natural oils found in turmeric root and turmeric powder can enhance the bioavailability of curcumin seven to eight fold. When eaten with fat, curcumin can be directly absorbed into the bloodstream through the lymphatic system thereby in part bypassing the liver.

How is it prepared in India? With fat and black pepper. Amazing how they could figure that out without double blind trials. (Though maybe it just tastes good, and it’s merely coincidence?) Their traditional knowledge certainly failed them with ghee, however, which is practically pure butter fat, which may explain India’s relatively high rates of heart disease despite all their turmeric.

Why would we care about boosting curcumin levels? Learn why in my videos Which Spices Fight Inflammation? and Spicing Up DNA Protection, Turmeric Curcumin and Rheumatoid Arthritis, and Turmeric Curcumin and Osteoarthritis. It’s also good to know Who Shouldn’t Consume Curcumin or Turmeric.

I’ve previously covered this topic of food synergy in videos such as Apples and Oranges: Dietary Diversity and Garden Variety Anti-Inflammation that emphasize the importance of eating a variety of plant foods to take advantage of some of these interactions.

The black pepper mechanism reminds me of the grapefruit (Tell Your Doctor If You Eat Grapefruit) and broccoli (The Best Detox) stories. A testament to the power of plants.

The painkilling properties of aspirin mentioned in the video are actually found throughout the plant kingdom: Aspirin Levels in Plant Foods.

In some circumstances, traditional medicine wisdom seems incredible (Tomato Effect); in others, dangerous (Get the Lead Out). But that’s what we now have science for!

-Michael Greger, M.D

Top Four Anti-Inflammatory Spices

Written by: Michael Greger M.D.
  
Once in a while I come across a study that’s so juicy I have to do a whole video about it (Which Spices Fight Inflammation?).

A group of researchers at the University of Florida, Gainesville and Pennsylvania State set up a brilliant experiment. We’ve known that ounce per ounce, herbs and spices have some of the greatest antioxidant activities known. But that’s only ever been tested in a test tube. Before we can ask if an herb or spice has real health benefits, it is first necessary to determine whether it is bioavailable — whether the active ingredients are even absorbed. This had never been done, until now.

The researchers could have taken the easy route and just measured the change in antioxidant level in one’s bloodstream before and after consumption, but the assumption that the appearance of antioxidant activity in the blood is an indication of bioavailability has a weakness. Maybe more gets absorbed than we think but doesn’t show up on antioxidant tests because it gets bound up to proteins or cells. So the researchers attempted to measure physiological changes in the blood. They were interested in whether absorbed compounds would be able to protect white blood cells from an oxidative or inflammatory injury—whether herb and spice consumption would protect the strands of our DNA from breaking when attacked by free radicals. I cover the DNA findings in my video, Spicing Up DNA Protection. They also wondered if the consumption might alter cellular inflammatory responses in the presence of a physiologically relevant inflammatory insult. What does this all mean?

The researchers took a bunch of people and had each of them eat different types of spices for a week. There were many truly unique things about this study, but one was that the quantity of spices that study subjects consumed was based on the usual levels of consumption in actual food. For example, the oregano group was given a half teaspoon a day—a practical quantity that people might actually eat once in a while. At the end of the week, they drew blood from the dozen or so people they had adding, for example, black pepper to their diets that week, and compared the effects of their blood to the effects of the blood of the dozen subjects on cayenne, or cinnamon, or cloves, or cumin. They had about ten different groups of people eating about ten different spices. Then they dripped their plasma (the liquid fraction of their blood) onto human white blood cells in a Petri dish that had been exposed to an inflammatory insult. The researchers wanted to pick something really inflammatory, so they chose oxidized cholesterol (which is what we’d get in our bloodstream after eating something like fried chicken. If oxidized cholesterol is a new concept for you, please check out its role in heart disease progression in my video Arterial Acne). So they jabbed the white blood cells with oxidized cholesterol and measured how much tumor necrosis factor (TNF) they produced in response.

TNF is a powerful inflammatory cytokine, infamous for the role it plays in autoimmune attacks like inflammatory bowel disease. Compared to the blood of those who ate no spices for a week, black pepper was unable to significantly dampen the inflammatory response. What about any of the other spices? The following significantly stifled the inflammatory response:

• cloves
• ginger
• rosemary
• turmeric

And remember, they weren’t dripping the spices themselves on these human white blood cells, but the blood of those who ate the spices. So the results represents what might happen when cells in our body are exposed to the levels of spices that circulate in our bloodstream after normal daily consumption—not megadoses in some pill. Just the amount that makes our spaghetti sauce, pumpkin pie, or curry sauce taste good.

There are drugs that can do the same thing. Tumor necrosis factors are such major mediators of inflammation and inflammation-related diseases that there are TNF-blocking drugs on the market for the treatment of inflammatory diseases such as osteoarthritis, inflammatory bowel disease, psoriasis, and ankylosing spondylitis, which collectively rake in more than $20 billion a year ($15,000–$20,000 per person per year). At that price, the side effects better be hugs and rainbows. But no, the drugs carry a so-called “black box warning” because they can cause things like cancer and heart failure. If only there was a cheaper, safer solution.

The spice curcumin, the yellow pigment in turmeric, is substantially cheaper and safer, but does it work outside of a test tube? There’s evidence that it may help in all of the diseases for which TNF blockers are currently being used. So with health-care costs and safety being such major issues, this golden spice turmeric may help provide the solution.

Food Dyes and ADHD

by Michael Greger M.D.  
There are currently thousands of additives in our food supply. Some are good—like supplementing foods with vitamin B12, for example (See Vitamin B12 Necessary for Arterial Health). Other additives involve weighing the risks and benefits. Take nitrites in processed meats. Yes, they may increase our risk of cancer but, as preservatives, they decrease our risk of dying from botulism (See When Nitrates Go Bad and Bacon and Botulism). Then there are additives used for purely cosmetic purposes, like food dyes, used to provide color to colorless and “fun” foods. According to the FDA, “Without color additives, colas wouldn’t be brown, margarine wouldn’t be yellow and mint ice cream wouldn’t be green.” Heavens forbid! Color additives are now recognized as an important part of practically all processed foods we eat.

Because we’re eating a lot more processed foods, we’re now getting five times more food dyes in our daily diet than we were 50 years ago. Fifteen million pounds of food dyes are used every year in foods, drugs, and cosmetics in the United States.

I always wondered why they called them, for example, Blue #1 instead of their actual chemical name in the list of ingredients. Then, after reading this report from the Center for Science in the Public Interest, I realized why. Picture a box of Kraft mac and cheese. It has Yellow #5. Would people be as likely to buy this product if instead of Yellow #5 it listed Trisodium 1-(4-sulfonatophenyl)-4-(4-sulfonatophenylazo)-5-(pyrazolone-3-carboxylate) on the label?

The list of food dyes used to be longer (See Artificial Food Colors and ADHD), but different dyes kept getting banned—including Violet #1, which, ironically, was the color used in the U.S. Department of Agriculture’s meat inspection stamp, so they may have been actually further cancer-ing up the meat.
Years ago I featured a landmark study in my video Are Artificial Colors Bad for You?, a randomized, double-blind, placebo-controlled food challenge in perhaps the most prestigious medical journal in the world. It showed that artificial colors increased “inattentiveness, impulsivity, and hyperactivity among young children.” So what happened? Well, the British government said, OK, there’re no health benefits to these dyes, only health risks, so it’s a no-brainer. They mandated that food manufacturers remove most of the artificial food colors from products. In fact, the whole European Union said that if manufacturers want to keep using the dyes, then they have to put a warning label stating: “may have an adverse effect on activity and attention in children.” Many international food companies have taken them out of their products in Europe, but continue to use them in the same products here in the U.S. where similar regulations are not currently in place. Why did the U.S. government take steps to get rid of them as well?

The FDA put together a committee that looked at the landmark study and conceded that the food additives may have resulted in changes in behavior, but the “type of treatment effects reported in the study, even though the investigators referred to increases in levels of ‘hyperactivity,’ were not the disruptive excessive hyperactivity behaviors of ADHD but more likely the type of over-activity exhibited occasionally by the general population of preschool and school age children.” A distinguished toxicologist basically responded, “look, low level lead exposure may only shave off a few IQ points off of kids, but just because they’d still fall within a normal range, doesn’t mean it’s OK to expose it to our kids.” And looking back now, the lead in leaded gas may have been causing brain cancer and possibly even urban violence—the aggravated assault rate in cities around the U.S. seemed to closely follow the lead levels in the air.

The Center for Science in the Public Interest continues to call on the FDA to ban food dyes and for food companies to voluntarily stop using them. Good luck with that. In the meantime, some researchers recently suggested a way to see which food colors may be damaging our child’s brain, advising parents to test artificial colors by purchasing little bottles of food dyes at the grocery store. Then have their kid do some homework or something and then have them chug down an artificial color and see if it affects their handwriting/reading/math at 30 minutes, at 90 minutes, and 3 hours. They also see if they get irritable later, have problems sleeping, and so on. If that’s OK, they say you should try even more to see if more will mess with their mind. If I may offer an alternate suggestion, maybe we shouldn’t buy our kids processed junk in the first place.

This whole saga reminds me of the artificial flavor in my video Butter-Flavored Microwave Popcorn or Breathing. It’s amazing what the food industry is able to get away with. There’s even sometimes Artificial Coloring in Fish.

There is a campaign to get Kraft to remove yellow #5 from their mac & cheese, but even if the stuff didn’t glow in the dark it’s still just a blob of sodium (750 mg), saturated fat (4.5 g), and trans fat (2.8 g). The food movement might better spend its time encouraging healthier fare altogether.
How can we get our kids to eat less processed junk? I review some practical tips in my videos Tricks to Get Kids to Eat Healthier at School and Tricks to Get Kids to Eat Healthier at Home.
-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death and More Than an Apple a Day.

Image Credit: Asif Ali / Flickr

Eggs

DESCRIPTION: Freedom of Information Act documents reveal that the U.S. Department of Agriculture warned the egg industry that saying eggs are nutritious or safe may violate rules against false and misleading advertising.

For more peeks behind the egg industry curtain see:

• Eggs and Cholesterol: Patently False and Misleading Claims (http://nutritionfacts.org/video/eggs-...)
• Eggs vs. Cigarettes in Atherosclerosis (http://nutritionfacts.org/video/eggs-...)
• Eggs and Choline: Something Fishy (http://nutritionfacts.org/video/eggs-...)
• Eggs, Choline, and Cancer (http://nutritionfacts.org/video/eggs-...)
• Eggs and Diabetes (http://nutritionfacts.org/video/eggs-...)
• Egg Industry Blind Spot (http://nutritionfacts.org/video/egg-i...)

Have a question for Dr. Greger about this video? Leave it in the comment section at http://nutritionfacts.org/video/who-s... and he'll try to answer it!

Treating Migraines With Lavender

 

 by Michael Greger M.D.

Lavender has been studied recently for several purposes, including treatment of mood and anxiety disorders (see, for example, the video I profiled in my last post, Lavender for Generalized Anxiety Disorder). Though it’s better known for its analgesic (pain-killing) properties, there hasn’t been a single documented clinical trial on lavender for the treatment of migraine headaches, which affect tens of millions of Americans every year. That is, until now: “Lavender Essential Oil in the Treatment of Migraine Headache: A Placebo-Controlled Clinical Trial.”
Migraine sufferers were asked—at the early signs of headache—to rub two to three drops of lavender essential oil onto their upper lip and inhale its vapor for a 15-min period, then score the severity of their headache for the next two hours. In the control group they did the same thing, but with drops of unscented liquid wax instead. Neither group was allowed to use any painkillers. In the lavender group 74 percent of patients had an improvement in their symptoms—significantly better than placebo.

Although lavender wasn’t directly compared to more conventional treatments and outcome measures differed, as you can see in the associated video Lavender for Migraine Headaches, lavender appears to stack up pretty well against typical migraine drugs. Lavender helped about three quarters of the time; high dose Tylenol may only work about half the time; and Ibuprofen 57% of the time. The top prescription drug, generic Imitrex, is effective 59% of the time, and the hardcore treatment they use in emergency rooms where they inject you under the skin works 70% of the time. Fortunately all of these work better than the original migraine therapy, known as trepanning, where doctors drilled holes in our head to let the evil spirits escape!

The lavender researchers concluded that the results of the study suggest that inhalation of lavender essential oil may be an effective and safe treatment modality in acute management of migraine headaches.

Migraine sufferers may also want to experiment with avoiding potential triggers such as aspartame (see my video Diet Soda and Preterm Birth). Saffron may also help with headaches (Saffron for the Treatment of PMS) as well may the avoidance of certain parasites (Pork Tapeworms on the Brain and Avoiding Epilepsy Through Diet). A note of caution, though: Pregnant migraine sufferers seeking natural remedies should be wary of advice they may get (Dangerous Advice From Health Food Store Employees).

What’s better than treating your pain with natural remedies? Not having pain in the first place! Those eating healthy diets are less likely to be on pain medications in general (Say No to Drugs by Saying Yes to More Plants). See, for example:

• Cholesterol and Lower Back Pain
• Potassium and Autoimmune Disease
• Fibromyalgia vs. Vegetarian & Raw Vegan Diets
• Fibromyalgia vs. Mostly Raw & Mostly Vegetarian Diets

-Michael Greger, M.D.

How Plants May Help Stop Cancerous Tumors

Dr. Michael Greger

About a third of common cancers may be prevented by eating a healthy, plant-based diet; being physically active; and maintaining a healthy weight. One of the ways plants may help is by cutting off the supply lines to cancerous tumors.
A tumor cannot grow without a blood supply. Currently, it is believed that a tumor mass cannot exist in a volume greater than about the size of the ball at the tip of a ballpoint pen without a proper blood supply. This indicates that angiogenesis, the creation of new blood vessels, is critical to tumor growth.

Each one of us has cancer cells in us right now. By age 70, for example, microscopic cancers are detected in the thyroid glands of virtually everyone. Most of these tumors never cause problems or become clinically significant, leading to the concept of “cancer without disease” as a normal state during aging. Cancer cells are commonly present in the body, but they can’t grow into tumors any bigger than that tiny dot size–no more than 10 million cancer cells–before needing to get hooked up to a blood supply. One way cancer turns on the tap is silencing certain tumor suppressor genes. How do you turn them back on? See, for example, Apple Skin: Peeling Back Cancer.

Another way tumors commandeer a blood supply is by diabolically releasing angiogenic factors, chemicals that cause new blood vessels to sprout into the tumor. The most important one is called vascular endothelial growth factor (VEGF). But we can suppress VEGF with veggies.

Many of the phytonutrients we know and love in tea, spices, fruit, berries, broccoli, and beans can block cancer’s stimulation of new blood vessels. They’re ideal for prophylactic long-term use against breast cancer because of their reliability, availability, safety, and affordable price. This review concludes that we now have convincing evidence that dietary plant constituents possess the unique ability to affect tumor angiogenesis, which may be deemed advantageous in the prevention and treatment of human breast cancer and other tumors.

Most of these studies have only been done in a petri dish, though. You stimulate human blood vessel cells and they start forming tubular structures trying to make new capillaries to feed the tumor. This tube formation can be substantially blocked by adding add plant compounds such as apigen or luteolin, found throughout the plant kingdom in foods such as citrus, celery, and peppers. If you click on the above video, you can see the effect of fisitin, a phytonutrient found in strawberries, shrinking the beginnings of new blood vessel formation right down. How else can strawberries smack on the cancer kibosh? See Strawberries versus Esophageal Cancer and Cancer Fighting Berries.

Where do researchers get their hands on human blood vessels? They get them from discarded umbilical cords or, more controversially, from the eyes of aborted fetuses. But either way, you can stimulate blood vessel formation with the tumor compound VEGF and then abolish that effect with plant compounds. Therefore, the daily consumption of natural foods containing adequate flavonoids could be beneficial for the prevention of cancer metastasis or could improve cancer prognosis. Given the power of plants, one might speculate that the foundation of an anti-angiogenic approach to cancer might be a whole food vegan diet.
Because we all likely have cancer cells inside us, Cancer Prevention and Treatment May Be the Same Thing. To die with cancer rather than from cancer, we need to slow down cancer doubling time. Check out one of my oldie-but-goodie videos Slowing the Growth of Cancer.

The cancer-promoting growth hormone IGF-1 is another angiogenic factor, helping tumors turn on the gravy train. This may be another reason plant-based diets protect against cancer, since as few as two weeks on a healthy diet can lower IGF-1 levels. If you’re interested, check out my video series on the elegant experiments that discovered this:

• Ex Vivo Cancer Proliferation Bioassay
• IGF-1 as One-Stop Cancer Shop
• Cancer-Proofing Mutation
• The Answer to the Pritikin Puzzle
• How Plant-Based to Lower IGF-1?

In health,
Michael Greger, M.D.

More Than an Apple a Day

More Than an Apple a Day: Combating Common Diseases

 Dr. Greger has scoured the world’s scholarly literature on clinical nutrition and developed this brand-new live presentation on the latest in cutting-edge research on how a healthy diet can affect some of our most common medical conditions.

How Does Meat Cause Inflammation?

How Does Meat Cause Inflammation?

-Michael Greger, M.D.

 

The anti-inflammatory effect of plant-based diets is about more than just the power of plants. It’s also the avoidance of animal foods. In my blog last week, Treating Crohn’s Disease With Diet, I profiled the extraordinary power of even a semi-vegetarian diet to calm inflammatory bowel disease. We’ve known for 14 years that a single meal of meat, dairy, and eggs triggers an inflammatory reaction inside the body within hours of consumption. This results in a stiffening of our arteries (you can see the arterial response curve in my 4-min. video The Leaky Gut Theory of Why Animal Products Cause Inflammation). Within 5 or 6 hours, the inflammation starts to cool down, but then what happens? Lunchtime! At that point we can whack our arteries with another load of animal products for lunch. In this routine, we may be stuck in a chronic low-grade inflammation danger zone for most of our lives. This can set us up for inflammatory diseases such as heart disease, diabetes, and certain cancers one meal at a time.

What exactly is causing the meat-induced inflammation? Inflammation is an immune response to a perceived threat, but what’s the body attacking? At first, scientists thought it might be the animal protein, which is thought to be the culprit in certain types of arthritis. However, similar inflammatory reactions were triggered by whipped cream, which is mostly just animal fat. After digging deeper, investigators discovered that after a meal of animal products one’s bloodstream becomes soiled with bacterial toxins known as endotoxins. No wonder there’s so much inflammation! But where are the endotoxins coming from?

Endotoxins come from bacteria. Where are there lots of bacteria? In our gut. Thus, researchers figured that maybe the saturated animal fat was causing our gut lining to become leaky, allowing our own bacteria to slip into our blood stream. Experiments on mice showed that indeed saturated fat made their guts leaky, so for years this was the prevailing theory as to why animal products caused inflammation within hours of consumption. Only recently did researchers realize this didn’t make any sense.

In my 2-min. video The Exogenous Endotoxin Theory, I illustrate the critical flaw to the leaky gut theory: the time scale. The rise in inflammation after a meal of meat, dairy, and eggs starts within just an hour of ingestion, but our gut flora aren’t in our small intestine–rather, twenty feet farther down in our large intestine. It can take food hours to get down there, so what was going on? If the bacterial endotoxins were not coming from our gut, maybe they were coming from the food.

For the first time ever, 27 common foodstuffs were tested and they found endotoxin equivalents in foods such as pork, poultry, dairy, and egg products, as well as certain fermented foods. Can endotoxins be cooked out of the meat? Find out in the final wrap-up video in the series, Dead Meat Bacteria Endotoxemia.

Saturated fat also appears to have other deleterious effects such as increasing the risk of heart disease (see Blocking the First Step of Heart Disease and Tolerable Upper Intake of Zero) and shortening the lives of breast cancer survivors (Breast Cancer Survival, Butterfat, and Chicken). For more on foods that fight inflammation, see my videos Fighting Inflammation in a Nut Shell and Anti-Inflammatory Effects of Purple Potatoes.

-Michael Greger, M.D.