 I'm often asked what my opinion about a diet or disease is. Who cares what my or anyone else's opinion is? All we should care about is what the science says. What does the best available balance of evidence publish to the peer-reviewed medical literature have to say right now? Welcome to the Nutrition Facts Podcast. I'm your host, Dr. Michael Greger. Our story today is about an alternative approach to some of the health problems that bother us, and we start with the unusual powers of garden variety lettuce. There is a perception that time spent asleep is time wasted, but is widely recognized that inadequate sleep is associated with multiple acute and chronic conditions and results in an increased risk of death and disease. Forced people to go one week with only six hours of sleep a night you can change expression when 700 genes. The most dire effect may be endothelial dysfunction. The endothelium is the thin layer of cells that covers the internal surface of blood vessels and is responsible for allowing our arteries to relax and dilate back open properly. Randomized people for about a week to get five rather than seven hours of sleep, and just that two-hour difference a night resulted in a significant impairment in artery function. Okay, but what do these numbers mean? I mean, how bad is a week of five-hour nights? Sleep deprivation is no joke. The magnitude of impairment is similar to that reported in people who smoke, have diabetes, or have coronary artery disease. No wonder people who sleep less than seven hours a night may experience a 12 to 35% increased risk of premature death, compared to those who get a full seven hours. Yet a significant proportion of the population may routinely get less than that. Sufficiently long, restful sleep sessions each night are said to be an indisputable cornerstone of good health. Okay, so what can we do about it? Those who have a sleep apnea, a common consequence of obesity that interferes with sleep, benefit from the use of CPAP machines, while they're losing the weight to treat the underlying cause, hopefully. But what if apnea isn't your problem? What if you just have trouble falling asleep or staying asleep? Any natural dietary remedies? I already have videos on using kiwifruit to fight insomnia and tart cherries, too. Are there any vegetables that might help? Lactuca sativa is a plant that has been traditionally used in the treatment of insomnia. What is this exotic-sounding leafy vegetable? Lettuce. Evidently, lettuce extracts have been used from the time of the Roman Empire as agents with sedative and sleep-inducing properties. Lettuce actually does have a hypnotic substance in it called lactucin, which is what makes lettuce taste a little bitter. But you don't know if it actually works until you put it to the test. And it works in toads, but it also works in rodents. Sleep in both mice and rats is enhanced by romaine lettuce. They used romaine since it has a higher lactucin content compared to other lettuces. Okay, but does it work in people? About 10 years ago, a study was published in which insomnia sufferers were randomized to receive lettuce seed oil, oil extracted from lettuce seeds. Within a week, about 70% of those in the lettuce seed oil group said their insomnia very much or much improved, compared to only 20% in the placebo control group. The researchers concluded that lettuce seed oil was found to be a useful, safe sleeping aid in geriatric patients suffering from sleeping difficulties. They chose to study older individuals, because insomnia affects surprisingly 20 to 40% of older adults, at least a few nights a month. You think that's bad? Sleep disturbances can plague as many as nearly 8 out of 10 women during pregnancy. Of course, there's lots of different sleeping pills, but they may endanger the fetus or mother. For example, doctors frequently prescribe ambient for pregnant women who have trouble sleeping, but ambient uses associate with a wide range of adverse pregnancy outcomes, like low birth weight babies, premature birth and cesarean section. And the use of valium during pregnancy has been linked to birth defects, including limb deficiencies. There has to be a better way. What about trying lettuce? The lettuce oil study had a number of limitations. For example, it was only single blind, being the researchers knew who was on the lettuce supplements and who was on placebo, which could have introduced some bias, but the researchers essentially said, give us a break, right? Big Pharma has billions to spend on research, and no one wants to fund studies on lettuce. Finally, we got a double blind, placebo-controlled study, but this time on a whole food, not just a lettuce seed extract. Yeah, but how do you come up with a placebo lettuce? How are you going to hide who gets lettuce and who doesn't? Well, you can't fit ahead of lettuce into a capsule, but you can fit whole lettuce seeds, and here we go. A double blind randomized placebo-controlled trial on lettuce seeds for pregnancy-related insomnia. 100 pregnant women with insomnia were randomized to receive capsules, containing either a quarter teaspoon of ground lettuce seeds or a placebo for two weeks, and those on the lettuce seeds saw a significant improvement in a sleep quality index score compared to the placebo, with no reported side effects. In our final story today, we look at how cranberries and pumpkin seeds may help with an enlarged prostate. More than 50% of men in their 50s, 70% or more of men in their 60s, suffer from benign prostatic hypertrophy, or BPH, otherwise known as an enlarged prostate. This can result in burdensome lower urinary tract symptoms, such as having to get up frequently at night to pee. Current medical treatments are clinically effective, but their efficacy is compromised by side effects and low compliance rates. Symptoms include sexual dysfunction, high-grade prostate cancer, and depression. No wonder there is poor compliance, and when medication treatment fails, surgical procedures are considered, such as transurethral resection of the prostate. There has got to be a better way. Population studies suggest that low intake of animal protein and high intake of fruits and vegetables may be protective, but not just cutting down on any animal protein. Eggs and poultry seem to be the worst, along with refined grains, but no association was found for red meat or dairy. Population studies aside, are there any foods that have been put to the test? There have been more than 30 randomized controlled trials on the herb saupalmetto, and it's been found to be totally useless. Evidently, cranberries were used by Native Americans to treat urinary ailments, but you don't know until you put them to the test. Now when they say dried cranberries, they're not talking about those sugary, oily craisins, but rather just straight, whole cranberry powder. And significant improvements were seen in BPH symptoms, quality of life, and all urination parameters for just about a teaspoon a day of powdered cranberries. So we know a teaspoon works, but what about a third of a teaspoon, or a sixth of a teaspoon? They also helped. And now this study used a supplement because it was funded by the supplement company, but the supplement is just straight cranberry powder. So you might as well just buy it in bulk for much cheaper and just add it to a smoothie or something. What about using a berry that's a little tastier, like drinking purple grape juice? No benefit whatsoever. In a previous video, I talked about the use of flax seeds, which may have a therapeutic efficacy comparable to that of commonly used drugs, with only good side effects. Okay, so what about other seeds? Pumpkin seeds have evidently been used in folk medicine as a remedy for prostate disorders for centuries. And in a Petri dish, they can cut the growth of BPH prostate cells in half. Scientists have also injected pumpkin seed extracts into rabbits, but what about people? Pumpkin seed oil appears to help with prostate issues. When pitted head-to-head against the drug prososin, it seemed to work as well as the pill. The same when it was head-to-head against the drug pterososin. What they didn't have, though, is a placebo group. It would have been nice to see how all the pumpkin seed oil supplements did against placebo. And hey, in an ideal world, I'd love to also see a group just giving whole pumpkin seeds themselves, and boom, there it is! More than a thousand men were randomized, either a pumpkin seed extract, a placebo, or just about a tablespoon a day of plain pumpkin seeds. The study was funded by the drug company that made the supplement, but the supplement flopped. It was no better than placebo, but the pumpkin seeds themselves worked. The supplement appeared to reduce symptoms, but not better than placebo, however just the plain old seeds did. So it wasn't just some compound extracted from the oil, and in fact we've since learned that even an oil-free extract seemed to work. Bottom line, the researchers concluded, is that pumpkin seed could be recommended for BPH patients with mild-moderate symptoms. This conclusion was echoed by the European equivalent of the FDA. Pumpkin seeds can be used for the relief of lower urinary tract symptoms related to an enlarged prostate after more serious conditions have been excluded by a medical doctor. We would love it if you could share with us your stories about reinventing your health through evidence-based nutrition. Go to nutritionfacts.org slash testimonials. We may share it on our social media to help inspire others. To see any graphs, charts, graphics, images, or studies mentioned here, please go to the Nutrition Facts Podcast landing page. There you'll find all the detailed information you need plus links to all the sources we cite for each of these topics. For a timely text on the pathogens that cause pandemics, you can order the e-book, audiobook, or hard copy of my last book, How to Survive a Pandemic. For recipes, check out my second to last book, My How Not to Diet Cookbook. It's beautifully designed with more than 100 recipes for delicious and nutritious meals. And all the proceeds I receive from the sales of all my books goes to charity. 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