 What's the best way to stay healthy in the face of so much conflicting nutrition information? Well, ideally you would go to the source, the gold standard, the peer-reviewed medical literature, and read through the stacks of the latest medical journals. But who's got time for that? I do! Welcome to the Nutrition Facts podcast. I'm your host, Dr. Michael Greger. Today we'll run the gamut of topics from whether or not those with genetic markers for breast cancer should eat soy, the importance of getting enough vitamin D, and why some of us are overly sensitive to garlic and onion. Let's see what questions you have for me today. Here's one from Nanabuga. Says, is there any benefits aspirin has to offer if you must take other medications that might cause blood clots? Well, I mean ideally you would treat the cause of whatever disease condition that made you have to take drugs that cause blood clots, and so then you wouldn't have to be on those drugs. But taking aspirin for primary prevention, trying to, for example, prevent a heart attack in the first place, is not according to the USPSDF, the United States Permanent Service Task Force, not recommended as the risks, which include major bleeding, outweigh the benefits. That however changes in certain circumstances for secondary prevention. So for example, you already had a heart attack, and you're at such high risk of having a second heart attack. In that case, the pros and cons may shift in the other direction. Let's see who's next. Cheryl says, help! Breast cancer my family. Should I not eat tofu? Any soy? Like yogurt or milk? Fantastic question. So first of all, only about 2% of breast cancers actually fallen families, you know those so-called broccatines. 98% of breast cancer is what we're exposed to. And so just because it appears to come down in the family, it may just be because they're similar lifestyles, diets and lifestyles run in families as well. And so that's fantastic news. And of course, even if you do have those broccatine mutations or have mutations, I put you at high risk. Well, I mean, that's just, you know, the genetics loads the gun lifestyle, pulls to trigger, regardless of what kind of genetic cards we've been dealt, we can reshuffle that deck with diet. And one of the ways we can do that is by going out of our way to eat soy foods. So there's now been a half a dozen studies now that have followed thousands of breast cancer survivors and those who ate soy have significantly put them all those studies together, have significantly lower risk of breast cancer recurrence, meaning significantly lower risk of breast cancer coming back and significantly improve survival. So live longer than those breast cancer survivors who don't eat soy. Even better would be to eat soy foods, particularly in the adolescent years, to decrease the risk of breast cancer later in life. Between 30 and 50 percent lower risk associated, breast cancer risk associated with eating soy, particularly at a younger age. And so would encourage people to include soy foods, some healthier than others. So a whole soy food would be ideal, something like edamame, the immature green soybeans in a pod, fun, tasty snack. In fact, one of my favorite snacks, as opposed to something like the soy yogurt, which typically has a lot of sugar added, or soy milk, which has those isoflavones, those those phytoestrogens, that are so beneficial. But you know, you're missing the fiber. You're missing a lot of the other goodies that are in whole soybeans. So that would be the preferable route. Okay, next one is angelic astringes. Is black human have to be ground to get the best absorption? I think most of the studies were using ground on black human seeds. And so we know from experiments with like flax seeds, for example, that you really do need to grind them to get the beneficial effects. Otherwise, they just pass through you unless you chew really, really well. But you know, black human seeds are so tiny that you really probably got to miss a few. So yes, ground black human is the way to go for all its associated benefits. Okay, next up Laura says going on a lung transplant, let's do the hypersensitivity pneumonitis. I'm so sorry to hear that. In the years of the diet, I should focus on currently losing weight. So I mean, if you're overweight, and certainly that could help prep you for surgery. So my advice in this circumstance is really just, you know, all the typical healthy advice, but just to the nth degree, right? So instead of like, let's get a little, let's make sure you exercise, you really want to maximize your exercise regimen, maximize smoking cessation, maximize eating healthy, daily dozen all the way to really get your body prepped for the kind of trauma that is any surgery. And something like a lung transplant is certainly major surgery. Now, after surgery, increasing protein intake can help with healing. But before surgery, it was just a matter of eating, you know, the recommended point of grants for health care around body weight. Okay, next up. Oh, no, no, no is back. And can I 20 sheets of Nori see me today? I'm so glad that you love healthy foods. So two sheets has about 150 micrograms. So 10 would have 1500. What's the maximum upper daily limit? Let me look that quick. upper daily limit high oh nine, let's check it out. Oh, is 1100 microgram today. Okay, so that's too much. So let's stick, let's let's let's take a few sheets away. Let's go. What 16 was that going to be? Anyway, yeah, so I know they're delicious. I snack on them myself. But two sheets a day should get you the recommended 150 micrograms you need. So let's not do 20. The risk of excess iodide intake cause something called hyperthyroidism and overactive thyroid glands which you want to avoid. Okay, next up, Emily says hello. Anything recommend for oh, long COVID fatigue and one kidney since donating. Oh, you are so sweet. I hope your mom is doing okay. So so anyone with one kidney needs to eat a very extraordinarily kidney healthy diet. What is that? There's a low sodium hopeful plant-based diet, plant protein and not excess protein. And I've got a bunch of videos on both preventing and treating kidney failure. And so that's that's for that piece. And then what do we have for long COVID? So we know, you know, from this massive Harvard study 600,000 people that those who eat more whole plan foods and last meat, eggs, dairy and junk are not only significantly less likely to get COVID in the first place, but if they do get COVID significantly less likelihood of suffering a severe course, not to mention all the comorbidities, right? What increases one's risk of a serious COVID case, you know, obesity, diabetes, high blood pressure, heart disease, et cetera, all of which can be prevented, arrested and reversed with a health enough plant-based diet. But what about long COVID? We simply don't know. The studies haven't been done to find out what kind of lifestyle approaches can be used to deal with long COVID symptoms. Yeah, you know, if it is an inflammatory component, one would presume an anti-inflammatory diet on which is synonymous with a hopeful plant-based diet would help, but it hasn't been put to the test. I myself suffered a long COVID symptom of this sciatic mononuropathy for about a month and thankfully it went away, but definitely was like that couldn't be on my treadmill. I remember I was giving my Q&A one month though treadmill. Again, I can recommend just taking good care of yourself. Unfortunately, we don't have data either way for any diet, any lifestyle intervention, or really any drug intervention at this point. I mean, they should reach us so early with understanding long COVID that unfortunately, all I can do is, you know, this generic healthy advice, you know, getting up, sleep, et cetera, et cetera. Now on his back, all right, can you be sensitive? Can you be sensitive to garlic and onion? I feel bloated every day. Well, there are, you know, FODMAPs. There are these prebiotics found in alien family vegetables like garlic, onion, chives, shallots, et cetera, that are super healthy for your gut bugs, but if you have dysbiosis, if you have the wrong gut bugs, then you can foster the growth of the wrong kind. And so if you're really sensitive, then you can try cutting down and see if that helps, but I would start slowly adding them back to your diet based on your tolerance, so you can build up the good bugs because you want to get to the point where you include the super healthy foods into your diet. Okay, Heather says, can I touch more on supplements beyond the daily dose? And I drink a protein shake. Should I be wary of these or are there certain ones I'd recommend, the one I use all pump based from a company in Vega, I'm 53, take a multivitam. Okay, you do not need to eat a protein shake. All right, we should get all our macronutrients, our protein, our carbs and fat from whole plant foods. And so it's not like we don't get our carbs in the form of sugar, we don't get our fat in the forms of oil, and we don't get our protein in the form of powder, which is what these protein shakes are. And so it's so simple to get the recommended intake, .8 grams per health to go around body weight of protein, eating whole healthy foods and some of the healthiest foods like legumes, beans, spippies, chickpeas, lentils, that's what I would recommend you eat instead. So I've got videos about multivitamins, and there's some people like, you know, alcoholics during pregnancy, there's some situations in which taking multivitamin is a good idea. And I talk about circumstances in my videos, but for most people it is unnecessary. Of course, what you should be the supplement I would do recommend is vitamin B12, critically important for anyone eating a healthy diet, getting a regular reliable source of vitamin B12. And if you're not getting enough sun, and so during the winter months, if you're getting inadequate sunshine, you may want to supplement with 2,000 international units of vitamin D3. Okay, what does science show? Oh, mushrooms, like ashwagandha. Ashwagandha is not a mushroom, it's a root. And other types of mushrooms that claim to be supportive for good mood relaxation. Actually, I just, I talk about ashwagandha in my sex chapter in how not to age. Let's look it up. Preserving your sex life. That's my, that's the chapter. I remember I talked about all the various roots, maka, ashwagandha, what's the other one? Jinseng, I think. Yeah. All right, let's see what we got. Ashwagandha, a revered herb of the Ayurvedic system of medicine, which is the Indian tradition of medicine. Its name comes from ashwame meaning horse and gandha meaning smell, because the roots evidently possess the distinctive smell of a wet horse. I did not know that before writing this book. Ashwagandha is used as household remedy in India where it's considered a rasayana. I don't know, probably mispronouncing that, a rejuvenator or tonic for thousands of years, earning it the nickname Indian Jinseng. Okay, so does it actually help? Let's find out. Rodents, front of the deep end. The swim twice as long before sinking, 12 hours versus six hours after being fed ashwagandha. And so what about people? Benefits for physical performance, including increases in aerobic fitness have been found in people too. That's exciting. One study demonstrates evidence of cognitive benefit as well. Its Latin name, Wothonia somnifera, points to another use. Somnifera means sleep inducer. A men analysis of five randomized controlled trials of ashwagandha extracts found a small but significant effect on overall sleep. What about, which is what this chapter is about, what about ashwagandha in female sexual function? Women ages 21 through 50 were randomized to two months of the estimated equivalent of three grams of ashwagandha root powder, so it would be about a teaspoon a day, did not have an increase in sexual desire, but did show improvements over placebo in arousal, lubrication, orgasm, and satisfaction, translating into an additional successful sexual encounter by the end of the study. And so how many, two months? One per two months. All right. Okay. What are the downsides? Ashwagandha belongs to the nightshade family, which includes some shady characters like tobacco and well, deadly nightshade. There have been rare cases of ashwagandha linked liver toxicity, though commercial herbal supplements are often mislabeled. So it's hard to definitively attribute certain cases, right? So just because someone has liver toxicity and they're taking something that says ashwagandha, who knows what's actually in the bottle. However, there have been several liver injury cases in which supplements have been tested and found to be contaminant free. So was actually ashwagandha suggesting that ashwagandha induced liver toxicity is a real phenomenon, even though it's rare. But what should we expect from a plant known by another nickname, poison gooseberry? So I don't recommend you take it. Sorry for the long explanation, but what a nice little sneak preview from a little blurb from how not to age. Okay. Anyway, often read that cancer feeds off sugar, asks Karola. Some people say whole fruit is like sugar for cancer cells. Do you recommend cutting down on fruit for healthy people? There's too many fruit a day. That's fantastic questions. So I actually did a video talking on this very question. Cancer like all cells feeds off of sugar, but cancer can feed off of fat too. In fact, there's the, you know, there's, I talk about these ketone eating cancer cells. They're just fast growing cells. So they eat whatever we're eating. Fruit is pacified in nutrients, actually cancer preventive. The American Institute for Cancer Research was kind of like the kind of main body that talks about diet and cancer recommends the same diet for cancer prevention as for cancer treatment, the same diet that prevents cancer can be used to treat it, to help treat it. And what's that cancer preventive diet? It is a diet centered around whole plant foods, specifically lying out of the way to include, to increase fruit and vegetable intake, whole grains, legumes, et cetera, cut down on meat and added sugars, et cetera. So yes, I would cut down that sugars, added salt, added fat, and stick to whole plant foods. Ramon, 70 year old trying to avoid BPH and cancer by eating pumpkin seeds, pumpkin seeds, and oysters once a month. What do I think about that? All right, let's look at BPH. Want to go back to the, that's not in the sex chapter. That's in the bowel and bladder chapter, preserving your bowel and bladder function. Do not talk about oysters in the BPH chapter. So presumably there's no research either way. But let's look about pumpkin seeds, shall we? Flax seeds can be used to treat BPH. Men given the equivalent of three tablespoons of flax seeds a day experience relief comparable to that, to that provided by a commonly prescribed drug such as Fulmax or ProScar without the drug side effects. That's exciting. What about other seeds? So I think I talked about flax seeds and how not to die. And so I just do the quick little, all right, it works, works as well as the drug. Let's move on to see what other seeds, pumpkin seeds, evidently known as a folk medicine treatment for prostate disorder for centuries. Petri dish can cut down the growth of BPH, prostate cells in half. That's good. And we can reduce the size of rat, prostates, but who cares unless you have a pet rat or something? What about people? Here we go. So pumpkin seed oil and oil free pumpkin seed extracts, both the fat soluble and non-fat soluble supplements have appeared to help. One with comparable efficacy in the drug pterizocin. Others didn't do as prezocin or tamilocin, but also didn't cause drug side effects with names like retrograde ejaculation. Unfortunately, none of the drug trials had placebo on. So it'd be nice to see how well the placebo, the supplement does against placebo. And in an ideal world, we'd like to see a third group who's just given whole pumpkin seeds, not like some extract and boom. A group of German researchers took up the mantle, more than a thousand men were randomized either pumpkin seed extract, a matching placebo, or just a tablespoon a day of plain pumpkin seeds. Let's see what happens. The study was funded by the drug company that made the supplement, but the supplement totally flopped, reducing symptoms no better than the placebo. But guess what? Pumpkin seeds themselves worked. Supplement appeared to reduce symptoms, but not better than placebo, but the seeds did. The placebo was actually quite effective, offering clinical significant relief in 68% of men. Wow, but the pumpkin seeds did the same for 83%. So that's exciting. Bottom line, the researchers suggest, quote, pumpkin seed could be recommended for BPH patients with mild to moderate symptoms, and the conclusion was echoed by the European equivalent of the FDA. Pumpkin seeds can be used for, quote, the relief of lower urinary tract symptoms related to enlarged prostate after more serious conditions have been excluded by a medical doctor, unquote. So yeah, I encourage you to take pumpkin seeds, and I got a whole bunch of other things you can do. I hope you enjoy that chapter. What do I think about avoiding sun exposure? Do you think if we avoid sun exposure and take vitamin D3 supplements, will you lose any other positive essential benefits that the sun may offer? Well, it's certainly true that if you avoid sun exposure, you would avoid the benefits, but you also avoid the downsides like skin cancer, as well as skin aging. I talk a lot about percent avoidance for skin aging. But the critical benefit that we know of is vitamin D, so we can offset that through supplementation. And the other benefits, like potentially the infrared and stuff, even though it does cause skin aging, might it have some other benefits? I talk about some really funky thing with CoQ10, I have a video about that, but they're really more theoretical. So we just have theoretical benefits versus actual very real risks. And so that's why I would encourage people to use some protective behaviors. 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 be able to 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 nutritionfacts 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 vital, timely text on the pathogens that cause pandemics, you can order the ebook, audiobook, or hard copy of my latest book, How to Survive a Pandemic. For recipes, check out my new How Not to Diet Cookbook. It's beautifully designed with more than 100 recipes for delicious and nutritious meals. And of course, all of the proceeds I receive from sales of all my books go to charity. NutritionFacts.org is a non-profit science-based public service where you can sign up for free daily updates. In the latest in nutrition research, we have bite-sized videos and articles. Everything on the website is free. There's no ads, no corporate sponsorship, no kickbacks. It's strictly non-commercial, not selling anything. I just put it up as a public service, as a labor of love, as a tribute to my grandmother, whose own life was saved with evidence-based nutrition.