 Trying to stay healthy can seem like a full-time job sometimes, especially during a pandemic. But I'm here to make that goal a little easier. Welcome to the Nutrition Facts Podcast. I'm your host, Dr. Michael Greger. Today, the mighty power of oats. Now, I don't recommend you wear a feedback around your neck, but I will say that oats are a very versatile brain. Here is my first story. Fiber continues to be singled out as a nutrient of public health concern. There is a fiber gap in America. We're only getting about half the minimum considered a public health concern for all Americans. Well, not all Americans, less than 3% meet the recommended minimum, meaning less than 3% of all Americans eat enough plant-based foods. The only place fiber is found, even though a nominal 0.1 is thrown in for the meat category, in case someone eats a corn dog or nibbles on the garnish. If even half of the adult population ate 3 more grams a day, like a quarter cup of beans or a bowl of oatmeal, we could save billions in medical costs, and that's just for constipation. The consumption of plant foods, the consumption of fiber-containing foods, reduce risk for diabetes, heart disease, stroke, cancer, and obesity, as well. The first to make this link between fiber-intake and killer disease was probably Dr. Hugh Trowell many decades ago. He spent 30 years practicing in Africa and suspected it was their high consumption of corn, millet, sweet potatoes, greens, and beans that protected them from chronic disease. This kind of got twisted into the so-called fiber hypothesis, but he didn't think it was the fiber itself, but the high fiber foods that were so protective. There are hundreds of different things in whole grains, besides fiber, that may have beneficial effects. For example, yes, the fiber in oatmeal can lower our blood cholesterol levels, so less gets stuck in our arteries, but there are anti-inflammatory and antioxidant phytonutrients that can help prevent atherosclerotic buildup and then help maintain arterial function. Visionaries like Trowell were not entrapped by the reduction of fiber, and Trowell-Mind had focused on dietary fiber and insisted that the whole plant foods should receive the emphasis. Fiber-intake was just kind of a marker for plant food intake. Those with highest fiber intake, the lowest cholesterol, were those who ate exclusively plant-based diets. Risk factors like cholesterol are one thing, but can these individual foods actually affect the progression of heart disease? We didn't know until this study was published. Hundreds of older women were subjected to coronary angiograms, where you can inject dye into the coronary arteries of the heart to see how wide open they are. They got an angiogram at the beginning of the study, then one a few years later, all while analyzing their diets. This is what they found. The arteries of women eating less than a serving of whole grains a day significantly narrowed, whereas the arteries of women who ate just a single serving or more also significantly narrowed, but they narrowed less. These were all women with heart disease eating standard American diet, so their arteries were progressively clogging shut. Heart disease is the number one killer of American women, but there was significantly less clogging in the women eating more whole grains, significantly less progression of their atherosclerosis. In fact, almost as much slowing of their disease as one might get to taking cholesterol-lowering statin drugs. Statins can also slow the rate at which our arteries close. But do we want to just slow the rate at which we die from heart disease, or not die from heart disease at all? A whole food plant-based diet has been shown to reverse the progression of heart disease, opening our arteries back up. Whole grains like the drug can help counter the artery clogging effects of the rest of the diet, and having oatmeal with bacon and eggs is better than just eating bacon and eggs, but better, perhaps, to stop eating an artery-clogging diet altogether. In our next story, oats are put to the test against certain chemo-side effects to see just how soothing and anti-inflammatory they can be. Oatmeal has been used for centuries as a topical soothing agent on the skin to relieve itch and irritation in dermatology. Of course, this is coming from Johnson & Johnson. That sells a brand of oatmeal lotion, but look if it helps with dry skin or a bug bite. I can imagine having some soothing quality, but this study shocked me. There's a class of chemo-drugs like satuximab that causes an awful rash. It's bad enough you have some horrible cancer, but then to have some painful, itchy rash on top of it, various treatments have been tried and failed. No clear, preventive, or curative treatment for this eruption? Or is there? The researchers had heard about this study, in which human skin fragments from plastic surgery were subjected to an inflammatory chemical and adding an oatmeal extract appeared to help. So, hey, what do you have to lose? Of the 10 patients with chemo rashes they were able to get access to to try some oatmeal lotion, six had a complete response, and four a partial response, giving an overall oatmeal response rate of 100%. Doctors wrote in from around the world, significant improvement in all patients seemed rather too good to be true, but out of desperation they tried it and got the same astonishing results. Oatmeal, a simple topical agent producing such spectacular benefit where more complex therapies have failed. In an age, whenever more expensive treatments are consistently being championed, it would be a great pity if this inexpensive natural approach to relieving distressing symptoms were to be overlooked. Ironically, two of the cancer cell lines found resistant in vitro to this kind of chemotherapy were found to be sensitive to avanathromides, which are unique phytonutrients found in oats, suggesting that people should apply oatmeal to their insides as well. Finally today, is whole grain consumption just a marker for healthier behaviors, or do whole grains have direct health benefits? If oatmeal is so powerful that it can clear up some of the ravages of chemotherapy just applied to the skin, what might it do if we actually ate it? The pharmacology of oatmeal. Oats are reported to possess very drug-like activities like lowering blood cholesterol and blood sugar, boosting our immune system, anti-cancer, antioxidant, anti-atherosclerosis, in addition to being a topical anti-inflammatory it may also be useful in controlling childhood asthma, body weight, etc. Whole grain intake in general is associated with lower risk of type 2 diabetes, cardiovascular disease and weight gain. All the cohort studies on type 2 diabetes and heart disease show whole grain intake is associated with lower risk. They observed the same for obesity, consistently less weight gain for those who consumed a few servings of whole grains every day. Yes, all the forward-looking population studies demonstrate that higher intake of whole grains is associated with lower body mass index and body weight gain. However, these results do not clarify whether whole grain consumption is simply a marker of a healthier lifestyle or a factor favoring per se lower body weight. For example, high whole grain consumers, those who eat whole wheat and brown rice and have oatmeal for breakfast, tend to be more physically active, smoke less, and consume more fruits, vegetables, and dietary fiber than those that instead reach for fruit loops. Statistically, one can control these factors, effectively comparing only non-smokers to non-smokers with similar exercise in diet, as most of the studies did, and they still found whole grains to be protective via a variety of mechanisms. So, for example, in helping with weight control, the soluble fiber of oatmeal forms a gel in the stomach, a delaying stomach emptying, making one feel full for a longer period, which helps with weight loss, and then there are other effects in the small and large intestine. So it all seems plausible that whole grain intake does indeed offer direct benefits. However, only results from randomized controlled intervention studies can provide the evidence of cause and effect. In other words, the evidence is clear that oatmeal consumers have lower rates of disease, but that's not the same as proving that if we start to eat more oatmeal, our risk will drop. To know that, we need an interventional trial. Ideally, a blinded study where you give half the people oatmeal and the other half fake placebo oatmeal that looks and tastes like oatmeal to see if it actually works. As you can imagine, this has not been done until now. Double-blinded randomized trial of overweight, no-beast men and women, and almost 90% of the real oatmeal-treated subjects had reduced body weight, compared to no weight loss in the control group, a slimmer waist on average, a 20-point drop in cholesterol, and an improvement in liver function. Non-alcoholic fatty liver disease, meaning a fatty liver caused by excess food rather than excess drink, is now the most common cause of liver disease in the United States, found on autopsy in up to 90% of obese individuals, and can lead in mere cases to cirrhosis of the liver, cancer of the liver, and death. Theoretically, whole grains could help prevent and treat fatty liver disease, but this is the first time it had actually been put to the test like this. A follow-up study in 2014 confirmed these findings of a protective role of whole grains, but refined grains were associated with increased risk, so one would not expect to get such wonderful results with Wonder Bread. 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, and we may share it on social media to help inspire others. To see any graphs, charts, graphics, images, or studies mentioned here, please go to the nutritionfacts.org 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 e-book, audio book, or hard copy of my latest book, How to Survive a Pandemic. For recipes, check out my even newer book, the How Not to Diet Cookbook, is beautifully designed with more than 100 recipes for delicious and nutritious meals. All the proceeds I receive from the sales of all my books goes to charity. NutritionFacts.org is a non-profit, science-based public service where you can sign up for free daily updates on the latest in nutrition research via bite-sized videos and articles. Everything on the website is free. There's no ads, no corporate sponsorship. 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.