Natural Health Blog


Study links irregular sleep to diabetes and obesity


Understanding the reasons we sleep has been a subject of study for years. Although scientists haven’t yet discovered all that occurs during sleep, there have been unique discoveries leading to a better understanding of cognitive1 and physical health.2,3

The Centers for Disease Control and Prevention finds 1 in 3 Americans doesn’t get enough sleep4 and note insufficient sleep is linked with a wide variety of health problems.5 For example, getting less than five hours of sleep each night may double your risk of heart disease or stroke.6 Researchers have also found a persistent link between sleep deprivation, weight gain7 and insulin resistance.8

Sleep deprivation also influences your mental and cognitive abilities and emotional well-being. In fact, one of the reasons sleep deprivation is so detrimental is it doesn't impact just one aspect of your health: It impacts many.

In a recent study published in Diabetes Care,9 funded by the National Heart, Lung and Blood Institute, researchers found it isn't just the number of hours of sleep each night, but also the regularity of your sleep that impacts on your health.

Erratic sleep pattern increases risk of obesity and diabetes

Previous research has found detrimental health effects with sleep deprivation, but this new study discovered that when participants did not stick to regular bedtime and wake-up schedules it put them at higher risk for obesity, high blood pressure, high blood sugar and other metabolic disorders.

Researchers enrolled participants from the Multi-Ethnic Study of Atherosclerosis.10 They completed a seven-day actigraphy, which is a noninvasive way of monitoring rest and activity cycles. A sensor is worn for a week to measure gross motor activity. They were then followed for a median of six years.11

Metabolic abnormalities were defined using criteria developed for the National Cholesterol Education program, and researchers used five cross-sectional analyses adjusted for socio-demographic and lifestyle factors.

They found that for every one-hour deviation of sleep duration, the participants’ risk of metabolic syndrome increased by as much as 27%; a one-hour deviation in timing (i.e., going to bed earlier or later than regular) was associated with 23% higher odds.12 Study author Tianyi Huang, epidemiologist at Brigham and Women’s Hospital, commented:13

“Many previous studies have shown the link between insufficient sleep and higher risk of obesity, diabetes, and other metabolic disorders. But we didn’t know much about the impact of irregular sleep, high day-to-day variability in sleep duration and timing.

Our research shows that, even after considering the amount of sleep a person gets and other lifestyle factors, every one-hour night-to-night difference in the time to bed or the duration of a night’s sleep multiplies the adverse metabolic effect.”

Bedtime changes came before metabolic dysfunction

The study followed 2,003 men and women between the ages of 45 and 84. In addition to wearing sensors for seven days, the participants also filled out a sleep diary and answered standard questionnaires about their sleep habits and other lifestyle and health factors.14

The prospective results demonstrated variations in duration and bedtimes came before the development of metabolic dysfunction, providing evidence for a causal link between irregular sleep and metabolic disorders.

Researchers found the participants whose duration changed by more than one hour had a higher likelihood of being African-American, working non-day shift schedules, smoking and having shorter sleeping duration. Co-author Dr. Susan Redline with the Division of Sleep and Circadian Disorders at Brigham and Women's Hospital, said:15

"Our results suggest that maintaining a regular sleep schedule has beneficial metabolic effects. This message may enrich current prevention strategies for metabolic disease that primarily focus on promoting sufficient sleep and other healthy lifestyles."

Metabolic syndrome leads to greater health challenges

Metabolic syndrome is characterized by a cluster of symptoms, including large waist circumference indicating high levels of visceral fat, high blood pressure, insulin resistance and/or high blood sugar, low high-density lipoprotein cholesterol and high triglycerides. The combination of three or more of these factors is evidence of metabolic dysfunction.16

These risk factors raise your risk for heart disease, diabetes and stroke. Your risk is also raised even when you have “borderline high-risk factors.”17 Although a large waistline is a visible sign, the remainder have no visible signs or symptoms.

The incidence of metabolic syndrome often parallels obesity and Type 2 diabetes. According to a global survey18 of 195 countries in 2015, 604 million adults and 108 million children were obese. Researchers have found the problems of obesity have doubled in 73 countries since 1980.

However, obesity is not always synonymous with metabolic syndrome, as scientists have found there are individuals who are obese with high levels of insulin sensitivity yet have no high blood pressure. The data on metabolic syndrome is difficult to ascertain, as many who have the condition do not carry the diagnosis and many of the factors have no symptoms.19

Some researchers believe metabolic syndrome is three times more common than diabetes and estimate the global prevalence to be 25%. This global estimate is close to an estimation for the U.S. population. The CDC20 estimates 9.4% of the U.S. population has diabetes and three times this is 28.2%, slightly higher than the global estimation.

The high cost of sleep deprivation

Sleep deprivation comes at a steep cost to individuals and communities. For instance, third mate Gregory Cousins’ sleep deprivation led to one of the greatest environmental catastrophes in history when he ran the supertanker Exxon Valdez aground, causing 11 million gallons of crude oil to spill into Prince William Sound.21

The accident devastated 23 species of wildlife and nearly 1,300 miles of coastline habitat. As reported in The Balance, in just the first few days 140 bald eagles, 302 harbor seals, 2,800 sea otters and 250,000 sea birds were killed.22

According to the American Sleep Association,23 37.9% of Americans report unintentionally falling asleep during the day at least once a month. Unfortunately, many skimp on sleep to “get things done.” However, the evidence shows when you skimp on sleep, you lose productivity.24

Sleep deprivation costs the U.S. economy $411 billion every year in accidents and lost productivity.25 Loss of sleep not only affects quality of life, but when individuals like construction workers, nurses, doctors and pilots choose to push through sleep deprivation, it may have lethal consequences.

The CDC finds drowsy driving is a major problem in the U.S. and estimates it was responsible for 83,000 crashes, 37,000 injuries and 886 fatalities annually between 2005 and 2009.26 While falling asleep at the wheel is dangerous, being sleepy or drowsy makes you less attentive, slows your reaction time and affects your ability to make decisions behind the wheel.

The CDC finds those who do not get enough sleep, such as shift workers, those with untreated sleep disorders or those taking certain medications, are most likely to drive drowsy.27 Additionally, a loss of sleep increases your risk of cardiovascular disease,28,29 premature birth,30 lower academic performance,31 depression, anxiety,32 dementia and Alzheimer's disease.33

More sleep may help you reach your goal weight

In addition to lowering your risk for these conditions, improving your sleep time and quality may well help you with your weight loss efforts. U.K. researchers investigated the connection between sleep duration, diet and metabolic health in 1,692 adults.34 The researchers analyzed adiposity, metabolic markers and food intake.

Blood pressure and waist circumference were also recorded. After results were adjusted for confounding factors such as age, gender, ethnicity, smoking and socioeconomic status, the researchers found the number of sleep hours was negatively associated with body mass index and waist circumference. However, it was not associated with any dietary measures.

They found adults sleeping fewer hours were more likely to be obese.35 If you're trying to lose weight, getting an adequate amount of sleep may mean the difference between success and failure.

Researchers at the University of Chicago found those who slept 8.5 hours lost 55% more body fat than those who slept 5.5 hours. According to these researchers,36 "Lack of sufficient sleep may compromise the efficacy of typical dietary interventions for weight loss and related metabolic risk reduction."

Light and EMF pollution reduces sleep quality

Your quality of sleep may be impacted by the number of hours you spend sleeping, an irregular sleep pattern and by light and electromagnetic pollution. If you have ever gone camping, you likely noticed a change in the quality of sleep you enjoyed. Chances are you slept deeper and awakened more rested.

Two influential factors resulting in better sleep outdoors and away from “civilization” are a drastic reduction in exposure to artificial lights and electromagnetic fields (EMF). Your circadian clock is affected by your melatonin levels, which is in turn affected by your exposure to light at night. This plays a role in how deeply you sleep and how well rested you might feel the next day.

Even exceptionally dim light during sleep may have a detrimental effect on quality and quantity. Ideally, you'll want to avoid having any light in your bedroom at night.

Consider using blackout blinds on your window if you have a street lamp outside your bedroom. Also, consider moving any alarm clock or other light emitting device outside the bedroom and/or wearing a sleep mask to reduce light exposure.

EMF may also impair your sleep quality37 and produce oxidative damage.38 Consider shutting off all electronic devices and your Wi-Fi at night to reduce your exposure and improve your sleep quality.

Strategies to improve your sleep quality

Sleep continues to be one of the mysteries of life. Although it was once thought to be little more than a waste of time, modern research has shed light on the crucial component sleep plays in a healthy lifestyle.

Unfortunately, sleep debt has a cumulative effect and a persistent lack of sleep may disrupt your health. The good news is there are many natural techniques you may use to restore sleep health, develop a regular pattern of sleep and enjoy high-quality sleep.

Whether you have difficulty in the early hours of the night falling asleep, waking up too often, difficulty falling back to sleep or don't feel rested when you wake up in the morning, you will likely find tips in my previous article, “Top 33 tips to optimize your sleep routine,” to help adjust your pattern and improve your sleep quality.

Additionally, the article gives you the ideal amount of time you need to sleep depending on your age. As discussed, maintaining a natural rhythm of daylight and darkness is essential to quality sleep, and we share more about this in my interview with Dan Pardi in the article.

The depression pill epidemic


According to the World Health Organization, depression is the leading cause of ill health and disability worldwide, and increased 18% between 2005 and 2015.1 In the U.S., an estimated 17.3 million American adults, or 7.1% of the adult population, experienced at least one major depressive episode in 2017.2 The highest rates are reported among those aged between 18 and 25.3

Questions abound, however, over whether clinical depression is actually increasing, or whether people are simply being inappropriately diagnosed, and even more importantly, what the best treatment might be. With regard to treatment, my review will focus primarily on exercise which, rather overwhelmingly, appears to have a solid scientific basis of support.

Many are needlessly taking antidepressants

According to one 2013 study,4 major depression may be vastly overdiagnosed and overtreated. When Dr. Ramin Mojtabai, associate professor at the Johns Hopkins Bloomberg School of Public Health, evaluated the diagnostics of 5,639 participants with clinician-identified depression, he found only 38.4% of them actually met the DSM-4 criteria for a major depressive episode (MDE).5 Among seniors over the age of 65, only 14.3% met the criteria. Furthermore:6

"[P]articipants with more education and those with poorer overall health were more likely to meet the criteria. Participants who did not meet the 12-month MDE criteria reported less distress and impairment in role functioning and used fewer services. A majority of both groups, however, were prescribed and used psychiatric medications."

Mojtabai told The New York Times:7

"It's not only that physicians are prescribing more, the population is demanding more. Feelings of sadness, the stresses of daily life and relationship problems can all cause feelings of upset or sadness that may be passing and not last long. But Americans have become more and more willing to use medication to address them."

An earlier 2009 meta-analysis8 of 41 studies that assessed the accuracy of diagnoses of depression by general practitioners found "GPs correctly identified depression in 47.3% of cases." So, over the years, it appears overdiagnosis is becoming more prevalent and not less.

According to this review, findings suggest "that for every 100 unselected cases seen in primary care, there are more false positives (n=15) than either missed (n=10) or identified cases (n=10)," and that "Accuracy was improved with prospective examination over an extended period (three to 12 months) rather than relying on a one-off assessment or case-note records."

There's a fine line between depression and normal

While we must not downplay the seriousness of major depression, we must also not lose sight of the fact that the experience of a wide range of human emotions is normal and healthy.

In a controversial move, the bereavement exclusion9 — where "clinicians were advised to refrain from diagnosing major depression in individuals within the first two months following the death of a loved one" — which was included in DSM-4, was removed in DSM-5 in 2013. As noted in the paper, "The bereavement exclusion and DSM-5: An update and commentary:"10

"The removal of the bereavement exclusion in the diagnosis of major depression was perhaps the most controversial change from DSM-IV to DSM-5. Critics have argued that removal of the bereavement exclusion will "medicalize" ordinary grief and encourage over-prescription of antidepressants.

Supporters of the DSM-5's decision argue that there is no clinical or scientific basis for 'excluding' patients from a diagnosis of major depression simply because the condition occurs shortly after the death of a loved one (bereavement). Though bereavement-related grief and major depression share some features, they are distinct and distinguishable conditions.

Bereavement does not 'immunize' the patient against a major depressive episode, and is in fact a common precipitant of clinical depression. Recognizing major depression in the context of recent bereavement takes careful clinical judgment, and by no means implies that antidepressant treatment is warranted.

But given the serious risks of unrecognized major depression — including suicide — eliminating the bereavement exclusion from DSM-5 was, on balance, a reasonable decision."

1 in 6 Americans is on a psychiatric drug

The problem with taking an antidepressant to maneuver through difficult emotional territory is that many end up taking them long-term, and many find they cannot get off them without suffering debilitating withdrawal symptoms. As noted by in April 2018:11

"Initially, the drugs were cleared for short-term use; but even today, with millions of long-term users, there is little data about their effects on individuals who take them for years …

And yet, it is not clear that everyone who is taking an open-ended prescription should stop. Most physicians agree that a subset of users may benefit from a lifetime prescription, though they disagree on the size of that group."

According to a 2017 study,12 1 in 6 Americans between the ages of 18 and 85 were on psychiatric drugs, most of them antidepressants, and 84.3% reported long-term use (three years or more). Out of 242 million U.S. adults, 12% were found to have filled one or more prescriptions for an antidepressant, specifically, in 2013.

Long-term use places life and limb at risk

Research does show there may be a price to pay for the long-term use of antidepressants. For example, one 2015 study13,14 found that, compared to perimenopausal women treated with H2 antagonists or proton pump inhibitors (indigestion drugs), selective serotonin reuptake inhibitors (SSRI, a class of antidepressants) raised bone fracture rates by 76% in the first year of use.

After two years of treatment, the fracture rate was 73% higher. In 2017, Canadian researchers warned SSRIs might increase patients' risk of cardiovascular events by 14% and all-cause mortality by 33%,15 likely due to their anticlotting properties. As noted in the abstract:16

"We conducted a meta-analysis assessing the effects of ADs on all-cause mortality and cardiovascular events in general-population and cardiovascular-patient samples … Seventeen studies met our search criteria. Sample type consistently moderated health risks.

In general-population samples, AD [antidepressant] use increased the risks of mortality (HR = 1.33, 95% CI: 1.14-1.55) and new cardiovascular events (HR = 1.14, 95% CI: 1.08-1.21). In cardiovascular patients, AD use did not significantly affect risks.

AD class also moderated mortality, but the serotonin reuptake inhibitors were not significantly different from tricyclic Ads … The results support the hypothesis that ADs are harmful in the general population but less harmful in cardiovascular patients."

Low serotonin theory demolished, but antidepressant use goes on

Research17,18 published in 2009 also strengthened the evidence indicating the low serotonin idea is incorrect, finding strong indications that depression actually begins further up in the chain of events in the brain. Essentially, SSRIs focus on an effect of depression, not the cause.

As noted by investigative health journalist Robert Whitaker, as early as 1983 the National Institutes of Mental Health investigated whether or not depressed individuals had low serotonin.

At that time, they concluded there was no evidence that there is anything wrong in the serotonergic system of depressed patients. Drug companies kept running with the low serotonin theory, though, as it justified the aggressive use of antidepressants to correct this alleged "imbalance."

The placebo response in depression

According to the 2015 paper,19 "Depression: How Effective Are Antidepressants?" studies suggest antidepressants may, on average, improve symptoms in 20 people out of 100. (Studies comparing the drugs to placebo found 20 to 40 out of 100 found relief from placebo alone, while 40 to 60 out of 100 reported improvement on an antidepressant after six to eight weeks.)

Several studies have addressed the surprisingly robust placebo response seen in those with depression.20 For example, a 2002 paper21 in the journal Dialogues in Clinical Neuroscience noted that, "With its naturally fluctuating course, depression is a highly placebo-responsive condition: Mean placebo response rates in antidepressant clinical trials are 30% to 40%."

In those with mild depression, the likelihood of a positive response to placebo is even higher — as high as 70%.22 This paper also notes that when a placebo effect is at play, the patient will be more likely to experience a relapse, compared to when a true drug response is responsible for the improvement.

It also cites studies showing the placebo response rate tends to be highest "for women with a single episode of depression (66.7%) and lowest for women with recurrent depressive episodes (13.3%)."

Antidepressants may do more harm than good in most patients

In a recent article,23 professor Dr. Peter C. Gotzsche, co-founder of the Cochrane Collaboration and the Institute for Scientific Freedom, also points out other factors that can influence study results, falsely making antidepressants appear better than placebo in some studies. He writes:

"[V]irtually all trials are flawed, exaggerate the benefits of the drugs, and underestimate their harms … Virtually all patients in the trials are already on a drug similar to the one being tested against placebo.

Therefore, as the drugs are addictive, some of the patients will get abstinence symptoms (usually called withdrawal symptoms) when randomized to placebo, even if a wash-out period before randomization is introduced.

These abstinence symptoms are very similar to those patients experience when they try to stop benzodiazepines. It is no wonder that new drugs outperform the placebo in patients who have experienced harm as a result of cold turkey effects.

To find out how long patients need to continue taking drugs, so-called maintenance (withdrawal) studies have been carried out, but such studies also are compromised by cold turkey effects. Leading psychiatrists don't understand this, or they pretend they don't.

Most interpret the maintenance studies of depression pills to mean that these drugs are very effective at preventing new episodes of depression and that patients should therefore continue taking the drugs for years or even for life …

The smallest effect that can be perceived as an improvement on the Hamilton Depression Rating Scale is 5 to 6, but flawed trials attain only approximately 3. Several meta-analyses24 have found that the effect is larger if the patients are severely depressed, but the reported effects are small and below what is clinically relevant for all severities of depression."

More health risks linked to antidepressants

Gotzsche also summarizes some of the known harms of these drugs, citing research showing antidepressants:

  • Double the risk of harm from suicide and violence in healthy adults. According to this study,25 the number needed to treat to harm one healthy person was 16
  • Increase suicidality and aggression two- to threefold in children and adolescents26 — "an important finding considering the many school shootings where the killers were on depression pills," Gotzsche says
  • Increase risk of suicide and violence by four to five times in middle-aged women with stress urinary incontinence27
  • Double the risk of a core psychotic or potential psychotic event in women28

"I have described the dirty tricks and scientific dishonesty involved when drug companies and leading psychiatrists try convincing us that these drugs protect against suicide and other forms of violence," Gotzsche writes,29 pointing out that "Even the FDA was forced to give in when it admitted in 2007, at least indirectly, that depression pills can cause suicide and madness at any age."30

Whitaker takes it a step further in a commentary he wrote in 2005:

"A review of the scientific literature reveals that it is our drug-based paradigm of care that is fueling this epidemic. The drugs increase the likelihood that a person will become chronically ill, and induce new and more severe psychiatric symptoms in a significant percentage of patients …

… As with any epidemic, one would suspect that an outside agent of some type — a virus, a bacterial infection, or an environmental toxin — was causing the rise in illness. That is indeed the case here. There is an outside agent fueling this epidemic of mental illness, only it is found in the medicine cabinet."31

Criteria for major depression

According to DSM-5 criteria,32 to receive a diagnosis of major depression, you must:

  • Experience five or more of the following symptoms (see symptom list below) during a single two-week period
  • At least one of the symptoms must include depressed mood and/or loss of interest or pleasure
  • The symptoms must cause you "clinically significant distress or impairment in social, occupational or other important areas of functioning"
  • The symptoms must not be related to substance abuse or another medical condition (see "More than 200 commonly used drugs are known to cause depression as a side effect" for more information on medical conditions and drugs that might influence your state of mind)

Major depression symptom list:

Depressed mood most of the day, nearly every day

Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day

Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day

A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down)

Fatigue or loss of energy nearly every day

Feelings of worthlessness or excessive or inappropriate guilt nearly every day

Diminished ability to think or concentrate, or indecisiveness, nearly every day

Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

Keep in mind that major depression is typically associated with thoughts of suicide and feelings of deep hopelessness or helplessness, making it critical to recognize and address such symptoms. To assess your or a loved one's risk factors, see "These types of children have an increased risk of suicidal thoughts," and "Suicide is on the rise — Know the warning signs, and how to help."

If you are feeling desperate or have any thoughts of suicide, please call the National Suicide Prevention Lifeline,33 a toll-free number 1-800-273-TALK (8255), or call 911, or simply go to your nearest Hospital Emergency Department.

What science says about exercise as treatment for depression

If antidepressants are not the answer in most cases of depression, what is? There's a solid and ever-growing body of scientific evidence showing physical exercise is a major key in the successful treatment of depression. Here's a short-list of studies and scientific review articles that have investigated this oft-ignored prescription, starting with the most recent:

JAMA Psychiatry 201834,35 (a study funded in part by the National Institute of Mental Health) concluded exercise "may have greater efficacy than current approaches that target depressed mood."

Contrary to popular belief, they found that while physical activity affected the participants' mood afterward, their mood did not affect the amount of physical activity they engaged in. This defies the common assumption that depression causes physical inactivity. In fact, the results suggest it's largely the other way around.

Frontiers in Pharmacology 201736 addressed the question of whether a comparison between exercise and drug treatment is evidence based, noting that:

"The literature on the benefits of exercise for depression is extensive. Nevertheless, two recent reviews focusing on antidepressants vs. other therapies as a basis for clinical practice guidelines recommended mainly antidepressants, excluding exercise as a viable choice for treatment of depression. The aim of this perspective is to analyze the literature exploring the reasons for this discrepancy …

[I]t is possible that academics and health care practitioners are skeptical of viewing exercise as medicine. Maybe, there is a reluctance to accept that changes in lifestyle as opposed to pharmacological treatment can alter biological mechanisms."

In conclusion, they found three randomized controlled trials comparing four months of exercise to the use of antidepressants (two of which involved patients with major depression and one recruited those with minor depression). All of them found that exercise and antidepressant treatment were equally effective.

Of 11 randomized controlled trials comparing exercise as an adjunctive treatment to antidepressants (combination comparisons) against a wide variety of controls, 10 of them found "a significant depressive improvement after the exercise period, and/or that the proportion of patients with a clinical response was larger for the exercise group than the control."

The paper reviews a variety of biological mechanisms by which exercise can benefit those with depression, including boosting BDNF and serotonin and lowering inflammation biomarkers. The authors also point out that:

"Two meta-analyses examining the efficacy of exercise as a treatment for major depression concluded that exercise as a treatment for depression can be recommended as a stand-alone treatment or as an adjunct to antidepressant medication, and that exercise can be considered an evidence-based treatment for the management of depression …

Almost all reviews examining exercise vs. other treatments of depression, including antidepressants, support the use of exercise in the treatment of depression, at least as an add-on therapy …

Based on the present review, which examined most or all RCTs published in 1999-2016, and most or all meta-analyses/systematic reviews published in 2009-2016, it can be stated that exercise is an evidenced-based medicine for depression — at least as an add-on to antidepressants."

Current Opinion in Psychology 201537 highlighted the role of inflammation in depression, and how biological markers can help explain how exercise reduces depressive symptoms. As explained in this review:

"There is growing support for the efficacy of exercise interventions for the treatment of individuals who present with mild-to-moderate depression … The present article reviews contemporary theoretical accounts and recent empirical data pointing to neuroinflammatory states and neurotrophin production as possible biomarkers of the antidepressant response to exercise …

Recent research suggests that depressed patients have elevated levels of pro-inflammatory cytokines, with the most reliably observed elevations in Interleukin-6 (IL-6) and Tumor Necrosis Factor-alpha (TNF-alpha)

Along with the elevated levels of pro-inflammatory cytokines among depressed individuals, several studies show lower than average levels of anti-inflammatory cytokines such as Interleukin-10 (IL-10) and a lack of correlation between IL-10 and IL-6 that typically is present, suggesting there is a dysregulation of the inflammatory system among depressed patients

Exercise has emerged as an effective strategy to target inflammatory deregulation ... For example, acting as a stressor, acute bouts of exercise result in the release of the pro-inflammatory cytokine IL-6 from muscles.

This release of IL-6, in turn, activates the synthesis of anti-inflammatory cytokines such as IL-10 and inhibits release of pro-inflammatory cytokines such as TNF-alpha, suggesting that exercise promotes, in this way, an anti-inflammatory environment.

Similarly, when occurring chronically, exercise (training) reduces the production of pro-inflammatory cytokines such as IL-6 and TNF-alpha and increases the production of the anti-inflammatory cytokine IL-10."

Many other studies support the view that depression is mediated, and perhaps directly caused,38 by inflammation, especially gastrointestinal inflammation.39 Cytokines40 in your blood, and/or inflammatory messengers such as CRP, interleukin-1, interleukin-6 and TNF-alpha are all predictive of41 and correlate42 to depression.

In melancholic depression, bipolar disorder and postpartum depression, white blood cells called monocytes express proinflammatory genes that provoke secretion of cytokines.43

At the same time, cortisol sensitivity goes down, and cortisol is a stress hormone that buffers against inflammation. Together, these inflammatory agents transfer information to your nervous system, typically by stimulating your vagus nerve, which connects your gut and brain.44

In one study,45 the researchers suggested "depression may be a neuropsychiatric manifestation of a chronic inflammatory syndrome," and that "these findings justify an assumption that treating gastrointestinal inflammations may improve the efficacy of the currently used treatment modalities of depression …"

In this model, depression is the result of your body's attempts to protect itself from an inflammatory response, and involves hormones and neurotransmitters. Depressive symptoms most strongly associated with chronic inflammation include:46

  • Fatigue
  • Psychomotor slowing
  • Mild cognitive confusion
  • Memory impairment
  • Anxiety
  • Deterioration in mood that mirrors features of depression

Asian Journal of Sports Medicine 201547 looked at "systematic reviews, meta-analyses and large-scale randomized control trials on effects of exercise on depression" to devise recommendations for doctors "who plan to use exercise protocols in depression."

Here, they highlighted 10 different biological effects of exercise known to have a beneficial effect on people with depression. These effects include48 upregulation or increase in the levels of norepinephrine, serotonin, BDNF, endorphins and endocannabinoids, and a downregulation or decrease in the levels of cortisol, TNF-alpha, IL-1beta, IL-6 and ACTH.

They also note psychosocial effects that have a beneficial impact, such as self-mastery, social interaction and distraction from rumination. According to this evaluation, depressed patients most likely to benefit from exercise are: Under 20 or over 40 years old, have higher education status, untrained, and have mild to moderate depression.

Characteristics of an exercise program most likely to benefit people with depression include: Supervised and/or structured exercise; individually tailored exercise consisting of aerobic exercise and resistance training (or a mix); low to moderate intensity; 45 to 60 minutes per session at least three to four times per week for a minimum of 10 weeks. The authors also encourage physicians to employ a multidisciplinary team, noting that:

"It is very beneficial to encourage physicians and exercise specialists to work in collaboration on depression and exercise treatments. It seems that most medical professionals have little or no training in exercise programs and exercise specialists are not familiar with the clinical population particularly depressed patients.

Physicians' recommendation is often limited to 'get more exercise' while the exercise specialist may advise physical activities that are not actually useful for patients with depression.

However with a multidisciplinary team, it is possible to prescribe an exercise program more safely, efficiently, operatively, objectively and realistic. Such a multidisciplinary team may include a psychiatrist or clinical psychologist, sports medicine specialist and exercise trainer."

Journal of Clinical Psychiatry 201149 concluded 12 weeks of high-intensity exercise led to a 28.3% remission rate in patients who had previously failed to get any relief from SSRIs.

Clinical Psychology: Science and Practice 2006.50 This meta-analysis of 11 studies concluded doctors would be well advised to recommend exercise to patients suffering from depression, anxiety and eating disorders, as the evidence showed "substantial benefit."

Archives of Internal Medicine 199951 reported 16 weeks of aerobic exercise was just as effective as Zoloft for the treatment of major depression in older patients.

Consider nondrug solutions first

Addressing your nutrition is perhaps the best place to start if you're feeling depressed. Foods have an immense impact on your brain, and eating whole foods as described in my nutrition plan will best support your mental and physical health.

Avoiding processed foods, sugar (particularly fructose) and grains is particularly important as it will help normalize your insulin and leptin levels, which is an important contributing factor to depression. Certain nutrients are also known to cause symptoms of depression when lacking, and specific herbs and nutritional supplements may also help counteract symptoms.

To suggest that depression is rooted in nutrient deficiencies and other lifestyle related factors does not detract from the fact that it's a serious problem that needs to be addressed with compassion and nonjudgment. It simply shifts the conversation about what the most appropriate answers and remedies are.

For a list of nutrients, herbs and supplements that have been shown to be particularly helpful for depression, as well as a long list of studies showing just how ineffective antidepressants are, and guidelines for safe drug withdrawal, please see "What Does the 'Best Evidence' Say About Antidepressants?"

Canola oil — When a great oil isn’t so great after all


Warning: This oil comes with potentially damaging side effects due to either the ingredient it's made from or the manufacturing process used to extract it. Because these negative effects overshadow the potential benefits, I do not recommend this oil for therapeutic use. Always be aware of the potential side effects of any herbal oil before using.

Canola oil is widely promoted as “one of the best oils for heart health.”1 However, this information is rather flawed, as canola oil and similar highly processed cooking oils hold untold dangers to your health.

Read on to learn what you should know about canola oil, and what my personal recommendations for the best cooking oil are.

What is canola oil?

Referred to as “the healthiest cooking oil” by its makers, canola oil is low in saturated fats and high in monounsaturated fatty acids (MUFA) and polyunsaturated fats (PUFA) such as oleic acid, linoleic acid and alpha-linolenic (ALA).2,3 The oil is produced from a series of processes ranging from solvent extraction with hexane, to refining, bleaching and deodorization.4

Although canola is a type of rapeseed, the canola you see on store shelves is not the rapeseed you may be familiar with that is used for industrial and nonedible purposes, such as for lubricants, plastics and hydraulic fluids. The edible canola oil, on the other hand, is specifically grown as a food crop, genetically altered to contain significantly lower levels of erucic acid and glucosinolate in it, which makes it safe to eat.5

The modification focuses on broadening the seasons and regions where the plants can be cultivated and maximizing yield. The bad news is that in order to boost the resistance, researchers have developed herbicide-tolerant canola, including Roundup-ready and Liberty-tolerant types.6

How is canola oil used?

Canola oil is a common ingredient in food products such as salad dressings, salad oil and margarines.7

Even though it’s marketed as a food product, according to the Canola Council of Canada, once plant-sourced oils like canola oil are processed they “can be used industrially to formulate lubricants, oils, fuels, soaps, paints, plastics, cosmetics or inks.”

Canola can also be used to produce ethanol and biodiesel. The point is, the Canola Council says, is that “just because you can do this doesn’t make the approved food oils at the grocery store somehow poisonous or harmful.”8

Composition of canola oil

Canola oil is often praised by the mainstream food industry due to its fatty acid content:9

  • Saturated fat — Canola oil contains about 7%, or about half the amount found in corn oil, olive oil and soybean oil.
  • Monounsaturated fatty acids (MUFA) — This is the most abundant fat in canola oil. The MUFA oleic acid makes up 61% of canola oil — second only to olive oil.
  • Polyunsaturated fatty acid (PUFA) — Compared to palm oil and olive oil, canola oil has a higher amount of PUFA. It has a ratio of omega-6 fat (linoleic acid) and omega-3 fat (alpha-linolenic acid) of 2-to-1.

How is canola oil made?

Unfortunately, details you're told by vegetable oil manufacturers about canola oil's production and benefits don’t tell the whole story. As mentioned, canola oil was created through the hybridization and genetic alteration of the rapeseed, a plant used for industrial purposes.10 Rapeseed oil came from the plant known as "rape," from a Latin word meaning "turnip."11 Along with cruciferous vegetables, rape is a domesticated crop belonging to the Brassicaceae family.12

Although rapeseed oil is composed of 60% monounsaturated fat, it is inedible because of two dangerous substances:

  • Erucic acid — a type of fatty acid that is associated with Keshan's disease, characterized by fibrotic lesions in the heart13
  • Glucosinolates — bitter compounds that negatively affected the taste of rapeseed oil14

To turn rapeseed oil into an edible product, Canadian manufacturers used selective breeding to formulate seeds that had lower levels of erucic acid and glucosinolates. Canola oil, also known as "low erucic acid rapeseed (LEAR)," was formed.15

But, what the manufacturers don’t call attention to when they’re calling canola “healthy” is that hexane, one of the chemicals needed to extract oil from the seeds, is an HAP: a hazardous air pollutant. This begs the question of whether hexane is safe when ingested.16

According to the Toxicology Data Network, hexane may target the central nervous system and respiratory system when ingested.17 While hexane occurs in canola oil in only minute amounts, there are no sufficient studies that prove that it is safe to ingest.

Another part of the processing of canola oil is deodorizing, which is the step responsible for its bland taste. The bad news with this is that deodorizing reduces canola oil’s omega-3 fatty acids by up to 20%18 — so in the end, there’s not enough omega-3s for you to reap the benefits.

Is canola oil safe?

Although the food industry says it is, I do not believe canola oil is safe. Despite its "generally recognized as safe" (GRAS) status, no long-term human safety studies have been conducted on canola oil.19 Animal studies, however, contradict some of the health claims about canola oil.

For example, in Canadian research published in 1997 in Nutrition Research, piglets fed with milk replacers containing canola oil had signs of vitamin E deficiency, even if the replacement contained sufficient amounts of the nutrient. Deficiency in vitamin E can be dangerous, as it can lead to free radical damage and cardiovascular problems.20

A year later, researchers found the piglets fed with canola oil had reduced platelet count and an increase in platelet size. The researchers concluded that the ingestion of canola oil interfered with normal hematological development.21 In another animal test conducted, rats ended up with high blood pressure, an increased risk for stroke and a shortened lifespan when canola oil became their primary source of fat.22

It is important to take note that these studies were made prior to the introduction of GE canola oil. This means you face not only the dangers of canola oil discovered in these studies, but also the potential hazards of genetically modified vegetable oils that may remain as residues in the final product.

Side effects of canola oil

So, what really happens when you use canola oil in your food? The answer is that canola oil and other heated vegetable oils are some of the worst ingredients you can add to your food, if for no other reason that eating foods with canola oil will only distort your omega-6 to omega-3 ratio.

The bottom line is if you're using canola oil, it's time to throw it out and replace it with fats that will truly benefit your health. One of your best options is coconut oil, which I personally use. Olive oil is also good, but if you’re going to cook with an oil, coconut is the better choice because it tolerates higher heat levels, as I explain later in this section.

Another problem with canola oil is that it’s even more dangerous when hydrogenated, which is common in processed foods. Manufacturers hydrogenate the oil because it prolongs processed foods’ shelf life.23 And then, to make matters worse, consuming these foods exposes you to even higher levels of trans fats.24

So, the idea that canola oil is beneficial to your health is nothing but a myth. Another myth is that saturated fat is bad for you. The “bad” fat belief stemmed from Ancel Keys' Seven Countries Study,25 which linked saturated fat with heart disease. The truth is that his research was manipulated to achieve the conclusion that saturated fat is “bad,” as he selectively analyzed data from seven countries rather than comparing all data from 22 studies available to him at the time.

When you look at the majority of the data he had available to him, you’ll find that all the data combined actually disproved his theory. The truth is saturated fat does not cause heart disease and is, in fact, an important part of a healthy diet.26

The reason coconut oil is the best choice for cooking is that it’s resistant to heat damage, unlike canola oil and other vegetable oils. Coconut oil also carries beneficial fat like lauric acid, which provides antiviral, antibacterial and antiprotozoa properties.27

If you’re not cooking with it, another beneficial oil I recommend is olive oil. It’s important to remember that olive oil is highly sensitive to heat damage, so you definitely don’t want to cook with it. But it’s great at room temperature drizzled over cold salads.

Another caveat: Make sure you purchase only high-quality authentic olive oil, as 60% to 90% of the brands sold in the market today are adulterated. Good quality olive oil contains important vitamins and nutrients, and can be a salad superstar if you buy the right kind. For more information on olive oil, check out my article on using it in salads, “Olive Oil: The salad superstar.”

Nanoparticle additives in your food


Processed food is the antithesis of a healthy diet for a number of different reasons, the addition of unregulated and often undisclosed chemicals being a significant one. Besides preservatives, emulsifiers, colors and flavors, which are generally listed, there are any number of others that do not have to be disclosed, as they’re considered “processing aids.”

Additives are used in food processing to slow spoilage, prevent fats and oils from going rancid, prevent browning, and fortify or enrich the food with synthetic vitamins and minerals to replace the natural ones that were lost during processing.

They’re also added to improve taste, texture and appearance, as many processed foods would be as dull and bland as cardboard without some artificial help. But despite widespread use, many food additives have questionable safety profiles, or none at all, since only a small percentage have ever been properly tested.

One such in the U.S.’s largely unregulated, group of food additives are nanoparticles, which are rapidly gaining favor in the food industry. Tests by the Adolphe Merkle Institute of the University of Fribourg and the Federal Food Safety and Veterinary Office in Switzerland found nanosized titanium dioxide, silicon oxide and talc in 27% of the food products tested.1

This suite of ingredients, engineered to almost atomic scale, may have unintended effects on cells and organs,2 particularly the digestive tract.3

There are also indications that nanoparticles may get into the bloodstream4 and accumulate5 elsewhere in the body. They have been linked to inflammation,6 liver and kidney damage7 and even heart8 and brain damage,9 The Guardian reports in a recent article.10

Nanoparticles — A hidden health hazard in processed food?

Nanoparticles have gained popularity in the food industry for their ability to “improve” the texture, appearance and flavor of food. Silicon dioxide, for example, is added to many spices and salts as an anticaking agent, meaning it allows the spices to flow easier and not clump together.

Titanium dioxide (labeled E171 in the EU), is a whitening agent used in a wide variety of products, from chocolate and chewing gum to baked goods, milk powders and mayonnaise. However, while titanium dioxide has long been considered inert, concerns about nanosized titanium dioxide have been raised for years.11

According to The Guardian,12 “the tiny metal additive has … been shown to accumulate in liver, spleen, kidney and lung tissues in rats when ingested and to damage the liver and heart muscle.”

Christine Ogilvie Hendren, executive director of the Center for the Environmental Implications of NanoTechnology at Duke University, told The Guardian that she washes “all my foods like crazy,”13 in an effort to remove surface nanoparticles.

Christine K. Payne, associate professor of mechanical engineering and materials science, Duke University, added “There might be concerns for toddlers when you have a small body mass that you’re eating a lot of these … products.”14

France bans nanosized titanium dioxide

Due to mounting safety concerns, France recently banned nanosized titanium dioxide in food, effective 2020. According to Reuters,15 “the country’s health and safety agency said there was not enough evidence to guarantee the safety of the substance.”

According to Payne, her studies (which are focused on the inhalation of nanomaterials) have revealed “lots of unexpected molecular and genetic effects” even at levels up to 100 times below those deemed safe by conventional toxicology tests. Payne told The Guardian:16

“What all labs [doing such research] are seeing now is that there are effects beyond toxicity, so you can work at non-toxic concentrations but still see, for example, an oxidative stress response which can lead to inflammation.”

In his safety review17 “Is Nano Safe in Foods?” published November 2017, David Julian McClements from the University of Massachusetts discusses nanoparticles’ effect on the human gastrointestinal tract, as well as some of the potential toxicity mechanisms of various food-grade nanoparticles, concluding “there is evidence that some of them could have harmful effects.”

Not all nanoparticles are added directly to the food itself. They’re also used in packaging, and may migrate onto the food. According to McClements,18 these nanoparticles may also pose health hazards. Nanosized silver, for example, commonly used as an antimicrobial agent in food packaging, may kill beneficial gut bacteria and alter your gut microbiome if ingested.

Nanosized titanium dioxide linked to gut inflammation

Research19,20 published in May 2019, found nanoparticle-sized titanium dioxide administered in drinking water impacted the gut microbiota in mice in a way that might trigger inflammatory bowel diseases and/or colorectal cancer. As explained by the authors:21

“While TiO2 [nanosized titanium dioxide] had minimal impact on the composition of the microbiota in the small intestine and colon, we found that TiO2 treatment could alter the release of bacterial metabolites in vivo and affect the spatial distribution of commensal bacteria in vitro by promoting biofilm formation.

We also found reduced expression of the colonic mucin 2 gene, a key component of the intestinal mucus layer, and increased expression of the beta defensin gene, indicating that TiO2 significantly impacts gut homeostasis.

These changes were associated with colonic inflammation, as shown by decreased crypt length, infiltration of CD8+ T cells, increased macrophages as well as increased expression of inflammatory cytokines.

These findings collectively show that TiO2 is not inert, but rather impairs gut homeostasis which may in turn prime the host for disease development.”

Associate professor Wojciech Chrzanowski, a nanotoxicology expert with the University of Sydney's School of Pharmacy and Sydney Nano Institute, told Science Daily:22

"There is increasing evidence that continuous exposure to nanoparticles has an impact on gut microbiota composition, and since gut microbiota is a gate keeper of our health, any changes to its function have an influence on overall health.

This study presents pivotal evidence that consumption of food containing food additive E171 (titanium dioxide) affects gut microbiota as well as inflammation in the gut, which could lead to diseases such as inflammatory bowel diseases and colorectal cancer.”

Nanosized titanium dioxide alters intestinal homeostasis

Another recent study23 published in the journal Environmental Science: Nano sought to determine whether nanosized titanium dioxide could affect the intestinal barrier function, the aim of which is to protect your body from external threats, if so, how.

To do that, the researchers co-cultured two types of colorectal cells to “reconstitute an in vitro mucus-secreting intestinal epithelium,” which was then exposed to three different agents: nanosized titanium dioxide, pure anatase (a mineral form of titanium dioxide), or an anatase and rutile mix (two mineral forms of titanium dioxide). As reported by the authors:24

“Two exposure scenarii were used: acute exposure for 6 h or 48 h after cell differentiation (21 days post-seeding), or repeated exposure during the course of cell differentiation, i.e., twice a week for 21 days post-seeding.

Epithelial cells repeatedly exposed to TiO2 developed an inflammatory profile, together with increased mucus secretion. Epithelial integrity was unaltered, but the content of ATP-binding cassette (ABC) family xenobiotic efflux pumps was modified.

Taken together, these data show that TiO2 moderately but significantly dysregulates several features that contribute to the protective function of the intestine.”

All nanoparticles bind to gut bacteria

According to a study25,26 published last year, all nanoparticles in food have the ability to bind to all types of gut bacteria, albeit to varying degrees, thereby altering the bacteria’s life cycle and activity inside your body.

While the authors suggest these characteristics may render nanoparticles usable in medicine — they could potentially be used to push the gut microbiome in a positive direction, for example — they may also cause problems. As noted in Medical News Today, which reported the team’s findings:27

Compared with bigger particles derived from the same materials, nanoparticles have a much larger surface area relative to their size … and are able to cross biological barriers. These barriers include the mucus layer that lines tissues such as the gut.

For these reasons, their fate in the human gut is likely to differ greatly from that of larger-scale counterparts derived from the same materials. According to the study authors, ‘It is, therefore, important to ensure that any nano-enabled food ingredients are safe for application in foods’ …

A potential outcome that could be of benefit is the inhibition of infections, for example by H. pylori. The team made this discovery when experimenting with silica nanoparticles in cell cultures.

However, a potentially disturbing prospect that came up in other experiments was that binding to nanoparticles could render some unfriendly bacteria less visible to the immune system. Such a result could increase inflammation responses, for instance.”

Safety testing lags behind identification of novel ingredients

As noted in a 2018 paper28 in the journal Nanotechnology Reviews, “There is an imbalance between the increase in research to identify new nanoparticle applications and their safety …”

The authors further point out that “It has been observed that people perceive nanotechnology risks similar to genetically modified food, thus reducing the consumption of such food,” and that while “there are numerous studies on the use of nanotechnology in food and the effect of nanoparticles on human health,” few analyses of the available evidence have been performed.

In an attempt to fill this void, the authors “present and analyze different studies on the use and the safety of nanoparticles in food.” This is a good paper to read through if you want a comprehensive overview of their use and potential toxicities.

Problematically, “After years of research, we have only come to the conclusion that materials at nanoscale show drastically different properties and unexpected behavior,” the authors state, adding that “This unexpected behavior is what leads to our concerns about its toxicity.” The fourth section, “Nanotoxicity,” reads in part:29

“Nanoparticles have the unique property of increased surface area per unit volume. This renders them to behave completely different from their bulk counterparts … [N]anoparticles are more likely to react with various biological entities such as lipids and proteins or cells as a whole. Nanoparticles may cross the cell membrane entering various organs and activate inflammatory or other immune responses.

To foresee the unknown consequences of nanoparticle usage, nanotoxicological studies are performed. A typical toxicity test involves cells or organisms subjected to a specific dose of chemicals (nanoparticles, in the case of nanotoxicological studies) and measuring the response of the cells over a period of time.

The dose-response relationship from these experiments determines the optimum dose and acceptable limits for chemicals. However, unlike conventional chemicals … nanoparticles … have shapes, surface area, and surface electrical charge completely different from bulk counterparts. These might diffuse, aggregate, sediment, and change the physical and chemical properties of the media they are kept in.

The major inference that we draw is that the conventional in vitro assays may misinterpret the results and the dose-response regimes. These conventional assays do not take into account the anomalous behavior of nanoparticles in the environment and their cellular uptake.”

According to the authors, several factors can affect the toxicity of nanoparticles, including dosage, chemical reactivity, charge distribution, size and shape of the particle, and the particle’s surface area. Other influencing factors include the fact that “the interaction between the nanoparticle and the biological membrane can be either physical or chemical.”

Physical interactions between a nanoparticle and a biological membrane typically trigger “disruption of membranes and its activity, protein folding, aggregation and various transport processes,” while chemical interactions primarily result in “reactive oxygen species (ROS) generation and oxidative damage.”

Multiple exposure routes further complicate the picture when trying to identify health risks. Similarly, the route a nanoparticle uses to enter any given cell can also influence its toxic potential to the cell, as different entry routes generate greater or lesser stress.30

“The fact that their particles can distort lipid organization and overall membrane structure is an evidence in itself that the nanoparticles may affect biology as a whole,” the authors note, adding “There is an urgent need for information to better understand the nanoparticle-biological interactions and processes.”

FDA does not regulate nanoparticles in food

While the EU has required engineered nano ingredients to be clearly indicated on the food label, no such rules exist in the U.S. When asked for a comment, the U.S. Food and Drug Administration told The Guardian31 “there are no specific provisions in the Federal Food, Drug, and Cosmetic Act that deal with nanomaterials in food.”

Many do not realize that food additives are not automatically required to get premarket approval by the FDA,32,33,34 or that items that fall under the “generally recognized as safe” (GRAS) designation are exempt from the approval process altogether.

The problem with the GRAS program is that a company can simply hire an industry insider to evaluate the chemical, and if that individual determines that the chemical meets federal safety standards, it can be deemed GRAS without any involvement from the FDA. No independent third party objective evaluation is required.35 As a result, we now have many so-called GRAS chemicals in our food supply that have never existed in the food supply before.

Used in combination, food additive hazards are amplified

Adding further complexity to an already complicated picture is research showing that when you consume multiple food additives in combination, the health effects may be more serious than previously imagined.

In 2015, Denmark’s “largest research project on chemical cocktail effects in food,”36 led by the National Food Institute, concluded that even small amounts of chemicals can amplify each other’s adverse effects when combined. As reported by the Institute:

“A recently completed, four-year research project on cocktail effects in foods … has established that when two or more chemicals appear together, they often have an additive effect.

This means that cocktail effects can be predicted based on information from single chemicals, but also that small amounts of chemicals when present together can have significant negative effects.

‘Our research shows that indeed, little strokes fell great oaks also when it comes to chemical exposure. Going forward this insight has a profound impact on the way we should assess the risk posed by chemicals we are exposed to through the foods we eat,’ Professor Anne Marie Vinggaard from the National Food Institute says.”

While this research did not address nanosized additives, it stands to reason that since nanoparticles tend to be more reactive and unpredictable than their bulkier conventional counterparts, when combined with other additives — nanosized or not — the risk of toxicity may be significantly magnified.

Avoid processed foods to sidestep many potential hazards

The food industry has dramatically altered our diet, and these changes directly affect your weight and overall health. A large part of the problem stems from the processes used to manufacture the food, as food processing destroys valuable nutrients.

It also removes much of the food’s original flavor, and to address these shortcomings, synthetic nutrients, flavors, colors and other additives are used. Many of these added chemicals can wreak metabolic havoc, as your body doesn’t quite know what to do with them.

Another factor that makes processed foods the antithesis of a healthy diet is the excessive use of refined sugar and processed fructose. Virtually all processed foods contain added sugar — including commercial infant formula and baby food. Most processed foods are also loaded with genetically engineered ingredients and/or glyphosate, the most widely used herbicide in the history of agriculture.

If you’re concerned about your health, buying a good cook book and cooking from scratch using whole, organic ingredients is one of the best investments you could possibly make. For a step-by-step guide to making wiser food choices for yourself and your family, please refer to my free optimized nutrition plan.

Remember, a processed food diet sets the stage for obesity and any number of chronic health issues. In fact, many of the top diseases plaguing the United States are diet-related, including heart disease, diabetes and cancer. The answer to these health problems lies not in a pill, but, primarily, in what you eat every day.

Buried reports hide details of medical device failures


According to the Medicare Payment Advisory Commission,1 the medical device industry has developed and sold an enormous number of products they feel play a crucial role improving the ability to diagnose and treat illness. However, there are a relatively small number of large diversified companies supplying these devices specific for therapeutic use.

In a report to Congress, the Medicare Payment Advisory Commission stated:2 “The industry is distinctive both for its tendencies to make frequent, incremental changes to its products and its extensive ties with physicians.”

While medical devices are regulated by the Food and Drug Administration (FDA), the regulatory framework is less stringent than that used for pharmaceutical drugs. Many devices considered to be low risk may be marketed without prior approval and those considered medium risk are only required to demonstrate they are substantially equivalent to an existing device before being marketed.

Due to a rapidly expanding scientific and engineering knowledge base, there's been an acceleration in the development of new devices. The FDA3 maintains information for manufacturers to determine if their product is a medical device, how to classify it, label it and report it. The FDA Medical Device Reporting (MDR) regulation mandates reporting device-related adverse events.4

On the surface it appears as if the FDA and other federal agencies are seeking to protect consumers from malfunctioning or poorly designed devices. However, an investigative report by Kaiser Health News (KHN)5 revealed a hidden program.

The Voluntary Malfunction Summary Reporting has allowed manufacturers to submit MDRs in summary form. The KHN6 investigation found these collections included 1.1 million reports since 2016.

MAUDE tracks public reports

Publicly, the Manufacturer and User Facility Device Experience Database (MAUDE)7 is where adverse events are reported for medical devices. The FDA also maintains MedWatch,8 an adverse event reporting program for the public where individuals may subscribe to safety alerts and learn of new reports made on human medical products or may report serious problems themselves.

Within the MAUDE system is an online search that allows the public to look through the database for information on medical devices that may have malfunctioned or caused a death or serious injury. According to the FDA, the database remains current through the end of the past month, and the they seek to include all reports.9

Before KHN revealed the existence of a hidden database kept by the FDA, The Associated Press reported spinal stimulators used to treat pain and other conditions caused more than 80,000 deaths from 2008 to 2018. While marketed as a panacea for a wide range of pain disorders, the stimulators accounted for the third highest number of medical device injury reports to the FDA.10

These devices became one of the fastest growing medical products as doctors and companies aggressively marketed them as a safe antidote to the opioid crisis. However, patient reports indicate they are responsible for shocks, burns or spinal cord nerve damage resulting in muscle weakness and paraplegia.

Of the 4,000 different types of medical devices tracked by the FDA, metal hip replacements and insulin pumps are the only two logging more injuries. Medical device manufacturers have insisted spinal cord stimulators are safe and 60,000 are implanted annually.

An investigative collaboration between the AP, NBC, the International Consortium of Investigative Journalists and 50 other media partners around the world, discovered more than 1.7 million injuries and nearly 83,000 deaths related to spinal cord stimulators.

In response to the investigative piece by the AP, the FDA released a statement saying it would take new action to create11 “a more robust medical device safety net for patients through better data. Unfortunately, the FDA cannot always know the full extent of the benefits and risks of a device before it reaches the market.”

This statement was made just months before information was released by KHN showing FDA has supported a program that hides reports on faulty medical devices, injuries and malfunctions, leaving doctors and medical forensics professionals unable to make informed decisions about treatment.

Hidden reports place patients at risk

The program was initiated 20 years ago. The FDA justified it saying the program was designed to allow for more efficient internal review of well-known risks.12 This special exemption allowed manufacturers to file reports of malfunctions into a database that remained hidden from doctors and the public view.

The repository of device-related injuries has expanded since its inception. At least 1.1 million incident reports have found their way into the internal alternative summary reporting archive instead of the widely scrutinized public database.

An FDA official who spoke with KHN13 said this program “is for issues that are well-known and well-documented with the FDA” and that it “has allowed the FDA to more efficiently review adverse events … without sacrificing quality” of the review or information received.

The simple goal two decades ago was to cut down on redundant paperwork. A former FDA official told KHN14 the program took shape after under-reporting triggered changes allowing criminal penalties against device companies. Once this happened, thousands of injury and malfunction reports came into the agency every month.

Some of these were so similar that Larry Kessler, a past FDA official, reported they were “mind-numbing” to review. As a solution, they proposed device makers could seek a “special exemption” to avoid reporting certain complications into a public database and would instead send a spreadsheet each quarter, six months or year, listing the injuries or malfunctions of their devices.

In this way, reviewers would look for problems or spikes in known issues while the public and physicians remained unaware of the vast number of injuries and malfunctions being reported every month.15

Buried data in FDA special exemption reports

KHN read over reams of records looking for references of reporting exemptions. In addition, the FDA also opened other pathways for manufacturers to report thousands of injuries and deaths listed in lawsuits. These exemptions were applied to products considered risky, such as pelvic mesh and devices implanted in the heart.16

A spokeswoman for the FDA confirmed these exemptions were created without public notification. Records from the FDA provided to KHN showed more than 480,000 injuries or malfunction reported in this program in 2017 alone. These alternative summary reports are not well-known, even within the industry.

For instance, Matthew Baretich, a biomedical engineer from Denver, Colorado, helps several area health systems analyze patient injuries and make equipment purchasing decisions. In order to do his job, he regularly scans public injury reports and when asked about these alternative summary reports he said,17 “I've got to tell you, that's a new term to me.”

Bruce Barkalow, president of a biomedical engineering firm in Michigan, is who government officials and attorneys call when medical devices fail. In an interview with KHN18 he said he was not aware of the reports, and that the data would be meaningful to his forensic investigations. Former FDA commissioner Dr. Robert Califf, who held the post from 2015 to 2017, said he was unaware of the program.

Information blackout on 100 medical devices

All deaths are mandated to be reported in MAUDE, but hidden databases have included malfunction reports for nearly 100 medical devices, including those implanted in patients or used in surgeries. The FDA declined to give KHN a complete list of devices granted exemptions but confirmed exemptions have been used for intra-aortic balloon pumps, surgical staplers and mechanical ventilators.19

Recently, the FDA announced it will be terminating the alternative summary reporting program in an effort to increase transparency. It also revealed it would open past records to the public within weeks. Former FDA official Dr. S. Lori Brown called this:20

“… a victory for patients and consumers. The number one job of the FDA — it shouldn't be “buyer beware” — is to have the information available to people so they can have information about the devices they're going to put in their body.”

Federal records have also shown the agency allowed makers of breast implants to hide hundreds of thousands of injuries and malfunctions in alternative summary reports. Exemptions will end for implantable cardiac defibrillators, pacemakers and tooth implants.21 The FDA reportedly began to close the program as far back as mid-2017.

However, data provided to KHN22 shows that in the first nine months of 2018 the FDA accepted more than 190,000 injury reports and 45,000 malfunction reports in their hidden reporting program. In the upcoming release of data, the FDA will open summary reports filed before mid-2017. Going forward, device makers will be required to file individual reports for each patient harmed by medical devices.

However, the FDA also said it will not stop device makers from filing exemption reports withheld from the public when there is mass litigation over a device, nor has a plan been announced to open records that contain injury reports related to pelvic mesh and surgical robots.

As a comparison, KHN23 found 84 accounts of stapler related injury were filed with MAUDE in 2016 while 10,000 malfunction reports were sent to the in-house database.

The FDA had initiated a newer summary reporting program in which more than 5,500 types of devices are covered, allowing manufacturers to log device malfunctions. They announced these will be left in place, but manufacturers will not be allowed to report serious injuries in this program. However, the FDA has a spotty historical record of disclosing reports to advisers.24

Bad information devastates families

While it may be easier for those counting reports to forget, the millions of hidden accounts of medical device malfunctions and injuries have devastated families and destroyed countless lives.

After living for years in pain after a crushing injury, Jim Taft consented to using a spinal cord stimulator from Boston Scientific to cloak the pain and get off pain medication.25 The stimulator failed soon after it was surgically implanted, delivering electric shocks so strong he couldn't sleep and at one point fell down a flight of stairs.

It was implanted in April 2014 by a neurosurgeon who received $181,000 from the company over five years as consulting fees and payment for travel and entertainment. By the time Taft had the spinal cord stimulator removed four years later, the damage sustained left him unable to walk more than a few steps. He’s now virtually paralyzed.26

A lawsuit brought by the family of Mark Levering, 62, alleges he nearly lost his life during surgery. Hospital staff performed CPR for 22 minutes while surgeons sutured a severed vein caused by a stapler malfunction. He was in a medically-induced coma and underwent several more surgeries to repair the damage.

After awakening from the coma, he was unable to walk and cannot consistently recognize his wife or son due to the lack of oxygen to his brain and the subsequent brain injury.27

In 2013, April Strange had surgery to remove a benign liver growth. When the stapler malfunctioned, she bled to death, leaving behind a husband and two daughters, then ages 6 and 8. After surgery, the stapler was thrown out, leaving Strange's husband unable to prove it had a defect. While stapler-maker Covidien denies allegations their product has a defect, they reached an agreement to settle with the family.28

FDA collaborates with manufacturers and CDC with states

Federal agencies charged with protecting public health interests appear to take actions leaning toward protecting big business instead. As the FDA begins revealing the number of under reported injuries and malfunctions in surgical equipment and medical devices, the Centers for Disease Control and Prevention (CDC) is hiding information about deadly infections in hospitals.

Although the CDC is vigilant in their surveillance of hospitals out of the country, The New York Times29 exposed a culture of secrecy within the U.S. that affects health care. One recent infection affecting hospitals has been Candida auris, which the CDC calls30 “an emerging fungus that presents a serious global health threat.”

The fungus is often multidrug-resistant, difficult to identify using standard lab methods and causes outbreaks in multiple health care settings. However, the CDC and states appear to be collaborating to hide outbreaks as a way to avoid frightening patients.

Knowledge of an outbreak is important when you're making decisions about nonurgent matters, such as elective surgery. The New York Times31 reports hospitals hide the outbreaks even when disclosure could have saved lives.

Take steps to protect your health

The best way to avoid the potential for medical device malfunction or uncontrolled infection is to protect your health. While there are times when you may need to seek immediate medical attention for accidents and injuries, I believe your best course of action is to maintain optimal health using strategies I've discussed in past articles.

Begin by getting eight hours of quality sleep, maintaining a healthy gut microbiome, eating a nutritionally balanced diet and getting plenty of exercise and movement each day. For guidelines and tips to help you, see the following articles:

The most dangerous 'nonprofit' harming your health


The International Life Sciences Institute (ILSI) is a nonprofit organization headquartered in Washington, D.C. Their mission, according to their website,1 is "to provide science that improves human health and well-being and safeguards the environment."

The organization was founded by Alex Malaspina, a former senior vice president at Coca-Cola Co. and a regulatory affairs leader. While he founded ILSI in 1978, his ties with Coca-Cola were not severed. Coca-Cola awarded scientists the inaugural ILSI Malaspina International Scholars Travel Award in 2015 when Coca-Cola attended the 2015 ILSI annual meeting in Phoenix, Arizona.2

Malaspina continued to work with Coca-Cola as a vice president in Atlanta, Georgia, long after founding ILSI.3 He also served4 as coordinator for new products at the pharmaceutical company Pfizer Inc., and was president of the International Technical Caramel Association,5 a food industry trade group for users and producers of caramel colors.

While often referred to as Dr. Malaspina, he is not a medical doctor. Rather, he earned his doctorate in philosophy in 1955 and was conferred an honorary Ph.D. from the University of Salvador, Argentina.6 In 1994 he received the International Award from the Institute of Food Technologists. The goals of the ILSI are reportedly to bring:7

"… together scientists from government, academia and industry to uphold the scientific integrity and objectivity of nutrition and food safety science so that the resulting data and its applications are used ethically to improve food systems for the betterment of public health."

However, Malaspina has been an influential figure in the food industry, driving an epidemic of obesity8 and Type 2 diabetes9 through unique and strategic devices.10

Study exposes ILSI as shill for multinational food industry

A new study11 based on the organization's internal documents shows ILSI embedded itself in public health panels across Europe and the United Nations in an effort to promote its own industry-focused agenda to raise profits at the expense of public health worldwide.

Sarah Steele, Ph.D., from the department of politics and international studies at the University of Cambridge, led the research published in Globalization and Health. Information in the study is based on documents U.S. Right to Know (USRTK) obtained through state Freedom of Information Act (FOIA) requests.12

USRTK is a nonprofit investigative research group focused on investigating the food industry. Simon Barquera, Ph.D., a consultant for the World Health Organization,13 tweeted following the release of the study:14 "Today is #blackmonday for #ILSI an organization that has blocked public health nutrition efforts in Mexico & other countries."

The study found some of the top officials at ILSI were asked to sit on international panels discussing the negative impacts of tobacco, chemicals and sugary foods on individuals, where they used their position to push for more lenient regulations on products that have mountains of scientific evidence proving the impact on health. Lead author Sarah Steele told The Guardian:15

"Our findings add to the evidence that this nonprofit organisation has been used by its corporate backers for years to counter public health policies. ILSI should be regarded as an industry group — a private body — and regulated as such, not as a body acting for the greater good."

Steele and her colleagues read through more than 170,000 pages of emails from 2015 to 2018, finding ILSI received funds from food companies, including Nestle, General Mills, Monsanto and Coca-Cola.16

While the organization publicly denies any involvement in public policy solutions or commercial interests,17 the study uncovered emails from founder Malaspina to executives at Coca-Cola in which he characterized new sugar intake guidelines as a "disaster" for Coke. Emails were uncovered suggesting ILSI protects industry interests, including this one, sent to Suzanne Harris18 at ILSI:19

"Dear Friends, These guidelines are a real disaster! They could eventually affect us significantly in many ways; Soft drink taxations, modified school luncheon programs, a strong educational effort to educate children and adults to significanty limit their sugar intake, curtail advertising of sugary foods and beverages and eventually a great pressure from CDC and other Agencies to force industry to start deducing drastically the sugar we add to processed foods and beverages.

Also we have to expect that many nations will follow the US guidelines. We have to consider how to become ready to mount a strong defence. Warm regards. Alex"

Nonprofit campaigns against public health policy

ILSI has affiliated chapters around the world20 and, in what may seem to be a juxtaposition of ideas, just completed participation in the 6th World Conference on Research Integrity in Hong Kong, China.21 According to the ILSI website:22

"Scientific integrity is fundamental to the mission and work of the International Life Sciences Institute (ILSI). Specifically, ILSI North America and its partners throughout the scientific community have been leaders in defining principles, guidelines, and best practices for establishing and maintaining the Integrity of the scientific process when diverse stakeholders collaborate — now ILSI and it's 16 entities are building on this work."

According to documentation, ILSI partners include large food industry giants and agribusinesses intent on promoting the use of chemicals in agriculture and manufacturing. In fact, the study authors wrote the nonprofit is a lobby group promoting the interests of agrichemical industries counter to healthy public policies.23 Co-author Gary Ruskin, co-director of USRTK commented:24

"ILSI is Big Food's global stealth network to defeat scientists, regulators and others who point out the health risks of their products. Big Food wants you to believe that ILSI works for your health, but really it defends food industry profits."

Trustees on the board of ILSI have included representatives from Kellogg's, General Mills, Nestle and Pepsico,25 while Kristin DiNicolantonio, ILSI global communication director, told The Guardian26 they did so "in an individual capacity."

In 2019, some of ILSI's industry board members include representatives from Cargill, Pepsico, Coca-Cola, DuPont, General Mills, ConAgra, Abbott Nutrition and Campbell Soup Co. Even the USDA and CDC are included as "liaisons" to the board.27 In Europe, employees from General Mills, DuPont and Nestle sit on the board.28

The World Health Organization (WHO) was involved in 2016 after ILSI vice president Alan Boobis chaired the meeting to establish public policy on glyphosate. ILSI had taken more than $1 million in donations from Monsanto. WHO cut formal ties with ILSI in 2017.29

In an interesting turnabout, Mars Co. quit ILSI in 2018 and issued a statement explaining:30 "We do not want to be involved in advocacy led studies that so often, and mostly for the right reasons, have been criticized."

ILSI disavows founder while maintaining ties with Coca-Cola

Three days after the featured study was released, ILSI31 published a response in which they said Steele's conclusions about its lobbying policies are incorrect. They reiterated the organization explicitly prohibits members from advocating commercial interests and informs on actions by industry rather than developing policy.

In the statement,32 ILSI was explicit Malaspina was no longer an ILSI trustee, officer or representative of the organization of any kind and has no position within the organization. Any comments he may have made after 2001 should be seen as a retired private citizen.

They encouraged anyone reading the study to discount emails from Malaspina in which he was in contact with ILSI members. However, while this deep dive into documents from the self-proclaimed industry watchdog establishes its involvement in policy and decision making on a global scale, it is not the first time dirt has been found when ISLI has come under the microscope.33

Earlier this year, papers published in the BMJ34 and the Journal of Public Health Policy35 revealed the powerful influence the ILSI held over the Chinese government policymaking related to obesity.

The nonprofit organization is funded by corporate membership and supporters. In 2015 they thanked a three-page list of worldwide corporate supporters,36 including McDonald's, Monsanto, Pfizer and Red Bull. Currently, its website lists industry members37 such as the Coca-Cola Co., ConAgra, General Mills, PepsiCo and DuPont.

ILSI worked to discredit scientist

ILSI supports the use of glyphosate, sugar and numerous other chemicals in the manufacturing of food, and takes great offense to scientists who dare to identify flaws in their conclusions. Dr. Tim Noakes is one who reviewed a meta-analysis called the Naudé Review.38

The review was published in 2014, in which the researchers claimed data showed low-carb diets are no more effective for weight loss than low-fat diets. Noakes and public health researcher Zoe Harcombe reviewed the publication, finding multiple flaws and saying the conclusions were not robust.39

In South Africa, Noakes is nationally famous as exercise scientist and physician transforming sport by challenging some of the most commonly held beliefs. In the past, he has addressed hydration, motivation and fatigue, but apparently bit off too large a bite when he took on carbs, big soda and sugar.40

In February 2014 he tweeted41 that babies should be weaned onto low-carbohydrate diets. Suddenly the floodgates opened, and he was pressed to defend his statement, even though he no longer practiced medicine. A colleague, Russ Greene from CrossFit Inc., flew to South Africa to speak to Noakes and read 300 pages of trial documents.

Court trial to defend low-carb statement

Greene writes the trial42 "sets a frightening precedent," as anyone who dares to tweet something out of sync with the food industry's proxy organizations may face the full force and deep pockets of the junk food industry. Although one dietitian was the face of the opposition, she was not the leader, nor were dietitians leading the charge. In fact, the dietitian most verbal is also a consultant for Kellogg's.43

She erased most of the online documentation of her relationship with Kellogg's following the start of the trial.44 During the 2014 Nutrition Congress, ILSI contributed to the program and three officials from South Africa's Department of Health spoke at the ILSI session. Noakes was initially acquitted, but the Health Professionals Council of South Africa filed an appeal.

He was again acquitted in mid-2018, being found not guilty of giving nutritional advice online, during which he demonstrated a low-carb diet was scientifically correct and could cause no harm. While the trial may seem frivolous to some, Greene calls it45 "just good business" for Coca-Cola and its proxies.

A whole food diet plan reduces health risks

If you want your body to perform optimally, you need real food and all-natural nutrients, which is common sense advice for everyone. A real food diet is a foundational pillar for optimizing your health and your gut microbiome. Choosing organic, whole foods grown without synthetic pesticides and fertilizers is key to avoiding toxins, and just as important as getting a wide variety of nutrients.

Organic fruits and vegetables may contain 19% to 69% more antioxidants than those conventionally-grown.46 Many of these have been linked to a reduced risk of chronic diseases, including cardiovascular disease and neurodegenerative disorders.

On the other hand, eating ultraprocessed foods places you at greater risk for disease, including metabolic syndrome,47 cardiovascular disease48 and diabetes.49 Research has also linked ultraprocessed foods to cancer50 and premature death. Unfortunately, eating processed foods has become the norm worldwide.

For a discussion on the dangers of processed foods see my previous article, "Processed foods lead to cancer and early death." Making changes to your nutrition may improve your health and help you more easily control your weight. For tips on eating more real food, see my previous article, "For optimal health and weight, eat real food."

Testing reveals PFOA chemicals in US food supply


Per- and polyfluoroalykyl substances1,2 (PFAS) are widely used chemicals that make products water-, oil-, grease- and stain-resistant. The chemicals are also used in firefighting foam. One type, perfluorooctanoic acid or PFOA, is commonly found in older nonstick cookware.

PFOA and its cousin perfluorooctanesulfonic acid (PFOS) are associated with a wide array of health problems, including cancer, immune and thyroid dysfunction, low birth weight and more.3

Disturbingly, because PFAS chemicals take thousands of years to degrade, and are found in groundwater across the country,4,5 they’ve become a significant environmental threat.

Research6 by the U.S. Centers for Disease Control and Prevention published in 2007 found PFAS chemicals in the blood of more than 98% of Americans tested. And, while concentrations of some PFAS (including PFOA and PFOS) declined by 10% to 32% between 1999 and 2004, another PFAS called PFNA doubled, resulting in a net increase.

The decline of PFOA and PFOS can be explained by the fact that both have been phased out, PFOS starting in 2000 and PFOA in 20067,8 Still, due to their persistence in the environment, they’re still showing up in the strangest places.

Sharon Lerner, a reporting fellow at The Investigative Fund and an investigative journalist for The Intercept and other major media outlets, has written extensively about PFAS and the industry’s attempts to cover up the damage.9

Testing reveals PFAS in US food supply

Research10,11 published in 2017 revealed 33% of fast food wrappers and containers contain fluorine, which suggests perfluorinated chemicals (PFCs) were used to give the paper that slick surface, and earlier studies12,13,14 have confirmed fluorinated chemicals can migrate from the packaging into the food.

Now, food testing by the U.S. Food and Drug Administration (performed in 2017 as part of its Total Diet Study15 and presented16 at the 2019 meeting of the Society of Environmental Toxicology and Chemistry) reveals PFAS chemicals are in the U.S. food supply,17,18,19,20,21 and at levels far exceeding the advisory limit for PFOA and PFAS in drinking water (there’s currently no limits in food).

Of the 91 foods tested for 16 types of PFAS, 10 were found to contain the chemicals.22 As reported by PBS:23

“The levels in nearly half of the meat and fish tested were double or more the only currently existing federal advisory level for any kind of … PFAS. The level in the chocolate cake was higher: more than 250 times the only federal guidelines, which are for some PFAS in drinking water …

PFOS, an older form of PFAS no longer made in the U.S., turned up at levels ranging from 134 parts per trillion to 865 parts per trillion in tilapia, chicken, turkey, beef, cod, salmon, shrimp, lamb, catfish and hot dogs. Prepared chocolate cake tested at 17,640 parts per trillion of a kind of PFAS called PFPeA.

The FDA presentation also included what appeared to be previously unreported findings of PFAS levels — one spiking over 1,000 parts per trillion — in leafy green vegetables grown within 10 miles (16 kilometers) of an unspecified eastern U.S. PFAS plant and sold at a farmer’s market.”

Dairy farm near Air Force base forced to ditch toxic milk

The FDA also reported that samples of drinking water and milk from cows raised on a farm near a U.S. Air Force base that uses PFAS-containing firefighting foam were found to contain disturbing amounts of the chemicals.

Drinking water contained 35 times more PFAS than the current health advisory level set by the U.S. Environmental Protection Agency (EPA), which is 70 parts per trillion (ppt).24 The milk contained high enough amounts it was deemed a human health concern, resulting in all milk from the farm being discarded.

In humans, the serum elimination half-life of PFOA ranges between 2.325,26 and 3.8 years,27 and for PFOS between 4.8 to 5.4 years.28 Similarly, it takes a long time for exposed cows to start producing clean milk. As reported by CNN Health:29

“The FDA noted that even after the cows are no longer exposed to the PFAS contaminated water or feed, the accumulated chemicals can remain in the cow. Just 30 days of eating and drinking contaminated food and water would require 1.5 years for a cow to rid their system of the chemicals.”

April 25, 2019, the EPA released draft interim guidance for groundwater contaminated with PFOA/PFOS above 70 ppt, which is a “key component of the agency’s PFAS Action Plan,” according to the press release.30 While that’s great news, it seems clear we also need regulations for PFAS contamination in food and not just drinking water.

Sewage sludge — A major source of PFAS on farms

As recently reported by The Intercept,31 sewage sludge appears to be another major source of these toxic, persistent chemicals. Documents32 obtained by The Intercept reveal 44 samples of sewage sludge tested by the Maine Department of Environmental Protection all contained at least one PFAS chemical, and “In all but two of the samples, the chemicals exceeded safety thresholds for sludge that Maine set early last year.”

Maine’s tolerance levels for PFAS are set at 2.5 parts per billion (ppb) for PFOA, 5.2 ppb for PFOS, and 1,900 ppb for PFBS. Mike Belliveau, executive director of the Environmental Health Strategy Center in Portland, told The Intercept these levels are “probably about 10 times weaker than they should be,” adding, “Even low parts-per-billion levels of PFAS in sludge can threaten the health of the food supply.”

How do PFAS get into the food supply?

At present, authorities do not know exactly how the chemicals are entering the food supply, but there are several possibilities, and it’s likely to be a combination of factors. One is that the chemicals are leaching from food packaging.

Another theory is that when biodegradable packaging in which PFAS are used are composted, the chemicals enter the food chain via the compost.33,34 As noted in study35 published online May 29, 2019:

“The loads and leachability of 17 perfluoroalkyl acids (PFAAs) were analyzed in nine OFMSW [organic fraction of municipal solid waste] commercial composts and one backyard compost.

PFAA loads ranged from 28.7 to 75.9 micrograms/kilo for OFMSW compost that included food packaging and from 2.38 to 7.6 micrograms/kilo for composts that did not include food packaging.

Perfluorooctanoic acid (PFOA) and perfluorooctanesulfonate (PFOS) were detected in all composts; however, OFMSW composts were dominated by short-chain PFAAs (>64%) and perfluoroalkyl carboxylates (PFCAs, >68%), particularly the C6 PFCA.”

A third hypothesis is that they’re entering the food chain via contaminated groundwater. According to the U.S. Department of Defense, 90 military bases have groundwater contaminated with PFAS at levels exceeding the EPA advisory level,36 and PFAS have been found in local water systems across the country as well.37,38,39 When contaminated groundwater is used to irrigate crop fields, the chemicals then enter the food chain.

Researchers experiment with PFOA as cancer treatment

Curiously, while PFOA has been implicated in certain cancers, particularly kidney and testicular cancer, a 2018 study40 details a human experiment to test the chemical’s chemotherapeutic properties. According to this paper:

“The International Agency for Research on Cancer (IARC) categorized PFOA as a possible human carcinogen for testicular and kidney cancer (group 2B).

In light of this IARC qualitative hazard index listing and the presence of PFOA in the general population, it is highly unusual that an environmental toxicant such as PFOA would ever be considered for its chemotherapeutic properties.

Interestingly, PFOA has been shown to cause endoplasmic reticulum stress in tumor cells, activity against PIM kinases, and activity in 5 xenograft models of solid tumors.

Because PIM kinases can be overexpressed in many cancers that involve cell survival, cell cycle progression, and cell migration, inhibitors of PIM kinases have become a focus for drug discovery research, including APFO [ammonium perfluorooctanoate].

Based on APFO’s antitumorgenicity profile, a phase 1 trial was sponsored by CXR Biosciences, Ltd … to determine the safety, dose limiting toxicity, and maximum tolerated dose (MTD) of APFO …

The purpose of this paper is to describe this APFO phase 1 trial and the time-dependent relationships that were observed over the course of this study between administered doses of APFO, plasma concentrations of PFOA, and several clinical markers, including cholesterol, in the participating subjects.”

In all, 49 “primarily solid-tumor cancer patients who had failed standard therapy” received a weekly dose of APFO — an ammonium salt of PFOA — ranging between 50 milligrams and 1,200 mg for six weeks.

It’s worth noting that three of the researchers have declared conflicts of interest, having received grants from or been employed by 3M Company, a former manufacturer of PFOA.

I bring that up, seeing how they propose that health concerns over environmental PFOA exposure may be overblown, as they could find “no evidence of any major effects other than a decrease in total cholesterol (but not HDL) and an increase in fT4 (but not TSH) for increasing levels of PFOA plasma concentration,” despite reaching “levels of PFOA more than four orders of magnitude higher than the levels observed in general populations.” Only one subject exhibited signs of “dose-limiting toxicity.”

Doubtful PFOA is helpful rather than harmful

I wouldn’t shrug off concerns about PFOA (or any other PFAS) based on that study, however. There’s a far more robust body of evidence showing PFAS chemicals can cause harm even in minute doses.

In 2005, the EPA fined DuPont $16.5 million for violating the Toxic Substances Control Act by withholding decades’ worth of information about health hazards associated with PFOA. That same year (2005), a panel of scientists was convened to determine PFOA’s effect on human health.

The results of this seven-year investigation, which was completed in November 2013, are detailed in more than three dozen peer-reviewed papers, and link PFOA to:41

  • Ulcerative colitis
  • High cholesterol
  • Pregnancy-induced hypertension
  • Thyroid disease
  • Testicular- and kidney cancer

Its health effects were deemed to be widespread and occurred even at very low exposure levels. In 2015, a woman who sued DuPont, blaming her kidney cancer on PFOA-contaminated drinking water, was awarded $1.6 million in damages.42

This and other legal processes against DuPont uncovered internal documents showing the company was fully aware of the chemical's danger to the public and employees, yet continued using it and hid contamination problems.

Madrid Statement details health effects of PFAS

In May 2015, more than 200 scientists from 40 countries signed the so-called Madrid Statement on PFASs,43,44 which warns about the harms of all PFAS chemicals, both old and new. According to the Madrid Statement, health effects associated with the older, long-chain PFASs such as PFOA, include:45

Liver toxicity

Disruption of lipid metabolism, and the immune- and endocrine systems

Adverse neurobehavioral effects

Neonatal toxicity and death

Tumors in multiple organ systems

Testicular and kidney cancers

Liver malfunction


High cholesterol

Ulcerative colitis

Reduced birth weight and size


Decreased immune response to vaccines

Reduced hormone levels and delayed puberty

The Madrid Statement also points out the problem with replacing PFASs known to be harmful with other similar, but less scientifically evaluated, compounds, saying:

“Although some of the long-chain PFASs are being regulated or phased out, the most common replacements are short-chain PFASs with similar structures, or compounds with fluorinated segments joined by ether linkages.

While some shorter-chain fluorinated alternatives seem to be less bioaccumulative, they are still as environmentally persistent as long-chain substances or have persistent degradation products.

Thus, a switch to short-chain and other fluorinated alternatives may not reduce the amounts of PFASs in the environment. In addition, because some of the shorter-chain PFASs are less effective, larger quantities may be needed to provide the same performance.”

How to avoid PFAS chemicals

The Madrid Statement recommends avoiding any and all products containing or manufactured with PFASs, noting they include products that are stain-resistant, waterproof or nonstick. More helpful tips can be found in the EWG’s “Guide to Avoiding PFCS.”46 Other suggestions that will help you avoid these dangerous chemicals include avoiding:

Items that have been pretreated with stain-repellants, and opt out of such treatments when buying new furniture and carpets

Water- and/or stain-repellant clothing — One tipoff is when an item made with artificial fibers is described as “breathable.” These are typically treated with polytetrafluoroethylene, a synthetic fluoropolymer

Items treated with flame retardant chemicals47 This includes a wide variety of baby items, padded furniture, mattresses and pillows. Instead, opt for naturally less flammable materials such as leather, wool and cotton

Fast food and carry out foods — The wrappers are typically treated with PFCs

Microwave popcorn — PFCs not only may present in the inner coating of the bag, but they also may migrate to the oil from the packaging during heating. Instead, use “old-fashioned” stovetop popcorn

Nonstick cookware and other treated kitchen utensils — Healthier options include ceramic and enameled cast iron cookware, both of which are durable, easy to clean and completely inert, which means they won’t release any harmful chemicals into your home.

A newer type of nonstick cookware called Duralon uses a nonfluoridated nylon polymer for its nonstick coating. While this appears to be safe, your safest bet is still ceramic and enameled cast iron.

While some recommend using aluminum, stainless steel and copper cookware, I don’t for the following reasons: Aluminum is a strongly suspected causal factor in Alzheimer's disease, and stainless steel has alloys containing nickel, chromium, molybdenum and carbon.

For those with nickel allergies, this may be a particularly important consideration. Copper cookware is also not recommended because most copper pans come lined with other metals, creating the same concerns noted above. (Copper cookware must be lined due to the possibility of copper poisoning.)

Oral-B Glide floss and any other personal care products containing PTFE or “fluoro” or “perfluoro” ingredients — The EWG has an excellent database called Skin Deep48 you can peruse to find healthier options

Unfiltered tap water — Unfortunately, your choices are limited when it comes to avoiding PFASs in drinking water. Either you must filter your water or obtain water from a clean source. Both solutions can be problematic and/or costly.

While many opt for bottled water, it’s important to realize that PFASs are not regulated in bottled water, so there’s absolutely no guarantee that it’ll be free of these or other chemicals. Bottled water also increases your risk of exposure to hazardous plastic chemicals such as bisphenol-A, which has its own set of health risks.

Most common water filters available in supermarkets will not remove PFASs. You really need a high-quality carbon filtration system. The New Jersey Drinking Water Quality Institute recommends using granulated activated carbon “or an equally efficient technology” to remove PFC chemicals such as PFOA and PFOS from your drinking water.49 Activated carbon has been shown to remove about 90% of these chemicals.

Genetically edited babies might die young


In 2018, He Jiankui, a Chinese scientist, claimed to have created the world's first gene-edited babies. He modified the DNA of human embryos during in vitro fertilization by disabling a gene called CCR5, which could potentially make the babies resistant to infection with HIV.1

The babies, twin girls known as Lulu and Nana, were born in 2018,2 and a third baby with an edited CCR5 gene is due to be born in 2019.3 He's team received major backlash from the highly controversial move, as while the technology to genetically edit human babies has existed for some time, ethical considerations had stopped researchers from tinkering with the human germline.

In the case of editing germline cells, such as embryos, eggs and sperm, changes made to the genome will be inherited by future generations, potentially altering the course of evolution. What's more, it's becoming increasingly clear that altering even a single gene can lead to a cascade of unexpected changes.

Such is the case with the CCR5 gene, as new research published in Nature Medicine revealed that knocking out that gene may lead to negative effects on life expectancy, potentially shortening the gene-edited babies' life spans before they were even born.4

World's first gene-edited babies may die early

University of California Berkeley used genotyping and death register information of 409,693 individuals of British ancestry to determine the effects of mutations to the CCR5 gene, similar to what He's team altered in the "designer" babies. While they did, indeed, find that such individuals may have higher immunity against HIV, they also had a 21% increase in all-cause mortality rate.

In other words, those with CCR5 mutations were about 21% less likely to live to be 76 years. Study author Rasmus Nielsen, a professor of integrative biology at the University of California, Berkeley, told NPR, "This is a cautionary tale … What we found is that they had significantly increased mortality … It's rather substantial. We were quite surprised the effect was this large."5

Nielsen and colleagues believe altering the CCR5 gene may weaken immunity against other viruses, such as acquiring a fatal case of influenza.6 So a gene alteration that may be considered to be protective can quickly turn out to actually be harmful. Nielsen continued to The Telegraph:7

"Beyond the many ethical issues involved with the CRISPR babies, the fact is that, right now, with current knowledge, it is still very dangerous to try to introduce mutations without knowing the full effect of what those mutations do. In this case, it is probably not a mutation that most people would want to have. You are actually, on average, worse off having it."

What is CRISPR and CRISPR-cas 9?

CRISPR, or Clustered Regularly Interspaced Short Palindromic Repeat, allows scientists to modify an organism's DNA, leading to possibilities that were unheard of generations ago not only in the medical field but also in agriculture and manufacturing. By tweaking genetics, researchers could theoretically help prevent inheritable diseases or create hardier, more nutritious plants, for instance.

Whereas gene editing was once a very imprecise and expensive process, scientists can now go into your DNA and essentially cut and paste it at specified places. The technology can be traced back to bacteria, which protect themselves by cutting out invading virus' DNA and inserting it into their own, then replicating the new sequences to prevent future viral invasions.8

In 2012, researchers refined the system and revealed that any DNA (not just bacteria) has this ability — and the process works in humans.9 With CRISPR-Cas 9, the technology was said to be even more precise, acting as a pair of scissors to "snip" DNA at specific locations. As explained by the U.S. National Institutes of Health:10

"CRISPR-Cas9 was adapted from a naturally occurring genome editing system in bacteria. The bacteria capture snippets of DNA from invading viruses and use them to create DNA segments known as CRISPR arrays. The CRISPR arrays allow the bacteria to 'remember' the viruses (or closely related ones).

If the viruses attack again, the bacteria produce RNA segments from the CRISPR arrays to target the viruses' DNA. The bacteria then use Cas9 or a similar enzyme to cut the DNA apart, which disables the virus.

… Although Cas9 is the enzyme that is used most often, other enzymes (for example Cpf1) can also be used. Once the DNA is cut, researchers use the cell's own DNA repair machinery to add or delete pieces of genetic material, or to make changes to the DNA by replacing an existing segment with a customized DNA sequence."

Why the world has resisted the creation of CRISPR babies

While the U.S. National Institutes of Health does not provide funding for studies on gene-editing technologies in human embryos, CRISPR technology has already been used to edit human embryos made from sperm from men carrying inherited disease mutations. The researchers successfully altered the DNA in a way that would eliminate or correct the genes causing the inherited disease.11,12

Unlike in the Chinese study, the gene-edited embryos were only allowed to develop for a few days.13 There was no intention to implant them into a womb to develop into babies, but had this been done, the gene edits would have been passed on to future generations as well.

This is a large part of the controversy surrounding He's gene-edited babies. William Hurlbut, a scientist and bioethicist at Stanford, told NPR, "I think we're facing a very serious issue as a species here … This is not like other technologies. It's not like you're just dealing with an individual patient. You're now dealing with the entire human gene pool."14

Also problematic, He's genetic editing disabled CCR5 in an attempt to replicate the effect of a CCR5 variant called delta 32, which occurs naturally in about 10 percent of northern Europeans,15 but much less often in Chinese people.16

However, while it approximated the natural CCR5 mutation, it did not duplicate it exactly, leading some experts, like professor Robin Lovell-Badge, from the Francis Crick Institute, to call the study "foolish" and question whether it would work to prevent HIV in the babies:17

"It is impossible to predict if the mutations carried by the twin girls will have any effect … [the study] shows once more that He Jiankui was foolish to choose CCR5 to mutate."

As a result of the rogue study that many believe violated ethical rules, He was fired from his university position and criticized by Guangdong's health ministry.18 Yet, according to Hurlbut, at least one fertility clinic in Dubai has already contacted He to ask if he would teach the technology to his clinic. "You can see from this that there will be immediate uptake for application of this," Hurlbut said.19

Xinzhu Wei, another author of the study that found CCR5 mutations may shorten life span, added: "Because one gene could affect multiple traits, and because, depending on the environment, the effects of a mutation could be quite different, I think there can be many uncertainties and unknown effects in any germline editing."20

She also told BBC News, "The Crispr technology is far too dangerous to use right now for germ-line editing."21

CRISPR leads to unexpected off-target mutations

Warning bells have been sounded before when it comes to CRISPR, as the technology leads to unexpected mutations — even in the case of the "more precise" CRISPR-Cas 9. One study used a different method to search for unintended mutations, based on a separate study that used CRISPR-Cas9 to restore sight in blind mice by correcting a genetic mutation.

The researchers sequenced the entire genome of the CRISPR-edited mice to search for mutations. In addition to the intended genetic edit, they found more than 100 additional deletions and insertions along with more than 1,500 single-nucleotide mutations, raising concerns that testing CRISPR in humans may be premature, even with CRISPR-Cas 9.22

Study author Dr. Stephen Tsang of Columbia University Medical Center said that even a single change to a nucleotide could have a "huge impact."23 Indeed, in animals, gene editing has led to unexpected side effects, including enlarged tongues and extra vertebrate.24,25

Does CRISPR carry cancer concerns?

Off-target mutations that occur as the result of gene editing include rearranging chromosomes, inactivating essential genes or improperly activating others, such as cancer-causing genes.26

For instance, CRISPR-Cas 9 leads to the activation of the p53 gene, which works to either repair the DNA break or kill off the CRISPR-edited cell.27 CRISPR actually has a low efficacy rate for this reason, and CRISPR-edited cells that survive are able to do so because of a dysfunctional p53.

Unfortunately, p53 dysfunction is also linked to cancer (including close to half of ovarian and colorectal cancers and a sizable portion of lung, pancreatic, stomach, breast and liver cancers as well).28

In one study, researchers were able to boost average insertion or deletion efficiency to greater than 80 percent, but that was because of a dysfunctional p53 gene,29 which would mean the cells could be predisposed to cancer. Tinkering with genetics is an exciting field and one that holds great allure to scientists looking for fame and fortune, but the fact is there's a great number of unknowns when it comes to altering genetics.

It's quite possible, for instance, that using CRISPR to cure one chronic or terminal disease could come at the "cost" of a shortened life span or an increased cancer risk later.30 And if that's the case, do the benefits still outweigh the risks? Hurlbut told CNBC, "We want to be very careful, nature is a profound balance and if we intervene in a way that is not profound we can upset things."31

Is caution also warranted for gene-edited food?

The evidence is in favor of using extreme caution when proceeding with genetic tinkering of human germlines — if it should be done at all. Some scientists have called for a global moratorium on CRISPR babies,32 even as another area of gene editing — that of your food — is moving full-steam ahead.

A gene-edited soybean oil created by biotech company Calyxt, contains two inactivated genes, resulting in an oil with no trans fats, increased heart-healthy oleic acid and a longer shelf life — but with unknown effects on human health.

Although they're genetically engineered, gene-edited foods are not marketed as GMOs, nor are they labeled as such.33 What's more, Calyxt's gene-edited soybean oil is already on the market and being served at restaurants, so you could be eating it without even knowing.

As for gene-editing on embryos, it raises an even more profound question about informed consent — is it ethical for parents to alter their children's genetics without their consent? Questions such as these will only continue to mount as CRISPR and other gene-editing technologies race forward at an unprecedented pace.

Why mosquitoes develop resistance to pesticides


Despite their tiny size, mosquitoes have been called the world's most dangerous creature because they spread deadly diseases. More than half the people on Earth live in an area where disease-carrying mosquitoes are present and, every year, mosquitoes cause millions of deaths from diseases like malaria, dengue and yellow fever.1

Insecticides are considered to be one of the primary defenses against insects like mosquitoes, but they come with their own set of risks, not the least of which is the potential for resistance.

The growing problem of insecticide resistance has not gone unnoticed by the World Health Organization, which reported that resistance to four commonly used classes of insecticides — pyrethroids, organochlorines, carbamates and organophosphates — is already widespread in regions of Africa, the Americas, South-East Asia, the Eastern Mediterranean and the Western Pacific.2

Now, research published in the journal Oecologia has shown that mosquitoes are also developing resistance to commonly used agricultural insecticides, but their predators are not, creating the perfect environment for mosquitoes to flourish.3 Paradoxically, in this way insecticide usage could be leading to increased numbers of mosquitoes in some regions.

Mosquito predators may die while mosquitoes thrive

Researchers from Utah State University were conducting research on Costa Rican orange plantations when they realized they were getting an awful lot of mosquito bites — more so than they received in other areas. This led to the first part of the featured study, in which the researchers detected mosquito larvae flourishing in bromeliads, plants that hold small pools of water between the folds of their leaves.

When they compared the mosquitoes on orange plantations treated for decades with dimethoate, an organophosphate insecticide, with mosquitoes found in forests not treated with insecticides, they found double the mosquitoes in the orange plantations, but a lack of damselfly larvae, which are insects known to feast on mosquitoes.4

The researchers also exposed mosquitoes to dimethoate in the lab, which revealed not only that mosquitoes from orange plantations were 10 times more tolerant of the insecticide than the pristine forest mosquitoes, but also that damselflies from plantations succumbed to the chemicals, suggesting they have not developed resistance the away the mosquitoes have.5

"This evolved resistance to pesticides may, therefore, allow W. abebela [mosquitoes] to colonize habitats free of the dominant predator in the system, explaining the higher W. abebela abundances in pesticide-exposed areas than in pesticide-free locations," the researchers explained.6

Beyond Pesticides, a nonprofit organization leading a mission to transition to a world free of toxic pesticides, further explained that differences in biology of mosquitoes and their damselfly predators are compounding the insecticide resistance problem:7

"Life cycles of the mosquitoes studied are 12 to 24 times shorter than damselflies, providing mosquitoes with a faster opportunity to develop resistant individuals. Given this short life cycle, even a small number of resistant mosquitoes can rapidly repopulate an area with their improved genetics.

Damselflies just cannot catch up in time. This further increases the dominance of mosquitoes in an ecosystem. Without predators to tamp down their populations, mosquitoes are able to colonize new habitats. In this case, mosquitoes in chemical-dependent groves are able to lay eggs in larger bromeliads, whereas in pristine areas the presence of damselflies and other predators make this highly unlikely."

Mosquitoes genetically adapt while predators are poisoned

One of the mechanisms that allows mosquitoes to so efficiently develop resistance to pesticides is through the overproduction of specific enzymes, as follows:8

  • Carboxylesterases, which are efficient against organophosphate and carbamate insecticides
  • Glutathione-S-transferases, or GSTs, which are efficient against organophosphates, organochlorine and pyrethroid insecticides
  • Cytochrome P450-dependent monoxygenases, which are efficient against most insecticide types, often in conjunction with other enzymes

At least one study, in which researchers analyzed more than 760 mosquito genes possibly involved in insecticide resistance, revealed that an increase in activity of detoxification enzymes in resistant insects was triggered by a rise in the copies of genes coding for the enzymes.9,10

Mosquitoes in at least 68 countries resistant to insecticides

According to a WHO global report on insecticide resistance in malaria vectors like mosquitoes, 68 countries have reported mosquitoes resistant to at least one class of insecticide, while 57 of them report resistance to two or more classes.11

That being said, as of February 2019, only 40 countries have completed insecticide resistance monitoring and management plans as recommended by WHO's report, leading the Organization to suggest that their understanding of the extent of the problem is incomplete.

The global fight against malaria is centered on insecticide application and distribution of insecticide-treated bed nets, but insecticide resistance renders these "weapons" highly questionable.

As for insecticide-treated bed nets, which are treated with pyrethroids, a five-year evaluation conducted across five countries found that mosquitoes were resistant to pyrethroids in all of the areas tested, but those using the nets still had significantly lower rates of malaria infection than those who did not.12

According to WHO, "They attributed the continued efficacy of LLINs [long-lasting insecticidal nets] to the barrier provided by the nets themselves and to the fact that, even in areas where mosquitoes have developed resistance to pyrethroids, treated nets may still kill the mosquitoes."13

One WHO scientist suggested that resistant mosquitoes landing on the treated nets may not die right away, but if they continue to be exposed to the insecticides while trying to find a way through the net, it's possible the higher exposure could eventually kill the mosquito.14 However, other studies have found that both treated and untreated nets have a "clear protective effect against malaria."15

Insecticide usage leads to devastating 'trophic cascades'

Applying insecticides and other pesticides is creating resistant bugs along with a host of other problems, as such chemicals do not exist in isolation. When they're applied in the environment, they lead to what Beyond Pesticides described as "trophic cascades."

"Beyond direct toxicity, pesticides can significantly reduce, change the behavior of, or destroy populations of plants and animals. These effects can ripple up and down food chains, causing what is known as a trophic cascade. A trophic cascade is one easily-understood example of ecosystem-mediated pesticide effects," the organization noted.16

They used the example of the organophosphate insecticide malathion, which is sometimes applied to aquatic environments for mosquito control. It's typically applied in low doses over the course of several weeks for this purpose. Researchers tested the effects of applying the chemical in this way as compared to a one-time exposure, such as may occur due to agricultural runoff, to a variety of plankton and tadpoles.

Both types of exposure were damaging, though the continued low-dose exposure was the worst. According to Beyond Pesticides, the trophic cascades in aquatic environments caused by insecticide exposure show the complexity of ecosystems and the widespread effects that insecticides cause:17

"In both instances, malathion's impact on zooplankton caused a trophic cascade. By depressing the zooplankton population, phytoplankton flourished. The increase in free-floating algae clouded water, decreased light penetration, and led to reduced periphyton growth.

Decreases in periphyton algae, the primary food source for tadpoles, retarded growth and development in leopard frogs, which prevented many from metamorphosing before the vernal pool in which they resided dried up (though wood frogs were generally unaffected).

While zooplankton in the single-application mesocosm eventually experienced a population rebound, it took nearly a month and a half before this occurred. Overall, frogs in single-application mesocosms fared slightly better than those in chronically exposed tanks, which experienced an ongoing state of disruption that never permitted zooplankton populations to bounce back."

Genetically engineered mosquitoes released

In January 2018, lab-bred Aedes aegypti mosquitoes carrying wolbachia bacteria were released in South Miami, Florida. It was the first phase of the Miami-Dade County Mosquito Reduction Test Program, which targeted a one-half square-mile treatment area that received the altered mosquitoes and a corresponding control area within the city.

Over a six-month period, the genetically engineered mosquitoes were released into an approximately 170-acre area. Interest in releasing lab-made mosquitoes has peaked in recent years in response to the Zika virus scare, which has since petered out in the U.S.

The project was conducted by the Miami-Dade County Mosquito Control & Habitat Management Division in collaboration with MosquitoMate, Inc., which created the technology.

MosquitoMate's lab-bred male mosquitoes are infected with wolbachia bacteria, which is naturally occurring in up to 60 percent of insect species, but not in Aedes aegypti mosquitoes. When the male wolbachia mosquitoes mate with female mosquitoes in the wild (which do not carry the bacteria), the resulting eggs do not hatch, which means the number of Aedes aegypti mosquitoes in the area should ultimately decrease.18

The project was said to be a success, showing a 75 percent reduction in mosquitoes in the area, due to egg hatch failure.19,20 However, once genetically engineered mosquitoes are released (as they already have been), there's no stopping them from mingling with wild mosquitoes.

While this may help to reduce the spread of certain viruses (although this remains to be seen), it may also have other unintended, as yet unknown consequences. There's also the potential ramifications to the ecosystem of eliminating the insects, which can occur whenever any species is removed or drastically reduced — even species we deem to be pests.

While mosquitoes are primarily viewed as a nuisance and vector for deadly diseases like malaria, there may be "undesirable side effects" of eradicating them entirely, according to Florida University entomologist Phil Lounibos, Ph.D. BBC News reported:21

" … [Lounibos] says mosquitoes, which mostly feed on plant nectar, are important pollinators. They are also a food source for birds and bats while their young — as larvae — are consumed by fish and frogs. This could have an effect further up and down the food chain …

He warns that mosquitoes could be replaced by an insect 'equally, or more, undesirable from a public health viewpoint.' Its replacement could even conceivably spread diseases further and faster than mosquitoes today."

Tips for avoiding mosquitoes

It's definitely something to consider, although you can also take sensible precautions to avoid getting bitten. Wear long sleeves and pants if you know you'll be outdoors in a mosquito-prone area and use natural insect repellants (not synthetic chemical versions), like cinnamon leaf oil, citronella essential oil or catnip oil, as necessary.

If mosquitoes are bothering you in your backyard, a house fan can keep them away while you're outdoors, as can the strategic planting of marigolds, which mosquitoes tend to stay away from.

Draining standing water, including pet bowls, gutters, garbage and recycling bins, spare tires, bird baths and children's toys, is also important to encourage mosquitoes to live elsewhere. This is where mosquitoes breed, so if you eliminate standing water you'll eliminate many mosquitoes. Finally, try installing a bat house, as mosquitoes are one of their favorite meals.

Protect your gums and your brain with K2


Has it ever occurred to you that the overall picture of your dental health is really a reflection of your physical health? That's the premise of Dr. Steven Lin, a dentist who uses a holistic approach and who says less-than-stellar oral health results from issues in other parts of your body.

According to Lin, if people view their mouth as the "gatekeeper" of their gut and keep their microbiome balanced and healthy, the positive results will show themselves in a healthy mouth — teeth, gums and all — and a healthier body overall.

By all means, brush your teeth after meals and floss daily, but besides looking at your teeth and your microbiome, Lin suggests that the next thing to look at is the content of your kitchen cabinets and refrigerator or, more precisely, the foods you put in them and subsequently into your mouth. Maintaining a healthy diet that includes enough vitamin K2 will benefit your teeth and gums from the inside out.

In fact, using this approach with children could ensure they grow up without such issues and even develop naturally straight teeth. For adults, focusing on the gut first could mean never having to get fillings, not to mention other dental procedures many dentists and orthodontists insist on as a matter of course.

One of the biggest problems people have in regard to gum disease is that they're lacking in vitamin K2, aka menaquinone, which causes bleeding gums. Over time, it could mean the loss of gums and bone. But even if you begin supplying more K2 to your body, unfortunately, your gums and bone don't grow back.

Finding the key in vitamin K2 ended up changing Lin's approach to dentistry. In fact, Lin says it's all related to vitamin K2, both inside and outside your teeth. He shows how gun disease can be prevented and how it can be stopped in its tracks — if it's caught early enough — and why it's important to cure the cause, not just treat the symptoms.

What is periodontal disease?

Lin describes his bewilderment when some patients who cleaned their teeth faithfully nevertheless suffered worsening gum disease. He began wondering if the cause went beyond just plaque build-up on teeth. The bottom line is this:

"Gum disease (periodontal disease) is a long-term chronic disease. It's an inflammatory condition that often progresses without response to treatment. While small amounts of gum regeneration may be possible and surgical options are there, the broad answer is that it's irreversible."1

The term periodontium refers to two structures that comprise your gums: the cementum and the alveolar bone. Merriam-Webster2 describes the periodontal ligament (PDL) as the fibrous connective tissue layer that covers the cementum of a tooth and holds it in place in the jawbone. This is the area the disease attacks, and it occurs in stages:

  • Mild periodontitis — Gingivitis or bleeding gums
  • Moderate periodontitis — Loss of ligament attachment, pocketing or receding gums
  • Severe periodontitis — Alveolar bone loss and deep gum pocketing
  • Advanced periodontitis — Loose, mobile teeth and tooth loss

It's clear that people who experience the first stages of gum disease are given fair warning when their gums begin bleeding, usually while brushing their teeth. Over time, perhaps a shorter time for some than others, the disease results in lost teeth.

Your gingiva is the part of your gum around the base of your teeth, which is why the first signs of gum disease, such as redness, inflammation and often pain, is called gingivitis. But what many don't realize is that gum disease is inflammation-based, and vitamin K2 can make all the difference.

How K2 and vitamin D help your teeth, gums and more

More specifically, it signals a "loss of tolerance between your oral microbiome"3 and an unbalanced immune system. Bleeding gums are also connected to your vitamin D status. Vitamin K2 is a cofactor for vitamin D and calcium to support bone health, but it also helps reduce inflammation and the factors involved with gum disease by:

  • Decreasing the production of inflammatory markers
  • Regulating immune cells that cause inflammation
  • Decreasing fibroblast cells

Vitamin K2 and vitamin D (along with calcium and magnesium) have a synergistic relationship. Calcium strengthens your bones and enhances overall skeletal health, but only works when it gets to the right place. Vitamin K2 directs calcium into the bone and prevents it from being deposited along blood vessel walls. According to Lin, K2 mediates gum inflammation two ways:

"It decreases fibroblasts known to fuel the gum disease process. In the healing process, fibroblasts act to form scar tissue. But in gum disease, their action is harmful and could advance the calcification of periodontal ligament — an early sign of gum disease.

It activates Matrix GLA protein: This Vitamin K2 dependent protein has been shown to prevent the calcification of the periodontal ligament. Many studies have shown that Vitamin K2 has the same anti-calcification effects around the body, including in the heart, kidneys and prostate."4

Matrix GLA protein, as explained in one study,5 is important because it inhibits calcification. To that end, there are other vital nutrients that work with K2 to promote oral health.

For example, human gingival fibroblasts (HGFs) are described in a Japanese study6 as the most abundant structural cell in periodontal tissue. Other research shows that HGFs may act as "accessory" immune cells7 that work to amplify immune responses to lipopolysaccharides,8 which are found in the outer membranes of infection-causing bacteria that cause inflammation and promote tissue destruction.

Another substance that quells inflammation is Coenzyme Q10, also known as CoQ10, which is produced in your body naturally. One study notes that CoQ10 "decreased oxidative DNA damage and tartrate-resistant acid-phosphatase-positive osteoclasts in the periodontal tissue"9 while suppressing inflammation.

The role vitamin K2 plays in your brain

Probably the most obvious way K2 makes such a difference in your oral health, then, is the way it works with vitamin D to help reduce all that inflammation and to regulate immune cells. In your brain, it may help prevent heart disease, cardiac embolism and stroke10 because matrix-GLA protein benefits both your brain and your heart.

Another way it expresses itself is through your central and peripheral nervous systems; it may even be an antioxidant in your brain, one study observes. Conversely, research shows how the drug warfarin can reduce vitamin K2 in your system:

"The relationship between vitamin K status and cognitive abilities needs to be further investigated. Notably, and despite the methodological challenges that such studies entail, it would be important to determine the long-term effect of warfarin therapy on cognitive abilities.

A potent anti-vitamin K agent, warfarin is widely prescribed for the prophylaxis and treatment of thromboembolic conditions … As individuals treated with warfarin are in a relative state of vitamin K deficiency, they could be at higher risk of cognitive problems based on the actions of vitamin K in the nervous system."11

Vitamin K2, working with K1, seems to enhance the effects of glutathione to prevent nerve cell death as well as brain damage.12 K2 also may be significant in its role of preventing neurodegenerative damage by preventing both oxidative stress and brain inflammation.13

Lin notes that low vitamin K2 appears to negatively influence incidences of Alzheimer's disease14 and, overall, either eating adequate K2 or taking it in supplement form is important for preventing degenerative disease and promoting optimal brain function.15

One of the effects of being vitamin K2 deficient is that it produces the symptoms of vitamin D toxicity, which includes inappropriate calcification of soft tissues that can lead to atherosclerosis.16

Osteocalcin — Crucial in healing gum disease

Lin says the first order of business in halting gum disease is calming the immune system, and at the first sign of bleeding gums, your vitamin K2 intake should increase. This is because your ability to repair damage from gum disease is dependent on the release of vitamin K2-activated proteins.

That's where osteocalcin comes in. Osteocalcin17 is a protein hormone found in bone and dentin. Gum tissue releases it where there's inflammation and gum disease, particularly in postmenopausal women.18 In fact, it's crucial for your body's ability to heal gum disease.

If you're deficient in vitamin K2, your body may release osteocalcin, but it won't be active. Osteocalcin also increases your insulin sensitivity,19 so Type 2 diabetes and advanced gum disease are both associated with this protein. According to Lin:

"Vitamin K2 has a critical role in bone loss in both gum disease and osteoporosis. Vitamin K2 inhibits bone loss through resorption by inducing osteoclast apoptosis. The severity of bone loss in gum disease is worse in the presence of osteoporosis."20

Lin says that while further studies are needed, gum disease and vitamin K2 are linked because K2 is a central mediator in inflammation, immune regulation, matrix-GLA protein and osteocalcin. Anyone noticing bleeding gums or advanced stages of gum disease can consider taking vitamin K2 supplements, but also to begin eating more foods that will help supply it.

How to get more vitamin K2

Foods with significant amounts of vitamin K2 are rare, Lin adds, so you need to be intentional about it because you're probably not eating enough. It's important to know that how foods that contain K2 are treated and prepared because this makes a difference in the amount that is ultimately made available to your body.

With that in mind, Lin explains that if K2 is derived from animals, they must be pasture raised. Brie and Gouda cheese, for instance, are particularly high in K2, as is grass fed butter or ghee and organic, pastured eggs. Lin's partial list of K2-rich meats21 include:

  • 2 to 2 oz. of pastured chicken, duck or goose liver pate
  • 6 to 12 oz. of pastured chicken legs or thigh meat
  • 2 to 3 slices of organic, grass fed beef or lamb liver

One reason you want to choose only pastured beef is because if cows are fed soy or grains, they won't get K1, which means they won't be able to convert it to K2. If cows eat "dead" hay that no longer has the proper nutrients, they may not produce K2-rich dairy products. In addition, Lin says:

"One dozen eggs a day from caged hens won't supply enough K2 for your daily requirement, whereas two to four eggs a day from pasture-raised hens may provide adequate K2 … Fermented foods also provide a different form of vitamin K2, however it needs to be cultured properly and then stored in a refrigerator, not pasteurized or contaminated. Today we eat far less fermented food rich in Vitamin K2."22

In the plant world, leafy greens are an excellent source of vitamin K1, and your choices come from more than just types of lettuce. They extend to turnip greens, mustard greens, collard greens, beet greens and, of course, spinach and kale.

Needless to say, though, organic greens are optimal choice, in light of information from the Environmental Working Group's 2019 Dirty Dozen23 list: The plant-based foods with the heaviest toxic load from pesticide overspray include spinach and kale in the No. 1 and No. 2 spots.

For vitamin K2, however,24 nattokinase (natto), which is fermented soy, is one vegetarian source of vitamin K2. Fermentation removes the disadvantages associated with eating raw or cooked soy. Other good sources of K2 include vegetables fermented at home using a starter culture of vitamin K2-producing bacteria.

If you think you may not be getting enough vitamin K2, besides eating grass fed raw dairy products, meat, eggs and fermented foods, supplementing is another option, but it should be menaquinone-7, or MK-7, a form of vitamin K2, which stays in your liver and helps support strong bones, but also helps reduce incidences of heart disease and cancer.25

I recommend getting around 150 micrograms (mcg) of vitamin K2 per day, although others recommend slightly more, such as 180 to 200 mcg per day.

Homeopathy for asthma


Asthma is a chronic condition affecting the airways. Inflammation makes your airways swell, triggering wheezing, shortness of breath and coughing. Symptoms may range from mild to severe and may happen rarely or every day. For most people, the condition starts during childhood and becomes a lifelong condition.

The goal of conventional medicine is to manage symptoms and avoid exacerbations, which are called asthma attacks. According to recent data from the Centers for Disease Control and Prevention (CDC),1 7.9% of adults and children currently hold a diagnosis of asthma.

The children's age group most affected is 5- to 14-year-olds, of whom 9.7% have asthma. Boys have a greater incidence than girls, but women have a greater incidence than men. Conventional treatment2 is aimed at managing symptoms to allow the individual the ability to engage in normal everyday activities, and realistically is only a stopgap measure.

The types of treatments used will depend upon age, severity and response to the treatment option. Many with asthma use daily medication for long-term control and short-term relief inhalers during an asthma attack. In addition to identifying environmental factors triggering asthma attacks, homeopathic treatments may offer enough relief to reduce or eliminate pharmaceutical drugs.

However, while asthma is amenable to homeopathic treatment, the British Homeopathic Association3 recommends treatment with a homeopathic professional and not self-treatment to find the best remedies for your specific condition.

History of homeopathy

The practice of homeopathy was popular in the U.S. and Europe in the 1800s. Some of its strongest advocates were European royalty, American entrepreneurs and literary giants. However, while gaining popularity, it has become the object of opposition from established Western medicine.4

Homeopathy began with the discoveries of Samuel Hahnemann, a German physician who coined the word homeopathy to refer to pharmacological principles. The basis is a "law of similars," previously described by Hippocrates and utilized in many cultures, including the Mayan, Chinese, Greek and Native American cultures.

By the time Hahnemann was 24 he could read and write in at least seven languages and ultimately translated over 20 major medical textbooks. The premise Hahnemann worked under was identifying small doses of compounds triggering biological changes.5

Coincidentally, in 1798 the discovery of giving small doses of cowpox to immunize against smallpox was generally accepted, while Hahnemann's work was not.

Many of the initial practitioners in homeopathy graduated from prestigious medical schools, yet orthodox medicine was threatened because homeopathic practitioners offered an integrated and systematic approach for therapeutic practice and were sharply critical of the use of conventional drugs.

Homeopaths believed masking an individual's symptom, as opposed to treating the underlying condition, could create deeper and more serious disease,6 which history has shown to be the true in many cases. By 1882 the American Medical Association (AMA) had purged their ranks of all homeopathic practitioners.

They also established a code of ethics asserting any physician would lose their membership if they even consulted with a homeopath. At the time, without membership in a local medical society a physician no longer had a license to practice medicine.

Despite this oppression, the practice thrived in the 1800s and early 1900s. However, while popular among the rich and poor alike,7 the most likely reason it survived was the success homeopathic treatment enjoyed in treating infectious epidemic diseases during the 1800s.

Basics of homeopathy

Statistics showed the death rate in homeopathic hospitals were one-half to one-eighth those found in orthodox medical hospitals. In 1849 during the cholera epidemic, Cincinnati homeopaths were so successful they published a list of those who were cured and those who died. Only 3% of their patient population died while from 48% to 60% of those under orthodox medical treatment died.8

After the 1900s, the AMA became increasingly effective at suppressing the practice and by 1910 the Carnegie Foundation issued the infamous Flexner Report, an evaluation of medical schools. The report gave homeopathic colleges poor ratings based in part on faculty who continued in clinical practice and schools offering courses in pharmacology, which was not considered worthwhile.

As a result, those who graduated from schools without a high rating were not allowed to take the medical licensing examination. The decline of homeopathic practice may also have been associated with poor economic viability as it demands more time with the patient.9

In Hahnemann's practice, he based treatment on the totality of symptoms and prescribed one medication at a time. However, as the practice of homeopathy progressed, others prescribed medicines for specific symptoms as opposed to the underlying condition.

Currently, homeopathic remedies are essentially nanomedicines. The premise on which homeopathic treatments have been made for over a century is that the more diluted the remedy, the more effective it becomes. These nano doses may penetrate the blood-brain barrier and cellular membranes with greater ease, without triggering a defense mechanism.10

Additionally, there are no side effects and no adverse reactions. To date there are more than 300 double-blind placebo-controlled trials on homeopathy published in peer review medical journals, including:

The Lancet11

BMJ (British Medical Journal)12,13

Chest (the publication of the American College of Chest Physicians)14

Pediatrics (publication of the American Academy of Pediatrics)15

Cancer (journal of the American Cancer Society)16

Pediatrics Infectious Disease Journal (publication of the European Society of Pediatric Infectious Diseases)17

European Journal of Pediatrics (publication of the Swiss Society of Pediatrics and the Belgium Society of Pediatrics)18

Asthma affects millions

The exact cause of asthma is unknown, and it may vary from person to person. Researchers believe it is the result of a strong immune response to an allergen in the environment, such as seasonal proteins or pet dander. These make their way into the airway, where the immune system reacts strongly.

According to Asthma and Allergy Foundation of America,19 African-Americans in the U.S. die from asthma at a higher rate than people of other ethnicities. It is the leading chronic disease in children and the top reason children miss school days. In 2013, 13.8 million school days were missed that could be attributed to asthma.

Every day, 10 Americans will die from asthma, and many of those deaths may be avoidable with proper treatment and care. Adults are four times more likely to die from an asthma attack than a child, and women are more likely to die than men. According to the CDC,20 the economic burden of asthma is greater than $80 billion per year in medical expenses, days missed from work and school, and death.

However, researchers believe these numbers are likely higher21 as data only included individuals treated for asthma, defining this as having at least one medical encounter for asthma or prescription filled within the calendar year. Additionally, the information in the study did not account for nonmedical costs such as transportation and diminished productivity at work or school.

Signs and symptoms of asthma include chest tightness, coughing, shortness of breath and wheezing, which triggers a whistling sound as you exhale. Attacks may happen suddenly and may be life-threatening.22

Symptoms may get worse with viral infections, can be triggered by exercise, allergies, cold air or hyperventilation, and may be worse at night or early in the morning. Those living with asthma may find their symptoms increase and decrease over time, or even within the same day.

Homeopathic remedies for asthma

Your homeopathic professional will identify a remedy to help your body reduce or eliminate breathing difficulties associated with asthma. As a result, you may expect to spend about an hour with your homeopathic practitioner as they determine the best medications to try first. Homeopathic remedies commonly prescribed for asthma include:23,24,25,26,27,28

Ipecacuanha — Prescribed for sudden wheezing and cough with constant gagging and vomiting, the medication is from a creeping shrub, Cephaelis ipecacuanha, native to Brazil. Patients presenting with a chest rattle, symptoms worsening in warm humid weather or heat, sweating, feeling clammy or nauseous may benefit.

Arsenic album — This may be prescribed for difficulty breathing at night, thirstiness accompanied by frequently sipping water and anxiety related to breathing difficulty. The person may feel exhausted but restless and anxious. They have more difficulty breathing while lying down and symptoms are usually more intense between midnight and 2 a.m.

Natrum sulphuricum — This is prescribed for asthma occurring in damp weather when the patient is reporting thick, green sputum.

Nux vomica — This is prescribed for asthma symptoms that happen with an upset stomach; attacks are worse in the morning, after eating or during dry weather.

Lobelia inflata — This is prescribed when there is over inflation of the lungs and shortness of breath out of proportion to wheezing. It may be triggered by anxiety, leading to working unnecessarily hard to breathe, or in smokers.

Asthma attacks during labor and delivery may be helped with Lobelia inflata. Those who get relief also find cold, damp weather tends to make their asthma worse, while slow, deep breathing makes it better.

Antimonium tartaricum — This has traditionally been used as an emetic, inducing vomiting. Doses used in homeopathy are infinitesimally small and this may be used with some benefit in children and the elderly when the symptoms are associated with an infection and a lot of mucous. Other symptoms may include respiration that is rapid and difficult, and mucus that is expelled with difficulty.

Sambucus nigra — The extract from the elderberry is also used as an antiviral. In homeopathy it may be beneficial to those who feel like they are suffocating at night or whose symptoms are worse between midnight and 3 a.m.

Natrum sulphuricum — This is useful in children and adults in asthma symptoms worse near 4 a.m., during damp weather and before menstruation.

Pulsatilla — This may used when asthma symptoms appear when the person gets warm or eats rich foods. Yellow-colored mucus with gagging and choking and tightness in the chest in the evening or night relieved by cool fresh air may indicate you will benefit from Pulsatilla.

Spongia tosta — When there is a hard, barking, dry cough associated with the asthma it is a strong indication for this remedy. The person may find warm drinks are helpful or sitting up with the head tilted backward. The symptoms are more common before midnight at night.

Balanced omega fats may reduce symptoms of asthma

If you struggle with asthma, also consider your omega-3 intake. Your body needs a balance between omega-6 and omega-3 fatty acids. Unfortunately, most Americans eat a diet too high in omega-6 and too low in omega-3.29 A study from Johns Hopkins Medicine30 demonstrated children diagnosed with asthma who had higher levels of omega-3 fat also had fewer asthma symptoms.

In the study,31 data was gathered from 135 children from age 5 to 12. Roughly one-third of the children had mild symptoms of asthma, one-third had moderate and one-third had severe symptoms. Data on diet, symptoms and inhaler use were gathered through questionnaires.

The researchers were focused on exposure to air pollution and subsequent asthma symptoms. They found children with higher intake of omega-3 had a lower asthma response to indoor air pollution and appeared to be more resilient. The study adds to a growing body of evidence suggesting dietary intake has an influence on your body's response to air pollution and may help reduce asthma symptoms.

Weekly health quiz — Magnesium, measles and grounding


1 Which of the following nutrients helps shuttle magnesium to the cells that need it most, thereby augmenting the benefits of magnesium and reducing symptoms of magnesium deficiency?

  • Vitamin B6

    Vitamin B6 escorts magnesium to the cells that need it most, thus ensuring that the magnesium you're getting, whether from foods or supplements, is being used as efficiently as possible. Vitamin B6 thus helps augment the many benefits of magnesium. Learn more.

  • Calcium
  • Vitamin K2
  • Vitamin D

2 Which of the following scenarios will grant you lifelong immunity against wild measles infection?

  • Being vaccinated with a single dose of measles vaccine
  • Recovering from measles infection

    The only way to get lifelong immunity is to successfully recover from measles infection. Learn more.

  • Receiving two or three doses of measles vaccine
  • 100% of a population being vaccinated against measles with one or more doses of measles vaccine

3 Which of the following chemicals is the most heavily used agricultural chemical in history?

  • Atrazine
  • 2,4-D
  • Glyphosate

    Glyphosate, the active ingredient in Monsanto's Roundup herbicide — identified as a probable human carcinogen by the International Agency for Research on Cancer in 2015 — is the most heavily used agricultural chemical in history. Learn more.

  • Dicamba

4 Which of the following supplements has been shown to significantly improve anxiety and other symptoms of chronic stress?

  • Astaxanthin
  • Curcumin
  • Vitamin E
  • Ashwagandha

    Ashwagandha is a powerful adaptogenic herb that helps your body manage and adapt to stress. Compared to placebo, ashwagandha has been shown to significantly reduce anxiety and other symptoms of stress. Learn more.

5 Which of the following strategies is a proven strategy that can help solve many of our most pressing environmental and health problems, including food security, malnutrition, water scarcity and topsoil degeneration?

  • Widespread implementation of regenerative gardening and farming

    Widespread implementation of regenerative agriculture and biodynamic farming is the answer to many of our most pressing environmental and health problems, including food security, malnutrition, water scarcity, topsoil degeneration and more. Classes on regenerative gardening and lifestyle are offered by the nonprofit Kiss the Ground, June 18 through July 31, 2019. Sign up now for early bird registration. Learn more.

  • Turning wetlands into farmland
  • Eliminating diversity to focus on staple food crops
  • Increased use of synthetic chemicals that are inexpensive to manufacture

6 Grounding's positive effects are achieved by

  • removing the constriction of shoes
  • neutralizing free radicals with the negatively charged electrons from the Earth

    Grounding's positive effects are achieved by neutralizing free radicals with the negatively charged electrons from the Earth. Learn more.

  • relaxation from being in nature
  • exposure to the clay found in soil

7 Which of the following is a key prevention strategy for sarcopenia?

  • Getting plenty of rest
  • Aerobic exercise
  • Muscle strengthening activities

    About 50% of 80-year-olds have sarcopenia (loss of muscle mass). One of the key prevention strategies for sarcopenia is to stay active and use your muscles as much as possible. This is also why strength training is so highly recommended for seniors. Learn more.

  • Exercises that focus on flexibility

How to use the top 10 medicinal plants and herbs


Before the advent of drugs, plant remedies were the go-to medicines, and they can serve you just as well today as in the past. While there are many thousands of plants, any one of which can serve a medicinal purpose, some are better known than others, and can provide relief from common ailments.

Here, I’ll review the use and benefits of 10 important herbs and medicinal plants, many of which you can grow yourself to ensure you always have some on hand.

No. 1 — Aloe vera

Aloe vera1 is a succulent plant well-known for its soothing qualities, especially for skin conditions such as burns, rashes, cuts and scrapes, but also for more serious skin conditions such as psoriasis. I have hundreds of aloe plants at my home and harvest them every day for topical use on my skin and also for eating. It is one of my medicinal plants.

In one animal study,2 an ethanolic extract of aloe vera gel had an overall antipsoriatic activity of 81.9%. Its wound healing abilities stem from the gel’s disinfectant, antimicrobial, antiviral, antifungal, antibiotic and antibacterial properties.

Properties related to a compound called glucomannan also help accelerate wound healing and skin cell growth. As an adaptogen,3 aloe vera gel may also be used internally to help your body adapt to stress.

Aloe vera contains about 75 potentially active compounds, including lignin, saponins, salicylic acids and 12 anthraquinones (phenolic compounds traditionally known as laxatives). It also provides campesterol, β-sisosterol and lupeol, and the hormones auxins and gibberellins that help in wound healing and have anti-inflammatory action.4

The pulp contains most of the healing compounds, including5,6 polysaccharides7 such as mannose (which is great for gut health and has immune-boosting benefits), essential amino acids your body needs but cannot manufacture, polyphenol antioxidants, sterols (valuable fatty acids), vitamins and minerals.

While you can purchase aloe vera gel at most health food stores and pharmacies, if you grow your own, you’ll always have fresh aloe on hand when cuts, scrapes or even psoriasis flare-ups occur. For medicinal use, be sure to select an aloe species with thick, “meaty” leaves. A good choice, and one of the most popular, is Aloe Barbadensis Miller.8

To harvest, select an outer, mature leaf, and using a sharp knife, cut the leaf as close to the base as possible. Remove the spines by cutting along each side.

  • For topical use — Simply cut a 1- to 2-inch piece off, then slice it down the middle, revealing the gel, and apply it directly to your skin. Aside from soothing burns, including sunburn, or cuts and scrapes, it also works great as an aftershave for men. For sunburn, fresh aloe gel is the most effective remedy I know of, besides prevention.
  • For internal use — If you’re going to eat it, you can use a potato peeler to peel off the outer rind, then scrape off the gel and place it in a small glass container. I like mixing mine with some lime juice. Simply blend together with a handheld blender for a delicious immune-boosting aloe shot.

While fresh aloe vera is very safe, you should not use it internally or externally if you’re allergic. If you’re unsure, perform a patch test on a small area and wait to make sure no signs of allergic reactions occur.9,10,11

No. 2 — Lemongrass

Lemongrass, an herb noted for its distinctive lemon flavor and citrus aroma, has been used traditionally to treat stomach aches, high blood pressure, common cold, convulsions, pain and vomiting.12 Lemongrass benefits listed by Organic Facts include:13

“[R]elief from insomnia, stomach disorders, respiratory disorders, fever, pain, swelling, and infections. The antioxidant activity of the lemongrass herb maintains the immune system and protects against antibiotic-resistant Staphylococcus aureus.

It even helps in maintaining optimum cholesterol levels, managing type 2 diabetes, and promoting healthy skin. It is extensively used in aromatherapy and helps combat fatigue, anxiety, and body odor.”

The leaves and extracted essential oil are the parts most commonly used, and depending on the form can be taken orally, applied topically or inhaled (as aromatherapy) for the following conditions:

Relieve stress, anxiety, irritability and insomnia by diffusing a few drops of lemongrass essential oil.14

Relax and tone your muscles; relieve muscle pain, period cramps and headaches by rubbing a few drops of the essential oil mixed with carrier oil onto the area, or diffuse as an aromatherapy treatment.

Energize tired feet by mixing essential oil and 2 tablespoons of Epsom salts in a bowl of warm water — You can also create your own foot massage oil by mixing diluted lemongrass oil with a carrier oil such as coconut oil, and adding other essential oils as desired, such as sweet almond, geranium and sandalwood.15

Treat cuts and scrapes by rubbing a small amount of diluted essential oil over the area — Lemongrass essential oil has antibiofilm properties against staphylococcus aureus16 and interrupts the growth of bacteria in the body.17

Treat gastrointestinal problems by consuming lemongrass tea or lemongrass-infused water — Lemongrass oil has anti-ulcer effects,18,19 stimulates digestion and helps regulate bowel function.20

Improve sleep by drinking a cup of lemongrass tea or lemongrass-infused water before bed.21

Relieve pain associated with headaches, muscle and joint pain, muscle spasms and sprains, either by applying diluted essential oil topically, inhaling the scent by diffusing the essential oil, or by drinking lemongrass tea or infused water.

Improve insulin sensitivity by drinking lemongrass tea or infused water — The citral present in lemongrass has demonstrated ability to regulate blood glucose and improve insulin sensitivity,22 and testing shows the citral content of decoctions and infusions are the same as that of fresh lemongrass.23 Tea is basically a weak infusion. You could also make your own lemongrass decoction. For basic instructions, see The Herbal Academy.24

Keep in mind, however, that since lemongrass essential oil can lead to lowered blood glucose,25 it may be contraindicated for people taking oral diabetes or antihypertensive medications, as well as those who are diabetic and hypoglycemic. Take special precautions if you have been diagnosed with diabetes or hypoglycemia or if anyone in your family suffers these conditions.

Treat oily hair by massaging a few drops of diluted essential oil to your scalp and let sit for 15 minutes before washing as usual.26

Fight body odor naturally — With its antifungal and antibacterial properties, diluted lemongrass essential oil can be used as a natural deodorant.

No. 3 — Dandelion

Dandelions contain vitamins A, B, C and D, and can be used as a remedy for fever, boils, diarrhea and diabetes.27 Dandelion leaf tea has diuretic, mild laxative and digestive aid properties, while tea made from dandelion roots has detoxifying properties, and can help relieve liver, gallbladder and prostate problems.28

Dandelion root is also antirheumatic, and may help dissolve urinary stones. 29 Dandelion leaves are usually picked during the spring,30 while the roots are often harvested in autumn or winter, since they're believed to be sweeter during these seasons.31

Since dandelions are widely available and are extremely simple to grow, you can easily harvest them to make a tea of your own from fresh ingredients. You may also opt to buy tea bags made from dried organic dandelion roots or leaves.

While dandelion tea is considered generally safe to consume, it may cause allergic reactions like itching, rashes and runny nose in people who are allergic to ragweed and other related plants, including chamomile, chrysanthemums and marigold.

No. 4 — Sage

Sage has been used as a medicine for thousands of years and boasts a long list of potential health benefits, including the following:32

Aids digestion — The rosmarinic acid found in sage acts as an anti-inflammatory agent, soothing your stomach and preventing gastric spasms. Sage can help reduce the incidence of diarrhea and gastritis.

Boosts cognitive function — Research has shown even small amounts of sage, taken as food or inhaled as an essential oil, can be an effective brain booster, increasing concentration, memory recall and retention.

In vitro and animal studies have confirmed several sage species contain active compounds shown to enhance cognitive activity and protect against neurodegenerative diseases such as Alzheimer’s and other types of dementia.33

Improves bone health — Sage contains a superior level of vitamin K, which along with its high calcium content supports strong bones and teeth.

Aids diabetes management — Sage possesses compounds known to mimic the drugs typically prescribed for managing diabetes. As such, it appears to regulate and inhibit the release of stored glucose in your liver, which balances your blood sugar, helping to prevent Type 2 diabetes or assist in managing the condition if already present.

Authors of a study published in the British Journal of Nutrition34 said, “[I]ts effects on fasting glucose levels … and its metformin-like effects … suggest sage may be useful as a food supplement in the prevention of Type 2 diabetes mellitus by lowering the plasma glucose of individuals at risk.”

Promotes healthy skin — Given its many antioxidant properties, sage is useful to counteract the signs of aging such as age spots, fine lines and wrinkles. These antioxidants protect against free radicals known to damage your skin cells and cause premature aging. Some have had success using sage in the form of a tincture or topical salve to treat skin conditions such as acne, eczema and psoriasis.

Strengthens immunity — Sage contains antimicrobial properties researchers suggest, when applied in the form of an essential oil, is effective in inhibiting the growth of bacteria such as Staphylococcus aureus.35

In addition, sage is a natural expectorant and useful to clear mucus and reduce coughs.36 Consider adding a drop of sage essential oil to a cup of tea or hot water the next time you have a cold.

Treats inflammation — Antioxidant compounds in sage can help neutralize free radicals and prevent them from creating oxidative stress in your body.37 Sage is effective with respect to inflammation that affects your brain, heart, joints, muscles, organ systems and skin. To reduce inflammation, chew fresh sage leaves, drink sage tea or apply a sage tincture.

Eases pains — Sage essential oil can be used in a bath or incorporated into a massage oil to help relax muscles. When combined with a carrier oil and applied to your lower abdomen, sage essential oil can also help soothe menstrual cramps and pain.

No. 5 — Chamomile

Chamomile is one of the highest sources of the polyphenol apigenin, a powerful inhibitor of an enzyme on the surface of your cells called CD38. While CD38 is useful for your immune function it also is a major consumer of NAD+ which is the most important coenzyme in your body.

You need NAD+ to fuel another enzyme called PARP, an enzyme instrumental in the repair of damaged DNA. When you are regularly exposed to electromagnetic fields, PARP is regularly activated and consumes NAD+, which is one of the reasons it is so low in most of us, aside from the fact that simply aging tends to lower it.

When NAD+ is lowered, then PARP doesn't function, and you don't repair your DNA damage. This is one of the reasons why I pay attention to keeping my NAD+ levels high and why I use chamomile every night.

Additionally, the volatile oils found in chamomile flowers are said to be responsible for most of its beneficial properties,38 which include an ability to:39,40

  • Calm nerves, promoting general relaxation, relieving stress41 and controlling insomnia
  • Ease allergies, inflammation42 and infections
  • Alleviate muscle spasms
  • Relieve nausea and flatulence
  • Ease stomach ailments, gastritis, ulcerative colitis, diverticular disease,43 Crohn’s disease44 and irritable bowel syndrome

Chamomile mustn’t be taken by people who are allergic to daisies, asters, chrysanthemums or ragweed. Chamomile is also known to interact with some drugs and substances, so exercise caution if you’re taking anticoagulants, antiplatelet medication, blood pressure medicines, diabetes drugs, sedatives, drugs broken down by your liver such as statins and antifungals.

No. 6 — Echinacea

Before antibiotics, echinacea was used as a general cure for various infections and wounds, including malaria, scarlet fever and syphilis.45 Centuries ago, Native Americans primarily used echinacea to help treat the common cold. Today, common uses include:

  • Boosting your immune system — The compounds in echinacea may help improve your immune system. In a study46 published in Integrative Cancer Therapies, echinacea has been shown to help reduce the severity and duration of colds if it is administered right away once symptoms appear. However, if you use echinacea several days after getting a cold, it won't have much of an effect.
  • Fighting against bacteria and viruses — Echinacea contains a compound called echinacein, which can help against bacterial and viral infections. According to a study47 in Pharmaceutical Biology, echinacea exhibited antimicrobial properties and is effective against 15 different pathogenic bacteria and two pathogenic fungi.
  • Speeding up wound healing — When applied to a wound, echinacea may help speed up the formation of new skin cells, while helping prevent an infection thanks to its antibacterial properties. According to a study48 in the Journal of Ethnopharmacology, the compound responsible for echinacea's wound-healing benefit is echinacoside, which is present in several varieties of the flower.

To learn more about this valuable plant and how it can benefit your health, see “10 Potential Benefits of Echinacea.” One of the easiest ways to obtain the benefits of echinacea is brewing homemade tea by simmering one-fourth cup dried echinacea flowers in 8 ounces of filtered water for 15 minutes.

No. 7 — Ashwagandha

Ashwagandha, known as a multipurpose herb and "rejuvenator," has been used in ancient Ayurvedic and Chinese medicine for thousands of years.49 It’s a powerful adaptogenic50 herb, meaning it helps your body manage and adapt to stress51 by balancing your immune system,52 metabolism and hormonal systems.53

Ashwagandha also has natural pain reliever (analgesic) properties,54 which can help increase physical strength, and its rejuvenating effects can promote general health when used regularly.

Flavonoids and other compounds are the active ingredients that give ashwagandha its many powerful properties. In one study,55 bioactive withanolides — naturally occurring steroids — in ashwagandha were identified as agents that suppress pathways responsible for several inflammation-based illnesses, including arthritis, asthma, hypertension, osteoporosis56 and cancer.

Withanolides in ashwagandha also have immunomodulating properties,57 described as substances that can either stimulate or suppress your immune system to help fight infections, cancer and other diseases.

One of the alkaloids in ashwagandha, called somniferin, helps promote relaxation and sound sleep. A study58 at the University of Tsukuba in Japan found it can relieve insomnia and restless leg syndrome.

As an adaptogen, ashwagandha is frequently used to support healthy adrenal function, which can be adversely affected by persistent stress, be it physical or psychological. Research shows the root reduces cortisol levels, restores insulin sensitivity and helps to stabilize mood.59

Ashwagandha also supports sexual and reproductive health in both men and women, and may be used as an aid to boost your libido. In men struggling with infertility, ashwagandha has been shown to balance their luteinizing hormone,60 which controls reproductive organ function in both men and women.

It’s been shown to improve the quality of semen in infertile men,61 in part by inhibiting reactive oxygen species and improving essential metal concentrations, including zinc, iron and copper levels. Other research62 suggests ashwagandha improves semen quality by regulating important reproductive hormones.

Ashwagandha can also help boost testosterone levels in men,63,64 which can have a beneficial effect on libido and sexual performance. In otherwise healthy women, ashwagandha has been shown to improve arousal, lubrication, orgasm and overall sexual satisfaction.65

In addition, ashwagandha’s ability to rebalance hormones (including thyroid hormone, estrogen and progesterone) has been shown to improve polycystic ovary syndrome66 and relieve symptoms associated with menopause.67

Ashwagandha also has antitumor and blood production (hemopoietic) capabilities, and benefits the cardiopulmonary, endocrine and central nervous systems, all "with little or no associated toxicity."68

Ashwagandha is contraindicated69 for, and should not be used by pregnant women, as it may induce abortion; breastfeeding women, as it may have an effect on your child; and people taking sedatives, as ashwagandha may augment the sedative effects.

Also, while ashwagandha appears to be beneficial for thyroid problems, if you have a thyroid disorder, use caution and consult with your doctor, as you may need to tweak any medications you’re taking for it. To learn more about this incredibly useful plant, see my most recent ashwagandha article.

No. 8 — CBD oil and/or whole hemp oil

The medical benefits of cannabidiol (CBD) are now increasingly recognized, and we now know the human body produces endogenous cannabinoids and that this endocannabinoid system (ECS) plays an important role in human health by regulating homeostasis between your bodily systems, such as your respiratory, digestive, immune and cardiovascular systems.

According to Project CBD, at least 50 conditions70 are believed to be improved by CBD, including pain, seizures, muscle spasms, nausea associated with chemotherapy, digestive disorders, degenerative neurological disorders such as multiple sclerosis and Parkinson's disease, mood disorders, anxiety, PTSD and high blood pressure.

CBD is nonpsychoactive, nonaddictive, does not produce a "high" and has few to no dangerous side effects. In states where CBD is becoming widely used, there are also few reports of negative social or medical consequences, in fact, CBD has been shown to provide valuable benefits for those struggling with opioid addiction.

Endogenous cannabinoid production declines with age and, according to clinical nutritionist and expert on phytocannabinoids, Carl Germano, endocannabinoid deficiency has been identified in people who have migraines, fibromyalgia, irritable bowel syndrome, inflammatory and neurological conditions and a variety of treatment-resistant conditions.

A paper71 in Translational Psychiatry also found low levels of anandamide (one of the endocannabinoids your body produces naturally) are a statistically positive indicator for stress-induced anxiety.

According to Germano, one of your best and healthiest options may be to use whole hemp oil rather than isolated CBD (from either hemp or cannabis). The reason for this is because CBD is just one of more than 100 different phytocannabinoids found in whole hemp, and the synergistic action between them is likely to produce better results.

According to Germano, CBD alone cannot fully support your body’s ECS. You need the other phytocannabinoids and terpenes, which are very complementary to the phytocannabinoids, as well. To learn more, see my interview with him, featured in “The endocannabinoid system and the important role it plays in human health.”

In the past, before the signing of the new Farm Bill that legalizes the growing of hemp in the U.S., the leaf, flower and bud of the hemp plant could not be used in the production of CBD-rich hemp oil. The oil had to be pulled from the stalk and stem of the plant only — the less concentrated part.

With the new law, all parts of the plant can be used, which will make processing easier and more economical, as the cannabinoids are more concentrated in the leaves, flowers and buds. The law also makes it legal to grow hemp in every state, so if you wanted to, you could grow it in your backyard.

While the raw unprocessed plant could be juiced, processing will convert the cannabinoids into more usable forms. Germano offers the following advice:

“[To process it], you can take the leaf, flower and bud. You can blend it and store it in the refrigerator. Over a day or two of exposure to heat, air, light and moisture, it’ll decarboxylate to some extent and you’ll benefit more from that … [P]robably an ounce or two [of raw plant] would do the trick as a healthy plant beverage.”

No. 9 — Milk thistle

While most people consider milk thistle a pesky weed, it actually possesses remarkable medicinal benefits72,73 that make it worth keeping around. Notably, milk thistle has been prized for centuries for its anti-inflammatory, antioxidant and antiviral properties.

It is also highly regarded as a liver tonic due to high amounts of a chemical compound known as silymarin. Silymarin is a group of flavonoids known to help repair liver cells damaged by toxic substances. As such, milk thistle greatly improves the overall functioning of your liver, with specific applications related to cirrhosis of the liver, chronic liver inflammation and liver damage from alcohol and other intoxicating substances.

Silymarin has also been shown to prevent the formation of gallstones,74 support prostate health and treat prostate cancer.75 Under the direction of your doctor, you may want to consider adding milk thistle to your diet if you are dealing with a liver-based problem such as cirrhosis, hepatitis, jaundice and nonalcoholic fatty liver disease.76

Silymarin also activates AMP-activated protein kinase (AMPK), an enzyme inside your cells that plays an important role in metabolism,77 energy homeostasis and cellular repair.78 It also inhibits the mammalian target of rapamycin (mTOR)which, when chronically activated, may increase your risk of cancer.

While all parts of the milk thistle plant are edible, silymarin is contained in the seeds only. Whether or not you are able to grow your own, high-quality, organic milk thistle is inexpensive and readily available at your local health food store. Below are some ways you can incorporate this unique herb into your diet:79

  • Powdered — Use a mortar and pestle to crush milk thistle seeds into a powder that can be added to soups, stir-fries and other dishes
  • Salads — Because the entire plant is edible, you can add milk thistle flowers, leaves, roots and stalks to salads or incorporate them into cooked dishes
  • Smoothies — For a healthy liver smoothie,80 soak 2 tablespoons of milk thistle seeds in filtered water overnight; the next morning, add the milk thistle (and soaking water), 1 cup of lemon juice, one-third cup of lycium berries and 1.5 cups of ice to your blender and combine until smooth
  • Snacks — Although it may be a bit of an acquired taste, milk thistle seeds can be eaten dry, as is
  • Tea — Crush either or both milk thistle seeds and dried leaves to make a loose tea blend you can steep in an infuser with hot water; add a healthy sweetener of your choice to tone down the somewhat bitter flavor, or add a peppermint teabag for a different taste sensation81

No. 10 — Tulsi

Tulsi, also known as holy basil, is an Ayurvedic herb considered vital in India. Like ashwagandha, it’s a powerful adaptogen with antibacterial, antiviral, antifungal, anti-inflammatory, analgestic, antioxidant and adaptogenic properties, just to name a few.82

There are many tulsi products available today, including tea, tablets, powder, extracts and tulsi essential oil. Among its many benefits, tulsi may help:

Manage blood glucose levels — Tulsi has hypoglycemic and hypolipidemic effects, which may be beneficial to diabetics. One study noted that after being given the tulsi leaf powder, diabetic rats had "a significant reduction in fasting blood sugar, uronic acid, total amino acids, total cholesterol, triglyceride, phospholipids and total lipids."83,84

Boost immunity — The leaf extract of tulsi was found to have immunotherapeutic potential in mammal subjects. The researchers noted the “crude aqueous extract of O. sanctum (leaf) possesses some biologically active principles that are antibacterial and immunomodulatory in nature.”85

Ease stress and anxiety Compounds found in tulsi leaf extract, namely ocimarin and ocimumosides A and B, have anti-stress effects.86 A test done on human subjects found that taking the plant extract may help ease generalized anxiety disorder.87

Improve dental health — Using tulsi tea as a mouth rinse may have benefits for your oral health. A study88 found an herbal mouth rinse of natural herbs like neem, clove oil, tulsi and more were able to inhibit oral bacteria like Actinomyces sp., E. nodatum, P. intermedia and more.

Boost cognitive function — One study89 found dementia-induced rats had improved cognition after being given tulsi leaf extract.

Promote liver health — Tulsi may have hepatoprotective effects, and was found to help protect against induced liver damage among rat subjects.90

Protect against different kinds of infections — Tulsi is believed to help alleviate various bacterial infections, including urinary tract infection,91 dermal infections caused by Staphylococcus aureus and other bacteria92 and respiratory tract infections like pneumonia93

Ease pain — Sipping tulsi tea may help you acquire its antipyretic, anti-inflammatory and analgesic properties. One study notes that it may be a potential alternative to nonsteroidal anti-inflammatory drugs (NSAIDs).94

Dr. Weil on the development of integrative medicine in modern practice


Dr. Andrew Weil, director of the University of Arizona Center for Integrative Medicine, is one of the true pioneers of this field, having advocated holistic approaches to health for about 50 years.

"I was always interested in science and biology," Weil says, and "I have a lifelong interest in plants … that led me to be a botany major at Harvard as an undergraduate and started me on a career interest in medicinal plants."

Fascinated by mind-body interactions, Weil began studying alternative medicine in college. After graduating medical school, he did a yearlong fellowship with the National Institutes of Health. He also did a fellowship with the Institute of Current World Affairs, which allowed him to travel around Latin America and Africa to collect information on medicinal plants and traditional healing.

"I chased around the world looking for healers and to see what I could learn because I felt that what I had learned in my conventional medical education wasn't going to serve me. I saw the methods do too much harm, and I had learned nothing about keeping people healthy," Weil says.

"The irony is that when I finished traveling and landed back in Tucson, it turned out the person who had most to teach me had been here all along. That was Dr. Robert Fulford. He was a doctor of osteopathic medicine (D.O.). He was then in his 80s and a master of cranial therapy.

He really made me aware of the healing power of nature. I am an enormous fan of osteopathic manipulation and cranial therapy. I recommend them a lot. I hope more D.O.s will go back to their roots and again practice manipulation ...

After I finished my internship, I took a course at Columbia University on medical hypnosis — one of the most interesting courses I ever took. As a result of that, I also make frequent referrals to hypnotherapists. I have, again and again, seen how changes in the mental realm initiate healing and affect the physical body.

To me, that's one of the great limitations of the dominant scientific and medical paradigm, which only looks at the physical as being real and believes that changes in the physical system must have physical causes to be physical. Nonphysical causation of physical events is not allowed for. Integrative medicine philosophy challenges that materialistic paradigm."

The emergence of integrative medicine

It wasn't until the 1990s that medical institutions began opening up to Weil's methods. "I had a large following in the general public, but none of my medical colleagues paid any attention to me," he says. In the '90s, however, health care economics began faltering, forcing institutions to start listening to what patients really wanted.

At a fundamental level, integrative medicine is the solution to the desperate problems and complications of chronic degenerative disease experienced in the U.S. Conventional medicine is really ineffective when it comes to these issues. As for the best way to help conventional physicians embrace these strategies, Weil says:

"My focus has been on training physicians and allied health professionals through the University of Arizona Center for Integrative Medicine. We have a two-year intensive fellowship. We now have 1,800 graduates: highly physicians, nurse practitioners and physicians' assistants in practice in all states and in a number of other countries.

Many of them are now training other people. We also have a curriculum in integrative medicine in residency training that's now been adopted by 70-some residency programs around the country (as well as in Canada, Germany and Taiwan)."

While 1,800 doctors are a drop in the bucket — a fraction of a percent of the 1.1 million physicians in the U.S.1 — they are important change agents.

"I think for things to change, there has to be a grassroots sociopolitical movement in this country, in which enough people get angry enough about the way things are," Weil says. He hopes the growing numbers of health professionals trained in integrative medicine will catalyze that movement.

We also need to elect representatives who are not beholden to the vested interests that want the system to go on as it is. Those interests are blocking the implementation of more effective and less expensive strategies.

"We may have to have a total crash of the health care system for things to change," Weil says. "To every graduating class of our fellows, I say, 'You are the ones who could start this movement in the country.' Doctors are victimized by the current system. They should be marching in the streets, demanding change.

As dysfunctional as our health care system is, it's generating rivers of money. That money is flowing into very few pockets — the pockets of Big Pharma, the manufacturers of medical devices and the big insurers. Those vested interests have total control of our representatives …

I think doctors today are so unhappy. I hear many, many doctors say they wish they hadn't gone into medicine. They'd never let a son or daughter of theirs go into medicine. I never heard anything like that when I was in college. Medicine looked like a very desirable profession. You could be your own boss. You were highly regarded in society.

All that has changed. Throughout history, much of the satisfaction of practicing medicine derived from the therapeutic connection with the patient, the getting to know someone. All that has evaporated in this era of for-profit, corporatized medicine. The time allowed for medical visits gets shorter and shorter.

The main obstacle is that our priorities of reimbursement are totally backward. We happily pay for drugs, for invasive procedures, for diagnostic testing. We don't pay health professionals to sit with patients and talk to them about diet or teach them breathing exercises. That has to change.

Of course, we also need to have data to show to the people who pay for health care that integrative approaches using lifestyle modification and natural therapies save money and produce outcomes that are equal to or better than those of conventional medicine."

Breathing basics

One of Weil's health strategies is a simple breathing technique called "The 4-7-8 Breath." "I teach that whenever I get the chance. I've done it with all my patients. I teach it to all our fellows. I do it with friends. I teach to all groups I speak to," Weil says.

"It's breathing in through your nose to a count of 4, holding your breath for a count of 7, blowing air out through your mouth to a count of 8, and doing this for four breath cycles at least twice day day. You have to practice it regularly. It is the master key to changing the activity of the involuntary nervous system," he explains.

"Of all the remedies that I've given to patients over the years, the one that I've gotten the most positive feedback about is that simple technique. It costs nothing, uses no equipment, takes very little time. Medical doctors don't take it seriously because they don't believe that something so simple — something that does not involve a drug or device — can change anything in the body. For that reason, little research has been done on breath work.

I do the 4-7-8 breath at least twice a day — when I wake up and when I go to sleep — and any time during the day that I feel that I want to focus and relax. (I now do eight breath cycles at a time and don't recommend any more than that.) One result that I've seen in myself: I have a very low heart rate. It's usually in the low 40s, sometimes in the high-30s.

I exercise regularly, but I'm not fanatical. I swim and walk every day. But up until maybe 20 years ago, my heart rate was around 70. The only way I can explain the change is that it is a result of doing that breathing exercise regularly. It has increased my vagal tone, slowed my heart rate and kept my hands very warm most of the time. It's the power of the relaxation response — one of the great rewards of doing this breathing practice."

Aside from activating your parasympathetic nervous system, which increases your heart rate variability, proper breathing will help improve your digestion and blood circulation and lower high blood pressure.

Maintaining cognitive and physical health into your senior years

At 77, Weil is also a testament to the cognitive benefits of this and other holistic techniques. His mental acuity for someone in their late 70s is truly remarkable, and doesn't seem to have changed since his youth. When asked what he attributes his general health to, he says:

"I get good rest and sleep. I use supplements wisely. I'm a great believer in the power of mushrooms. I take a number of mushroom products that I think are helpful both mentally and physically. I eat a lot of fermented foods. You know there's increasing research on the connection between the microbiome and mental-emotional well-being.

I think that's another strategy. And I drink matcha green tea every day. (I am so much a fan of it that I created a company — Matcha Kari — and got the URL to bring high-quality matcha from Uji, Japan, to people in this country.

I spend time with people who are active and happy and positive and I think that's a great strategy as well. I have two companion animals, two wonderful dogs that I spend a lot of time with. I attribute a lot of my well-being to living with them as well."

Among Weil's favorite medicinal mushrooms are turkey tail and lion's mane. Turkey tail has a number of cancer-protective effects, both preventively and therapeutically, while lion's mane contains a unique nerve-growth factor. "I recommend it to people with neuropathy," Weil says. There's also evidence suggesting lion's mane can help improve cognitive function.

True food kitchen

Last year, I had the opportunity to try out the True Food Kitchen while at the Paleo f(x)™ conference in Austin, Texas — a restaurant chain Weil conceptualized. He explains:

"I'm a very good home cook. I'm not a chef. But over the years, many people have said, 'You ought to open a restaurant.' I was never tempted to do that because I know nothing about the restaurant business, and it looked like a very tough business.

But about 11 years ago, a mutual friend introduced me to a very successful restaurateur in Arizona, Sam Fox. I proposed the concept of a restaurant that would serve wonderful, delicious food that was also healthy. His immediate reaction was, "Health food doesn't sell."

I think he thought I meant tofu and sprouts. He regarded me as a hippie and didn't see any possibilities for a collaboration. I invited him and his wife to my home. I cooked a meal for them. They liked the food. His wheels began to turn, and he said he would give it a try, but he was very skeptical that the concept would succeed.

We opened our first True Food Kitchen in Phoenix 11 years ago. It was a success right out of the gate. There are now 29 of them around the country. People love the food. We still don't have any real competition. The menu is based on my anti-inflammatory diet, with something for everyone there.

You can go with a mixed group. There are meat entrees — although not many of them — wonderful produce and fish. Gluten-free people can get what they want, people who are vegans, paleo or keto can find what they want there. It's been a great delight to see people liking the kinds of food I've enjoyed most of my life."

We certainly need more restaurants like that, because eating too much processed food is one of the key challenges most people have. While you may not think of restaurant food as processed, a vast majority of it is.

Staying active is a key component of longevity and health

About 50% of 80-year-olds experience sarcopenia, loss of muscle mass. As noted by Weil, one of the key prevention strategies for sarcopenia is to stay active and use your muscles as much as possible. This is also why strength training is so highly recommended for seniors.

"I use my muscles a lot," Weil says. "I am careful in what I do, but I go up and down stairs a lot when I get the chance. I lift things. I don't feel that I've lost muscle strength. I certainly have more aches and pains than I did when I was younger, but I think my musculoskeletal system is in good shape …"

"It's important to pay attention to how your body changes and how it reacts to different things … In my 20s, I ran for a time — until I got signals from my knees that they didn't like that. I shifted to cycling and did that for a long time. And then I got into swimming, which agrees with me very much. I think it's good to be flexible and open to change …"

Integrative medicine is the answer to many growing problems

Like me, Weil sees integrative medicine as the way of the future. "I've always said that one day we'll be able to drop the word 'integrative' and it'll be just 'good medicine,'" he says. He believes this transition is inevitable, because the forces that are taking down our health care system continue to build.

This includes a growing population of seniors, uncontainable health care costs due to our dependence on expensive technologies and drugs, and growing epidemics of lifestyle-related disease that conventional medicine cannot successfully manage.

"This is happening all over the world, but it's most advanced in the U.S.," he says. "Our health care system is farther over the cliff. At the same time that we are paying more for health care than any other people in the world — now 18% of our GDP — we have worse health outcomes than any other developed nation. The World Health Organization ranks us 38th, on par with Serbia. Something is very wrong with that picture. It's unsustainable."

On cannabis

One positive change is the growing acceptance of medicinal marijuana and hemp, the latter of which was legalized in the 2018 Farm Bill. While Weil no longer uses cannabis, he recounts his personal history with the plant during his 30s. He also conducted the first ever double-blind human experiments with cannabis, which were published in the journal Science in 1968.

"We've been very stupid in our relationship with that plant," he says. "Cannabis sativa — the word 'sativa' means useful — is amazingly useful. It gives us a very high-quality oil and an edible seed, a medicine, an excellent fiber and an intoxicant. That's a lot of ways for one plant to serve us.

We have let a multibillion-dollar industry in hemp textiles slip away to China, a multimillion-dollar industry in edible hemp products go to Canada. We have rejected cannabis as medicine for a long time. I'm very happy to see this change.

I regard cannabis as the plant world's equivalent of the dog. Dogs long ago decided to co-evolve with us. Cannabis has done the same thing. We can't unravel the ancient history of cannabis, because as far back as we can look, it's always been associated with human settlements and human activity.

It wants to do nothing other than to serve us. It lets us manipulate its genome. It just wants to help us and we have turned it away. It's nice to see that change."

Psychedelics may have a place in medicine

Weil also believes there's a place for psychedelics, such as magic mushrooms. "The great magic and potential of psychedelics is that they can show you possibilities that you otherwise would not have believed," he says. However, once you've touched on these new possibilities, he says you need to find other, nondrug ways to re-experience or maintain them.

"If you try to use the drugs as the sole method of having them, they fail you," he warns. "The example I have written and talked about [is] when I was about 28, I wanted to learn to practice hatha yoga. I worked with a number of postures.

The one I had the most difficulty with was the plow — where you lie on your back and try to touch your toes on the floor behind your head. I worked at this for a long time and I got my toes to within a foot of the floor but no further, because I would have excruciating pain in my neck. No matter how I persisted, I couldn't make further progress.

One spring day, I took a dose of LSD with friends in a beautiful outdoor setting. I felt terrific. My body was completely elastic and flexible, and I thought I ought to try that yoga pose. I lay down, got my feet over my head and lowered them. I thought I had about a foot to go and they touched the ground. I couldn't believe it. I raised and lowered them. It was a source of such delight.

The next day I tried to do it and I got my toes within a foot of the floor and had a horrible pain in my neck. But now there was a difference. I had seen that it was possible. I was motivated to keep at it and, in a few weeks, I was able to do it. If I had not had that experience, I don't think I would have kept up the practice. To me, that's a model of how these drugs work. They can show you possibilities.

I think they have tremendous potential in medicine. Everyone looks at their use in psychotherapy, and that's fine, but I think they have a tremendous potential to change how people experience their bodies. For people who have chronic diseases, a structured psychedelic session can show them that it's possible to be without pain or other symptoms. And that can motivate them to figure out how to maintain the improvement in other ways."

More information

While Weil says he's done writing books, he's in the process of writing a collection of stories from his life. The University of Arizona Center for Integrative Medicine in Tucson, which he still heads up, is also entering a new phase of growth.

"The university has made a solid commitment to make integrative medicine a top priority," he says. We will get a dedicated building on campus and will open the first integrative medicine primary care clinic in Tucson early next year.

You can find more information about this on the Andrew Weil Center for Integrative Medicine website. There, you can also sign up for online courses to explore topics such as nutrition, integrative pain management, cardiovascular health management and more. There's also a research section you can peruse to learn more about the benefits of integrative medicine.

"We think we have a model that is replicable, sustainable, profitable that can be eventually replicated throughout the health care system here and elsewhere. We're expanding our teaching programs. We have a very strong research initiative as well.

This is all very exciting — something I've waited for, for a long time … I think the future is going to be very bright for our field. Medicine doesn't change as a result of intellectual argument. It changes as a result of economic necessity. And time is on our side.

Our health care system is in deep, deep trouble. The wisdom of what [Dr. Mercola] and I have been advocating for so long will become more and more apparent as the health care crisis deepens."

Introduction to myasthenia gravis — A rare, neurological autoimmune disease


The immune system plays an important role in keeping your body healthy. It helps protect your organs and tissues from disease-causing foreign bodies such as bacteria and viruses. To do this, your immune system releases specific antibodies that work to prevent infections.1

In certain situations, however, your immune system turns against your own body, causing autoimmune diseases to develop. Examples of autoimmune diseases include rheumatoid arthritis, lupus and multiple sclerosis.2 There is no known cure for autoimmune diseases. Instead, treatment focuses on relieving the symptoms.3

One autoimmune disease you should pay attention to is myasthenia gravis, which causes weakness in your voluntary muscles throughout your body. The Myasthenia Gravis Foundation of America estimates that 14 to 20 per 100,000 people, or 36,000 to 60,000 people, currently have it. Elderly men and middle-aged women are commonly at risk of this disease.4

Myasthenia gravis can be confused with other diseases

In addition to the rarity of myasthenia gravis among the population, patients have difficulty getting the proper treatment because its symptoms can be similar to other diseases. According to a study published in Seminars in Neurology, myasthenia gravis may be mixed with “disorders that limit eye movements … brainstem, cranial nerves, neuromuscular junction, muscles or local orbit anatomy.” Systemic diseases such as sepsis are possibly mixed up with myasthenia gravis as well.5

Due to the various diseases that can be confused with myasthenia gravis, a person who has it can have a delayed diagnosis that can last for months, or even years, especially if the symptoms are only mild.6

Common misconceptions about myasthenia gravis

Not many are educated about how myasthenia gravis affects the human body and how it can be treated. John L. Keefe, an attorney specializing in disability law, outlines common misconceptions about myasthenia gravis:7

  • Laziness — You may think that a person with myasthenia gravis is just lazy, especially when asking for help with even the simplest of tasks. This is not true, because the disease can weaken your muscles to the point of inactivity.
  • It’s made up — Some days you have normal muscle control, but on other days, your muscles become very weak. This can lead people to think you’re faking a disease.
  • Exercising regularly could have helped — While regular exercise is beneficial for most people, a person with myasthenia gravis can easily become tired with the slightest movement. The cause of the fatigue is not the lack of exercise, but the faulty immune system.
  • It’s just all in the mind — Saying that a person with myasthenia gravis simply doesn’t want to get better is offensive. In truth, the disease can appear at any time, causing days where you feel very weak. Support is needed for those who have the disease.

Learn more about myasthenia gravis in this guide

Myasthenia gravis is a disease that should not be taken lightly. While it usually appears in the elderly, it can still happen to anyone — even newborn children.8 This guide will help you learn about this neurological condition, including its symptoms, diagnostic methods and how it can be treated.

Learn More About Myasthenia Gravis

Myasthenia Gravis: Introduction

What Is Myasthenia Gravis?

Myasthenia Gravis Symptoms

Myasthenia Gravis Causes

Myasthenia Gravis Types

Myasthenia Gravis Diagnosis

Myasthenia Gravis Treatment

Myasthenia Gravis Prevention

Myasthenia Gravis Diet

Myasthenia Gravis FAQ

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What Is Myasthenia Gravis?


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