Saturday, May 18, 2019

Why is the Mediterranean Diet So Important?

The Harvard T.H. Chan School of Public Health and the Mayo Clinic are endorsing the Mediterranean Diet as a way to reduce the risk of heart disease, inflammation, blood sugar and body mass index.
The diet is a plant based eating plan consisting of a daily intake of whole grains, olive oil, fruits, vegetables, beans and other legumes, nuts, herbs and spices. The preferred animal protein is fish and other seafood at least twice weekly.  Poultry, eggs and low-fat dairy can be eaten in small portions daily, or a few times per week.  Olive oil replaces butter or margarine. Avocados, nuts and oily fish like salmon or sardines are other sources of healthy fat.  Red meat is limited to a few times per month.  Water is the main beverage.  Plain coffee and tea are fine.  Fruit juices contain too much sugar, and should be replaced by eating the whole fruit.  Wine, especially red wine, can be consumed with meals.  Women should drink no more that one 5 ounce glass per day, and men should stop at 2 glasses.  People who do not drink alcohol do not need to begin.  Eating and socializing with other people is encouraged. Daily physical activity is important.

The Mediterranean diet emphasizes whole grains, such as whole wheat, rye and barley.  People wanting a gluten free diet can use brown rice, quinoa, buckwheat, millet, oats and corn.  

 Research has shown that the Mediterranean diet reduces the risk of cardiovascular disease and overall mortality.  A study of 26,000 women over 12 years showed a 25% lower risk of developing heart disease and stroke among those whose eating plan was close to the Mediterranean diet.  Favorable changes in inflammation, blood sugar, 
Type 2 diabetes and body mass index were also seen.  

Fat intake is high in the Mediterranean diet, consisting of 39-42% of daily calories – note that the fats are healthy ones, such as olive oil, nuts, avocados and oily fish.  This promotes satiety – feelings of fullness – so that the diet is easy to follow.  The Ketogenic diet is also high in fat, but relatively low in plant food while emphasizing meat eggs, and cheese. The lack of a wide variety of plant foods means a considerably smaller intake of protective antioxidants.  This diet has been popular for weight loss without hunger.  Compared to the Mediterranean diet it is less healthy for the individual and ultimately for the planet.  
Sadja Greenwood, MD, MPH

Sunday, April 28, 2019

The Carter Center's Amazing Work on Guinea Worm Disease

Since 1986, The Carter Center has led the international campaign to eradicate Guinea worm disease. Guinea worm disease is a parasitic disease caused by a nematode roundworm parasite called Dracunculus. It is contracted when people consume water from stagnant sources contaminated by Guinea worm larvae. Inside a human’s abdomen, male and female worms mature and grow.  After about a year, the female Guinea worm, one meter long, creates an agonizingly painful lesion on the human’s skin as it slowly emerges.  Guinea worm sufferers often try to seek relief from burning sensations and immerse themselves in water.  The emerging worm releases its larvae into the water and so the cycle of infection goes on.  
In 1986 there were an estimated 3.5 million cases of Guinea worm disease in 21 countries in Asia and Africa.  Today that number has been reduced by 99.99% to 28 cases in 2018. It could be the second human disease, after smallpox, to be eradicated without the use of a vaccine or medicine.  The Carter Center has worked closely with ministries of health and local communities, US Centers for Disease Control and Prevention, the WHO and UNICEF.  Community based interventions have included teaching people to filter all water, done in some ingenious ways, and keeping people with an emerging worm from entering water sources.  
A challenge to eradication has been the emergence of Guinea worm disease in animals, such as domesticated dogs, who may eat infected fish and fish entrails.  Cash rewards are being paid to the reporting of infected animals, and the use of veterinary deworming drugs.  In 2018 Ethiopia reported infections in 11 dogs, 5 cats and 1 baboon. Another challenge is insecurity – conflicts make some areas unsafe for travel.  
Enormous dedication and attention to detail is critical for all field supervisors and the thousands of community-based volunteers charged with executing the campaign.  The disease has been eliminated in 17 countries. 80 million cases have been averted among the world’s poorest and most neglected people. 
WHO is responsible for certifying countries as free of Guinea worm disease.  The US Centers for Disease Control and Prevention provide technical assistance and verify whether worms from patients are truly Guinea worms. UNICEF helps to provide safe sources of drinking water. 

Dear Readers – the take home message from this column is one of hope and awe, that President Jimmy Carter has provided such important leadership in the relief of suffering. Donations to his center are always appreciated.  I am dedicating this column to the memory of my ex- husband, Dr. Robert Goldsmith, father of my 2 sons and step-daughter. Dr. Goldsmith died last week in San Francisco. His children provided a beautiful and meaningful memorial service for him yesterday.  He was a Professor of Tropical Medicine at UCSF, and would have known all about the efforts to eliminate Guinea worm disease.   I am sorry I could not discuss this matter with him.  
Sadja Greenwood, MD, MPH

Friday, April 19, 2019

Too Busy to Floss? This Could Change Your Mind!

There is new research on how bacteria involved in gum disease can travel through the body, exuding toxins connected to Alzheimer’s disease, rheumatoid arthritis and aspiration pneumonia.  Experiments in mice, using  bacteria from people with Alzheimer’s disease, showed that the bacteria can find their way from mouth to brain.  The bacterium is Porphyromonas gingivalis (P g for short).  It is involved in periodontitis – inflammation of the gums. According to Jan Potempa, PhD, DSC, a professor at the University of Louisville School of Dentistry and head of the Department of Microbiology at Jagiellonion University in Krakow, Poland, oral hygiene is important and will decrease the risk of many serious diseases. Researchers  compared brain samples of deceased people with and without Alzheimer’s disease, same age at death, and found that P g was more common in the samples from people with Alzheimer’s , as evidenced by DNA and the presence of certain key toxins.  Studies in mice showed that P g can move from mouth to brain. An experimental drug that blocks bacterial toxins is in phase 1 clinical trial for Alzheimer’s.  About 20% of people have low levels of P g in their gums by age 30.  While not necessarily harmful, if it grows to large numbers it creates inflammation. Smokers and older people are at increased risk.  
The take-home message here is clear.  Brush your teeth and floss regularly.  Visit your dentist and dental hygienist, at least yearly.  
Sadja Greenwood, MD, MPH

Sunday, March 24, 2019

We All Depend on the Survival of Bees

In the film Fantastic Fungi by Louie Schwartzberg, amazing time lapse photography shows the growth of numerous kinds of fungi as they digest dead plant and animal material and in so doing enrich the earth.  Fungi, a separate form of life from plants and animals, have healing properties for the immune systems of animals, including humans, which are beginning to be researched.  The film, which stars the mycologist Paul Stamets, among others, has an important section on the use of fungi to help bees resist viruses in their hives.

According to a new paper from Washington State University (WSU), and colleagues at Fungi Perfecti, a mushroom extract fed to honey bees greatly reduces virus levels in their hives.  Colonies fed mycelium extract from amadou and reishi fungi showed a 79-fold reduction in deformed wing virus and a 45,000-fold reduction in Lake Sinai virus compare to control colonies. 
Mycelium is the vegetative part of a fungus consisting of a mass of branching, threadlike hyphae.  It penetrates deep into the soil.  Fungi Perfecti is a business dedicated to promoting the cultivation of high quality medicinal mushrooms.  Paul Stamets grows his mushrooms organically in the Pacific Northwest.  
"Our greatest hope is that these extracts have such an impact on viruses that they may help varroa mites become an annoyance for bees, rather than causing huge devastation," said Steve Sheppard, a WSU entomology professor and one of the paper's authors. "We're excited to see where this research leads us. Time is running out for bee populations and the safety and security of the world's food supply hinges on our ability to find means to improve pollinator health."
The research was published in the journal Scientific Reports.
At present, the mycelium extract isn't currently available in levels for beekeepers to purchase for their hives.
"We are ramping up production of the extracts as rapidly as is feasible, given the hurdles we must overcome to deploy this on a wide scale," Stamets added. "Those who are interested in being kept up to date, can sign up for more information at"
Sheppard said he and his colleagues plan to do more work to refine their now-published results. That way beekeepers will have the best information when supplies are more available.
"A portion of this project was funded by USDA-NIFA project WNP00604.

 Journal Reference:
1.     Paul E. Stamets, Nicholas L. Naeger, Jay D. Evans, Jennifer O. Han, Brandon K. Hopkins, Dawn Lopez, Henry M. Moershel, Regan Nally, David Sumerlin, Alex W. Taylor, Lori M. Carris, Walter S. Sheppard. Extracts of Polypore Mushroom Mycelia Reduce Viruses in Honey BeesScientific Reports, 2018; 8 (1) DOI: 10.1038/s41598-018-32194-8

 Chlorpyrifos  Another threat to honey bees and other forager bees is the insecticide chlorpyrifos.  Honey bees experience a learning and memory deficit after ingesting small doses of this insecticide, potentially threatening their survival, according to a study in New Zealand.  Chlorpyrifos is a highly neurotoxic organophosphate pesticide used worldwide on crops to protect against insects and mites.
The effects of this insecticide on animals and humans has been widely studied since the 1970s. Chlorpyrifos affects living things to various degrees: it is very toxic to birds and insects, including bees, quite toxic to fish, and also toxic to humans. Home use of chlorpyrifos was banned in 2000, when Dow withdrew it from the market voluntarily, though it is still found in insect baits. Golf courses still combat pests with it, and it is also
used by farmers on nearly 50 crops—many of which we consume, like oranges—and in cattle ear tags.  Farmworkers are exposed, and pregnant farmworkers may have lasting damage to their children.  Recent studies of small children have found a link between chlorpyrifos and lower IQ and developmental problems
Hawaii is the first state to ban Chlorpyrifos.  California should follow suit.  Contact your congressperson, senators and governor Gavin Newsom to ban this highly toxic chemical.  
Sadja Greenwood, MD, MPH

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Monday, March 11, 2019

New and Important News on Sleep

Researchers at Bar-lian University in Israel have identified a function of sleep that can explain why humans as well as all other animals with a nervous system spend a significant portion of their lives in sleep. Even Invertebrates such as flies, worms and jellyfish sleep.  The reason why animals sleep – despite the threat of predators, has been considered one of the biggest questions in life sciences.

In a new study, published in March, 2019 in the journal Nature Communications, researchers at Bar-Ilan University in Israel reveal a novel and unexpected function of sleep that they believe could explain how sleep and sleep disturbances affect brain performance, aging and various brain disorders.

Using 3D time-lapse imaging techniques in live zebrafish, the researchers were able to define sleep in a single chromosome resolution and show, for the first time, that single neurons require sleep in order to perform nuclear maintenance.  DNA damage can be caused by many processes including radiation, oxidative stress, and even neuronal activity.  DNA repair systems within each cell correct this damage. The current work shows that during wakefulness, when chromosome dynamics are low, DNA damage consistently accumulates and can reach unsafe levels.

The role of sleep is to increase chromosome dynamics, and normalize the levels of DNA damage in each single neuron. Apparently, this DNA maintenance process is not efficient enough during the online wakefulness period and requires an offline sleep period with reduced input to the brain in order to occur. "It's like potholes in the road," says Prof. Lior Appelbaum of Bar-Ilan University. "Roads accumulate wear and tear, especially during daytime rush hours, and it is most convenient and efficient to fix them at night, when there is light traffic."

Appelbaum calls the accumulation of DNA damage the "price of wakefulness." He and his doctoral student David Zada, first author of the study, as well as co-authors, Dr. Tali Lerer-Goldshtein, Dr. Irina Bronshtein, and Prof. Yuval Garini, hypothesized that sleep consolidates and synchronizes nuclear maintenance within individual neurons, and set out to confirm this theory.

Their discovery was achieved thanks to the characteristics of the zebrafish model. With their absolute transparency, and a brain very similar to humans, zebrafish are a perfect organism in which to study a single cell within a live animal under physiological conditions. Using a high -resolution microscope, the movement of DNA and nuclear proteins within the cell -- inside the fish -- can be observed while the fish are awake and asleep. The researchers were particularly surprised to find that chromosomes are more active at night, when the body rests, but this increased activity enables the efficiency of the repair to DNA damage. 

The results establish chromosome dynamics as a potential marker for defining single sleeping cells and propose that the restorative function of sleep is nuclear maintenance. "We've found a causal link between sleep, chromosome dynamics, neuronal activity, and DNA damage and repair with direct physiological relevance to the entire organism," says Prof. Appelbaum. "Sleep gives an opportunity to reduce DNA damage accumulated in the brain during wakefulness."
"Despite the risk of reduced awareness to the environment, animals -- ranging from jellyfish to zebrafish to humans -- have to sleep to allow their neurons to perform efficient DNA maintenance, and this is possibly the reason why sleep has evolved and is so conserved in the animal kingdom.”
Journal Reference:
1  D. Zada, I. Bronshtein, T. Lerer-Goldshtein, Y. Garini, L. Appelbaum. Sleep increases chromosome dynamics to enable reduction of accumulating DNA damage in single neuronsNature Communications, 2019; 10 (1) DOI: 10.1038/s41467-019-08806-w
 ScienceDaily. 5S 5 March 2019. 
The take-home message of this column is that we should find a way to sleep every night until we feel refreshed and rested.  We can’t put it off until the weekend and get the daily needed brain repair.  Going to bed earlier could be an answer for many people.  Zzzzzzzz  Read the news on sleep and heart disease in the previous column on this website.
Sadja Greenwood M.D., MPH

Sunday, March 10, 2019

Sleep and Heart Disease

A recent study from Massachusetts General Hospital (MGH), published in the journal Nature, shows how getting enough sleep protects against heart disease. Insufficient sleep increases the production of inflammatory white blood cells that are known to be major contributors of atherosclerosis – the deposition of plaques of fatty material on the inner walls of arteries.  Sleep helps to regulate the production in the bone marrow of these inflammatory cells. Sleep disruption breaks down the control of inflammatory cell production, leading to more inflammation and more heart disease.  According to Filip Swirski, Ph.D. of the MGH Center for Systems Biology, there is a brain hormone known to control wakefulness that controls processes in the bone marrow that protects against heart disease. 
Mice that had been genetically programmed to develop atherosclerosis were subjected to repeated interruptions of their sleep, similar to the experience of someone constantly waking up because of noise or discomfort.  Compared to mice from the same strain that were allowed to sleep normally, those subject to sleep disruption developed larger arterial plaques and had higher levels of inflammatory cells in their blood vessels.  They had a nearly two fold increase in the production of in their bone marrow of stem cells that give rise to white blood cells.  A hormone called hypocretin, produced in the brain structure known as the hypothalamus, which is known to regulate sleep, was found to have an unexpected role in controlling white blood cell production. While normally produced in high levels when animals, including humans, are awake, hypocretin levels were significantly reduced in the sleep deprived mice.  Dr. Swirski, an associate professor of Radiology at Harvard Medical School, plans to explore further mechanisms by which proper sleep maintains vascular health, and further explore this newly identified neuro-immune axis.
The complete article from which this column is based can be found at Science Daily, February 13, 2019.
The take home messages from this study are important.  Safeguard your sleep by reducing or eliminating caffeine from coffee, caffeinated teas, caffeine containing soft drinks, kombucha, etc. late in the day. People who are sensitive to caffeine should not drink it after noon.  Be careful with alcohol around bedtime as well – it can put you to sleep, but will often disrupt your sleep quality later in the night. If you have sleep apnea, take steps to control it. Sleep apnea is a serious sleep disorder  - breathing is interrupted many times each night, resulting in insufficient oxygen for the brain and body. Talk to your doctor about getting a device called CPAP (continuous positive airway pressure) or talk to your dentist about a dental device that may help with sleep apnea.  Losing weight may help, and so will quitting smoking!  Wear blue blocking glasses starting an hour before bedtime, so that bright lights from your home, your TV, computer or cell phone will not reduce your natural melatonin production as bedtime gets near. If you get up at night to go to the bathroom, wear the blue blocking glasses at that time.  All these measures are important, and potentially life saving.
Sadja Greenwood, MD, MPH

Thursday, February 7, 2019

Portion Control

 Jane Brody’s column on Jan 28th, 2019 in the New York Times was on portion control, an approach to eating that enabled her to lose 40 pounds over two years and to keep the weight off without feeling deprived.  Brody wrote the column because data from the Centers for Disease Control show that American men and women have continued to grow fatter, with the average BMI now close to obesity. Brady followed the advice of a dietician and adjunct professor of Nutrition at New York University, Lisa R Young, whose book is called Finally Full, Finally Slim.Young describes a practical approach to food and eating that can be adapted to most people’s lives, whether they eat at home (the best way) or eat out.  Eating at home, you downsize your dinner plate to salad plate size. You fill half your plate with cooked vegetables like spinach, cabbage, broccoli, carrots, mushrooms and green beans, and add a side salad with some chopped fruit and a dribble of dressing. You limit baked white or sweet potatoes, or whole grains, to ½ cup servings.  A serving of avocado or nuts is ¼ cup. Weigh meat, poultry or fish so that a portion is 3-4 ounces. Vegetarians can have similar amounts of eggs or low-fat plain yogurt with chopped fruit. Vegans are rarely overweight!)  A serving of wine is 5 ounces, and should be measured.  You can have sweets and treats a few times a week in your weight loss plan, so that you will not feel totally deprived.  Eat a few spoonfuls of ice cream instead of a pint.  When your weight is where you want it to be, have a small treat more often.

 If you eat out, the best approach is to bring along a box or tiffin carrier and put half your serving away, or share it with your dinner companion, before starting to eat.  Always have salad with dressing on the side.  Drink water before and during the meal.  Have a healthy snack an hour or two before going to the restaurant, such as a low sodium v8 with a whole grain cracker.  You can get great ideas for eating out by going to the website of Lisa R. Young, PhD, RDN.  Sign up for her Slice of Advice newsletter and you can download a whole chapter on eating out in a healthy manner.

Here’s my take-home message from this column: Avoiding overweight and obesity will lessen your chances of several cancers and help to avoid heart disease. It will make it easier to enjoy whatever sports you may like, including hiking and walking your dog.  Jane Brody and Lisa R. Young have outlined a plan that will help in a sensible way, without costing money or making you starve and be resentful.  

Sadja Greenwood, MD, MPH  Leave me a message and I’ll answer you.

Monday, January 21, 2019

Lutein – Some New Findings

Lutein is an antioxidant, a pigment found in plants, especially in dark green vegetables, and also in pistachio nuts, avocados and egg yolks. Many people with atherosclerosis (hardening of the arteries) have low-grade chronic inflammation that is linked to an increased risk of heart attack.  A research group at Linkoping University in Sweden has studied the ability of lutein to dampen inflammation in immune cells in patients with coronary artery disease. They also showed that lutein can be stored in immune cells, which means that it is possible to build up a reserve of lutein in the body. 
 In a new study the Swedish researchers investigated which method of food preparation is the best way of obtaining lutein. They chose to study spinach, which contains comparatively high levels of lutein and is eaten by many people. Since lutein is degraded by heat, they suggest eating spinach in the form of a smoothie, or finely chopped salad. They also found that adding fat will increase the solubility of the lutein in the fluid of the smoothie.  Although they suggest adding cream, a healthier choice could be adding avocado and/or pistachio nuts to the smoothie or the salad..
My experience with spinach smoothies has been that they are more easily digested if sipped slowly throughout a few hours rather than all at once.  
This study from Linkoping University was published in Food Chemistry,2019, 277:573.
Recent studies from the University of Illinois, published in the journal Frontiers in Aging Neuroscience, have shown that lutein seems to be associated with cognitive benefits.  It also plays an important role in the prevention of age-related macular degeneration. 
The take-home message here – get out your blender and see what you can do to make your green smoothie as delicious as possible. I usually add a few raisins for sweetness. (Remember they are good for your teeth!). If you don't have a blender, try a finely chopped salad with spinach and/or kale. An olive oil dressing will provide the needed fat. 
Sadja Greenwood, MD, MPH  Leave me a message and I’ll answer you.

Monday, January 7, 2019

We Evolved to Exercise

The January, 2019, issue of Scientific American has a great story by Herman Pontzer about how we humans are similar and profoundly different from our cousins –chimpanzees, bonobos, orangutans and gorillas  - with whom we share over 97% of our DNA.  Herman Ponzer is a professor of evolutionary anthropology at Duke University, who has studied hunter gathering humans and apes for many years.  Apes remain healthy at low activity levels, often spending 8-10 hours a day resting, grooming and eating before going to sleep for 9-10 hours. They remain remarkably healthy and lean at these low levels of physical activity, with very little heart disease or diabetes, even in captivity.  

For us human, however, it’s a different story.  We split from chimpanzees and bonobos about 6-7 million years ago.  Recent findings indicate that we gradually became fully upright, walking creatures who could still get up into the trees.  About 1.8 million years ago we began to develop stone tools for butchering animals, indicating that we probably ran them down. At the same time we expanded out of Africa into Eurasia and as far as Indonesia.  The ability to hunt as well as gather was the key.  Relying on meat requires cooperation and sharing. It is thought that these early humans got roughly half their calories from plants and half from meat.  Hunter-gatherers typically walked 12,000 to 18,000 steps a day. 

Our physiology has changed and adapted to this active life.  The brain has evolved to need less sleep – about 7 hours, far less than the apes. Our brain has also evolved to reward prolonged exercise, producing endocannabinoids.  Exercise enables the expansion of the brain in childhood and adulthood, and is known to improve memory.  Our leg muscles are 50% bigger than those in other apes, and we have more red blood cells to carry oxygen to our working muscles.  You can understand that our bodies have evolved to requiredaily physical activity. Exercising muscles release hundreds of signaling molecules.  They reduce chronic inflammation, and lower levels of testosterone, estrogen and progesterone.  This may account for the reduced rate of reproductive cancers among those who exercise regularly.  The morning rise of cortisol is blunted, which may mitigate stress.  Exercise reduces insulin insensitivity and helps to put glucose into muscle glycogen instead of fat.  Diabetes is thus prevented.  Exercise improves the ability of the immune system to stave off infection. Even light activity, such as standing instead of sitting, is helpful.  

Another article in the January Scientific American concerns a genetic mutation that may have occurred in our species 2-3 million years ago, enabling humans to run long distances, sweat to cool off, and hunt their prey to exhaustion.  Biologist Ajit, Varki at UC San Diego is studying this hypothesis. 

The take-home message from these studies is that we have evolved to move – a lot more than most of us are accustomed to.  To stay healthy as we grow from childhood into old age, we need to stay active. This will take social planning – to make more sidewalks, playgrounds and parks in many towns and cities, and keep them safe.  Children of all ages need places to get outside and play.  They may also do sports, skateboard, bicycle, run with a dog, swim or dance. 

 It will take individual planning to bring activity into our adult  lives despite sedentary desk jobs and the pull of screen time.  We can sign up for Yoga, Pilates and walking groups. We can join a gym. I have a sturdy floor bicycle called a Desk Cycle, so while I watch Rachel Maddow or read a book at least I’m moving my legs.  It can fit under a desk.  There are lots of other home exercise machines. Housework counts!  People who are on their feet all day in restaurants and stores still need to think about weekend activity.  We have evolved to move.
Sadja Greenwood, MD, MPH

Tuesday, December 18, 2018

Raisins and Green Tea Can Help your Teeth and Gums

Dr. Christine D. Wu is a professor and Associate Dean for Research at the University of Illinois at Chicago College of Dentistry.  For several years she has studied compounds that can fight the bacteria that cause cavities and gum disease.  She has looked at antioxidant compounds in raisins and found that oleanolic acid in raisins inhibits the growth of two species of  oral bacteria – Streptoccocus mutans, which causes cavities, and Porphyromonas gingivalis, which causes periodontal (gum) disease.  The compound blocked S. mutans  from adhering to tooth surfaces.  Adherence is crucial for bacteria to form dental plaque, the sticky biofilm  consisting of oral bacteria that accumulates on teeth.  When you eat a sugary meal, these bacteria release acids that erode the tooth enamel.   “Raisins are perceived as sweet and sticky, said Dr. Wu,  “and any food that contains sugar and is sticky is assumed to cause cavities. But our study suggests the contrary.  Phytochemicals in raisins may benefit oral health by fighting bacteria that cause cavities and gum disease.”   However, bran cereals that have added sugar and raisins are not the best.  Finding a cereal without added sugar such as oatmeal, and adding raisins to it would be better. Raisins can also be enjoyed as a snack, along with nuts, during the day. People with diabetes should test their blood sugar values if they snack on raisins, as data about this has been controversial.  

The ability of tea to fight dental caries has been suggested for decades.  The polyphenols in tea, especially EGCG (epigallocatechin gallate) have been shown to inhibit dental plaque accumulation, but the exact mechanisms are not clear.  Dr. Wu and her colleagues think that EGCG suppresses genes in S. mutans  and prevents the initial attachment of this bacterium to the teeth, and thus the formation of mature biofilms.  The effects of ECGC  on other  properties of S. mutans were also studied.  The research showed a dose dependent inhibition of the initial attachment of S. mutans and also an effect on the genes of this bacterium.  These findings suggest that ECGC may represent a novel and natural way to inhibit biofilm formation on the teeth.   ECGC is also being studied in laboratories throughout the world for its properties to combat many systemic diseases.  Stay tuned.

 You may be aware that green tea has much more ECGC than black tea, although they come from the same plant.  Researchers have warned that excessive amounts of ECGC found in some supplements can lead to toxicity and liver damage, so it is prudent to avoid high doses of this supplement. Brew green tea and swish it around in your mouth before swallowing.  Enjoy one or more cups a day, depending on your tolerance for caffeine, Green tea has about 1/3 to 1/2 the caffeine as coffee.  Kukicha green tea is made of the stems, stalks and twigs of the tea plant and is naturally low in caffeine. Powdered green tea, such as matcha, is considerably stronger. Water to brew a cup of green tea should be less than boiling temperature, around 150 to 160  degrees F . 

May all be well on your next trip to the dentist!

Sadja Greenwood, MD, MPH