Trying to stay healthy can seem like a full-time job sometimes.
Especially during a pandemic.
But I’m here to make that goal a little easier.
Welcome to the Nutrition Facts Podcast.
I’m your host Dr. Michael Greger.
Today, the mighty power of oats.
Now I don’t recommend you wear a feedbag around your neck.
But I will say that oats are a very versatile grain.
Here’s my first story.
Fiber continues to be singled out
as a nutrient of public health concern.
There is a fiber gap in America.
We’re only getting about half the minimum,
considered a public health concern for all Americans.
Well, not ALL Americans.
Less than 3% meet the recommended minimum,
meaning less than 3% of all Americans
eat enough plant-based foods,
the only place fiber is found,
though a nominal 0.1 is thrown in for the meat category
in case someone eats a corn dog or nibbles on the garnish.
If even half of the adult population ate 3 more grams a day,
like a quarter cup of beans or a bowl of oatmeal,
we could save billions in medical costs,
and that’s just for constipation.
The consumption of plant foods,
the consumption of fiber-containing foods
reduce risk for diabetes, heart disease,
stroke, cancer, and obesity as well.
The first to make this link between fiber intake and killer disease
was probably Dr. Hugh Trowell many decades ago.
He spent 30 years practicing in Africa
and suspected it was their high consumption of corn, millet,
sweet potatoes, greens, and beans
that protected them from chronic disease.
This kind of got twisted into the so-called fiber hypothesis,
but he didn’t think it was the fiber itself,
but the high-fiber foods that were so protective.
There are hundreds of different things in whole grains
besides fiber that may have beneficial effects.
For example, yes the fiber in oatmeal can lower
our blood cholesterol levels so less gets stuck in our arteries,
but there are anti-inflammatory, and antioxidant phytonutrients in oats
that can help prevent atherosclerotic build-up and
then help maintain arterial function.
Visionaries like Trowell were not entrapped
by the reductionist “simple-minded” focus on dietary fiber
and insisted that the whole plant foods should receive the emphasis.
Fiber intake was just kind of a marker for plant food intake.
Those with highest fiber intake, and the lowest cholesterol,
were those who ate exclusively plant-based diets.
Risk factors like cholesterol are one thing,
but can these individual foods actually affect the progression of heart disease?
We didn’t know, until this study was published.
Hundreds of older women were subjected to coronary angiograms,
where you can inject dye into the coronary arteries of the heart
to see how wide open they are.
They got an angiogram at the beginning of the study,
and then one a few years later,
all while analyzing their diets.
This is what they found.
The arteries of women eating less than a serving
of whole grains a day significantly narrowed,
whereas the arteries of women who ate just a single serving
or more also significantly narrowed,
but they narrowed less.
These were all women with heart disease
eating the standard American diet,
and so their arteries were progressively clogging shut—
heart disease is the #1 killer of American women,
but there was significantly LESS clogging
in the women eating more whole grains,
significantly less progression of their atherosclerosis.
In fact, almost as much slowing of their disease as one might get
taking cholesterol lowering statin drugs.
Statins can also slow the rate at which our arteries close.
But do we want to just slow the rate at which we die from heart disease,
or NOT die from heart disease at all?
A whole food, plant-based diet has been shown
to REVERSE the progression of heart disease,
opening our arteries back up.
Whole grains, like the drug, can help counter
the artery-clogging effects of the rest of the diet.
Having oatmeal with bacon and eggs,
is better than just eating bacon and eggs,
but better, perhaps, to stop eating an artery-clogging diet altogether.
In our next story, oats are put to the test against certain chemo side effects
to see just how soothing and anti-inflammatory they can be.
Oatmeal has been used for centuries
as a topical soothing agent on the skin
to relieve itch and irritation in dermatology.
Of course this is coming from Johnson & Johnson,
that sells a brand of oatmeal lotion, but look,
if it helps with dry skin or a bug bite,
I can imagine it having some soothing quality,
but this study shocked me.
There’s a class of chemo drugs, like Cetuximab,
that causes an awful rash.
It’s bad enough you have some horrible cancer,
but then to have painful itchy rash on top of it?
Various treatments have been tried and failed,
and no clear preventive or curative treatment for this eruption.
Or is there…?
The researchers had heard about this study,
in which human skin fragments from plastic surgery
were subjected to an inflammatory chemical,
and adding an oatmeal extract appeared to help,
so, hey, what do you have to lose?
Of the 10 patients with chemo rashes
they were able to get access to try some oatmeal lotion,
6 had a complete response, and 4 a partial response,
giving an overall oatmeal response rate of 100%.
Doctors wrote in from around the world.
Significant improvement in all patients?
Seemed rather too good to be true,
but out of desperation they tried it,
and got the same astonishing results.
Oatmeal, a simple topical agent producing such spectacular benefit
where more complex therapies have failed.
In an age when ever more expensive treatments
are consistently being championed,
it would be a great pity if this inexpensive, natural approach
to relieving distressing symptoms were to be overlooked.
Ironically, two of the cancer cell lines
found resistant in vitro to this type of chemotherapy,
were found to be sensitive to avenanthramides,
which are unique phytonutrients found in oats,
suggesting that people should apply oatmeal to their insides as well.
Finally today, is whole grain consumption just a marker for healthier behaviors,
or do whole grains have direct health benefits?
If oatmeal is so powerful that it can clear up some of
the ravages of chemotherapy just applied to the skin,
what might it do if we actually ate it?
The pharmacology of oatmeal.
Oats are reported to possess varied drug-like activities
like lowering of blood cholesterol and blood sugar,
boosting our immune system, anticancer,
antioxidant, anti-atherosclerosis,
in addition to being a topical anti-inflammatory,
and may also be useful in controlling
childhood asthma, body weight, etc.
Whole-grain intake in general is associated
with lower risk of type 2 diabetes,
cardiovascular disease, and weight gain.
All of the cohort studies on type 2 diabetes and heart disease
show whole grain intake is associated with lower risk.
They observed the same for obesity—
consistently less weight gain for those
who consumed a few servings of whole grains every day.
Yes, all the forward-looking population studies
demonstrate that a higher intake of whole grains
is associated with lower body mass index and body weight gain.
However, these results do not clarify whether
whole grain consumption is simply
a marker of a healthier lifestyle,
or a factor favoring “per se” lower body weight.
For example, high whole grain consumers—
those that eat whole wheat and brown rice,
and have oatmeal for breakfast—
tend to be more physically active, smoke less,
and consume more fruit, vegetables, and dietary fiber
than those that instead reach for Froot Loops.
Statistically, one can control these factors,
effectively comparing only nonsmokers to nonsmokers
with similar exercise and diet, as most of the studies did,
and they still found whole grains to be protective,
via a variety of mechanisms.
So, for example, in helping with weight control,
the soluble fiber of oatmeal forms a gel in the stomach,
delaying stomach emptying,
making one feel full for a longer period,
which helps with weight loss,
and then there are other effects in the small and large intestine.
So it all seems plausible that whole grain intake
does indeed offer direct benefits,
however, only results from randomized
controlled intervention studies
can provide the evidence of cause and effect.
In other words, the evidence is clear
that oatmeal consumers have lower rates of disease,
but that’s not the same as proving that if we start
to eat more oatmeal, our risk will drop.
To know that we need an interventional trial,
ideally a blinded study where you give half the people oatmeal,
and the other half fake placebo oatmeal
that looks and tastes like oatmeal to see if it actually works.
As you can imagine this has not been done, until now.
Double-blinded randomized trial
of overweight and obese men and women,
and almost 90% of the real oatmeal-treated
subjects had reduced body weight,
compared to no weight loss in the control group,
a slimmer waist on average, a 20 point drop in cholesterol,
and an improvement in liver function.
Nonalcoholic fatty liver disease, meaning a fatty liver caused by
excess food rather than excess drink,
is now the most common cause
of liver disease in the United States,
found on autopsy in up to 90% of obese individuals,
and can lead in rare cases to cirrhosis of the liver,
cancer of the liver, and death.
Theoretically, whole grains could help
prevent and treat fatty liver disease,
but this is the first time
it had actually been put to the test like this.
A follow-up study in 2014 confirmed these findings
of a protective role of whole grains,
but refined grains were associated with increased risk.
So one would not expect to get such wonderful results with Wonder Bread.
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please go to the Nutrition Facts Podcast landing page.
There you’ll find all the detailed information you need –
plus links to all of the sources we cite for each of these topics.
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