Açaí vs. Wild Blueberries for Artery Function

“Plant-based diets…have been found to reduce the risk of cardiovascular disease” and some of our other leading causes of death and disability. “Studies have shown that the longest living and least dementia-prone populations subsist on plant-based diets.” So why focus on açaí berries, just one plant, for brain health and performance?

Well, “foods rich in polyphenols…improve brain health,” and açaí berries contain lots of polyphenols and antioxidants, so perhaps that’s why they could be beneficial. If you’re only looking at polyphenols, though, there are more than a dozen foods that contain more per serving, like black elderberry, regular fruits like plums, flaxseeds, dark chocolate, and even just a cup of coffee.

As you can see at 1:02 in my video The Benefits of Açaí vs. Blueberries for Artery Function, in terms of antioxidants, açaí berries may have ten times more antioxidant content than more typical fruits, like peaches and papayas, and five times more antioxidants than strawberries. But blackberries, for instance, appear to have even more antioxidants than açaí berries and are cheaper and more widely available.

Açaí berries don’t just have potential brain benefits, however. Might they also protect the lungs against harm induced by cigarette smoke? You may remember the study where the addition of açaí berries to cigarettes protected against emphysema—in smoking mice, that is. That’s not very helpful. There is a long list of impressive-looking benefits until you dig a little deeper. For example, I was excited to see a “[r]eduction of coronary disease risk due to the vasodilation effect” of açaí berries, but then I pulled the study and found they were talking about a vasodilator effect…in the mesenteric vascular bed of rats. There hadn’t been any studies on açaí berries and artery function in humans until a study published in 2016.

Researchers gave overweight men either a smoothie containing about two-thirds of a cup of frozen açaí pulp and half a banana or an artificially colored placebo smoothie containing the banana but no açaí. As you can see at 2:26 in my video, within two hours of consumption of their smoothie, the açaí group had a significant improvement in artery function that lasted for at least six hours, a one or two point bump that is clinically significant. In fact, those walking around with just one point higher tend to go on to suffer 13 percent fewer cardiovascular events like fatal heart attacks.

As I show at 2:52 in my video, you can get the same effect from wild blueberries, though: about a one-and-a-half-point bump in artery function two hours after blueberry consumption. This effect peaks then plateaus at about one and a half cups of blueberries, with two and a half cups and three and a half cups showing no further benefits.

What about cooked blueberries? As you can see at 3:12 in my video, if you baked the blueberries into a bun, like a blueberry muffin, you get the same dramatic improvement in artery function.

Cocoa can do it, too. As shown at 3:30 in my video, after having one tablespoon of cocoa, you gain about one point, and two tablespoons gives you a whopping four points or so, which is double what you get with açaí berries.

One and a quarter cups’ worth of multicolored grapes also give a nice boost in artery function, but enough to counter an “acute endothelial insult,” a sudden attack on the vulnerable inner layer of our arteries? Researchers gave participants a “McDonald’s sausage egg breakfast sandwich and two hash browns.” They weren’t messing around! As you can see at 3:56 in my video, without the grapes, artery function was cut nearly in half within an hour, and the arteries stayed stiffened and crippled three hours later. But when they ate that McMuffin with all those grapes, the harmful effect was blunted.

Eat a meal with hamburger meat, and artery function drops. But if you eat that same meal with some spices, including a teaspoon and a half of turmeric, artery function actually improves.

What about orange juice? Four cups a day of commercial orange juice from concentrate for four weeks showed no change in artery function. What about freshly squeezed orange juice? Still nothing. That’s one of the reasons berries, not citrus, are the healthiest fruits.

For a beverage that can improve your artery function, try green tea. Two cups of green tea gives you that same effect we saw with cocoa, gaining nearly four points within just 30 minutes. And, as you can see at 5:05 in my video, that same crazy effect is also seen with black tea, with twice as powerful an effect as the açaí berries.

So, why all the focus on just that one plant? Why açaí berries? Well, the real reason may be because the author owns a patent on an açaí-based dietary supplement.

How do the antioxidant effects of açaí berries compare to applesauce? See The Antioxidant Effects of Açaí vs. Apples.

What about the effects of other foods on artery function? Coronary artery disease is, after all, our leading cause of death for men and women. See:

What else can blueberries do? Check out:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

Dark Chocolate Put to the Test for Peripheral Artery Disease

One of the problems with publishing research on chocolate is that the press jumps on it, oversimplifying and sensationalizing the message, and then the money starts rolling in from candy companies and the message is muddied even more. As a result, an important idea is lost in all the frenzy: The flavanol phytonutrients in cocoa appear to be beneficial, as I discuss in my video Chocolate and Stroke Risk. Though the sugar, fat, and excess calories in chocolate aren’t good for us, “natural cocoa powder can be a health food.” So, adding cocoa to a smoothie or oatmeal, for example, would be health-promoting. Try to use unprocessed, undutched cocoa, though. The beneficial flavanols are what give cocoa its bitterness, so manufacturers try to process cocoa with alkali to destroy them on purpose. Thus, when it comes to cocoa, bitter appears to be better.

In my previous video Dark Chocolate and Artery Function, you can see how high-tech angiography showed that dark chocolate could improve the function of coronary arteries in the heart within two hours of consumption, but there are some blood vessels you can visualize with your own eyes: the blood vessels in your eyes. Two hours after eating dark chocolate, as I show at 1:18 in my Chocolate and Stroke Risk video, you can observe a significant improvement in the ability of the little veins in your eyes to dilate.

What about the blood vessels in our legs? Peripheral artery disease (PAD) is atherosclerosis in the arteries feeding our limbs, which leads to claudication, a crampy pain in our calf muscles when we try to exercise, due to impaired blood flow. So, maximal walking distance and time were studied in 20 PAD patients two hours after subjects ate either dark chocolate with at least 85 percent cocoa or milk chocolate with no more than 35 percent cocoa. After eating the dark chocolate, the subjects could walk about a dozen more yards and about 17 seconds longer than before they had the dark chocolate. In comparison, after the milk chocolate, they weren’t even able to walk as far as baseline and not for a single second longer. So, there does seem to be something in cocoa that’s helping, but a few seconds here and there isn’t much to write home about. How about reversing the atherosclerosis, which we didn’t even think was even possible until 1977.

1977? Dean Ornish didn’t start publishing on heart disease reversal until 1979. In actuality, the first demonstration of atherosclerosis reversal with a cholesterol-lowering diet and drugs wasn’t on the coronary arteries going to the heart, but on the femoral arteries going to the legs.

What have researchers observed regarding the arteries going to the brain? There is a noninvasive way to measure arterial function within the brain using transcranial ultrasound. At 2:49 in my video, you can see a chart of what happens when we hold our breath. Once we start, our brain starts opening up the arteries to increase blood flow to compensate. If the arteries in our brain are stiffened and crippled by atherosclerosis, however, they’re unable to open as much and as fast as they should, and so are said to have a smaller “breath holding index,” which can be a risk factor for stroke. So, researchers designed an experiment in which they compared the results of a target food to something neutral, like oatmeal. What target food did they choose? A spoonful of cocoa powder or something? No. They chose a randomized crossover trial of oatmeal versus a deep-fried Mars bar.

Why a deep-fried Mars bar? The study was published in the Scottish Medical Journal, and, evidently, the “deep-fried Mars bar (DFMB) is a snack…strongly associate[d] with Scotland.” Really? Yes, really. Researchers phoned a total of 627 fish and chips shops in Scotland “to ascertain the delicacy’s availability.” More than one in five shops said they did carry deep-fried Mars bars and sold up to 200 a week. (Batter-dipped and deep-dried Snickers was evidently less popular.) The researchers “conclude[d] that Scotland’s deep-fried Mars bars is not just an urban myth. Encouragingly, [they] did also find some evidence of the penetrance of the Mediterranean diet into Scotland, albeit in the form of deep-fried pizza.”

Could this be contributing to Scotland having among the highest stroke rates in Europe?  Interestingly, there was a significant drop in men compared to women, which you can see at 4:29 in my video. Maybe men are from Mars and women are from Snickers? Regardless, what about chocolate that’s not deep-fried? There have been a few population studies that have followed people over time that found that those who ate chocolate appeared to have lower stroke rates, which has since been confirmed by another study. Is it possible, though, that chocolate consumption just happens to be related to other behaviors that are heart- and brain-healthy? Maybe people who exercise a lot have to eat more food, so maybe they eat more chocolate? Researchers didn’t see any evidence of that, but you can’t account for everything. To prove cause and effect, people would need to be randomized into two groups, with half eating chocolate and the other half not, and then followed for a decade or two. To this, one researcher replied that “it would be hard to gain consent from most people to the possibility of being randomized to a ‘no chocolate’ arm. How many people would agree to forego chocolate for a ‘sufficiently long follow-up period’?” Ten to twenty years without chocolate is a pretty long time.

Want more chocolate? See:

For more on stroke prevention, check out:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:


Who Should Avoid Coffee?

Do coffee drinkers live longer than non-coffee drinkers? Is it “wake up and smell the coffee” or don’t wake up at all? I discuss these questions in my video, Coffee and Mortality.

The largest study ever conducted on diet and health put that question to the test, examining the association between coffee drinking and subsequent mortality among hundreds of thousands of older men and women in the United States. Coffee drinkers won, though the effect was modest, a 10-15% lower risk of death for those drinking six or more cups a day. This was due specifically to lower risk of dying from heart disease, respiratory disease, stroke, injuries and accidents, diabetes, and infections.

However, another study that amount of coffee was found to increase the death rate of younger people under age 55. It may be appropriate, then, to recommend that you avoid drinking more than four cups a day. But if you review all the studies, the bottom line is that coffee consumption is associated with no change or a small reduction in mortality starting around one or two cups a day, for both men and women. The risk of dying was 3% lower for each cup of coffee consumed daily, which provides reassurance for the concern that coffee drinking might adversely affect health, or at least longevity.

A recent population study found no link between coffee consumption and symptoms of GERD, reflux diseases such as heartburn and regurgitation. If you actually stick a tube down people’s throats and measure pH, though, coffee induces significant acid reflux, whereas tea does not. Is this just because tea has less caffeine? No. If you reduce the caffeine content of the coffee down to that of tea, coffee still causes significantly more acid reflux. Decaf causes even less, so GERD patients might want to choose decaffeinated coffee or, even better, opt for tea.

Coffee intake is also associated with urinary incontinence, so a decrease in caffeine intake should be discussed with patients who have the condition. About two cups of coffee a day worth of caffeine may worsen urinary leakage.

A 2014 meta-analysis suggested that daily coffee consumption was associated with a slightly increased risk of bone fractures in women, but a decreased risk of fractures in men. However, no significant association was found between coffee consumption and the risk of hip fracture specifically. Tea consumption may actually protect against hip fracture, though it appears to have no apparent relationship with fracture risk in general.

Certain populations, in particular, may want to stay away from caffeine, including those with glaucoma or a family history of glaucoma, individuals with epilepsy, and, not surprisingly, people who have trouble sleeping. Even a single cup at night can cause a significant deterioration in sleep quality.

We used to think caffeine might increase the risk of an irregular heart rhythm called atrial fibrillation, but that was based on anecdotal case reports like one of a young woman who suffered atrial fibrillation after “chocolate intake abuse.” These cases invariably involved the acute ingestion of very large quantities of caffeine. As a result, the notion that caffeine ingestion may trigger abnormal heart rhythms had become “common knowledge,” and this assumption led to changes in medical practice.

We now have evidence that caffeine does not increase the risk of atrial fibrillation. Low-dose caffeine—defined as less than about five cups of coffee a day—may even have a protective effect. Tea consumption also appears to lower cardiovascular disease risk, especially when it comes to stroke. But given the proliferation of energy drinks that contain massive quantities of caffeine, one might temper any message that suggests that caffeine is beneficial. Indeed, 12 highly caffeinated energy drinks within a few hours could be lethal.

To learn more about various health aspects of coffee, see my videos Coffee and Cancer, What About the Caffeine?, Preventing Liver Cancer with Coffee?, and Coffee and Artery Function.

What else can we consume to live longer? Check out Nuts May Help Prevent Death, Increased Lifespan from Beans, Fruits and Longevity: How Many Minutes per Mouthful?, and Finger on the Pulse of Longevity.

And, for more on controlling acid reflux, see Diet and GERD Acid Reflux Heartburn and Diet and Hiatal Hernia.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: