The Benefits of Sesame Seeds for Knee Osteoarthritis

Doctors have been injecting arthritis patients with gold since the 1920s. In fact, “[g]old-based medicines have been in use for thousands of years…and remarkably…are still in clinical use as DMARDs,” or disease-modifying anti-rheumatic drugs, meaning they can slow the progression of rheumatoid arthritis. Unfortunately, such drugs can be toxic and even fatal, causing conditions such as gold lung, a gold-induced lung disease. “Although its use can be limited by the incidence of serious toxicity,” injectable gold has been shown to be beneficial to patients with rheumatoid arthritis. But maybe, as some researchers have suspected, some of that benefit comes from the sesame oil that’s injected, which is used as the liquid carrier for the gold.

As I discuss in my video Sesame Seeds for Knee Osteoarthritis, sesame seeds contain anti-inflammatory compounds with names such as sesamin and sesamol, which researchers suggest “may serve as a potential treatment for various inflammatory diseases.” Those observations, however, came from in vitro (test tube) studies. First, we have to see if sesame seeds have an anti-inflammatory effect in people, not just in cells in a petri dish, but there haven’t been any studies on the effects of sesame seeds on inflammatory markers in people with arthritis, for example…until now.

The abstract states: “Considering the high prevalence of osteoarthritis (OA) and since until now there had not been any human studies to evaluate the effect of sesame in OA patients, this study was designed to assess the effect of administration of sesame on inflammation…” Indeed, researchers found a significant drop in inflammatory markers, but what effect did sesame seeds have on the patients’ actual disease?

Fifty patients with osteoarthritis of the knee were split into two groups. Both received standard treatment, but the sesame group also received about a quarter cup of sesame seeds a day for two months. Before they started, the patients described their pain as about nine out of ten, where zero is no pain and ten is the maximum tolerable pain. After two months, the control group felt a little better and reported their pain was down to seven, but the sesame group dropped down to three and a half, significantly lower than the control group. The researchers concluded that sesame appeared to have a “positive effect…improving clinical signs and symptoms in patients with knee OA…”

The main problem with the study, though, is that the control group hadn’t been given a placebo. It’s hard to come up with a fake sesame seed, but without a placebo, researchers basically compared doing nothing to doing something, and any time you have patients do something, you can’t discount the placebo effect. That said, what are the downsides? That’s the nice thing about using food as medicine—only good side effects. Though the results are mixed, there have been studies using placebo controls that found that adding sesame seeds to our diet may improve our cholesterol and antioxidant status, and the amount of sesamin found in as little as about one tablespoon of sesame seeds can modestly lower blood pressure a few points within a month, enough, perhaps, to lower fatal stroke and heart attack risk by about 5 percent, potentially saving thousands of lives.

What other dietary interventions can help with arthritis? Check out:

If the placebo effect is really that powerful, should doctors prescribe them? They already do! Check out The Lie That Heals: Should Doctors Give Placebos? for more on this.

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:

Almonds vs. Rice vs. Potatoes for Osteoporosis

Currently, an estimated ten million Americans suffer from osteoporosis, causing more than a million fractures, including hundreds of thousands of hip fractures, a common reason people end up in nursing homes. Many older women say they’d rather be dead than break their hip and end up in a home.

Bone is a living, “dynamic organ that is constantly renewed through a process of remodeling and modeling” involving bone breakdown by cells that eat bone, called osteoclasts, and bone formation by cells that build bone, called osteoblasts. Osteoporosis is caused by an imbalance between bone loss and bone gain, most often related to hormonal changes that occur during menopause. Is there anything we can do to help tip the balance back in bone’s favor?

There are a number of specific compounds in plant foods that look promising, but, as I discuss in my video Almonds for Osteoporosis, they are based on in vitro studies where researchers basically just drip some plant compound like cranberry phytonutrients on bone cells in a petri dish and see a boost in bone-builder cells or a drop in bone-eater cells. But no matter how much people like cranberry sauce, they’re not injecting it into their veins. For phytonutrients to reach the bone, they first have to get absorbed from the digestive tract into our bloodstream and make it past the liver before they can circulate to our skeleton. So, what we need is a so-called ex vivo study, where you take people, feed them a food—or not, draw their blood a few hours later, and then drip their blood onto bone cells to see if there’s any difference.

Normally, I’m not impressed with studies funded by marketing boards that pay for studies like the one that found that eating almonds improved cycling distance and athletic performance—compared to cookies. But the study I discuss in my video mentioned above was brilliant, not surprisingly, given it was performed in the world-famous lab of Dr. David Jenkins. There was a population study that suggested that eating almonds could protect against osteoporosis. Researchers could have simply dripped some almond extract on bone cells, but that’s not testing the whole food. Instead bone cells could be treated with the blood obtained from donors who had been fed the whole food to directly test the effects of these foods at the cellular level.

So, researchers exposed human osteoclasts, the bone-eating cells, to blood obtained before and four hours after eating a handful of almonds. But, wait. If you ate a handful of almonds every day, wouldn’t you gain weight? That’s almost 200 calories a day. Women in one study added to their regular diet a handful of almonds—like 35 nuts—as a mid-morning snack and were instructed to eat as much as they wanted for lunch and dinner that day. What happened? They ate less. In fact, they ate so much less, they canceled out the nut calories. In the study, the participants all had the same breakfast and then 0, 173, or 259 calories’ worth of almonds as a snack, before eating as much lunch and dinner as they wanted. The nuts appeared to be so satiating that the subjects ate less for lunch or dinner such that, at the end of the day, there was no significant difference in total caloric intake amongst any of the three groups. Part of the reason we don’t tend to gain weight when adding nuts to our diet may be because we end up flushing nearly one third of the calories down the toilet because we just don’t chew well enough. This is why we think there’s so much less fat in our bloodstream after eating whole almonds compared to the same amount of almond oil taken out of the same quantity of nuts.

Back to the study: So, researchers wanted to see if they could suppress the activity of the cells that eat away our bones. What did they find? Blood “serum obtained following the consumption of an almond meal inhibits human osteoclast formation, function, and gene expression…[providing] direct evidence to support the association between regular almond consumption and a reduced risk of developing osteoporosis.” The researchers also tried before and after eating other meals, including rice and potatoes, to make sure there wasn’t just some effect of eating in general. But, no: The protective effect did appear specific to the almonds.

What about dairy products? See my Is Milk Good for Our Bones? video.

And what about calcium supplements? Check out Are Calcium Supplements Safe? and Are Calcium Supplements Effective?.

Surprised by the lack of weight gain from eating all those nuts? You won’t be after watching Nuts and Obesity: The Weight of Evidence. And if you think that’s surprising, Pistachio Nut for Erectile Dysfunction will really shock you.

Want to learn more about ingenious ex vivo studies? See:

One possible mechanism for why nuts may be so healthy for our bones can be found in my video Phytates for the Prevention of Osteoporosis. What about the power of prunes? See Prunes for Osteoporosis.

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:

The Best Food for Acne

We hear a lot about traditional Chinese herbal medicine, but less about the herbs used in Japan. There is a root called Rhizoma coptidis that appears to have similar anti-acne activities to drugs like Accutane, a drug infamous for its side effects that has been since pulled from the market. But there are side effects to the root, too. A poor fellow took it to clear up his skin and as you can see in my video, let’s just say it made things  worse.

The anti-acne active component of the root is thought to be berberine. Is there any way to get the active ingredient in a safer plant? Yes, apparently: barberries, which I cover in my video Treating Acne with Barberries. You may remember barberries as being perhaps the most antioxidant-packed dried fruit available (see my video Better Than Goji Berries). You can find them cheap at Middle Eastern grocers, since they’re used to make a signature Persian rice dish. Their taste is described as “pleasantly acidulous,” which is just doctor-speak for sour. I love sprinkling them on my oatmeal just because I love their taste, but, evidently, they have played a prominent role in herbal healing for thousands of years around the world. They have been described rather flamboyantly in a pharmacology journal as an “herbal remedy [that] has no match in serving the human race.” And I just thought they were kind of tangy.

The problem with the herbal medicine literature is that there is often a long, impressive list of traditional uses, but little or no science to back them up. And what does exist is often either test tube or animal data that has questionable clinical applicability. Who cares, for example, if barberries “induce menstruation in a guinea pig” (except maybe the guinea pig)? So, you end up with drug companies injecting herbs into the penises of rabbits in hopes of coming up with the next Viagra, but they conduct few, if any, human studies.

I’ve seen petri dish studies over the years suggesting anti-cancer effects of barberries on human tumor cells in a petri dish or having anti-acne effects on hamsters, but there weren’t any such human studies… until, now.

Evidently, there had been anecdotal reports of acne clearing up after barberry juice consumption, so researchers decided to put it to the test in a double-blind, randomized, placebo-controlled clinical trial of fifty 12- to 17-year-olds with moderate to severe acne. Half got a sugar pill, and the other half got the equivalent of about a teaspoon of dried barberries three times a day for a month.

The results were remarkable. After four weeks on the placebo, as expected there was no change. The teens had just as many pimples as before. But in the barberry group, there was a 43 percent drop in the number of zits and about a 45 percent drop in the number of inflamed zits. That’s extraordinary. A spoonful of dried barberries costs about eight cents. Barberries have no reported side effects, and they are healthy for you anyway. The only potential concerns I could find were about eating them during pregnancy, and we don’t have good data on barberry consumption during lactation, so it’s best to stay away from barberries during breastfeeding as well until we know more.

For more on acne check out these older videos:

And a few new ones I just released this year:

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: