Hello and welcome to the Nutrition Facts Podcast. I'm your host, Dr. Michael Greger.

Now I know I've made a name for myself and explaining how not to do certain things.

Just look at my books. How not to die in my upcoming book, How Not to Diet.

But what I want to share with you is actually quite positive.

What's the best way to live a healthy life? Here are some answers.

Today we imagine a world without back pain. A condition that has become one of the biggest problem for public health systems in the second half of the 20th century.

The lifetime prevalence of people experiencing low back pain is reported to be as high as 84% and chronic low back pain is present in about 1 in 5, with 1 in 10 being disabled by it.

In our first story, we hear how atherosclerotic plaque clogging the arteries feeding our spine may lead to low back pain, disc, degeneration, and sciatic nerve irritation.

It's an epidemic. Are people just lifting more heavy stuff? No, mechanical factors such as lifting, carrying, probably do not play a major role in the disease.

Well, then what causes it? Atherosclerosis can obstruct the arteries that feed the spine and this diminished blood flow can result in various back problems.

This can be seen on angiography showing normal arteries on the left and clogged on the right or on autopsy, where you can see the openings to the spinal arteries can get squeezed shut by these cholesterol-filled plaques on the right.

Autopsy because back pain may predict fatal heart disease, just like clogs in the penile arteries erectile dysfunction can proceed heart attacks because it's the same disease clogged crippled arteries throughout our body.

Now we have MRI imaging that can show the occlusion of spinal arteries in people with back pain and the degeneration of their discs.

Normal blood flow and some without back pain versus constricted blood flow and someone with.

They show that patients with long-term lower back pain and these kinds of arterial clogs and those with high cholesterol appear to suffer more severe symptoms.

Those with narrowed arteries appear about eight and a half times more likely to have suffered from chronic back pain.

This makes sense the discs in our lower back are the largest avascular tissue in the body meaning or discs don't have any blood vessels.

Thus its nutrition just kind of diffuses in from the margins making especially vulnerable to deprivation.

Using MRIs you can measure the effects of impaired blood flow on that diffusion.

Although disc degeneration has multiple causal factors with genetic, occupational, mechanical influences,

alteration in nutrition has been proposed as a final common pathway by age 49, 97% of the discs of those in the standard American diet show at least grade 2 degradation.

Cholesterol plaques in the walls of the aorta can obliterate the orifices, the lumbar and middle-sacral arteries and make decreased blood flow of the lumbar spine and surrounding structures,

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