Dr. Steve Chaney

Gestational Diabetes Causes: High Folate Levels?

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What Should You Look For In A Prenatal Supplement?

Author: Dr. Stephen Chaney

 

gestational diabetes causesAccording to the CDC, almost 10% of the women in this country will develop diabetes during pregnancy, something referred to as gestational diabetes. After delivery, their blood sugar levels will usually return to normal.

However, gestational diabetes is not a benign condition. It increases your risk of serious complications during both pregnancy and delivery. It also increases the risk that your baby will suffer complications during birth, and it increases their risk of developing obesity and diabetes later in life.

Obesity and a family history of diabetes both increase the likelihood that you will develop gestational diabetes during pregnancy. Beyond that, what could be gestational diabetes causes are not well known.

There have been numerous suggestions in the literature that high folate levels may increase your risk of gestational diabetes. If that is true, it is concerning.  After all you are being told you should probably be taking a folic acid supplement before and during pregnancy to prevent birth defects. Could the very supplement you are taking to prevent birth defects be harming both you and your unborn child?

Before you throw out your folic acid supplements, I should hasten to add that the science is not definitive. Some studies have reported an association between high folate levels and gestational diabetes. Other studies have seen no association. It has been very confusing. No one has been able to figure out why the study results have been so inconsistent.

In this issue of “Health Tips From The Professor,” I share a study that may clear up the confusion.

How Was The Study Done?

pregnancy diabetesThis study (Lai et al, Clinical Nutrition, doi: 10.1016/j.clnu.2017.03.22 ) was part of a larger study,  “Growing Up in Singapore Towards Healthy Outcomes” (GUSTO). The larger study was designed to assess multiple factors related to the health of pregnant mothers and their offspring. This particular study was designed to assess whether there was an association between high blood folate levels and gestational diabetes in Asian women.

The investigators recruited 923 women of Chinese, Malay, and Indian descent when they were less than 14 weeks pregnant. The women returned to the clinic at 26-28 weeks of pregnancy. Fasting blood samples were obtained for analysis of plasma folate, B12, and B6 levels. Gestational diabetes was diagnosed during the same clinic visit based on a fasting blood glucose level followed by a second blood glucose test 2 hours after ingestion of 75 grams of glucose. The women also completed a diet recall during this office visit.

 

Do High Folate Levels Cause Gestational Diabetes?

 

When the data were analyzed:

  • A high blood level of folate was associated with a 30% increase in gestational diabetes.
  • A high blood level of B12 was associated with a 20% decrease in gestational diabetes.
  • A high blood level of B6 showed no association with gestational diabetes.

vitamin b12When the investigators looked at the association between folate status and gestational diabetes in each of the ethnic groups individually, they discovered that the association between high blood folate levels and gestational diabetes occurred almost entirely in the Indian women.

This offered an important clue. A high proportion of the Indian women were following a vegetarian diet, which could predispose to B12 deficiency. When the investigators looked at both folate and B12 status, they found:

  • A high blood level of folate combined with B12 insufficiency was associated with a 97% increase in gestational diabetes.
  • A blood level of folate in women with normal B12 status showed no association with gestational diabetes.

What Does This Study Tell Us?

This is a single study, and it is based on associations which do not prove cause & effect. Additional studies are clearly needed to prove this hypothesis. However, if these data are confirmed, this study has several interesting ramifications.

#1: It offers a possible explanation for the inconsistencies of previous studies looking at the associations of high folate status with gestational diabetes. Most previous studies simply measured folate status without looking at B12 levels. This study suggests it is important to assess both folate and B12 status. Elevated blood folate levels may only predispose to gestational diabetes in populations that are also B12 deficient.

#2: This study suggests a previously unknown interaction between folate and B12. This is not simply a case of high folate levels masking the symptoms of B12 deficiency. The prevalence of gestational diabetes was much greater when blood folate levels were elevated than it was with B12 deficiency alone. In other words, folate made the symptoms worse. The authors offered a potential mechanism for this interaction, but it was speculative. In short, we simply do not understand the mechanism of this interaction at present.

What Does This Study Mean For You?

folic acid pregnancyIf this study is confirmed, it has several important implications for any woman who is pregnant or is considering becoming pregnant.

#1: Methyl folate offers no advantage over folic acid: These data are based on blood folate levels, not on folic acid intake. Methyl folate and folic acid are equally likely to increase blood folate levels.

#2: B12 supplementation is important if you are vegetarian or are restricting meat intake: This is just a reminder of what you have probably heard before. There are many potential causes of B12 deficiency. However, in the younger age range, vegetarianism is the most common cause of B12 deficiency.

#3: A holistic approach to supplementation is better than taking individual vitamins. In this case, it is clearly preferable to take a supplement containing both folic acid and B12 than one just containing folic acid or methyl folate. That is an important message. You are constantly being reminded that optimal folate status is important for a healthy pregnancy. It is easy to find supplements containing just folic acid or methyl folate. Avoid those supplements! Look for ones that contain both folic acid and B12 (preferably with B6 and the other B vitamins as well). The same holds true for prenatal supplements. Make sure they contain all the B vitamins in balance, not just folic acid.

So, could high folate levels be one of the gestational diabetes causes?  We simply don’t know yet.

 

The Bottom Line

 

  • Recent headlines have suggested that high blood folate status is associated with an increased risk of developing gestational diabetes during pregnancy. This raises the question as to whether the supplementation you have been told was essential to prevent birth defects could also put you at risk for another health problem.
  • The study actually showed that high blood folate status only increases the risk of gestational diabetes in women who are also B12 deficient.
  • If you are pregnant or thinking of becoming pregnant, this study has several important implications for you.
    • Methyl folate offers no advantage over folic acid. These data are based on blood folate levels, not on folic acid intake. Methyl folate and folic acid are equally likely to increase blood folate levels.
    • B12 supplementation is important if you are vegetarian or are restricting meat intake. This is just a reminder of what you have probably heard before.
    • A holistic approach to supplementation is better than taking individual vitamins. In this case, it is clearly preferable to take a supplement containing both folic acid and B12 than one just containing folic acid or methyl folate. That is an important message. You are constantly being reminded that optimal folate status is important for a healthy pregnancy. It is easy to find supplements containing just folic acid or methyl folate. Avoid those supplements! Look for ones that contain both folic acid and B12 (preferably with B6 and the other B vitamins as well). The same holds true for prenatal supplements. Make sure they contain all the B vitamins in balance, not just folic acid.
  • For details, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Is Coconut Oil Bad For You?

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Nutty About Coconut Oil

Author: Dr. Stephen Chaney

is coconut oil bad for youCoconut oil is the latest miracle food. Bloggers and talk show hosts are telling us how healthy it is. We are being told to cook with it, spread it on our toast, and put it in our smoothies. We are told to be creative. The more coconut oil you can get in your diet, the better.  But, is coconut oil bad for you?

The hype is working. 72% of the American public believes coconut oil is healthy. This is why the recent American Heart Association (AHA) Presidential Advisory on saturated fats has proven so controversial.

Interestingly, most of the AHA advisory was about the linkage between saturated fats from meat & dairy and heart disease risk. Only one paragraph of the 24-page report was devoted to coconut oil, but the AHA recommendation to avoid coconut oil generated the lion’s share of headlines.

What Did The AHA Presidential Advisory Say?

The AHA advisory concluded that saturated fats from meat and dairy foods increased the risk of heart disease. This conclusion was based on randomized clinical trials in which the diet was carefully controlled for a period of at least two years. More importantly, the conclusion was not based on LDL cholesterol, particle size, HDL cholesterol, inflammation or any other potential marker of heart disease risk. It was based on actual cardiovascular outcomes – heart attacks, strokes, deaths due to heart disease.

I have reviewed the AHA report in a previous issue of “Health Tips From the Professor,” Are Saturated Fats Bad For You, and have concluded their statement that saturated fats from meat and dairy increase the risk of heart disease was based on solid evidence. We can now say definitively that those saturated fats should be minimized in our diets.

 

Is Coconut Oil Bad For You?

 

coconut oil bad for heartIn contrast to the saturated fats in meat and dairy, there have been no studies looking at the effect of coconut oil on cardiovascular outcomes. Instead, the authors of the AHA report relied on studies measuring the effect of coconut oil on LDL cholesterol levels. There have been 7 controlled trials in which coconut oil was compared with monounsaturated or polyunsaturated oils.

  • Coconut oil raised LDL cholesterol in all 7 studies.
  • The increase in LDL cholesterol in these studies was identical to that seen with butter, beef fat, or palm oil.

This evidence makes it probable that coconut oil increases the risk of heart disease. However, LDL is not a perfect predictor of heart disease risk. The only way to definitively prove that coconut oil increases the risk of heart disease would be to conduct clinical studies in which:

  • Coconut oil was substituted for other fats in the diet.
  • All other dietary components were kept the same.
  • The study lasted at least 2 years.
  • Adherence to the “coconut oil diet” was monitored.
  • Cardiovascular outcomes were measured (heart attack, stroke, death from heart disease).

In short, one would need the same type of study that supports the AHA warning about saturated fats from meats and dairy. In the absence of this kind of study, there is no “smoking gun.” We cannot definitively say that coconut oil increases the risk of heart disease.

Is Coconut Oil Healthy?

coconut oil healthyDoes that mean all those people who have been claiming coconut oil is a health food are right? Probably not. At the very least, their health claims are grossly overstated.

Let’s start with the obvious. In the absence of any long-term studies on the effect of coconut oil on cardiovascular outcomes, nobody can claim that coconut oil is heart healthy. It might be, but it might also be just as bad for you as the saturated fats from meat and dairy. It’s effect on LDL cholesterol suggests it might increase your risk of heart disease, but we simply do not know for certain.

I taught human metabolism to medical students for 40 years. I was also a research scientist who published in peer reviewed journals. When I look at the health claims for coconut oil on the internet, I am dismayed. Many of the claims are complete nonsense. Others sound plausible, but are based on an incomplete understanding of human metabolism. None of them would pass peer review, but, of course, there is no peer review on the internet.

In addition, some of the claims have been “cherry picked” from the literature. For example, claims that coconut oil increases metabolic rate or aids weight loss are based on short-term studies and ignore long-term studies showing those effects disappear over time.

Let me review some of the more plausible-sounding claims for coconut oil.

  • Coconut oil increases HDL levels, which is heart healthy. The effects of HDL cholesterol are complex. Elevated HDL levels are not always heart protective.

For example, a few years ago a pharmaceutical company developed a drug that raised HDL levels. They thought they had a blockbuster drug. You didn’t need to exercise. You didn’t need to lose weight. You would just pop their pill and your HDL levels would go up. There was only one problem. When they did the clinical studies, their drug had absolutely no effect on heart disease risk. It turns out it is exercise and weight loss that reduce heart disease risk, not the increase in HDL associated with exercise and weight loss.

The implications are profound. Just because something increases HDL levels does not mean it will reduce cardiovascular risk. You have to actually measure cardiovascular risk before claiming something is heart healthy. That has not been done for coconut oil, so no one can claim it is heart healthy.

  • Coconut oil consists of medium chain triglycerides, which are absorbed more readily than other fats. That is true, but it is of interest to you only if you suffer from a fat malabsorption disease. Otherwise, it is of little importance to you.
  • Medium chain triglycerides are preferentially transported to the liver, where the fats in coconut oil are converted to energy or released as ketones rather than being stored as fat. This is partially true, but it is misleading for two reasons.
    • First, the fat in coconut oil actually has three possible fates in the liver. Some of it will be converted to energy, but only enough to meet the immediate energy needs of the liver. If carbohydrate is limiting, the excess will be converted to ketones and exported to other tissues as an energy source. If carbohydrate is plentiful, the excess will be converted to long chain saturated fats identical to those found in meat and dairy and exported to other tissues for storage.
    • Secondly, nobody has repealed the laws of thermodynamics. If the fat in coconut oil is being preferentially used as an energy source by the liver and being exported as ketones to other tissues as an energy source, you need to ask what happens to the calories from the other components in your diet. If you are eating a typical American diet, the carbohydrate that would have been used for energy will be converted to fat and stored. If you are eating a low carbohydrate diet, the other fats that would have been used for energy will simply be stored. Simply put, if you are preferentially using the calories from coconut oil for energy, the calories from the other foods in your diet don’t just evaporate. They are stored as fat.
  • Coconut oil increases metabolic rate, which will help you lose weight. When you look at the studies, this is only a temporary effect. This is due to a phenomenon called metabolic adaptation that is often seen when one makes a dramatic shift in diet composition. Initially, you may see an increase in metabolic rate and weight loss. After a few weeks, the body adapts to the new diet,and your metabolic rate returns to normal.
  • Coconut oil is metabolized to ketones which have many beneficial effects. There is some truth to this claim. As I discussed in my analysis of the keto diet,  ketones have some real benefits, but not nearly as many as proponents claim. Furthermore, the amount of ketones produced by coconut oil will depend on the availability of carbohydrate. Much of the coconut oil in the context of a very low carbohydrate diet will likely be converted to ketones. Coconut oil spread on a piece of bread or used in baking is more likely going to be converted to fat.

I could go on, but you get the point. The hype about the benefits of coconut oil sounds good, but is misleading. There may be some benefits, but in the absence of long-term studies we have no convincing evidence that coconut oil is good for us.

What Does This Mean For You?

coconut oil bad or goodWhen you started reading this article, you were probably hoping that I would settle the coconut oil controversy. Perhaps you were hoping that I would tell you the American Heart Association was right, and you should avoid coconut oil completely. More likely you were hoping I would tell you the coconut oil proponents were right and you could continue looking for more ways to incorporate coconut oil into your diet. As usual, the truth is somewhere in between.

Coconut oil may increase our heart disease risk, but the evidence is not definitive. We cannot say with certainty that coconut oil is bad for us. On the other hand, most of the hype about the benefits of coconut oil is inaccurate or misleading. We have no well-designed, long-term studies on health outcomes from coconut oil use. We cannot say with certainty that coconut oil is good for us.

I recommend moderation. Small amounts of coconut oil are probably alright. If you have a particular recipe for which coconut oil gives the perfect flavor, go ahead and use it. Just don’t add it to everything you eat.

Finally, there are other oils we know to be healthy that you can use in place of coconut oil. If you are looking for monounsaturated oils, olive oil and avocado oil are your best bets. Olive oil can be used in salads and low temperature cooking. Avocado oil is better for high temperature cooking. Also, less frequently mentioned, safflower and sunflower oils are also good sources of monounsaturated fats.

If you are looking for a mixture of monounsaturated and polyunsaturated fats, safflower oil, canola oil and peanut oil are your best bets. Peanut oil is also good for high temperature cooking.

Corn oil and soybean oil are your best sources of omega-6 polyunsaturated fats, while flaxseed oil is your best vegetable source of omega-3 polyunsaturated fats.

 

The Bottom Line

 

  • Coconut oil is the latest diet fad. It is highly promoted by the popular press, and 72% of Americans think it is healthy, even though it is a saturated fat.
  • The American Heart Association (AHA) has recently advised against the use of coconut oil because it likely increases the risk of heart disease and “has no offsetting beneficial effects.”  Because this statement is controversial, I have carefully analyzed the pros and cons of coconut oil use.
  • Coconut oil may increase our heart disease risk, but the evidence presented by the American Heart Association is not definitive. We cannot say with certainty that coconut oil is bad for us.
  • On the other hand, most of the hype about the benefits of coconut oil is inaccurate or misleading. We have no well-designed, long-term studies on health outcomes from coconut oil use. We cannot say with certainty that coconut oil is good for us.
  • I recommend moderation. Small amounts of coconut oil are probably alright. If you have a particular recipe for which coconut oil gives the perfect flavor, go ahead and use it. Just don’t add it to everything you eat.
  • For details of my analysis and suggestions for healthy fats you can substitute for coconut oil, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Frozen Shoulder Pain Treatment

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Regain Your Full Range Of Motion

Author: Julie Donnelly, LMT – The Pain Relief Expert

Editor: Dr. Steve Chaney

 

frozen shoulder pain treatmentRecently I’ve had a client coming to me for frozen shoulder pain treatment.  “Mary” is suffering from “Frozen Shoulder.”  It doesn’t sound so bad, but don’t let the simple diagnosis hide the fact that this condition causes more than just pain. Mary’s shoulder joint was so frozen that she had minimal range-of-motion in any direction, and sleeping was a nightmare!  Regardless of which way she slept – on her back or side, the ache would wake her up several times a night, often in tears from the pain.

Physical therapy wasn’t helping at all. Her frozen shoulder kept getting worse, and the only relief she had from the pain was by taking strong pain-killing drugs. The all-too-real fear of opioid addiction caused her to only take the drugs when the pain was unbearable.  She is a hairstylist so this situation was having a very negative effect on her income and future. On a more personal note, it certainly wasn’t helping her intimate relationship with her husband. She was getting frantic for a solution.

Fortunately, the client of a co-worker had come to my office when she was in pain, and she gave Mary my card.  That was the beginning of a long journey, but one that is helping her more than she’d ever imagined possible.

What Causes A Frozen Shoulder?

frozen shoulder pain causesYour shoulder has more muscle attachments than any other joint in your body. Several muscles don’t attach right into your shoulder joint, but as they pull on your arm or shoulder blade, your shoulder moves.  This is the reason that your shoulder and arm can move in so many directions.   More than 15 muscles need to all work together to enable you to have a full range-of-motion with your shoulder and arms.

Frozen shoulder is caused by several, or many, of these muscles all being held taut because of multiple spasms.  When one muscle contracts, another must lengthen to allow for the contraction.

For example, when you are swimming and the muscles of your chest are pulling your shoulders/arms forward, the muscles of your back need to lengthen. And, when you want to reach back to take a tennis swing, the muscles of your chest must lengthen.  Or, when you want to lift your arm up to reach the top of your closet, the muscles that bring your arm down must lengthen. But, when you reach down to pick something up from the floor, the muscles on top of your shoulder must lengthen.  It’s always a matter of opposing muscles both needing to do their part in order for you to move your shoulder and arm.

Frozen Shoulder Pain Treatment

frozen shoulder pain exercisesActually, there are too many treatments for me to cover in detail in this short article. If you have been receiving Health Tips from the Professor for some time, you have many of my treatments from previous blogs.

Basically, if you have stiffness in your shoulder, you need to look at the movements you can’t make. Next, think about the opposing muscle that needs to be lengthened in order to make that movement. This is the muscle that needs to be treated to start to release your frozen shoulder.

One treatment you can do is for your infraspinatus muscle. This is the muscle that pulls your arm back.

Put a ball on the belly of the muscle, which is at the center of your shoulder blade, and apply pressure. Hold the pressure for about a minute, release for 5 seconds, and repeat.  Do this several times and then stretch that muscle.

To help people eliminate pain and stretch safely, I created a program called Focus Flexibility Training. This DVD program shows you how to treat all of the muscles of your shoulder and a whole lot more.

When it comes to Frozen Shoulder pain treatment, you’ll ultimately need to treat most, if not all of your shoulder muscles.  It’s not a fast treatment, but it does work.

Wishing you well,

Julie Donnelly

 

About The Author

julie donnellyJulie Donnelly is a Deep Muscle Massage Therapist with 20 years of experience specializing in the treatment of chronic joint pain and sports injuries. She has worked extensively with elite athletes and patients who have been unsuccessful at finding relief through the more conventional therapies.

She has been widely published, both on – and off – line, in magazines, newsletters, and newspapers around the country. She is also often chosen to speak at national conventions, medical schools, and health facilities nationwide.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Are Saturated Fats Bad For You?

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The Saturated Fat Wars Heat Up Again

Author: Dr. Stephen Chaney

Are saturated fats bad for you? 

are saturated fats bad for youI feel your pain. It is so confusing. Just a few months ago we were being told our fears of saturated fats were outdated. Saturated fats were fine. It was carbohydrates we needed to avoid.

Then, just last week the headlines blared: “Hold your horses. Saturated fats are bad for you. You need to avoid them.” No wonder you are confused!

Last week’s headlines were based on a recently published Presidential Advisory by the American Heart Association (F.M. Sacks et al, Circulation. 2017;135.00-00. DO!: 10.1161/CIR.0000000000000510). A Presidential Advisory is the AHA’s highest-level health advisory. It is meant to guide public health policy by government agencies such as the US Surgeon General’s office, the USDA, and the CDC.

However, the warnings about the dangers of saturated fat are very much like the warnings about the dangers of global warming. They have their believers and their deniers, and both sides passionately defend their positions. I understand the passion of saturated fat deniers. Foods high in saturated fat are an integral part of our heritage and our culture. It is only natural to want to believe those foods are good for us.

Because of this, I knew the AHA advisory would be controversial. After all, if someone is telling us we need to give up the foods we love, they better have darn good evidence to back up their recommendations.

I knew you, my readers, would want a scientifically accurate evaluation of the evidence, so I carefully analyzed the research studies the AHA presented in support of their recommendations. Here is what I found.

How Was The Analysis Done?

saturated fats and heart diseaseThis report was put together by the top heart disease experts, both physicians and research scientists, in the country. They examined over 50 years of research studies. They also examined meta-analyses that combined the results of multiple research studies. In short, they examined the entire body of scientific evidence on diet and heart disease.

The AHA committee used very rigorous criteria in selecting the best studies for their analysis. They only included randomized clinical trials that:

  • Had actual cardiovascular end points – heart attack, stroke, and deaths due to heart disease. Studies looking at things like LDL, HDL, particle size, inflammation etc. only give you part of the picture. They may, or may not, accurately predict risk of dying from heart disease.
  • Lasted two years or more. The fats we eat determine the fat composition of our cell membranes, and that is what ultimately determines our risk of dying from heart disease. This is the one instance it is true to say: “We are what we eat.”  However, changing the fat composition of our cell membranes does not occur overnight. It takes 2 years or more to achieve a 60-70% change in the fat composition of cell membranes.

It also takes time for any intervention to meaningfully impact heart disease risk. For example, with statin drugs it takes 1-2 years before there is a significant reduction in heart disease risk. Thus, for a variety of reasons, studies of less than 2 years duration are doomed to fail.

  • Showed the subjects stuck with the new diet for the duration of the study. Subjects find it difficult to adhere to a diet to which they are not accustomed long term and often revert to their more familiar diet. This requires either very close monitoring of what the subjects are eating or measurement of fat membrane composition to verify diet adherence, or both. Studies that only measured what the subjects were eating at the beginning of the study and then looked at outcomes months or years later may or may not be valid. Without any measurement of diet adherence, it is impossible to know.
  • Carefully controlled or measured what the saturated fats were replaced with. The importance of this criterion will be clear when we look at the results of their study.

They then did a meta-analysis of what they referred to as “core randomized trials” that met all 4 criteria. In short, this was a very rigorous and well-done analysis.

Are Saturated Fats Bad For You?

saturated fats from meatsThe main finding of the report was:

  • Replacing saturated fats from animal products with polyunsaturated fats from vegetable oils decreased the risk of heart disease by 29%. This is equivalent to statin therapy, without the side effects.
  • The conclusions of this report applied equally to the saturated fats that come from meats and dairy products.
  • About 50% of the risk reduction could be due to lowering of LDL cholesterol. The rest came from reduced arterial inflammation, increased flexibility of the arteries, increased membrane fluidity and other factors.
  • When the replacement of saturated fats with polyunsaturated fats occurred in the context of a heart healthy diet such as the Mediterranean diet, heart disease risk was reduced by 47%.

What the saturated fats are replaced with is critically important. The authors of this report calculated what would happen if we were to replace half of our saturated fat calories with equivalent calories from other foods. Replacing half of our saturated fat intake with:

  • Polyunsaturated fats (vegetable oils and fish oil), lowers heart disease risk by 25%.
  • Monounsaturated fats (olive oil & peanut oil), lowers heart disease risk by 15%.
  • Complex carbohydrates (whole grains, fruits & vegetables), lowers heart disease risk by 9%.
  • Refined carbohydrates and sugars (the kind of carbohydrates in the typical American Diet), slightly increases heart disease risk.
  • Trans fats, increases heart disease risk by 5%.
  • The authors did not address the relative value of omega-6 and omega-3 polyunsaturated fats in their report. However, I have addressed the heart health benefits of omega-3s in a previous report, Fish Oil Really Snake Oil.

Why Is There So Much Confusion?

saturated fats and LDL cholesterolYou are probably saying: “If saturated fats are so bad for me, why do I keep seeing diet books and news headlines saying I have nothing to fear from saturated fats?” The answer is pretty simple. The studies that have given rise to misleading headlines about the safety of saturated fats ignored one or more of the criteria described above that are needed to assure a valid conclusion. For example:

  • Some recent headlines claiming that saturated fats did not increase the risk of heart disease were based on studies in which saturated fats were replaced by refined carbohydrates and sugars. Other headlines were based on studies that did not measure what the saturated fats were replaced with.
  • The popular high saturated fat-low carb diets are not backed by any studies looking at their effect on heart attacks, stroke, or heart disease deaths. They are only backed by studies looking at their effect on LDL cholesterol and other imperfect markers of heart disease risk.
  • In contrast, the Mediterranean diet, which lowers saturated fat intake and contains healthy carbohydrates (whole grains, fruits and vegetables), significantly decreases the risk of heart disease. Please reference Mediterranean Diet for Heart Health.

 

What Are The Saturated Fat Deniers Saying?

 

saturated fats deniersThe saturated fat deniers have wasted no time trying to discredit the American Heart Association advisory. Maybe they can’t bear the thought of having to give up their favorite fatty foods. Or maybe they just can’t bear to admit they were wrong.

However, their claims just don’t hold water. Let me give you some examples.

  • The AHA (American Heart Association) is a tool of the pharmaceutical industry. If the AHA were a tool of the pharmaceutical industry, I hardly think their report would have stated that replacing saturated fats with polyunsaturated fats was as effective as statin drugs at reducing heart attack risk.
  • The AHA is a tool of the food industry. If the AHA were a tool of the food industry, I hardly think they would have recommended replacing fats from meat & dairy with polyunsaturated fats.
  • The AHA advisory was based on associations, which do not show cause and effect. False. The AHA committee based their recommendations on randomized clinical trials, the strongest kind of evidence. They merely said that studies looking at the association between saturated fats and heart disease were consistent with their analysis of randomized clinical trials.
  • The AHA advisory was based on LDL cholesterol, which is an imperfect predictor of cardiovascular risk. False. Again, the AHA committee based their recommendations on randomized clinical trials of cardiovascular outcomes, not on LDL levels. They merely estimated that LDL cholesterol levels contributed to about 50% of the risk they observed.
  • saturated fats mythsThe AHA committee ignored an early study in which replacing butter with polyunsaturated fats increased cardiovascular risk. False. That study actually replaced butter with margarine. It was the first study showing that trans fats are worse for us than saturated fats.
  • The AHA committee ignored recent studies that did not fit their hypothesis. False. They developed a valid set of scientific criteria for evaluating clinical studies. As described above, they simply eliminated those studies whose design does not permit a definitive conclusion.
  • The AHA recommends low fat diets containing refined carbohydrates and sugary foods, which are even worse. False. The AHA has consistently recommended low fat diets with complex carbohydrates (whole grains, fruits & vegetables). It is the food industry that corrupted their message. More to the point, this AHA Presidential Advisory specifically recommended lowering saturated fats in the context of a heart healthy diet like the Mediterranean diet.
  • The AHA recommends replacing saturated fats with omega-6 polyunsaturated vegetable fats, which can be harmful if consumed in excess. I have some sympathy with this argument. I would have preferred to have seen more emphasis on omega-3 oils in their report. There should also have been some discussion of the importance of antioxidants to protect against free radicals generated by polyunsaturated fat metabolism. However, their final recommendation to replace saturated fats with polyunsaturated fats in the context of a healthy diet like the Mediterranean diet goes a long way towards satisfying both concerns.

In short, the saturated fat deniers have no persuasive counter-argument. The evidence that saturated fat causes heart disease is simply overwhelming.

What Does This Mean For You?

replace saturated fats with polyunsaturated fatsThe time for debate is over. The evidence is overwhelming. It should be obvious to any reasonable person that saturated fats increase our risk of heart disease.

It should also be obvious that any diet that claims saturated fats are heart healthy is a myth. There are no long-term studies to back up that claim.

It is time to consider what it would mean if everyone in this country were to follow the AHA recommendations and replace half of the saturated fat in our diet with polyunsaturated fat. That would decrease our risk of heart disease by 29%.

  • 800,000 Americans die of heart disease each year. 232,000 lives would be saved.
  • Heart disease costs our nation $316 billion each year. $92 billion health care dollars would be saved.
  • Heart disease costs are expected to exceed $1 trillion by 2035. $290 billion health care dollars would be saved.

What if we decreased our risk of heart disease by 47% by coupling decreased intake of saturated fats with a heart healthy diet like the Mediterranean diet?

  • 376,000 lives would be saved.
  • $148 billion health care dollars would be saved.
  • $470 billion health care dollars would be saved by 2035.

Each of us has the ability to save our health and our lives by what we put into our mouths every day.

In addition, our health care system will soon become financially non-viable if we continue to focus on disease treatment rather than prevention. Each of us also has the ability to save our health care system by what we put into our mouths every day.

 

The Bottom Line

 

  • The link between saturated fat and heart disease risk is like global warming. It has its believers and its deniers, and both sides passionately defend their viewpoints.
  • The American Heart Association (AHA) recently released a Presidential Advisory on the relationship between saturated fats and heart disease. Because I knew their report would be controversial, I analyzed its scientific accuracy very carefully.
  • The AHA report was prepared by the top heart disease experts in the country. They reviewed over 50 years of clinical studies and used a very rigorous set of criteria to decide which studies to include in their analysis and which to exclude. In my judgement, the criteria they used were valid. Studies that fail to meet one or more of these criteria may not provide valid results. Unfortunately, several of the studies that have generated some of the recent controversy did not meet those criteria.
  • From a meta-analysis of “core studies” meeting these criteria, they concluded:
    • Replacing saturated fats from animal products with polyunsaturated fats from vegetable oils decreased the risk of heart disease by 29%. This is equivalent to statin therapy, without the side effects
    • The conclusions of this report applied equally to the saturated fats that come from meats and dairy products.
    • About 50% of the risk reduction could be due to lowering of LDL cholesterol. The rest came from reduced inflammation, increased flexibility of the arteries, and other factors.
    • When the replacement of saturated fats with polyunsaturated fats occurred in the context of a heart healthy diet such as the Mediterranean diet, heart disease risk was reduced by 47%.
  • The AHA recommends replacing half of the calories from saturated fat with healthier choices. From a detailed analysis of the data, the authors concluded which foods replace the saturated fat is very important. Replacing half of our saturated fat intake with:
    • Polyunsaturated fats (vegetable oils and fish oil), lowers heart disease risk by 25%.
    • Monounsaturated fats (olive oil & peanut oil), lowers heart disease risk by 15%.
    • Complex carbohydrates (whole grains, fruits & vegetables), lowers heart disease risk by 9%.
    • Refined carbohydrates and sugars (the kind of carbohydrates in the typical American Diet), slightly increases heart disease risk.
    • Trans fats, significantly increases heart disease risk.
  • The saturated fat deniers have already started trying to discredit the AHA advisory. I have reviewed their claims and found them to be baseless.
  • The evidence is overwhelming. It should be obvious to any reasonable person that saturated fats increase our risk of heart disease. It should also be obvious that any diet that claims saturated fats are heart healthy is a myth. There are no long-term studies to back up that claim.
  • If everyone in this country were to follow the AHA recommendations and replace half of the saturated fat in our diet with polyunsaturated fat:
    • Between 232,000 and 376,000 lives would be saved next year.
    • Between 92 and 148 billion health care dollars would be saved next year.
    • By 2035 between 290 and 470 billion health care dollars would be saved annually.

In short, each of us has the ability to preserve our health and save our lives by what we put into our mouth every day.

So, are saturated fats bad for you?  The answer is a resounding “yes.”

For more details, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Can a Genetic DNA Test Provide Real Insight on Your Health?

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None Of Us Are Perfect

Author: Dr. Stephen Chaney

 

genetic dna testMost of us think of genetic diseases as something that is very rare. We have learned about diseases like cystic fibrosis or sickle cell disease in school. Those are examples of diseases caused by a rare mutation. If both chromosomes carry the mutation, you have the disease. If not, you don’t.

Can a genetic dna test give you real insight on your health?

We also know that family history is a strong predictor of genetic predisposition. If you are a guy, and most of the males in your family tree have dropped dead of a heart attack at an early age, you can assume you are genetically predisposed to heart disease. If you are a gal and most of the women in your family tree have developed breast cancer at an early age, you can assume you are genetically predisposed to breast cancer.

However, if none of these apply, we assume we are “normal”. We think we’ll probably live to 120. All this healthy lifestyle “stuff” is nice, but it isn’t a priority. It makes me think of Garrison Keillor’s tales of “Lake Wobegon” where all the children were above normal.

What if that weren’t true? What if none of us were normal? What if all of us are predisposed to some disease, perhaps even multiple diseases, and didn’t know it? Would that change how we thought about making the effort to follow a healthy lifestyle?

None Of Us Are Perfect

humans are not perfectOn one hand, this study (MacArthur et al, Science, 335: 823 – 828, 2012 ) may seem of interest only to geneticists, but its implications are huge. The authors looked at genetic variation among the human genomes sequenced as part of the human genome project. Specifically, they looked for loss of function (LOF) variants – mutations that would either partially or completely prevent the synthesis of a functional protein.

After a very complex genetic analysis they concluded that each of us harbors about ~100 LOF variants (mutations) in our genome.

Some of those mutations were in genes coding for proteins that have no known function. Other mutations coded for proteins whose loss might affect minor things like taste sensation.

Still other mutations were in genes coding for proteins that were redundant because there are other proteins in the cell that can perform the same function (Just as NASA designed the space shuttle with backup systems that could take over if a primary system failed, our bodies are frequently designed with more than one enzyme that can carry out the same function).

And, as you might expect, some of those mutations were in genes associated with known diseases like sickle cell disease or cystic fibrosis – but those mutations were very rare.

However, the authors concluded that each of us harbors about 20 LOF mutations that completely inactivate essential genes and might increase the probability that we will develop certain diseases.

That got me thinking. It validated scientifically something that we have all known instinctively for a long time – none of us are perfect. Or, as my childhood friends might have more cruelly put it: “We’re all defective in one way or another.”

What Does This Mean For You?

Now some of you may be saying: “What does this mean for me?” When you carry this idea through to its ultimate conclusion, the bottom line message is:

1) Nutritional recommendations are based on averages – none of us are average.

2) The identified risk factors for developing diseases are based on averages – none of us are average.

3) Clinical trial results are based on averages – none of us are average.

4) Clinical trials on the benefits and dangers of supplementation are based on averages – none of us are average.

5) Even clinical trials of drug efficacy for treating disease or drug safety are based on averages – none of us are average.

That means lots of the advice you may be getting about your risk of developing disease X, the best way to treat disease X, or the role of supplementation in preventing disease X may be generally true – but it might not be true for you.

So, my advice is not to blindly accept the advice of others about what is right for your body. Learn to listen to your body. Learn what foods work best for you. Learn what exercises just feel right for you. Learn what supplementation does for you.

Don’t ignore your doctor’s recommendations, but don’t be afraid to take on some of the responsibility for your own health. You are a unique individual, and nobody else knows what it is like to be you.

 

What Can a Genetic DNA Test Tell You About Your Health?

no-one is averageYou may be thinking: “If we know all the loss of function (LOF) mutations that cause disease, I should just send my saliva off to one of those companies that promises to give you a genetic DNA test and advise you of all your disease risks.”

Not so fast. It isn’t that simple. Here’s what those genetic testing companies aren’t telling you.

  • Genetic predisposition to most diseases is caused by multiple mutations that each make small contributions to your disease risk. There are only a few LOF mutations that dramatically increase your risk of major diseases like cancer, heart disease, and diabetes. Unless you have one of those rare mutations, you are in the dark about your disease risk.
  • LOF mutations are just the tip of the iceberg. There are many more mutations that affect regulation of metabolic pathways which impact your health. Many of these mutations are poorly defined at present. You might get a perfect score on your genetic testing and still be at risk for some major diseases.
  • The effect of LOF mutations on health outcomes varies from person to person. This is a phenomenon that my geneticist colleagues call “penetrance”. Simply put, the effect of any single mutation is modified by the expression of multiple other genes, which also vary from person to person. Your “score” on a genetic testing analysis may not predict your actual risk of disease.
  • Gene expression is modified by diet, lifestyle, and your environment. I have discussed this in previous articles like “Can Diet Alter Your Genetic Destiny?” and “What Is Epigenetics?”.  In short, genes do not determine your destiny. Your healthy lifestyle may protect you from a genetic predisposition to disease. Your unhealthy lifestyle may doom you to poor health in spite of a perfect score on your genetic testing analysis.

I only recommend genetic testing if you have a strong family history of a major disease and plan on working with a certified genetic counselor who can put the results of the analysis into the proper context.

 

The Bottom Line

 

  • A recent study looked at genetic variation among the human genomes sequenced as part of the human genome project. Specifically, the authors looked for loss of function (LOF) variants – mutations that would either partially or completely prevent the synthesis of a functional protein.
  • After a very sophisticated statistical analysis, the authors concluded that each of us harbors about 20 LOF mutations that completely inactivate essential genes and might increase the probability that we will develop certain diseases.
  • That means none of us are perfect. None of us are “average”. We all have genetic defects that predispose us to certain diseases. The implications are staggering.
  • Nutritional recommendations are based on averages – none of us are average.
  • The identified risk factors for developing diseases are based on averages – none of us are average
  • Clinical trial results are based on averages – none of us are average.
  • Clinical trials on the benefits and dangers of supplementation are based on averages – none of us are average.
  • Even clinical trials of drug efficacy for treating disease or drug safety are based on averages – none of us are average.
  • That means lots of the advice you may be getting about your risk of developing disease X, the best way to treat disease X, or the role of supplementation in preventing disease X may be generally true – but it might not be true for you.
  • So, my advice is not to blindly accept the advice of others about what is right for your body. Learn to listen to your body. Learn what foods work best for you. Learn what exercises just feel right for you. Learn what supplementation does for you.

I am not saying we know everything we need to know about genetic predisposition to disease. I’m not saying that genes determine our destiny. I’m not recommending you send off your saliva for a genetic analysis to determine your risk of developing a major disease. To understand why, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Can Diet Prevent Alzheimer’s

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Preserving Your Memories In Your Golden Years

Author: Dr. Stephen Chaney

 

can diet prevent alzheimer'sAlzheimer’s is a scary disease. There is so much to look forward to in our golden years. We want to enjoy the fruits of our years of hard work. We want to enjoy our grandkids and perhaps even our great-grandkids. More importantly, we want to be able to pass on our accumulated experiences and wisdom to future generations.

Alzheimer’s and other forms of dementia have the potential to rob us of everything that makes life worth living. What is the use of having a healthy body, family, and fortune if we can’t even recognize the people around us?

That is why anything that might reduce the risk of Alzheimer’s is BIG news, which brings me to the recent buzz about the MIND diet.  Can diet prevent Alzheimer’s.

 

What Is The MIND Diet?

the mind dietThe MIND diet is the brainchild of Dr. Martha Clare Morris, a nutritional epidemiologist at Rush University Medical Center. She started with the Mediterranean and DASH diets, which I have described in a previous issue of “Health Tips From the Professor,” because both of those diets have been shown to reduce the risk of dementia. Then she researched the literature for studies linking specific foods and nutrients to improving cognition and/or preventing dementia.

In short, she combined the brain-healthy features of the Mediterranean and DASH diets and further modified them based on the best scientific data available. She emphasized some components of those two diets and minimized others. She also modified the number of servings of some foods, based on the best available evidence.

She acknowledged that when she eliminated or reduced foods that were parts of those two diets, it did not mean those foods might not play an important role in preserving cognitive function as we age. It simply meant we don’t currently have strong evidence to prove their beneficial effects in preserving cognition.

The MIND diet is a whole food, plant-based, diet.

 

  • It includes 10 “brain-healthy” food groups: green leafy vegetables, other vegetables, nuts, berries, beans, whole grains, fish, poultry, olive oil, and wine (in moderation, too much alcohol kills brain cells).
  • It limits red & processed meats, butter and margarine, cheese, pastries & sweets, and fried & fast foods.
  • It neither recommends nor discourages low fat dairy foods and fruit other than berries. Dr. Morris notes that while those are healthy foods, they have no proven benefit for preventing cognitive decline.

 

Can Diet Prevent Alzheimer’s?

 

As you can tell, a lot of thought went into the design of the MIND diet, but does it work? Dr. Morris partnered with 5 of her colleagues at Rush University Medical Center to test the hypothesis (Morris et al., Alzheimer’s & Dementia 11: 1007-1014, 2015). They enrolled 923 participants, ages 59 to 98 years (average age = 81) from retirement communities and senior public housing units in the Chicago area. All participants were free of Alzheimer’s disease when the study began.

doctor's studyAt the beginning of the study each participant filled out a detailed food frequency questionnaire. Participants were given an extensive physical and neurological exam designed to diagnose the onset of Alzheimer’s disease and/or dementia on an annual basis. Participants were followed for an average of 4.5 years, during which time 144 of the participants developed Alzheimer’s and another 14 developed non-Alzheimer’s dementia.

At the end of the study the food frequency data were analyzed to determine how closely participants adhered to the MIND diet, the Mediterranean diet, and the DASH diet.  Adherence to each of these diets was then correlated with the onset of Alzheimer’s disease. [To be perfectly clear, none of the participants were given any dietary instruction. Nor were they advised to change their diet. This study simply looked at the diets they were already eating and determined how closely their diet matched the standards set for MIND, Mediterranean, and DASH diets.] The results were striking:

  1. Strict adherence to all 3 diets significantly decreased the risk of developing Alzheimer’s disease. The decreased risk was:
    • 53% for the MIND diet.
    • 54% for the Mediterranean diet.
    • 39% for the DASH diet.
  2. When the investigators looked at moderate adherence to each of the diets, the MIND diet performed slightly better than the other two diets:
    • Moderate adherence to the MIND diet decreased Alzheimer’s risk by 35%.
    • Moderate adherence to the Mediterranean and DASH diets had no significant effect on Alzheimer’s risk.

What Does This Study Mean For You?

Dr. Morris concluded that healthy diets, such as the Mediterranean and DASH diets, provide substantial protection against dementia. She stated that as new studies come along, these diets can be modified to provide even better protection. She considers the MIND diet is the first step in that process.

alzheimer's riskA 53% decrease in Alzheimer’s risk is impressive. However, if you are really concerned about dementia and Alzheimer’s disease, you should think of diet as only one component of a holistic approach. As I described in a recent article How to Prevent Memory Loss, a holistic approach to preserving your cognitive function includes:

  • A healthy diet
  • B vitamins & omega-3s
  • Weight control
  • Exercise
  • Adequate sleep
  • Socialization
  • Memory training (mental exercise)

The Bottom Line

 

  1. The Mediterranean and DASH diets have already been shown to preserve mental function as we age, thus reducing the risk of developing dementia and Alzheimer’s.
  2. Martha Morris at Rush University Medical Center used the latest studies on specific foods and nutrients that preserve mental function to modify those diets into something she calls the MIND diet.
  3. Morris and colleagues at Rush then evaluated the effectiveness of all 3 diets on reducing Alzheimer’s risk. Strict adherence to all 3 diets significantly decreased the risk of developing Alzheimer’s disease. The decreased risk was:
    • 53% for the MIND diet.
    • 54% for the Mediterranean diet.
    • 39% for the DASH diet.
  4. When the investigators looked at moderate adherence to each of the diets, the MIND diet performed slightly better than the other two diets:
    • Moderate adherence to the MIND diet decreased Alzheimer’s risk by 35%.
    • Moderate adherence to the Mediterranean and DASH diets had no significant effect on Alzheimer’s risk.
  5. Morris concluded that healthy diets, such as the Mediterranean and DASH diets, provide substantial protection against dementia. However, she feels that as new studies come along, these diets can be modified to provide even better protection. She considers the MIND diet as the first step in that process.
  6. Healthy diet is only one component of a holistic approach for preserving mental function. Other components include:
    • B vitamins & omega-3s
    • Weight control
    • Exercise
    • Adequate sleep
    • Socialization
    • Memory training (mental exercise)

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Relieve Hip Pain After Sitting or Driving

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Relief is Just a Few Movements Away!

Author: Julie Donnelly, LMT – The Pain Relief Expert

Editor: Dr. Steve Chaney

 

relieve hip pain after sittingI’m on a long business trip, speaking and teaching in Tennessee and New York, and the drive from Sarasota, FL meant many hours of driving over several days.  One of my stops was to visit with Suzanne and Dr. Steve Chaney at their home in North Carolina.  It was that long drive that became the inspiration for this blog.

After all those hours of driving, my hip was really sore. It was painful to stand up. While talking to Suzanne and Dr. Chaney I was using my elbow to work on the sore area, and when we were discussing the blog for this month it only made sense to share this technique with you.  So, Dr. Chaney took pictures and I sat at his computer to write.  I thought others may want to how to relieve hip pain after sitting or driving for long periods.

What Causes Anterior Hip Pain?

As I’ve mentioned in posts in the past, sitting is the #1 cause of low back pain, and it also causes anterior hip pain (pain localized towards the front of the hip) because the muscles (psoas and iliacus) pass through the hip and insert into the tendons that then insert into the top of the thigh bone.  When hip pain reliefyou try to stand up, the tight muscle tendons will pull on your thigh bone.  The other thing that happens is the point where the muscle merges into the tendon will be very tight and tender to touch. You aren’t having pain at your hip or thigh bone, but at the muscular point where the muscle and tendon merge.

It’s a bit confusing to describe, but you’ll find it if you sit down and put your fingers onto the tip of your pelvis, then just slide your fingers down toward your thigh and out about 2”. The point is right along the crease where your leg meets your trunk.

The muscle you are treating is the Rectus Femoris, where it merges from the tendon into the muscle fibers.  Follow this link, thigh muscle, to see the muscle and it will be a bit easier to visualize.

You need to be pressing deeply into the muscle, like you’re trying to press the bone and the muscle just happens to be in the way.  Move your fingers around a bit and you’ll find it.

Easy Treatment for Anterior Hip Pain After Sitting

relieve hip painHere is an easy treatment for hip pain after sitting you can administer yourself.  First, sit as I am, with your leg out and slightly turned.

Find the tender point with your fingers and then put your elbow into it as shown.

It’s important to have your arm opened so the point of your elbow is on top of the spasm.  It’s a bit tricky, but if you move about a bit you’ll come on to it, and it will hurt.  Keep the pressure so it’s tolerable, not excruciating.

After you have worked on this point for a few minutes you can move to the second part of the treatment.

hip pain treatmentPut the heel of your “same-side” hand onto your thigh as close to the spasm as you can get.  Lift up your fingers so the pressure is only on the heel of your hand.  You can use your opposite hand to help give more pressure.

Press down hard and deeply slide down the muscle, going toward your knee.  You can also kneed it like you would kneed bread dough, really forcing the muscle fibers to relax.

I’m putting in a picture from a previous blog to explain how you can also treat this point of your rectus femoris by using a ball on the floor.

As shown in this picture, lie on the floor with the ball on your hip muscle, and then slightly turn your body toward the floor so the ball rolls toward the front of your body. You may need to move the ball down an inch or so to get to your Rectus Femoris.

When you feel the pain, you’re on the muscle.  Just stay there for a minute or so, and if you want you can move so the ball goes along the muscle fibers all the way to your knee.

pain free living book coverIt may be a challenge to find this point, but it’s well-worth the effort!

In my book, Treat Yourself to Pain Free Living, I teach how to treat all the muscles that cause pain from your head to your feet.

Wishing you well,

Julie Donnelly

julie donnelly

About The Author

Julie Donnelly is a Deep Muscle Massage Therapist with 20 years of experience specializing in the treatment of chronic joint pain and sports injuries. She has worked extensively with elite athletes and patients who have been unsuccessful at finding relief through the more conventional therapies.

She has been widely published, both on – and off – line, in magazines, newsletters, and newspapers around the country. She is also often chosen to speak at national conventions, medical schools, and health facilities nationwide.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

How to Live a Healthy Lifestyle Longer

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Wish I Knew At 20

Author: Dr. Stephen Chaney

how to live a healthy lifestyleI wish I knew how to live a healthy lifestyle when I was 20.  But, I was a typical 20-year-old American. I ate lots of junk food. I thought an occasional tennis game was all the exercise I needed. I never really thought about what I was doing. I just did what all my friends did. If I hadn’t changed what I was doing, I might have had a short, unhealthy life.

Of course, I did change, and those changes made all the difference. Now I’m in my 70s, and I’m in perfect health. I have no diseases. Even the allergies I had when I was younger have gone away as I improved my diet and lifestyle. I am on no medications. I have the blood pressure of a 16-year-old.

I call this article “How to Live a Healthy Lifestyle:  Wish I Knew At 20”, but this article isn’t about me. I wrote this article for all the other 20-year-olds who know as little about nutrition and health as I did at 20. I also wrote this article for all those people who haven’t changed – those people with the same diet and lifestyle they had at 20. It’s never too late to change and begin to live a healthy lifestyle.

 

How to Live a Healthy Lifestyle:  What I Wish I Knew At 20

 

Here are 15 tips I would pass along to all the 20-year-olds, even those 20-year-olds in older bodies:

#1: You Are In Charge: You have a brain. You have free will. You don’t have to do what everyone else is doing. It is time to start thinking about what your health and your life will be like if you don’t change. More importantly, it is time to start thinking about what your health and your life could be like if you do make positive changes.

#2: It Matters: I can’t emphasize strongly enough how important it is to make positive changes in your diet, your exercise, and your overall lifestyle. We know all the major killer diseases (heart disease, cancer, diabetes, hypertension, etc) are affected by diet and lifestyle. However, it is much more than avoiding disease. As you age, your quality of life is dramatically affected by how much you have moved and what you have put in your mouth over your lifetime.

If you have any question about how important healthy eating can be, take time to view documentary movies like “Forks Over Knives” or “Eating You Alive.” I’m not necessarily advocating that extreme a diet, but these films will get you thinking.

fad diets#3: Avoid the Fads: Once you have decided to adopt a healthier lifestyle, the hardest part is deciding which changes you should make. You will need to practice a lot of due diligence. There is a lot of hype and misinformation out there. There is a new fad every week. First, it’s low fat. Then it’s low carb. Then it’s no bananas before noon on Thursdays (I’m joking here, but you get the point. Some of the diets are just plain weird).

Most of those diet recommendations sound plausible. They all have their advocates who are only too happy to offer their testimonials. My advice: If it sounds too good to be true, avoid it. If they tell you the medical profession is trying to keep their diet a secret, avoid it. The consensus advice of the medical and nutrition communities may seem boring, but it is generally based on dozens of clinical studies. It is much more likely to be true than advice from your friends, your trainer, or that blogger who values controversy more than accuracy.

#4: We Are All Different: Health recommendations are usually based on dozens of clinical studies. But, here is the secret that only scientists know. Clinical studies report averages, but none of us are average. Let me give you an example. Let’s say you wanted to do a clinical study to evaluate whether a low-carb diet helps people lose weight. You might enroll several hundred people in your study. If you put them all on an identical low-carb diet for 8 weeks, some of them would lose weight. Others would gain weight. At the end of the 8 weeks, you would average all weight changes together and report the average weight loss.

For the sake of argument, let’s say the average weight loss was 6.4 pounds. That’s fine except that not a single person in the study lost exactly 6.4 pounds, and some may have even gained weight. The bottom line is that your results may be different from conventional wisdom. Your results may be different from your friend’s. You will need to find out what works best for you.

#5: You Don’t Have To Change All At Once: Some people have an iron will and can make drastic changes overnight. Most of us aren’t like that. If we try to change too many things at once, we become overwhelmed. We become discouraged. Sometimes we quit. Think of this as a marathon, not a sprint. Make “Change One” your slogan. Change one thing each week until you are where you want to be. One week it may be replacing sugary desserts with fruits. Another week it may be adding a green vegetable to your dinner plate. Over time, all those small changes will result in a totally different lifestyle.

processed foods#6: Your Tastes Will Change: The first time you choose a low sodium food, it will taste bland. Over time you will come to enjoy the subtle flavors of the food and will come to dislike added salt. The first time you switch from whole milk to low fat milk it will taste like water. Over time you will learn to appreciate low fat milk, and whole milk will taste greasy. I could give lots more examples, but you get the point.

#7: Processed Foods, Sweets, and Sodas Will Kill You: I’m being dramatic here, but they are bad for your health. They have no place as part of a healthy diet. Replace the processed foods and sweets with whole foods. Replace the sodas with water or herbal teas.

#8: It’s What You Do Every Day That Matters: Refined grains, pastries and sweets should be only an occasional indulgence. Fruits, vegetables, and whole grains should be the mainstay of your everyday diet. Eat a plant-based diet as much as possible.

#9: Protein Is Important, Especially As We Get Older: Low fat or vegetarian protein sources should be your first choice. Chicken (with the skin removed) and fish are the healthiest meats. Nuts, beans & seeds are excellent vegetarian protein sources, especially in combination. Think of red meats as no more than an occasional indulgence.

#10: Avoid The Center Of The Supermarket: This is my only shopping advice. In general, supermarkets are arranged with real foods around the edges and the processed foods in the middle.

organic foods#11: Choose Organic: Our planet has become so polluted that is has become impossible to completely avoid toxic chemicals in our environment. They are in our air, our water, our soil, and our homes. Our only defense is to be informed consumers and avoid them whenever possible. If the cost of organic produce is an issue for you, be selective. There is a Dirty Dozen  list of fruits and vegetables that are the ones most likely to be contaminated with pesticides and herbicides.

#12: Get Lots Of Exercise: Most experts recommend at least 30 minutes of moderate intensity exercise 5 times per week. More is even better. For best results choose a combination of aerobic and weight bearing exercise.

#13: Control Your Weight: We are in the midst of an obesity epidemic. The problem is that 80% of us are genetically predisposed to become obese if we eat a typical American diet and follow a typical American lifestyle. The solution isn’t the fad diet du jour. The solution is to change our diet and our lifestyle. For most of us, the changes I have outlined above will allow you to gradually attain & maintain your ideal weight.

#14: Supplementation Plays A Role: Supplementation is not a magic bullet, but it is an important component of a holistic wellness program. Some of us need supplementation to fill in nutritional gaps in our diet. Some of us need supplementation because of increased needs, either because of disease or genetics. Some of us choose supplementation to achieve optimal health.

#15: Enjoy The Journey: If you think of a healthy lifestyle as depriving you of the things you enjoy, you will avoid it. Instead, think of it as an adventure. Have fun exploring new fruits and vegetables. Try cooking with herbs and spices. Seek out restaurants and recipes that turn healthy foods into a gourmet experience. Find exercises that you actually enjoy.  Now you know how to live a healthy lifestyle and for longer.

What Does This Mean For You?

This was not meant to be a diet book. Because each of us is different, I have shared 15 tips rather than a rigid diet plan that everyone should follow. However, I suspect many of you are scratching your heads and saying: “Where do I go from here?”. For those of you who would like more specific recommendations for your new, healthier lifestyle, I recommend my recent article “What Is The Best Diet For You?”.

 

The Bottom Line

 

In this article, I have shared 15 tips for a longer, healthier life. They are:

  • You are in charge.
  • It matters.
  • Avoid the fads.
  • We are all different.
  • You don’t have to change all at once.
  • Your tastes will change.
  • Processed foods, sweets and sodas will kill you.
  • It’s what you do every day that matters.
  • Protein is important, especially as we age,
  • Avoid the center of the supermarket.
  • Choose Organic.
  • Get lots of exercise.
  • Control your weight.
  • Supplementation plays a role.
  • Enjoy the journey.

For more details, read the article above and find out how to live a healthy lifestyle longer.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Help Prevent Postpartum Depression with Omega-3s?

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What Does Science Say About Depression During & After Pregnancy?

Author: Dr. Stephen Chaney

prevent postpartum depressionCan you help prevent postpartum depression by using omega-3s?  Pregnancy and breastfeeding should be a wonderful time in any woman’s life, but sometimes the dark days of depression take hold. Postpartum depression used to be taboo. It was never talked about unless a mother did something terrible enough to make it into the headlines. Nowadays we realize that it is nothing to be ashamed of. In fact, it is fairly common.

The CDC estimates that 11-20% of women will suffer some degree of depression after childbirth. A similar percentage of women will experience prenatal depression (depression during pregnancy). To put these numbers into perspective, 20% of women can expect to suffer depression during their lifetime.

Of course, that doesn’t make prenatal or postnatal (postpartum) depression any easier to understand for any woman who has suffered from it. How could such a joyous time in their lives lead to depression?

The causes of prenatal and postnatal depression are multifactorial. Some, such as genetic predisposition and hormonal imbalances, may be beyond a woman’s control. Others may require medical intervention.

However, many women ask: “Is there something natural, some change in diet and lifestyle, I could undertake that might help with the depression?” This week we will look at a study suggesting that omega-3s might help with prenatal and postnatal depression.

 

Can Omega-3s Help With Prevent Postpartum Depression?

can omega3 prevent postpartum depressionThere are several reasons for suspecting that omega-3s might help with both prenatal and postnatal (postpartum) depression.

  • Many studies have suggested that omega-3 deficiency is implicated in depression.
  • A recent study DHA During Pregnancy  reported that pregnant women in the US are only getting around 1/5 the recommended amount of omega-3s from their diet.
  • During the second and third trimester, the fetus requires tremendous amounts of omega-3s, particularly DHA, to support its developing brain. This could be another instance of the fetus robbing an important nutrient from the mother’s body.

However, clinical studies to date have been inconclusive. Some have shown a clear correlation between omega-3 deficiency and pre/postnatal depressions. Others have not.

The authors of this study (Lin et al, Biological Psychiatry, doi.org/10.1016/j.biopsych.2017.02.1182 ) did a meta-analysis of all studies measuring both omega-3 status and pre/postnatal depression. They included 12 studies with a total of 7739 women in their analysis. Of the women in the study 1094 (16.6%) suffered with prenatal and/or postnatal depression.

Their findings were:

  • Levels of total omega-3s and DHA were significantly lower in the women with prenatal and/or postnatal depression.
  • The ratio of omega-6 to omega-3 fatty acids was higher in the women with prenatal and/or postnatal depression.

 

What Does This Study Mean To You?

healthy livingThis study showed an association between omega-3 deficiency and depression during the prenatal and postnatal periods. It suggests, but does not prove, that omega-3 deficiency predisposes to pre/postnatal depression.  So, taking the recommended amounts of omega-3s may help prevent postpartum depression.

If this were the only reason to suggest adding extra omega-3s to your diet during pregnancy and lactation, it might not be sufficient to spur you to action. However, recent studies suggest that increasing your omega-3 intake during pregnancy and breastfeeding is also important for your child’s brain development. Thus, there are at least two important reasons to make sure your omega-3 intake is optimal during pregnancy and breastfeeding.

It is important to recognize that increasing your omega-3 intake may not be sufficient to cure pre- and postnatal depression by itself. It is probably best as part of a holistic approach. You should also:

  • Make sure you are getting adequate B vitamins (especially folic acid, B6 and B12). Clinical studies have also linked deficiencies of these nutrients with depression.
  • Make sure your protein intake is sufficient and limit sugars and simple carbohydrates. This helps stabilize blood sugar swings that can affect your mood.
  • Keep caffeine to a minimum and avoid alcohol.
  • Employ stress reduction techniques such as yoga, meditation, or conversations with friends.

Of course, there is nothing radical about any of these recommendations. These are the same recommendations every pregnant mother is being given for the health of their baby. For example, the importance of folic acid has been recognized for decades. The importance of omega-3s for your child’s brain development has received increasing recognition in recent years.

Finally, if natural approaches don’t work, consult your physician.

 

The Bottom Line

 

  • A recent meta-analysis has shown an association between omega-3 deficiency and both prenatal and postnatal depression.
  • That is significant in light of a recent study showing that pregnant women in the US are getting only 1/5 the recommended amount of omega-3s from their diet.
  • This study showed an association between omega-3 deficiency and depression during the prenatal and postnatal periods. It suggests, but does not prove, that omega-3 deficiency predisposes to pre/postnatal depression.
  • In addition, recent studies suggest that increasing your omega-3 intake during pregnancy and breastfeeding is also important for your child’s brain development. Thus, there is more than one reason to make sure your omega-3 intake is optimal during pregnancy and breastfeeding.
  • Increasing your omega-3 intake may not cure pre/postnatal depression by itself. It is probably best as part of a holistic approach. You should also:
    • Make sure you are getting adequate B vitamins (especially folic acid, B6 and B12).
    • Make sure your protein intake is sufficient and limit sugars and simple carbohydrates.
    • Keep caffeine to a minimum and avoid alcohol.
    • Employ stress reduction techniques such as yoga, meditation, or conversations with friends.
  • There are many other things that can contribute to depression. If natural approaches don’t work, you should consult your physician.
  • For more details, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Are Clinical Trials Misleading?

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Is Most Of What You’ve Been Told About Vitamins Wrong?

Author: Dr. Stephen Chaney

 

man searching with magnifying glassI am a scientist and a professor. I taught medical students for 40 years. I believe in evidence based medicine. Why would I tell you that many of the clinical trials about the impact of individual nutrients on your health are misleading?

Let me start by sharing a story that I used to tell every new graduate student in my lab. The story goes like this: There is this drunk on the sidewalk, on his hands and knees under a lamppost, just groping around. A policeman comes up to him and says, “What are you doing?” The drunk says, “I’m looking for my housekeys.” The policeman gets down on his hands and knees and he looks too, and finally he says, “I can’t find them anywhere. Are you sure you lost them here?” To which the drunk relies, “Nope, I lost them over there, but the light’s better here.”

The point I was trying to make is that we can only do experiments where the light is good. But the questions we sometimes want to ask are over in the corner, where we can’t really shine the light on it directly. It’s often difficult to look in the right place and/or to ask the right questions.

That’s particularly the case with holistic approaches because holistic approaches, by their very nature, are multi-factorial. You have multiple variables that you’re trying to change at one time. For example, you might want to optimize weight, exercise, vitamins, minerals, and essential fatty acids if you’re trying to look at a healthy lifestyle.

But, in the 21st-century, studies generally focus on individual nutrients or individual drugs in an intervention, placebo-controlled trial. This is considered the “Gold Standard” for evidence based medicine. However, it’s very difficult to evaluate holistic approaches with that kind of study.

 

The Whole Is Greater Than The Parts

internationally renowned expert sessionOne of the examples that I love to use, because it really made an impression on me as a young scientist, occurred at an International Cancer Symposium I attended more than 30 years ago.

I attended a session in which an internationally renowned expert was giving his talk on colon cancer. He said, “I can show you, unequivocally, that colon cancer risk is significantly decreased by a lifestyle that includes a high-fiber diet, a low-fat diet, adequate calcium, adequate B-vitamins, exercise and weight control. But I can’t show you that any one of them, by themselves, is effective.”

The question that came to me as I heard him speak was: “What’s the message that a responsible scientist or responsible health professional should be giving to their patients or the people that they’re advising?” You’ve heard experts saying: “Don’t worry about the fat” “Don’t worry about calcium.” “Don’t worry about B-vitamins.” “Don’t worry about fiber.” “None of them can be shown to decrease the risk of colon cancer.”

Is that the message that we should be giving people? Or should we really be saying what that doctor said many years ago – that a lifestyle that includes all those things significantly decreases the risk of colon cancer?

 

Are Clinical Trials Misleading?

 

clinical trialsA recent paper about how to best evaluate the relationships between nutrition and disease (Shao et al, European Journal of Nutrition, DOI: 10.1007/s00394-017-1460-9) caught my attention. This paper, written by a team of 10 international experts, was a summary of key findings from a recent international meeting of the Council for Responsible Nutrition.

The paper started out by reviewing the strengths of clinical studies in which the effect of a single intervention on a health outcome is evaluated in a double-blind, placebo controlled clinical study; something they referred to as a reductionist approach.

  • A reductionist approach is ideal for evaluating the effect of drug candidates on disease outcomes. That is because:
    • Everyone in the study already has the disease.
    • The drug is meant to be used by itself.
    • It is easy to measure outcomes. The drug either has an effect on the disease, or it doesn’t.
  • A reductionist approach has also been valuable in defining the role of nutrients in preventing deficiency diseases. That is because, in the words of the authors:
    • “A simple cause-effect relationship exists between a particular nutrient and a specific deficiency disease.
    • Symptoms of a specific nutrient deficiency can be explained in terms of the role played by the respective nutrient.
    • Providing the nutrient in the diet can prevent, and in many cases, reverse, the deficiency disease.”

However, the authors went on to say that the use of the reductionist approach to study effect of nutrients on optimal health or holistic approaches to health often has led to misleading results. They characterized these studies as often “leading down a rabbit hole.”

For example, the authors said: “In an effort to uncover the magic bullet, scientists inappropriately studied nutrients in a drug-like context. Unlike drugs, nutrients do not function in isolation and have beneficial effects on multiple tissues and organ systems.”

The authors concluded by saying that if we want to truly understand the role of nutrients on health outcomes, we need to focus on holistic studies in which the effect of multiple nutrients on multiple health outcomes are evaluated.

 

Clinical Trials That Have Mislead Us

 

I realize that the report I just described is conceptual. It’s difficult to wrap your mind around. To better understand how clinical trials employing a reductionist approach can often mislead us, let’s look at some specific examples comparing holistic studies to reductionist studies.

dash dietHealthy diets: Healthy diets have a significant impact on health, but it is not possible to show that individual components of those diets are beneficial: In previous issues of “Health Tips From the Professor,” I have discussed the Mediterranean and DASH diets. I have shared studies showing that the Mediterranean diet dramatically reduces the risk of heart disease, diabetes, cognitive decline, and some forms of cancer. However, you would be hard pressed to show that individual components of the Mediterranean diet have a significant impact on these health outcomes.

Similarly, the DASH diet is as effective as drugs at controlling blood pressure (Moore et al, Hypertension, 38: 155-158, 2001 ). Other than sodium restriction, you would also be hard pressed to show that the individual components of the DASH diet exert a significant effect on blood pressure.

Supplements That Are Going to Kill You: Individual nutrients can sometimes have adverse effects on your health. Those reports generate a lot of negative press, but the adverse effects usually disappear when those nutrients are consumed along with nutrients that complement their effect on whole body metabolism.

Here are two examples of the negative press that you may have heard about the dangers of supplementation, but what the studies actually showed is that a holistic approach to supplementation was superior to supplementation with individual supplements.

For example, there was something called the Iowa Women’s Health Study that got some negative press in 2011 (Mursu et al, Archives of Internal Medicine, 171:1625-1633, 2011). This is one of those studies that led to headlines saying: “Vitamins can kill you.”

The study did show a slight increase in mortality in people who consumed high-dose vitamin B6 or high-dose folic acid by themselves. But in that same study, people who were taking high-dose B complex containing both B6 and folic acid in balance had no increase in mortality.

Another example is vitamin E and prostate cancer. You probably saw the headlines, which said: “Vitamin E increases the risk of prostate cancer.” Those headlines were based on a study published in the Journal of American Medical Association in 2011 (J Klein et al, Journal of the American Medical Association, 306: 1549-1556, 2011). However, in that same study the people who were taking vitamin E and selenium (two nutrients that work together synergistically) had no increase in cancer risk.

There is a good biochemical rationale for those results. Vitamin E converts some reactive oxygen species to peroxides, which are quite dangerous themselves. Selenium is part of an enzyme that converts peroxides to water. Together, vitamin E and selenium convert reactive oxygen species (free radicals) to something that is completely harmless. By itself, vitamin E does only half the job.

Holistic Approaches to Supplementation: The same appears to be true if you look at holistic approaches to supplementation rather than holistic approach to supplementationsupplementing with individual nutrients. A study done by Dr. Gladys Block and published in Nutrition Journal in 2007 (Block et al, Nutrition Journal 2007,6:30 doi: 10.1186/1475-2891-6-30) looked at a holistic approach to supplementation for the very first time.

She compared people who were taking multiple supplements, typically a multivitamin, extra antioxidants, extra B vitamins, carotenoids, fish oil and probiotics; people who were taking only a multivitamin; and people who were using no supplements whatsoever over a 20-year period.

The results were dramatic. The holistic supplement users had one-third the prevalence of angina, heart attacks and congestive heart failure and one-quarter the prevalence of diabetes compared to the other two groups. In contrast, reductionist studies looking at the effect of those nutrients individually have generally been inconclusive.

So just like a holistic approach to health, a holistic approach to supplementation appears to be superior to using individual supplements. This is a small study, but it is an example of the kinds of studies that need to be done in the future, if we are to truly understand the role of holistic approaches for optimizing our health.

 

The Bottom Line

Studies in which the effect of a single intervention on health outcomes is evaluated in a double-blind, placebo-controlled clinical study is considered the “Gold Standard” for evidence based medicine. A recent report has questioned the value of this kind of study in defining the impact of holistic approaches on health outcomes.

  • The authors concluded that the “Gold Standard” of clinical studies, which they referred to as a reductionist approach:
    • Was ideal for evaluating the effect of drugs on preventing or treating diseases.
    • Has been well suited for evaluating the role of individual nutrients in preventing deficiency diseases.
    • Was not well suited for evaluating the role of holistic approaches on health outcomes.
    • Was not well suited for evaluating the role of nutrients for promoting optimal health.
  • The authors concluded by saying that if we want to truly understand the role of nutrients on health outcomes, we need to focus on holistic studies in which the effect of multiple nutrients on multiple health outcomes are evaluated.
  • I shared three examples illustrating cases in which holistic approaches were more accurate than reductionist studies:
    • Healthy diets have a significant impact on health, but it is not possible to show that that individual components of those diets are beneficial.
    • Individual nutrients can sometimes have adverse effects on your health, but the adverse effects disappear when those nutrients are consumed along with nutrients that complement their effect(s) on whole body metabolism.
    • A holistic approach to supplementation can have a significant, beneficial effect on health outcomes, but it is difficult to show any benefit from individual nutrients included in that holistic approach to supplementation.
  • For more details, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Health Tips From The Professor