Repetitive Strain Injury From Sleeping

Get Off To A Great Start Every Morning

Author: Julie Donnelly, LMT – The Pain Relief Expert

Editor: Dr. Steve Chaney

How Can Sleep Cause Repetitive Strain Injury?

repetitive strain injury causesFor most of us during sleep we stay in one position for hours at a time.  So if you wake up with back pain after sleeping, you are experiencing the side effects of muscles held in one position for hours.  This is an example of repetitive strain injury or repetitive stress injury.

Because the muscles have to contract to pull your body into your favorite sleeping position and then the muscles stay in a shortened position for hours this can cause pain and tension in your back.

When you wake up with back pain after sleeping you may think you need a new mattress.  You might, but it’s definitely worthwhile to address the tight muscles first as they may be the whole problem.

stretchingHave you ever seen a dog do their “downward dog” stretch after a nap?  Before the dog bounces back into the world it takes time to awaken its body.  This is your pain relief “role-model” for stretching your back after sleeping.  You’ll be amazed at how simply moving in bed before starting your day eliminates pain and tension.

Let’s get started!  While still in bed begin moving around; raise your arms over head and stretch your legs out and flex your feet.  Maybe roll to each side stretching the sides of your body.  Try these 3 stretches we recommend

Repetitive Strain Injury Treatment:  3 Stretches After Sleeping

The following stretches will help relieve symptoms of repetitive strain injury due to sleeping in one position for long periods.

When you are ready bring yourself to a seated position (still in bed!).

 

stretches for back painOne at a time, bring your arm across the front of your body.  Pull your shoulder and shoulder blade toward the front, but without moving the rest of your trunk.  This is a great stretch for your triceps, shoulders and upper back.

repetitive strain injury treatmentNext stretch!  Bring your feet together, as pictured here.Start with a straight spine then slowly roll your chin into your chest, rounding your back.  Mmmmm…this feels good!

repetitive stress injury treatmentAnd finally, try this juicy spinal twist.Sit with left leg straight out or you can bend it as pictured.  Cross the right foot over the left leg, press your right hand behind you, place your left elbow on your right knee now twist.  Stretch as far as you are comfortable.  Try holding it 15-20 seconds.

This stretch will even help to loosen your hips if you sit as pictured!

As with all stretches, start out easy – stretching should feel GOOD.  You’ll feel the tension ease as the blood starts flowing.The tight muscles that cause back pain after sleeping can hamper your entire day, but doing these simple stretches will make a world of difference!

Wishing you well,

Julie Donnelly

julie donnellyAbout The AuthorJulie 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.

Can Food Affect Your Mood?

An Apple A Day Keeps The Blues Away

Author: Dr. Stephen Chaney

 

Can food affect your mood? In rural North Carolina you still occasionally see bumper stickers that say “Life Happens”. Of course, the word they use isn’t exactly “Life”, but you get the point.

can food affect your moodWe can’t always control what happens to us. What is important is how we react when bad things happen to us. Do we brush them off and move on, or do we let them get us down? There is no shortage of experts telling us how we can keep the blues away. We are told to count our blessings, meditate, think happy thoughts, develop support groups – the list goes on and on.

But is there perhaps one important parameter that most of these experts are missing? Could the foods we eat make us blue?

The standard American diet (S.A.D.) is high in processed foods, fat (especially saturated and trans fats), refined grains, simple sugars, salt and calories. As I’ve said before, almost anything would be better.

You probably already know that the S.A.D. leads to obesity and a whole host of diseases – including heart disease, cancer and diabetes – just to name a few. But did you know that the S.A.D. could make you sad? That’s what two recent studies suggest.

Can Foods Affect Your Mood? Does Junk Food Make You Sad?

The first study by Akbaralay et al (British Journal of Psychiatry, 195: 408-413, 2009) looked at the dietary patterns and mental health outcomes of 3486 participants in the Whitehall II Prospective Study.

In case you didn’t know it, Whitehall is the central district in London where most of the British government offices are located. So the 3486 participants in this study were bureaucrats. They were middle aged (average age 55.6 years old) office staff (74% men, 26% women) who spent most of their day sitting and really didn’t like their jobs very much. (I made up the part about not liking their jobs. It is hard to imagine that kind of job would be deeply fulfilling, but I’m sure that some of the bureaucrats liked their jobs better than others – which is the whole point of this study.)

At the beginning of the study the participants were given a 127 item food frequency quiz to fill out. Interestingly enough, the food preferences of the participants in this study clustered neatly into two groups.

The diets of the processed foods groups predominantly consisted of sweetened desserts, chocolates, fried foods, processed meats, refined grains and high fat dairy products. In short the diet of this group was pretty similar to what we think of as the Standard American Diet (S.A.D.). In contrast, the diets of the whole foods group consisted mostly of vegetables, fruits, fish and whole grains.

Five years later the study participants were analyzed for depression using a 20 item standardized depression scale.

The results were pretty eye-catching. The processed food group was 58% more likely to suffer from depression than the whole food group! And this was after correction for age, gender, weight, marital status, education, employment grade, physical activity, smoking and diseases (high blood pressure, heart disease, diabetes, and stroke).

The reasons for this astounding correlation between diet and depression are not clear. Can food affect your mood? Does this give us more insight?

The authors speculated that the diets of the whole food group were likely higher in antioxidants, folic acid and omega-3 fatty acids than the diets of the processed food group – and studies have suggested that each of these nutrients may protect against depression.

The authors also suggested that it might be an indirect effect. Diets that are high in saturated fats and refined grains and low in omega-3 fatty acids increase inflammation, and studies have suggested that inflammation can lead to depression.

Can Food Affect Your Mood? Does Healthy Food Make You Glad?

an apple for healthy fruitThe previous study suggested that junk food may make you sad. So you might be asking: “Does that mean that healthy foods can make you glad?” According to one recent study (Br J Health Psychol, Jan 24, 2013, doi: 10.1111/bjhp.12021) the answer may be yes.

A team from the University of Otago in New Zealand enrolled 281 young adults (average age = 20) in a study that looked at the effect of diet on their mood. Each day for 21 consecutive days they recorded their mood and what foods they ate using an online questionnaire. In particular, they reported the number of servings of fresh fruit and vegetables and of several unhealthy foods such as biscuits or cookies, potato chips or French fries and cakes or muffins.

The investigators correlated the foods eaten with the moods reported by the participants on the same day, and again on the day after those foods were eaten. Once again, the results were pretty impressive.

On the days when people ate more fruits and vegetables they reported feeling calmer, happier and more energetic than they did on other days (p = .002 – anything less than .05 is considered a statistically significant difference). And the good effects of fruit and vegetable consumption carried over to the next day as well (p < .001).

Can food affect your mood? While I paraphrased the “apple a day” quote to introduce this study, one apple won’t quite do it. According to this study it takes about 7-8 servings of fruits and vegetables to positively affect mood. In addition, it probably wasn’t just the fruits and vegetables that made the difference. Based on the previous study I would guess that the participants in the study may have eaten other healthy foods such as whole grains and fish on their good days.

Can Food Affect Your Mood?

Taken together these two studies suggest that the next time you feel a little blue you may want to look at your diet. You may want to include a healthier diet along with the meditation and positive thinking.

Of course, these studies both measured correlations between diet and mood, and any good scientist will tell you that correlations do not prove cause and effect. It could be that when people are “down in the dumps” they just naturally reach for junk foods rather than fruits and vegetables.

However, since there is no downside to consuming fruits and vegetables, I feel fully comfortable recommending more fruits and vegetables in our diets. If their health benefits aren’t enough to motivate you, maybe the possibility of improving your mood will!

There are some things you just can’t control. To paraphrase those country songs, you can’t keep your girl and dog from running off. Life happens to all of us. Can food affect your mood? If you want to keep your mood where it should be, you can always reach for those fresh fruits and vegetables, whole grains and sources of omega-3 fatty acids.

 

The Bottom Line

  • Two recent studies have suggested what we eat can affect our mood.
  • The first study showed that people who habitually consumed a diet consisting of sweetened desserts, chocolates, fried foods, processed meats, refined grains and high fat dairy products were 58% more likely to suffer from depression than people who habitually consumed a diet consisting mostly of vegetables, fruits, fish and whole grains.
  • The second study showed that the subjects in their study reported feeling calmer, happier and more energetic on the days when they ate more fruits and vegetables than they did on the days they ate junk foods.
  • Of course, these studies both measured correlations between diet and mood, and any good scientist will tell you that correlations do not prove cause and effect. It could be that when people are “down in the dumps” they just naturally reach for junk foods rather than fruits and vegetables.
  • However, since there is no downside to consuming a healthier diet, I feel fully comfortable recommending more fruits and vegetables, whole grains and omega-3s in our diets. If their health benefits aren’t enough to motivate you, maybe the possibility of their improving your mood will!

 

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.

What Causes Back Pain?

Natural Remedies for Back Pain

 

Author: Julie Donnelly, LMT –The Pain Relief Expert

Editor: Dr. Steve Chaney

 

What Causes Back Pain? 

Exploring the Overlooked Muscular Causes:

 

what causes back painYour back is a symphony of overlapping, interconnected, groups of muscles, tendons, and nerves. Each muscle merges into a tendon, which then crosses over a joint and inserts into a bone. When the muscle contracts it will pull on the tendon and the joint moves.

Your spine has 7 cervical vertebrae, 12 thoracic vertebrae, and 5 lumbar vertebrae, each separated by a gelatinous disk that acts as a cushion to separate the bones and protect them from wear. Muscles span your entire spine, in some cases originating on the vertebrae and connecting each vertebra to the next, in some cases the muscles originate on the ribs and insert into the vertebrae in order to move your spine in the infinite number of angles, and in other cases the muscles originate on your vertebrae and insert into moveable bones such as your shoulder blade, pulling it in various directions.

In order to move in the opposite direction, the contracted muscle needs to relax to remove the strain from the bone, and the muscle on the opposite side contracts to pull the bone in the opposite direction. If the muscle that needs to release is in a spasm it can’t relax, and you have the muscles pulling in two opposite directions – and you have back pain.

The answer to what causes back pain is so broad that it needs to be broken down into four categories:

(1)   Why a Muscular Component Can Be What Causes Back Pain

Back pain is commonly caused by repetitively straining the muscles that insert into the vertebrae and ribs.  The list of muscles that insert into the bones of your back is long, with each muscle potentially causing pain when it is in spasm and pulling on the bone. Your back is a system of overlapping muscles, so many times when you are treating a muscle for one thing, you are also treating the source of a totally different problem.

This commonly happens when you are treating a thigh muscle that causes knee pain, but is also a key muscle that causes back pain, groin pain, and sciatica.

Natural Remedies for Back Pain

natural remedies for backTreating the muscle is one of the natural remedies for back pain. For this muscle treatment I suggest you use a 12″x 1 1/2″ length of PVC pipe and slide (don’t roll) from the top of your thigh to just above your knee.  The main area of treatment is shown in this picture.  It’s NOT on the front of your thigh, and it’s NOT on the outside of your thigh, but instead it is in between these two lines.

As you go down your thigh you’ll go over several “bumps,” which are actually large spasms that are pulling down on the front of your pelvis. The pelvis rotation causes a strain on your low back, and presses your posterior pelvis up into your sciatic nerve.

There’s a lot more to this muscle, but it’s so broad that it can’t be explained properly here. In fact, each of the muscles that cause back pain are fully explained, and treatments are demonstrated in my Trigger Point Yoga kit.

(2) Why a Bulging or Herniated Disk Causes Back Pain

herniated disk can be what causes back painThe disk between each vertebra is meant to be a cushion for the bones so they don’t rub on each other.  However, tight muscles that originate on each vertebra can pull the bones together, pressing down on the disks and cause them to either bulge in the opposite direction, or herniate.  For example, if the muscles on the right side of the spine are tight, they will bring the vertebrae closer together on the right, causing the disk to bulge toward the left.

If the muscles on both sides of the spine are tight, they will draw the vertebrae closer together and potentially cause the disk to herniate.

In either case the disks will put pressure on the spinal cord and causes back pain to be severe in that area.  However, if it is treated before permanent damage is done, releasing the muscle tension on the vertebrae will move the bones off the disk and the pain will be eliminated.

(3) Why a Vertebra Out of Alignment Can Be What Causes Back Pain

out of alignment can cause back painYour spine stays in perfect alignment because muscles are putting the exact amount of “pull” on each side. In fact, without muscles the spine would just hang straight and not be able to move at all — like a skeleton on a hook.  It is only because of muscles that the spine has any mobility at all.

The only way a vertebrae can move is either by a traumatic accident (such as falling down a flight of steps, or having a car accident), or by muscles pulling on the bones.

However, if muscles are pulling more on one side than the other the vertebrae will move toward the tight muscles.

The tension in the muscles must be released first if the bones are to be moved back into alignment and not be pulled out again by the tight muscles.

(4) Scoliosis, Osteoporosis, Spinal Stenosis, and other Causes of Back Pain

There are medical conditions such as scoliosis, osteoporosis, spinal stenosis, diabetes, and cancer that are also causes of back pain.  These are serious conditions that need medical attention.  It is always important to eliminate the possibility of any serious health risks before embarking on a path of treatment for back pain.

Conclusion

Obviously, as noted in #4 above, there are medical causes of back pain, but it is clear that the one that is consistently overlooked, and therefore not treated, is the muscular component.  My experience with thousands of clients over the years, both at my office and virtually online, is that muscles are frequently what causes back pain, and that the pain can be lessened or eliminated by treating the tight muscles demonstrating one of the natural remedies of back pain.

You have nothing to lose, and everything to gain, by exploring the muscular component to back pain!

 

Wishing you well,

Julie Donnelly

 

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.

 

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.

Does Exercise Make You Live Longer?

Run Long and Prosper

Author: Dr. Stephen Chaney

 

Does exercise make you live longer?  If you are a fan of the original Star Trek series, you may remember the phrase “Live Long and Prosper”. That sounded great, but it was just a wish – a platitude. It said nothing about how you might accomplish the feat of living longer and prospering.

elderly man runningWhat if something as simple as increasing your exercise levels might help you live a longer, healthier life? A recent study provides pretty convincing evidence that exercise can increase longevity. If that is really true, maybe the proper phase should be “Run Long and Prosper”.

In my past “Health Tips From the Professor” I have talked about how hard it is to prove the value of any individual lifestyle change on improving our longevity – whether we are talking about more exercise, lower fat diets or individual nutritional supplements.

Most studies have too few subjects and last too short a time to show any significant effect. That’s why the study I’m featuring this week (Byberg et al, British Journal of Sports Medicine, 43: 482-489, 2009) is so remarkable.

How Was The Clinical Study Designed?

The study was designed to answer the question of whether exercise can actually help people live longer.

But what was remarkable about the study was the number of people enrolled in the study and how long the study lasted. The study enrolled 2,204 men aged 50 from the city of Uppsala Sweden in 1970-1973 and followed the men for 35 years!

At the beginning of the study the participants completed a survey on leisure time physical activity and were categorized into low, medium or high activity groups. Participants were re-examined at ages 55, 60, 70, 77, and 82 years and changes in physical activity were recorded.

Other information, such as body mass index, blood pressure, cholesterol levels, smoking status and alcohol use, was also collected at each survey. And, of course, the researches recorded how many of the initial participants were still living at each of those ages.

Is Living Longer One of the Benefits of Exercise?

After adjusting for other risk factors (obesity, smoking, excess alcohol consumption, elevated cholesterol or blood pressure), the researchers found that men who reported high levels of physical activity from age 50 lived 2.3 years longer than sedentary men and 1.1 years longer than men who reported medium levels of physical activity.

They also looked at what happened to men who started at low or medium levels of activity and increased their exercise level during the study. After 5 years of increased activity there was no apparent benefit. But after 10 years of increased activity the risk of dying had been reduced just as much as if they had always been exercising at that level!

I find that last finding particularly significant because most studies of this type last 5 years or less. If this study had been concluded at the end of 5 years, you might be tempted to say: “Why bother. If I haven’t exercised before, there’s no point in starting now.” But, this study did last more than five years – so the conclusion was completely different.

The Bottom Line

  • We’ve known for years that exercise reduces the risks of several types of diseases and improves the quality of life. This study clearly answers “Does exercise make you live longer?” with a yes.
  • If you haven’t exercised before, it’s never too late to start. Just don’t expect instantaneous results.

 

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.

7 Easy Ways To Spot Fad Diets

dietIf It Sounds Too Good To Be True…

Author: Dr. Stephen Chaney

 

I think it was P. T. Barnum who said “There’s a Sucker Born Every Minute”. That’s particularly true in the diet world where hucksters seem to be all around us – especially this time of year.

You’ve seen the weight loss ads touting:

Pills or powders that suppress your appetite or magically prevent you from absorbing calories.

  • Fat burners that melt the pounds away.
  • New discoveries (juices, beans, foods) that make weight loss effortless.
  • The one simple thing you can do that will finally banish those extra pounds forever.

You already know that most of those ads can’t be true. You don’t want to be a sucker. But, the ads are so compelling:

Many of them quote “scientific studies” to “prove” that their product or program works.

  • Their testimonials feature people just like you getting fantastic results from their program. [You can do wonders with “computer enhanced” photographs.]
  • Many of those products are endorsed by well known doctors on their TV shows or blogs. [It is amazing what money can buy.]

So it is easy to ask yourself: “Could it be true?” “Could this work for me?”

Fortunately, the Federal Trade Commission (FTC) has stepped up to the plate to give you some guidance. Just in time for weight loss season, they have issued a list of seven claims that are in fact too good to be true. If you hear any of these claims, you should immediately recognize it as a fad diet and avoid it.

 

7 Easy Ways To Spot Fad Dietsfad diet

Here are the seven statements in ads that the FTC considers as “red flags” for fad diets that should be avoided:

  • Causes weight loss of two pounds or more a week for a month or more without changing your diet and exercise routine.
  • Causes substantial weight loss no matter what or how much you eat.
  • Causes permanent weight loss without lifestyle change even after you stop using the product.
  • Blocks absorption of fat or calories to enable you to lose substantial weight.
  • Safely enables you to lose more than 3 pounds per week for more than 4 weeks.
  • Causes substantial weight loss for all users
  • Causes substantial weight loss by wearing a product on your body or rubbing it on your skin.

I’m sure you have heard some of these claims before. You may have actually been tempted to try the products or program. You should know that the FTC said that it considers these to be “Gut Check” claims that simply can’t be true.

 

The Bottom Line

diet pillsThere are no magical pills or potions that will make the pounds melt away. You need to change your diet, change your activity level and make significant lifestyle changes if you want to achieve long term weight control.

For more science-based health tips visit https://chaneyhealth.com/healthtips

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 Resveratrol Improve Memory Performance In The Elderly ?

red wine benefitsWill Red Wine Make You Smarter?

Author: Dr. Stephen Chaney

It seems like every other day a new headline pops up telling us of yet another nutrient that might improve memory and slow cognitive decline. Perhaps it’s because we having a greying population. Lots of Americans are looking for that magic pill that will allow us to remember where we left the car keys.

This week the banner headlines were about resveratrol, a polyphenol from red wine. The headlines suggested that resveratrol could improve memory performance in healthy older adults. Are those headlines true, and what does that information mean for you?

What is Resveratrol?

Resveratrol is a member of a very large class of compounds called polyphenols that are found in red wine, green tea, and a variety of fresh fruits and vegetables. Polyphenols are very diverse structurally, but most of them are excellent antioxidants. They are one of the reasons that we are constantly being told to eat more fresh fruits and vegetables.

However, resvertrol and a few structurally similar polyphenols are unique in that they also bind to proteins called sirtuins which regulate metabolic processes related to the aging process. In fact, resveratrol garnered a lot of attention a few years ago when Dr. David Sinclair at Harvard Medical School published a study showing that obese mice given resveratrol escaped many of the metabolic consequences of obesity and actually lived longer than mice who were not given resveratrol.

In animal studies resveratrol appears to improve insulin sensitivity and mitochondrial function, lower cholesterol levels and blood pressure, and reduce inflammation and oxidative damage. Human studies have been limited to date, but suggest that resveratrol may impart many of these metabolic benefits to humans as well.

A recent study showed that resveratrol improved memory performance in grey mouse lemurs, a non-human primate species. However, no one had previously looked at whether resveratrol might improve memory in humans.

Can Resveratrol Improve Memory In Healthy Older Adults?

improve memoryIn this study (A. V. Witte et al, The Journal of Neuroscience, 34: 7862-7870, 2014) investigators recruited 46 older (average age 64), overweight (BMI 25-30), adults from Berlin, Germany. All of the subjects were healthy and none of them had any sign of cognitive impairment. For a six month period half of them were given 100 mg of resveratrol twice a day, and half of them were given a placebo (sunflower oil).

At the beginning of the test period they were given a memory test which measures how many of 15 listed words they could recall 30 minutes later. They also underwent a MRI scan that measured brain volume and functional connectivity of the hippocampus, a key region implicated in memory function. Finally, hemoglobin A1c, a measure of long term blood sugar control was measured.

Here are the results:

  • There was a significant effect of resveratrol on retention of words over 30 minutes compared to placebo. Memory improved significantly in the resveratrol group, while it declined slightly in the placebo group.
  • There was no effect of resveratrol on brain volume compared to the placebo (most interventions showing significant effects on brain volume required 2-3 years to demonstrate a significant effect).
  • Subjects in the resveratrol group showed significant increases in functional connectivity of the hippocampus to other brain regions involved learning and memory compared to the placebo group.
  • Subjects in the resveratrol group had lower hemoglobin A1c (better long term blood sugar control) compared to the placebo group.
  • When they statistically evaluated individual patients, the degree of improvement in the word memory test correlated with the increase in functional connectivity of the hippocampus and both of those measures correlated with decreased hemoglobin A1c.

What Does This Study Mean?

This study is promising in that it is well done and is consistent with previous animal studies. However, we need to keep in mind that this is the very first study of this kind. Similar to most first studies, it is small (only 46 subjects) and short in duration (6 months). It also only tested one dose of resveratrol (200 mg/day).

Now that this study has shown that resveratrol might improve memory in healthy older adults, it provides a strong rationale for more clinical studies to test this hypothesis. There is a need for larger, longer term studies in other population groups. Future studies should also evaluate different doses of resveratrol so that we know how much is needed to positively impact mental function.

Can resveratrol improve memory?

The Bottom Line:

  • A recent study suggests that resveratrol, a polyphenol from red wine, improves memory (measured by a word recall test) and functional connectivity of the hippocampus, a region of the brain involved in memory function.
  • This is the very first study of its kind. It was small (46 subjects) and short (6 months). However, it was well designed and consistent with previous animal results. Thus, it should be considered preliminary, but promising. More studies are clearly needed to test this hypothesis.
  • If the results of this study are substantiated, it will not necessary mean that other polyphenols will exert similar effects on memory. The action mechanism of resveratrol is different than most other polyphenols.
  • It also does not necessarily mean that red wine will make you smarter. The 100 glasses of red wine a day that you would need to drink to get the amount of resveratrol used in this study would probably kill more brain cells than the resveratrol could help.
  • Finally, as I said in a recent “Health Tips From the Professor” , there are no “magic bullets” when it comes to preventing cognitive decline. Your chances of reducing cognitive decline are best with a holistic approach that includes healthy diet, exercise, socialization, mental exercises, maintaining a healthy weight, B vitamins and omega-3 fatty acids. If this study is confirmed by future studies, you may be able to add resveratrol supplements to the list.

 

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.

Healthy Thanksgiving

The Holidays Don’t Have To Be Unhealthy

Author: Dr. Stephen Chaney

healthy thanksgivingWhile “Healthy Thanksgiving” doesn’t quite have the appeal of the more familiar “Happy Thanksgiving” greeting, I used it here to make the point that Thanksgiving dinner (and many other holiday meals) doesn’t have to be an unhealthy affair.

After all, there is a lot to like about the ingredients in Thanksgiving dinner. Turkey can be a healthy, low- fat meat, if prepared correctly. Sweet potatoes, yams, winter squash and pumpkin are all loaded with vitamin A and other important nutrients. And cranberries are a nutrition powerhouse.
Healthy Thanksgiving

Here are some healthy Thanksgiving ideas:

1) Skip the basting. Choose a plain bird and cook in a bag to seal in the moisture. Remove the skin before serving.

2) Refrigerate the turkey juices and skim off the hardened fat before making gravy and use a gravy cup that pours from the bottom to minimize fat.

3) Use ingredients like whole wheat bread, vegetables, fruits (cranberries, raisins, dates or apples), nuts and your favorite spices for the stuffing and bake it in the oven rather than in the turkey.

4) Serve your sweet potatoes or yams baked rather than candied and let your guests add butter to taste.

5) Use skim milk or buttermilk rather than whole milk and skip the butter for your mashed potatoes.

6) Give your meal gourmet appeal by cooking your green vegetables with garlic, nuts and herbs rather than creamy or fat-laden sauces.

7) Don’t serve the meal on your largest plates. By using smaller plates you ensure smaller portion size and even that second helping isn’t quite so damaging.

8) Use the Shaklee 180 meal replacement products for one or more meals the day before and/or after Thanksgiving so that your total caloric intake over the three day period is not excessive.

By now you have the idea. There are lots of little things that you can do to make your Thanksgiving dinner one that your waist and your heart will thank you for. Bon Appetit and have a Happy, Healthy Thanksgiving!

The Bottom Line

• If you make healthy food choices and choose your portion sizes wisely, you can make this a Healthy Thanksgiving as well as a Happy Thanksgiving.

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 Soda One of The Causes of Arthritis?

is soda one of the causes of arthritis

Author: Dr. Stephen Chaney

 

Recently, I came across an article which claimed an association between soda and arthritis.  So, is soda one of the causes of arthritis?  In previous health tips from the professor I have shared that soda consumption can cause weight gain  and heart disease . As if that weren’t reason enough to avoid sodas, recent headlines suggest that sodas can also cause rheumatoid arthritis. That is a pretty strong claim, so let’s look at the study behind those headlines.

Do Sodas Cause Arthritis?

This study (Hu et al., American Journal of Clinical Nutrition, 100: 959-967, 2014) followed 79, 570 women enrolled in the first Nurse’s Health Study (NHS) and 107,330 women enrolled in the second Nurse’s Health Study (NHS II) – that’s a total of 186,900 women – for at least 20 years. The women were aged 25-55 at the beginning of the studies and 857 of them developed rheumatoid arthritis over the next 20+ years.

All of the participants in the study filled out a questionnaire covering medical history, lifestyle and chronic disease at entry into the study and every two years afterwards. Compliance to this protocol was >90%, which is excellent for this type of study. The results were pretty impressive:

· Women who consumed ≥ 1 serving of sugar sweetened soda/day had a 63% higher risk of developing rheumatoid arthritis compared to women who consumed no sugar sweetened soda or consumed < 1 serving/month.

· The association between sugar-sweetened soda consumption and rheumatoid arthritis was much stronger for late-onset rheumatoid arthritis than it was for early-onset rheumatoid arthritis. When the authors restricted their analysis to women who developed rheumatoid arthritis after age 50, consumption of sugar sweetened sodas was associated with a 2.64-fold higher risk of developing rheumatoid arthritis (That’s a 264% increase).

· The type of sugar did not appear to matter. Sodas sweetened with sucrose and high-fructose corn syrup were equally likely to increase the risk of rheumatoid arthritis.

· There was no association between diet soda consumption and rheumatoid arthritis.

 

What Are The Strengths and Weaknesses Of The Study?

Strengths of The Study: The strengths of the study are fairly obvious.

This was a very large study and the effects (64%) and (264%) were also large. Those aren’t trivial differences. The size of the study and the magnitude of the effects bolster confidence in the outcome of the study.

Weaknesses of The Study:

This type of study measures associations. It doesn’t prove cause and effect. Therefore, the headlines saying “Soda Consumption is Associated With Arthritis” are more accurate than those saying “Sodas May Cause Arthritis”.

In studies of this kind we can never be sure whether the variable that was measured (soda consumption in this case) was responsible for the outcome or whether it was some other variable that wasn’t measured that was responsible for the outcome. In particular, the women who developed rheumatoid arthritis were also more likely to:

arthritis· Have lower incomes.
· Exercise less.
· Have higher energy (calorie) intake.
· Have poorer diets.
· Take fewer multivitamins and other supplements.

The authors tried their best to compensate for these differences statistically, and the fact that the very large effects of soda consumption on rheumatoid arthritis occurrence were not significantly affected when these differences were taken into account adds confidence to their conclusions. However, it is never possible to exclude the possibility that some other variable they did not measure was responsible for the increase in rheumatoid arthritis.

Are Diet Sodas Off the Hook?  Or,could They Be One of The Causes of Arthritis?

Could diet sodas be one of the causes of arthritis?  This study showed no association between diet soda consumption and rheumatoid arthritis. Previous studies have suggested that diet sodas don’t increase the risk of heart disease to the same extent as sugar-sweetened sodas. Does that mean that you should just start drinking diet sodas rather than sugar sweetened sodas?

diet sodas and arthritisThe answer is probably not. As I have pointed out in an earlier issue of “Health Tips From the Professor” , and has been confirmed by a recent meta-analysis of 24 clinical studies (Miller and Perez, American Journal of Clinical Nutrition, 100: 765-777, 2014), double blind studies in which all other caloric intake is carefully controlled generally show that people tend to gain slightly less weight when consuming diet sodas than when consuming sugar sweetened sodas.

But in the real world, people consuming diet sodas are just as likely to be overweight as people consuming sugar sweetened sodas. People seem to compensate for the calories saved with diet sodas by consuming more Big Macs, Mrs. Fields cookies and extra large Stabucks Lattes. In the real world, water is the only non-caloric beverage that is actually associated with lower weight.

Is It Enough To Just Stop Drinking Sodas?

I have often paraphrased that famous line from Western movies: “Just put down that soda and back away, and nobody gets hurt”. But is it that simple? Can you prevent rheumatoid arthritis just by drinking less soda?

Once again, the answer is probably no. There are a number of factors that can increase your risk of developing rheumatoid arthritis. Experts will tell you that the causes of rheumatoid arthritis are largely unknown, but that genetic predisposition, smoking and excessive alcohol use can increase your risk.

However, because rheumatoid arthritis is an inflammatory disease I would add overweight; diets high in animal protein, saturated fats, trans fats and sugar; food allergies; gut health issues; stress & exhaustion and chronic infections – and lack of fresh fruits and vegetables, omega-3 fatty acids and regular exercise.

The clinical study I described above found that soda consumption was much more strongly associated with late onset rheumatoid arthritis than early onset rheumatoid arthritis. Based on those data I would speculate that early onset rheumatoid arthritis may be more strongly influenced by genetics and other lifestyle factors, whereas late onset rheumatoid arthritis may be more strongly influenced by sugar sweetened sodas and other sugary foods. Only time will tell if my hypothesis is true.

Is soda one of the causes of arthritis?

The Bottom Line:

1) A recent study reported that women who consume ≥ 1 serving of sugar sweetened soda/day have a 63% higher risk of developing rheumatoid arthritis compared to women who consume no sugar sweetened soda or consume < 1 serving/month.

2) The association between sugar-sweetened soda consumption and rheumatoid arthritis is much stronger for late-onset rheumatoid arthritis than for early-onset rheumatoid arthritis. For women who first develop rheumatoid arthritis after the age of 50, consumption of sugar sweetened sodas is associated with a 2.64-fold higher risk of developing rheumatoid arthritis (That’s a 264% increase).

3) The type of sugar does not appear to matter. Sodas sweetened with sucrose and high-fructose corn syrup are equally likely to increase the risk of rheumatoid arthritis.

4) There was no association between diet soda consumption and rheumatoid arthritis. However, this does not mean that diet sodas are a good thing. Consumption of diet sodas is just as likely to be associated with obesity as is consumption of sugar sweetened sodas, and some recent studies suggest that consumption of diet sodas is associated with high blood pressure.

5) This was a very large and well done study, but it only measures associations, not cause and effect. Further studies will be needed to confirm this observation. However, we already know that sodas are bad for us. This may be just one more reason to minimize our consumption of sodas.

6) We shouldn’t assume that we can prevent rheumatoid arthritis by simply cutting sodas out of our diet. Arthritis has multiple causes (see article above). We should aim for a healthier overall lifestyle if we wish to reduce our risk of developing rheumatoid arthritis and other diseases.

7) Osteoarthritis is much more common than rheumatoid arthritis. This study did not include women with osteoarthritis, so it is uncertain whether these results will apply to osteoarthritis as well.

8) Men are much less likely to develop rheumatoid arthritis than women, so it will be difficult to do a comparable study in men. However, it is likely that the same association between soda consumption and rheumatoid arthritis would be seen in men as well.

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.

Should I Get a Flu Shot?

The Truth About About Flu Shots That Nobody Else Is Telling You

Author: Dr. Stephen Chaney

 should I get flu shot

It is flu season again, and the annual debate about whether everyone should get a flu shot is heating up. On the one hand we are told that the flu shot saves thousands of lives and everyone should be vaccinated. On the other hand we are being told that the flu shot is deadly and we should avoid it. As usual, the truth is somewhere in between.

When you examine the scientific literature it is clear that:

  1. The risks of the flu shot have been greatly exaggerated.
  2. The benefits of the flu shot have been greatly exaggerated.
  3. The medical profession has not leveled with us about the real reason they recommend that everyone get a flu shot.

Flu Shot Side Effects

The greatest fear of vaccination and therefor flu shot side effects for children has been the claim that the flu vaccine causes autism. It is easy to understand how the hypothesis arose that vaccinations and autism might be linked, because the first symptoms of autism usually appear around the time that children are completing their initial series of vaccinations.

However, clinical research has not substantiated that any causal relationship between vaccinations and autism. It isn’t that scientist haven’t looked. A number of clinical studies have looked for a link between vaccinations and autism and have failed to find any. The age of onset and prevalence of autism are virtually identical in vaccinated and unvaccinated children.

However, most vaccines still contain mercury, and mercury is a neurotoxin. So if you are getting your child vaccinated, I recommend that you insist on getting a mercury free vaccine. You may want to inquire about the preservatives and additives in the flu vaccine as well, because some of them are also toxic.

Beyond that the biggest concerns are severe allergic reactions and an autoimmune response called Guillian-Barré syndrome which causes symptoms ranging from muscle weakness and fatigue to partial paralysis. These side effects are real and they are serious, but they are also quite rare. They affect somewhere between 1 in a million to 1 in 100,000 children, depending on the vaccine.

In short, flu shot side effects risks are real, but they have been greatly exaggerated by some in the media.

Let’s Talk Science

It turns out that the benefits of the flu shot have been greatly exaggerated by health professionals and the media as well. However, to properly understand why the messages you hear are a bit misleading you need to understand some scientific jargon, namely the difference between relative risk and absolute risk.

Relative risk describes the effect of an intervention for people with a certain condition. In this case, relative risk would be the effect of the flu shot (intervention) for people who have been infected with the flu virus (condition). Relative risk is often used in media reports because it magnifies the effect of the intervention. In short, it makes the intervention look really good.

Absolute risk describes the effect of an intervention on the probability that you will develop a certain condition. In this case absolute risk would be the effect of the flu shot on you actually getting the flu. Since this takes into account your probability of being infected by the flu virus as well as the relative risk reduction once you have become infected, it is a much smaller number. Absolute risk is a much better measure of the actual benefit you can expect to receive.

 

Is The Flu Shot Effective?

flu shot side effectsThere is always year to year variation in the severity of the flu and the effectiveness of flu vaccines. In addition, many other viruses that cause flu-like symptoms and are completely unaffected by the flu vaccine.

For example, both enterovirus D68 and the Ebola virus are in the headlines – enterovirus D68 because it has hospitalized so many kids this fall and Ebola virus because it is so deadly. Unfortunately, the flu vaccine has no efficacy against either of those viruses.

In addition, there is also significant variation in both the efficacy and evidence for efficacy in different population groups that is generally not acknowledged during the annual campaigns recommending that everyone should get a flu shot. To better understand that we need to look at the efficacy of the flu shot in each population group individually.

 

Is The Flu Shot Effective in Children Age 6 Months To 2 Years?

In 2010, the US Advisory Committee on Immunization Practices began recommending flu vaccination for all healthy children older than 6 months. However, in 2012 the Cochrane Collaboration conducted a systematic review of all published clinical studies and concluded that for children in that age group currently licensed flu vaccines “are not significantly more effective than placebo”. [To fully understand the significance of that statement you need to know that the Cochrane Collaboration is an independent, non-profit organization that promotes evidence-based medicine. In fact, in the medical community Cochrane Collaboration systematic reviews are considered to be the gold standard for evidence based medicine.]

Summary: This is one of the groups at greatest risk for developing severe complications to the flu, so it is disappointing that the flu vaccine is not more effective for this group. I will talk about the best way to protect this group below.

Is The Flu Shot Safe & Effective in Healthy Children Age 2 To 7 Years?

This is the age group for which immunization makes the greatest sense, and the nasal spray gives the best results for this group. According to the 2012 Cochrane Collaboration review the flu shot reduces the relative risk of the flu by 48% and the nasal spray with attenuated live virus reduces the relative risk by 83%.

Since around 16% of unvaccinated children catch the flu in an average year this translates to an absolute risk reduction of 3.6% for the flu shot and 17% for the nasal spray. That is a smaller number, but still significant. This, of course, varies from year to year dependent on how well the vaccine matches the strains of virus that are actually circulating through the population.

Summary: The science behind vaccination for this group has shifted significantly in the past few years. The evidence for the efficacy of the flu shot in this age group has increased while the evidence for harm has deceased. The fear of the flu shot causing autism has been largely disproven by recent clinical studies. That leaves severe allergic reactions and the Guillian-Barré syndrome as the major complications of the flu vaccination.

Proponents of the flu vaccinations have estimated that if all children in this age range were vaccinated, around 200 would develop severe complications to the flu shot, and if all children in this age range were unvaccinated 20,000 would develop severe complications from the flu. I have not been able to independently substantiate those statistics. We also need to keep in mind that in those rare years, such as during the 1976 swine flu epidemic, when approximately 1 in 100,000 vaccinated children developed Guillian-Barré syndrome the incidence of severe complications to the flu shot could have reached the 2-3,000 range if the vaccination program had not been terminated early.

I realize that this is an emotional issue for parents, and there is no perfect answer. However, at present the weight of evidence is slightly in favor of vaccination for this age group.

 

Is The Flu Shot Effective in Healthy Children Age 8 To 18 Years?

According to a recent meta-analysis of all available clinical studies (Oosterholm et al, The Lancet Infectious Diseases, 12: 36-44, 2012), we simply don’t know whether the flu vaccine will be effective in this age group because no reliable studies have been conducted.

Even worse than that, we may never know whether the flu shot offers any protection for this age group because of a Catch 22 situation in modern clinical research. Once a particular treatment becomes “the standard of care” it is considered unethical to withhold that treatment in a clinical trial. Since the CDC is now recommending the flu shot for everyone over age 2, it would be considered unethical to conduct a clinical trial in which half the population received flu shots and half did not.

Summary: I suspect that the flu shot may offer some protection in this age group, but there is no convincing clinical evidence to support that belief at present and for the foreseeable future.

 

Is The Flu Shot Effective in Healthy Adults Age 18 To 65 Years?

is flu shot effectiveHere the answer is yes. According to a 2012 meta-analysis of 31 published clinical studies (Oosterholm et al, The Lancet Infectious Diseases) the flu shot gives an impressive 75% reduction in the relative risk of catching the flu. However, in an average year only 4% of this population will catch the flu if unvaccinated, so the absolute risk reduction is a modest 3%.

This is also the group that has the least to fear from the flu. Only about 1 in 100 people in this age range develop severe complications as a result of getting the flu, and these are usually the people with severe diseases and/or compromised immune systems. For most healthy adults in this age range, the flu is merely a one or two day inconvenience.

Summary: For healthy adults in this age range the flu vaccine offers only a modest decrease in the absolute risk of catching the flu, and this group has a relatively low risk of developing severe complications from the flu. If the self interest of this group were the only consideration, it is hard to understand the insistence of the medical community that everyone in this age range get a flu shot. It would appear to be a matter of personal choice.

 

Is The Flu Shot Effective in Seniors Age 65 And Older?

Flu shot proponents will tell you that flu shots cut the risk of death in this group by 50% based on a meta-analysis published in 2002 (Vu et al, Vaccine, 20: 1831-1836, 2002).

However, more recent research has come to the opposite conclusion. A recent meta-analysis (Oosterholm et al, The Lancet Infectious Diseases, 12: 36-44, 2012) concluded “Evidence for protection in adults aged 65 years or older is lacking”. The 2010 Cochrane Collaboration systematic review concluded “Due to the poor quality of available evidence, any conclusions regarding the affects of influenza vaccines for people aged 65 years or older cannot be drawn.”

The lack of protection of the flu virus in seniors is most likely due to the fact that, in many cases, their immune systems have weakened with age.

Summary: This is another group where you would most like to see protection by the flu shot, because this group is likely to suffer severe complications and death from the flu, so it is disappointing that the flu vaccine is not more effective for this group.

 

Who Has Most To Fear From The Flu?

flu shotWhen you hear that the flu shot significantly reduces the risk of severe complications and death from the flu, you should know that the risks are not spread evenly over the population. The very young are at risk because their immune systems haven’t fully developed. The very old are at risk because their immune systems have weakened with age and they may already be in precarious health because of other diseases. And, of course, anyone at any age who is in precarious health because of disease or who has a compromised immune system is at risk as well.

 

Why Do Health Professionals Recommend That Everyone Get A Flu Shot?

If you are a healthy adult in the 18-65 age range, your risk of severe complications and death is from the flu is very low. It is not zero, but it is low. So why are health professionals so insistent that you need to get a flu shot?

The reason is straight forward, but it is not the reason that they are giving you. It is a public health measure, pure and simple.

The very young, the very old, the sick and the infirm are the ones most likely to develop severe complications and die from a flu infection. However, the flu shot doesn’t offer them much protection because their immune systems are often compromised. The best way to protect those groups is to immunize everyone else. If the flu virus can’t gain a foothold in the rest of the population, those at greatest risk will never be exposed to the flu.

So the constant warnings that you need to get a flu shot is less about protecting you than it is about protecting those whom you might infect. Now you know the truth. If you decide to get a flu shot it will be for the right reason, not the reason you are being given by the medical profession.

In a similar vein, many health departments are warning about hospitalizations and deaths from enterovirus D68 infections and urging people to get flu shots. They are not telling people that the flu shot has no efficacy against enterovirus D68.

I understand the concept that the rare combination of the regular flu and enterovirus D68 infection in the same patient would be particularly deadly. But, I also believe in truth in advertising. The medical profession needs to level with people about why they are recommending flu shots, not use scare tactics that make promises the flu shot can’t deliver.

 

Should I Get A Flu Shot?

As you can see, your decision about whether or not the flu shot is the right thing for you is not an easy one. Both the benefits and risks of the flu shot have been greatly exaggerated in the media. I have tried not to be an advocate either for or against flu vaccinations. I have evaluated the scientific literature and tried to give you the unvarnished truth. It is now up to you to make an educated decision – one that is right for you.

My personal decision about the flu shot is influenced by my father’s example. He dutifully got his flu shot every year, and every year he came down with the flu shortly after getting the flu shot. I’ve seen the same phenomenon with several of my friends who work at area hospitals and are required to get an annual flu shot. I know that the experts claim you can’t get the flu from the flu shot. I don’t know about that. I only know what I have observed.

In addition, I do not have young children or elderly parents at home who might be compromised if I were to develop even a mild case of the flu. So I chose to follow the kind of lifestyle that keeps my immune system strong rather than relying on a flu shot to protect me from the flu. That immune-healthy lifestyle, of course, will be a topic for a future “Health Tips From the Professor”.

 

The Bottom Line:

  1. Both the effectiveness and risks of the flu shot have been greatly exaggerated.
  2. The flu shot has no proven effectiveness in children ages 6 months to 2 years, children aged 8-18 years and seniors 65 years and older.
  3. In children, aged 2 to 7, nasal sprays with partially inactive flu virus give a 17% decrease in absolute risk of catching the flu. Side effects of the flu vaccine in this population group are severe allergic reactions and an autoimmune response called Guillian-Barré syndrome. Both severe complications from the flu virus and side effects of the flu vaccine are very rare, but complications from the flu virus are several fold more common than side effects from the vaccine.
  4. Fears that the flu vaccine could trigger autism have not been validated by clinical studies. However, mercury is a neurotoxin so I recommend that you insist on mercury-free vaccines for your children. You may also wish to inquire about other preservatives and additives in the vaccine, because some of them are toxic.
  5. In healthy adults, aged 18 to 65, flu shots give a 3% decrease in absolute risk of catching the flu. This is also the population group with the lowest risk of severe complications from the flu. For most adults in this age group the flu is nothing more than a one or two day inconvenience.
  6. The groups most likely to develop severe complications and die from flu infections are the very young, the very old, and the sick. They are also the groups least likely to benefit from the flu shot because their immune systems are weak.
  7. If you are a healthy adult in the 18 to 65 age group, the constant warnings that you need to get a flu shot is less about protecting you than it is about protecting those whom you might infect if you catch the flu. It is a public health measure to protect the very young, the very old, and the sick. Now you know the truth. If you decide to get a flu shot it will be for the right reason, not the reason you have been given by the health profession.
  8. In addition, the flu shot has no efficacy against either enterovirus D68 or Ebola virus. Although both of these viruses are real concerns, neither is a justification for recommending that people get flu shots.
  9. As for me, I am influenced by the example of my father who got the flu from the flu shot every year. I chose to follow the kind of lifestyle that keeps my immune system strong rather than relying on a flu shot to protect me from the flu. That, of course, will be a topic for a future “Health Tips From the Professor”.

 

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.

Best Diet For Weight Loss

The Diet Wars Heat Up Again

Author: Dr. Stephen Chaney

best diet for weight loss

What is the best diet for weight loss? One week the headlines say that low-carbohydrate diets are better. The next week it’s low-fat diets that are better. There is even the occasional headline proclaiming that it doesn’t matter which diet you follow as long as you control your calories. It is no wonder that you are confused.

It is unusual, however, to have conflicting headlines within the same week, but that is exactly what happened last week. Let me take you behind the headlines to the actual clinical studies and help you sort through the conflicting headlines.

Are Low-Carbohydrate Diets Best For Weight Loss?

The manuscript behind this headline was published September 2nd in the Annals of Internal Medicine (Bazzano et al, Annals of Internal Medicine, 161: 309-318, 2014). This study was designed to determine which was the best diet for weight loss, low carb diet or low fat diet. The study recruited 148 overweight participants (mean age, 46.8, 88% female, 51% black) and randomly assigned them to either a low-fat diet or low-carbohydrate diet.

The participants on the low-fat diet were instructed to consume <30% of their calories from fat, while the participants on the low-carbohydrate diet were told to limit carbohydrates to <40 g/day. Neither group was told to limit calories. They met with a dietitian 10 times during the 12-month study and received information on dietary fiber (target = 25 g/day) and healthy fats (target = <7% saturated fat and little or no trans fats).

At the end of 12 months the low-carbohydrate diet resulted in significantly greater…

  • Weight loss (7.7 pounds)…
  • Decrease in triglyceride levels…
  • Increase in HDL cholesterol…
  • Decrease in the ratio of total to HDL Cholesterol…

…than the low-fat diet. In short, the results suggested that the low-carbohydrate diet was not only better than the low-fat diet for weight loss, but that it was also more effective in reducing risk factors for cardiovascular disease.

Case closed, you might be tempted to say. The low carb diet is the best the diet for weight loss. But there have been lots of other studies that have come to the opposite conclusion. So we have to ask the question: “Is this study significantly better than all of the studies that have failed to find any difference between the low-fat and low-carbohydrate diets with respect to weight loss and cardiovascular risk?”

What Are The Strengths & Weaknesses Of the Study?

Strengths of the Study: This was a very well designed study. In particular:

  • Dietitians met with the participants at multiple times during the program to assure adherence to the diet, which was very good.
  • The study utilized multiple dietary recalls, both during the week and on weekends.
  • The study had a diverse population.

Weaknesses of the Study:

  1. The study did not control calories. In fact, the caloric intake was ~160 calories/day greater for the low-fat group than the low-carbohydrate group for at least the first 6 months of the study. low carb dietThat alone would be enough to account for the 7.7 pounds difference in weight loss.The reason for the higher caloric intake of low-fat group is not known. It could be due to the lower palatability of the low-carbohydrate diet. Alternatively, it could be due to the lower satiety of the low-fat diet. It was low in both fat and protein, both of which contribute to satiety (the feeling of fullness after we eat).
  2. The study did not specify the type of carbohydrates consumed. The dietitians instructed the participants on the type of fat they should be eating, but not the type of carbohydrate. That was a significant omission. Diets high in sugars and refined carbohydrates provide less satiety and adversely affect cardiovascular risk factors compared to diets where the carbohydrate comes primarily from fresh fruits, vegetables and legumes.
  3. The study did not control protein intake. In fact, the low-fat group consumed significantly less protein than the low-carbohydrate group. As I pointed out in a previous “Health Tips From the ProfessorHigh Protein Diets and Weight Loss , higher protein intakes are essential for maintaining muscle mass during weight loss. That is important because loss of muscle mass can decrease metabolic rate (the rate at which we burn calories 24 hours a day – even at rest).

The amount of protein consumed by the low-carbohydrate group was close to the amount shown to maintain muscle mass during weight loss, while the amount of protein consumed by the low-fat group was close to the amount associated with loss of muscle mass during weight loss. That was reflected in the results. The low-fat group lost muscle mass while the low carbohydrate group actually gained muscle mass. The resulting difference in muscle probably meant that the low-carbohydrate group was burning more calories on a daily basis than the low-fat group.

In short, this is a good study, but it has important flaws. It is not a game changer.

Do Low-Carbohydrate & Low-Fat Diets Result In Identical Weight Loss?

The study behind this headline was published in the September 3rd edition of the Journal of the American Medical Association (Johnson et al, JAMA, 312: 923-933, 2014). This study was a meta-analysis that combined the results of 48 studies with 7286 participants. When the authors combined the data from all of the published studies there was no difference in weight loss for the low-fat and low-carbohydrate diets over a one or two year period.

The strength of the study is that it combines the results of multiple studies. That increases the statistical power of the observations and smoothes over the effect of outlier studies, such as the one described above. This is the study I would trust.

What Do The Experts Say?

Dr. Walter Willett, Chair of the Department of Nutrition at the Harvard School of Public Health was best diet for weight lossquoted as saying: “…some people [would] do well on either diet. The key issue for each person is finding a way of eating that is healthy and can be maintained for the long term.”

Dr. Bradley Johnson (the author of the meta-analysis) was quoted as saying: “The take home message is that people should choose a diet they can adhere to…”

The Bottom Line

1)  Ignore the recent headlines suggesting that low-carbohydrate diets may be more effective than low-fat diets for weight loss. When you control for calories and protein intake there is no difference between the two diets with respect to long term weight loss.

2)  You can also ignore the headlines telling you that low-carbohydrate diets are better for cardiovascular health. You don’t need to avoid carbohydrates to have a healthy heart. You just need to make healthy carbohydrate choices – fruits, vegetables, legumes and whole grains instead of refined flour products and sugary junk food.

3)  Experts will tell you that the best diet is a healthy diet that you can stick with long term.

4)  My personal recommendations are to avoid extremes (either low-fat or low-carbohydrate). Instead:

  • Aim for moderate amounts of healthy fats and healthy carbohydrates.
  • Don’t ignore protein. Make sure you get enough protein to maintain your muscle mass.
  • Control calories by reducing portion sizes and choosing healthy snacks.

 

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