Personalized Nutrition To Change Your Life?

Written by Dr. Steve Chaney on . Posted in Diets, Food and Health, Nutritiion, Personalize Nutrition

Author: Dr. Stephen Chaney

 

personalized nutritionCan a personalize nutrition assessment provide you with information to assist your health strategy?  We’ve been told that genetic testing is the wave of the future. We’ve been promised that genetic testing will tell us which diseases we are most likely to develop. Of course, the unspoken assumption is that if we knew which diseases were most likely to kill us, we’d be highly motivated to make the diet and lifestyle changes needed to reduce the risk of that disease.

But what if a personalized nutrition assessment based on a simple online diet survey was just as effective at getting us to make better food choices as all those fancy genetic tests? That is just what a recent study suggests.

How Was The Study Designed?

food4me surveyThe study was based on a simple online diet survey called Food4Me developed by University College Dublin and Crème Software Ltd. The Food4Me diet survey asks people how many times per week or per day they eat basic food groups and develops personalized diet recommendations based on what they are actually eating. It is a very simple, user friendly, survey requiring only 5-10 minutes to complete. Consumer satisfaction with this kind of survey is high. For example:

  • 92% of participants said that “the Food4Me website was easy to use.”
  • 76% of participants were “satisfied with the detail of information they received in their personalized nutrition report.”
  • 80% of participants felt that “the dietary advice in the report was relevant to them.”

In spite of its simplicity and ease of use, the Food4Me survey is also quite robust. Previous studies have shown that the reproducibility and validity of the Food4Me diet survey compares very favorably with much more extensive dietary analyses (For example, R. Fallaize, et al., Journal of Medical Internet Research, 16: e190, 2014).

This study (International Journal of Epidemiology, 2016, 1-11, doi:110.093/ije/dyw186)  measured the effectiveness of the Food4Me personalized nutrition reports at improving health-related behaviors. It was a 6-month randomized control study of 1269 adults from 7 European countries. It compared 4 different interventions on health-related behavior changes. The 4 interventions were:

  • standardized dietary advice
  • personalized nutrition advice based on the Food4Me survey
  • personalized nutrition advice based on the Food4Me survey plus BMI and blood biomarkers
  • personalized nutrition advice based on all that plus genetic testing

Is Personalized Nutrition The Wave Of The Future?

The results of the study were quite striking:

  • Compared to the group who just received standardized diet advice, the groups who received personalized nutrition advice were significantly more successful at improving health related behaviors. In particular, the groups receiving personalized nutrition advice:
    • personalized nutrition healthy foodConsumed less red meat.
    • Consumed less saturated fat
    • Consumed less salt
    • Got more folate from their diet
    • Had an improved “Healthy Eating Index” (a measure of overall diet quality)
  • Adding information on blood biomarkers (cholesterol, carotenoids, omega-3s, and vitamin D) and genotype received did not enhance the effectiveness of the personalized nutrition recommendations at changing health behaviors.

 

What Does This Study Mean For You?

This is a single study, but it does suggest several interesting take-home lessons.

#1: We are much more likely to follow diet advice that is personalized to us than we are to follow standardized diet advice. This should come as no surprise. We’ve had generalized diet advice like the USDA Food Guide Pyramid and, more recently, the USDA My Plate guidelines for decades, and they haven’t moved the needle. Maybe people think of generalized guidelines as applying to other people and personalized guidelines as applying to them.  Personalized nutrition seems to be more effective.

#2: This was personalized diet advice, not weird diet adviceThe participants were not being told to eat as much fat as they wanted. They weren’t being told that avoiding wheat will make them slimmer and smarter. They weren’t being told to eat like a caveman. They were being given USDA-approved diet recommendations. The only difference was that the dietary recommendations were personalized to them. For example, they were only being told to eat more fruits and vegetables if, in fact, fruits and vegetables were not a regular part of their daily diet. 

#3: Blood biomarkers did not provide any additional incentive to increase health related behaviors. I wouldn’t read too much into this observation. With the exception of cholesterol, the blood biomarkers selected for this study merely reinforced the diet analysis. For example, you could ask whether low blood carotenoid levels really provided any additional incentive to change their diet for an individual who was already told their intake of fruits and vegetables was low. If the study had measured disease-related blood biomarkers, it might have found that they provided additional incentive for individuals to make positive diet changes.

#4: Genetic testing did not provide any additional incentive to increase health related behaviors. This probably simply reflects the state of the science. Current genetic tests are only weakly predictive of major diseases like heart disease, diabetes, and cancer so they provide little incentive to make major lifestyle changes. This may change in the future as we improve our understanding of genetic influences on disease risks.

Missed Opportunities

This study clearly showed that a simple online diet survey like the Food4Me personalized diet assessment is very useful for changing health-related dietary behavior. However, this study also missed several opportunities to create an even more valuable tool for improving health-related behaviors. For example, the study collected data on obesity and activity levels, but did not attempt to provide personalized lifestyle recommendations based on that data. In addition, 44% of the participants reported that they had a disease, but no attempt was made to include health goals in the personalized diet and lifestyle recommendations.

 

The Bottom Line

  • A recent study showed that personalized nutrition recommendations based on a simple online survey were much more effective than standardized dietary advice at getting people to improve health-related eating habits.
  • Adding information on blood biomarkers and genetic tests did not enhance the effectiveness of the personalized nutrition recommendations at changing health behaviors.
  • The study did not evaluate the value of adding activity levels and health goals to the assessment. That perhaps represented a missed opportunity to create an even more powerful tool for positively influencing health-related behaviors.

 

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.

Skinny Fat

Written by Dr. Steve Chaney on . Posted in current health articles, Exercise, Food and Health, Health Current Events, Healthy Lifestyle, Nutritiion, Obesity

Overweight Vs. Obesity

Author: Dr. Stephen Chaney

skinny fatAre you skinny fat?  Weight loss season is upon us. Many of you are jumping on your bathroom scales so that you can decide how much weight you need to lose this year. For some the motivation for these New Year’s resolutions to lose weight is purely cosmetic. You just want to look better. For others the motivation for losing weight is better health. Obesity is a killer. It is associated with increased risk of diabetes, heart attack and stroke – and that’s just the tip of the iceberg.

But what if your bathroom scale says that you are normal weight? Are you off the hook? Maybe not. A recent study suggests that if you are normal weight but have central obesity (a fancy scientific term for belly fat), you are more likely to die prematurely than someone with normal fat distribution regardless of how overweight they are. That’s a pretty scary thought. It has even generated a new risk category called “skinny fat”.

How Can You Be Obese Without Being Overweight?

In recent years there has been some controversy about the health risks of obesity. Part of that controversy has arisen because obesity can be defined in multiple ways. Most of us simply hop on the scale and rely on actuarial tables to tell us what a healthy weight is for our height. Scientists, on the other hand use two very different measures of obesity.

#1 is Body Mass Index or BMI.BMI is a person’s weight in kilograms (kg) divided by his or her height in meters squared. By this measure:

  • Normal body weight is defined as a BMI of 18.5-24.9 kg/m2.
  • Overweight is defined as a BMI of 25-29.9 kg/m2.
  • Obesity is defined as a BMI of ≥30 kg/m2.

#2 is waist to hip ratio or WHR. WHR is a measure of central adiposity (belly fat). By this measure:

  • Obesity is defined as excess central adiposity (excess belly fat), which is a waist to hip ratio ≥0.85 in women and ≥0.90 in men.

In general BMI and WHR correlate. However:

  • 11% of men and 3.3% of women are normal weight according to BMI measurements, but have excess belly fat according to WHR measurements.These are the individualswho are obese according to their WHR measurements without being overweight according to their BMI measurements. These are the individuals often referred to as “skinny fat”.
  • There are similar percentages of men and women who are overweight or obese according to BMI measurements, but have low WHR measurements. These are often referred to as “pear shaped” obese individuals to distinguish them from the “apple shaped” obese individuals with a lot of belly fat.

Being Skinny Fat Can Kill You

obesity vs. overweightNumerous studies have shown that “apple shaped” obesity is much more likely to be associated with disease and premature death than “pear shaped” obesity, but there have been very few studies comparing health outcomes for normal weight individuals who have excess belly fat (people who are “skinny fat”) with health outcomes of overweight and obese individuals. This study (Sahakyanet al, Annals of Internal Medicine, 2015 Nov 10 doi: 10.7326/M14-2525) was designed to fill that void.

These scientists analyzed data from the National Health and Nutrition Survey III (NHANES III). NHANES III collected BMI, WHR and health data from 15,184 Americans (52.8% women) aged 18 to 90 years (average age 45) and followed the study participants for 14.3 years. By that time 3222 of them had died, with 1413 of those deaths being due to heart disease. The results were enlightening:

  • Normal weight individuals with excess belly fat (“skinny fat” individuals) were 1.5 – 2.0 fold more likely to die during the 14.3 year follow up period than individuals who were normal weight and had little belly fat (“skinny lean” individuals). This was expected because this had been shown in several previous studies.
  • However, the surprising finding was that normal weight individuals with excess belly fat were also more likely to die than individuals who were overweight or obese. Specifically:
  • Men who were “skinny fat” were 2.2 – 2.4 fold more likely to die prematurely than men who were either overweight or obese, but did not have excess belly fat (men with a “pear shaped” fat distribution). “Skinny fat” women were 1.3 – 1.4 fold more likely to die prematurely than overweight or obese women with “pear shaped” fat distribution.
  • Men who were “skinny fat” were even slightly more likely to die prematurely than overweight or obese men with excess belly fat (men with “apple shaped” fat distribution). “Skinny fat” women were just as likely to die as overweight or obese women with “apple shaped” fat distribution.
  • When they looked at deaths due to cardiovascular disease the results were essentially the same.
  • These results were novel and should, perhaps serve as a wake-up call for normal weight individuals with excess belly fat.

The authors concluded:

  • “Our analysis of data…show that normal-weight U.S. adults with central obesity [excess belly fat] have the worst long-term survival compared with participants with normal fat distribution, regardless of BMI category.”
  • “To our knowledge, our study is the first to show that normal-weight central obesity, measured by WHR, is associated with an increased risk of cardiovascular mortality.”
  • “Our findings suggest that persons with normal-weight central obesity may represent an important target population for lifestyle modification and other preventative strategies.”

Why Is Being Skinny Fat So Dangerous?

health riskAs the authors of this study pointed out, it is well established that excess belly fat is associated with:

  • Insulin resistance, which can lead to diabetes and predispose to heart disease.
  • High triglycerides and high levels of “bad” cholesterol, which can lead to heart disease.
  • Inflammation, which can lead to a number of deadly diseases.

The metabolic effects of excess belly fat are sufficient to explain why someone who is “skinny fat” is more likely to die prematurely than someone who is “skinny lean”. However, the effect of excess belly fat is not sufficient by itself to explain why a “skinny fat” individual is more likely to die prematurely than someone who is overweight or obese.

To understand this we need to recognize that both fat and muscle contribute to body weight (and to BMI). The “skinny fat” individual has more fat mass AND less muscle mass than a “skinny lean” individual of the same weight. That is a huge factor because metabolically speaking muscle is protective. It opposes all of the bad metabolic effects of belly fat.

Simply put, being “skinny fat” is extremely dangerous because you have increased all the bad metabolic effects of excess belly fat, ANDyou have decreased the protective metabolic effect of muscle mass.

How Do You Go From Being “Skinny Lean” To “Skinny Fat”?

Most of us were lean in our younger years. For those of us who end up as “skinny fat” as we age, it is pretty obvious that there are two processes going on simultaneously.

#1: Loss of Muscle Mass:It would be easy to say that becoming “skinny fat” is a natural part of aging. The natural tendency is to loose muscle mass and replace it with fat mass as we age. If we “just go with the flow” all of us will end up being “skinny fat” at some point. However, the loss of muscle mass as we age is accelerated by our sedentary lifestyle and our diet (more on that below).

#2: Gain of Belly Fat:To some extent whether we store excess fat as “pears” or “apples” is genetically determined. However, what we eat can also exert a major influence. For example:

  • Alcohol: The term “beer belly” says it all. Excess alcohol consumption is associated with an increase in belly fat. Once you understand the metabolism of alcohol the explanation is pretty simple. Alcohol causes blood sugar to drop, which increases appetite. Alcohol also interferes with our judgement, which can cause us to make poor food choices.
  • Excess saturated fat tends to be stored preferentially as belly fat.
  • Excess sugars and simple carbohydrates are rapidly converted to fat stores and stored as belly fat.

What Can You Do If You Are Already Skinny Fat?

gain muscle massLet’s start with what you shouldn’t do. You should not go on a reduced calorie weight loss diet to get rid of your excess belly fat. The last thing you want to do is to end up being underweight with excess belly fat! Here is what you should do:

#1: Increase Your Muscle Mass:I said that loss of muscle mass was a natural part of aging. I didn’t say that it was an inevitable part of aging. If you want to prevent or reverse loss of muscle mass you need to:

  • Get really serious about exercise. I’m talking about 30 minute workouts at least 3-5 times per week. These workouts need to include strength training as well as aerobics and flexibility exercises. I would suggest you ask your health professional what kind of exercise program is best for you and start your exercise program under the guidance of a personal trainer or physical therapist.
  • Make sure that your diet contains enough protein and enough of the essential amino acid leucine to maximize the gain of lean muscle mass following your workouts. I have covered the latest age-appropriate recommendations in, leucine and muscle gain, a previous “Health Tips From The Professor.”

#2: Lose Your Belly Fat:To some extent you will start to lose your belly fat naturally if you follow the recommendations above. In addition, you will want to:

  • Drink alcohol in moderation.
  • Make food choices that allow you to replace saturated fat with monounsaturated fat and polyunsaturated fats, especially the omega-3 polyunsaturated fats.
  • Replace excess sugars and simple carbohydrates with complex carbohydrates from fresh fruits and vegetables along with modest amounts of whole grain foods.

The Bottom Line

  • A recent study has shown that being “skinny fat” (having normal body weight, but excess belly fat) is more likely to result in premature death than if you were overweight, or even obese.
  • The most likely explanation for this alarming statistic is that someone who is “skinny fat” has excess belly fat, which predisposes to a number of diseases, and a loss of muscle mass, which protects against those same diseases.
  • If you are overweight or obese, you need to reduce your caloric intake to lose weight. However, if you are “skinny fat”, you don’t want to reduce your caloric intake. You need to change your exercise and diet habits.
  • Loss of muscle mass and gain of fat mass is a normal part of aging. However, you can slow or reverse the age-related loss of muscle mass with an exercise program and enough protein and leucine in your diet to maximize the effects of that workout program (details above).
  • You can prevent or get rid of excess belly fat by:
  • Following the exercise program and nutritional support of that exercise program described above.
  • Making food choices that replace saturated fats with monounsaturated fats and polyunsaturated fats, especially omega-3 polyunsaturated fats.
  • Replacing foods high in sugar and simple carbohydrates with fresh fruits and vegetables and whole grains in moderation.

 

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 Vitamin E Deficiency Common in the US

Written by Dr. Steve Chaney on . Posted in current health articles, Nutritiion, Supplements and Health, Vitamins and Health

 Does Vitamin E Matter?

Author: Dr. Stephen Chaney

are Americans vitamin E deficientA headline claiming “Over 90% of Twentysomethings Have Suboptimal Vitamin E Status” caught my eye the other day, so I decided to investigate further. If you have been following all of the information and misinformation about vitamin E in the online media, you are probably confused – and this headline just adds to the confusion. There are probably three basic questions you want answered:

  • Is the latest study valid? Are most Americans vitamin E deficient?
  • Does it matter? Vitamin E has been described as “a vitamin in search of a disease”. If there are no diseases associated with vitamin E deficiency, should we even be concerned if most Americans are vitamin E deficient?
  • Is there any value to vitamin E supplementation? You will see claims that vitamin E supplementation has been proven not to work. Are these claims valid?

Let me guide you through the maze. I will start by analyzing the study behind the current headlines.

Are Americans Vitamin E Deficient?

is vitamin e deficiency common in the usThe best food sources of vitamin E are nuts, seeds and unrefined vegetable oils, followed by green leafy vegetables. Since these foods are not abundant in the American diet, it is no surprise that previous studies have shown that 83% of US children and 91% of US adults do not consume the recommended 12 mg/day of vitamin E. Consequently, the 2015 Dietary Guidelines Advisory Committee identified vitamin E as a “shortfall nutrient”.

This study (McBurney et al, PLoS One 10(8): e0135510 doi: 10.1371/journal.pone.0135510) took the next logical step by asking whether the inadequate intake of vitamin E lead to inadequate blood levels of the vitamin. The authors analyzed data from 7,922 participants who had their blood levels of alpha-tocopherol (the most abundant form of vitamin E) determined in the 2003-2006 National Health and Nutrition Examination Survey (NHANES).

They subdivided participants into those who used no supplements (4049) and those who used supplements (3873). (Note: The supplement users were not necessarily using vitamin E supplements, but many were using a multivitamin supplement containing vitamin E). The authors compared the study participant’s blood levels of vitamin E with the Institute of Medicine standard for vitamin E deficiency (12 umol/L) and with a standard they set for adequate vitamin E levels (30 umol/L). Here are the results of their analysis:

  • People who did not use supplements had lower blood levels of vitamin E (24.9 umol/L) than those who used supplements (33.7 umol/L). No surprise here.
  • Only 0.6% of Americans were clinically deficient in vitamin E (blood levels < 12 umol/L). The prevalence of vitamin E deficiency did not vary significantly with age, gender or ethnicity.
  • When they looked at the people not using supplements, the percentage with suboptimal vitamin E status (blood levels < 30 umol/L) varied significantly by age, but was not significantly affected by gender or ethnicity. In this analysis the percentage with suboptimal vitamin E status was:
  • 7% for ages 20-30.
  • 8% for ages 31-50
  • 2 % for ages 51 and above

Were The Headlines Correct?

newspaper heallinesTechnically speaking the headlines were correct. 92.7% of Americans aged 20-30 who used no supplements had suboptimal blood levels of vitamin E as defined in this study. When you combined both supplement users and non-users, the percentage with suboptimal blood levels of vitamin E was only slightly less (87.4%). However, there are a couple of important caveats:

  • There is no internationally recognized standard for adequate blood levels of vitamin E. The authors had a reasonable rationale for choosing 30 umol/L as their standard for adequate blood levels, but they also acknowledged that the Estimated Average Requirement of vitamin E from food (12 mg/day) would result in a blood level of 27.9 umol/L, so their standard may be a bit high.
  • The average blood level of vitamin E for non-supplement users was 24.9 umol/L. While that is less than adequate, it is only slightly low – especially if the lower standard of 27.9 umol/L is used.

I think it would be more accurate to say that a large percentage of Americans have blood levels of vitamin E that are slightly below what is considered adequate but are far above what could be considered clinically deficient. The question then becomes “Does it matter?”

Does Vitamin E Matter?

Let me start with a little perspective. In the United States diseases like scurvy, pellagra and beriberi are things of the past. We simply don’t see deficiency diseases anymore. What we do see are intakes of essential nutrients that are slightly below optimal. Vitamin E is no different.

If we focus on suboptimal nutrient intake by itself, the answer would probably be that it doesn’t matter. Suboptimal nutrition is seldom enough to cause poor health by itself.

However, we also need to take into account individual differences that affect the need for essential nutrients. Poor health is much more likely to arise when suboptimal intake of one or more essential nutrients is coupled with increased needs due to genetic predisposition, risk factors that predispose to disease, and/or pre-existing disease.

With this perspective in mind, we are ready to ask whether suboptimal intake of vitamin E or any other essential nutrient matters. The answer is pretty simple. It doesn’t matter for everyone, but it matters very much for those individuals with increased needs.

If we had a good way of assessing individual nutritional needs, it would be easy to say who needed supplements and who didn’t. The problem is that we currently have no good way of assessing individual needs for essential nutrients. We simply cannot predict who will and who won’t be affected by suboptimal nutrient intake. That is why millions of Americans take supplements on a daily basis.

Is There Any Value To Vitamin E Supplementation?

vitamin e supplementationThat brings us to the final question. Is vitamin E supplementation a waste of money? You’ve probably already heard that most studies have failed to show any benefit from vitamin E supplementation, but you may be asking “How can that be when we also know that most Americans are getting suboptimal levels of vitamin E in their diet?”

With the perspective I described above in mind, the answer is pretty simple. Those studies have been asking the wrong question. They have been asking whether vitamin E supplements benefit everyone. They haven’t asked whether vitamin E supplements benefit people with increased needs.

When you ask that question the answer is very different. Let me give you three examples – one representing each of the kinds of increased need I described above:

  • In the Women’s Health Study (JAMA, 294: 56-65, 2005) vitamin E supplementation had no effect on heart attack or stroke in the general population. But when they looked at women over 65 (those at highest risk for heart disease), vitamin E supplementation reduced heart attack and stroke by 25% and cardiovascular deaths by 49%
  • In the Heart Outcome Prevention Evaluation Study (Diabetes Care, 27: 2767, 2004; Atherosclerosis, Thrombosis & Vascular Biology, 24: 136, 2008) vitamin E supplementation had no effect overall on heart attacks or cardiovascular deaths. But when they looked at a population who had a haptoglobin genotype that significantly increases the risk of heart disease, vitamin E supplementation significantly decreased the risk of both heart attacks and cardiovascular deaths.

 

The Bottom Line

  • Recent headlines saying that over 90% of young Americans have suboptimal vitamin E status are technically correct, but a bit overstated. It probably would have been more accurate to say that most Americans have slightly suboptimal vitamin E status.
  • The important question then becomes “Do marginal nutritional deficiencies matter?” The answer is pretty simple. Marginal nutritional deficiencies do not matter for everyone. However, they matter very much for those people who have increased needs for that nutrient due to genetic predisposition, risk factors for disease or pre-existing disease.
  • If we had a good way of assessing individual nutritional needs, it would be easy to say who needed supplements and who didn’t. However, we don’t have a good way of assessing increased needs for most nutrients, which is why many Americans use supplements on a daily basis.
  • As for all of those studies saying that vitamin E supplementation has no benefit, they are a bit misleading because they are asking the wrong question. They are asking whether vitamin E supplementation benefits everyone. They are not asking whether vitamin E supplementation benefits people with increased needs. When you ask that question the answer is very different (see examples in 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.

Soy and Hot Flashes

Written by Dr. Steve Chaney on . Posted in current health articles, Health Current Events, Nutritiion

Will Soy Put Out The Fire?

Author: Dr. Stephen Chaney

 

soy and hot flashesThere has been a lot of controversy in recent years about soy and hot flashes. The question is whether soy isoflavones reduce the hot flashes associated with menopause.

And this is an important question! Because of concerns about increase heart attack risk with hormone replacement therapy (HRT) many women have been looking for natural alternatives to HRT for reducing hot flashes and other symptoms of menopause. They’ve been asking whether soy isoflavones are effective, and the answers that they’ve been getting have been confusing.

For example, you can still find many experts and health professionals who will tell you that soy isoflavones have no proven effect on menopause symptoms.

That is somewhat surprising since two recent meta-analyses (Howes et al, Maturitas, 55: 203-211, 2006; Williamson-Hughes, Menopause, 55: 203-211, 2006) and a 2010 expert panel of The North American Menopause Society have all concluded that soy isoflavones alleviate hot flashes.

Will Soy Put Out The Fire?

However, clear guidance in this area was sorely needed, so Taku et al (Menopause, DOI: soy10.1097/gme.0b013e3182410159, 2012) performed an even larger meta-analysis that included 19 published clinical trials – some of which had been published after the previous two meta-analyses were performed.

I’ve talked about meta-analyses before, so you probably already know that they are very powerful because they combine the results of many individual clinical trials into a single data analysis.

But you also may remember me telling you that meta-analyses can be misleading if they introduce bias because of the kinds of clinical studies that they exclude from their analysis.

So I examined the design of this meta-analysis very carefully. It excluded clinical trials that:

  • were not double blind, placebo controlled and designed in such a manner that the placebo was indistinguishable from the soy isoflavone preparation.
  • contained other substances in addition to the soy isoflavones (The presence of other substances in the preparation might have influenced the response).

There were several other well justified reasons for excluding some studies from the meta-analysis, but they were technical in nature. In my opinion this was a very well designed study.

And the results were clear cut. An average of 54 mg of soy isoflavones (some studies used a little less, some a little more) was sufficient to reduce:

  • the frequency of hot flashes by 21% – and –
  • the severity of hot flashes by 26%

Soy and Hot Flashes: What This Study Mean For You?

The results of this study were highly statistically significant. So if you are suffering from hot flashes and are wondering whether soy isoflavones will put out the fire, the answer appears to be YES.

That’s the good news.

The bad news is that 21-26% is not a huge effect.

And, if you look at the individual clinical studies it is apparent that the response is highly variable. Some women experience major relief from hot flashes and other menopause symptoms, while other women experience little or no relief.

The reason for this variability is not known, but it is likely that the effectiveness of soy isoflavones on reducing hot flashes is modified by other components of the diet and by lifestyle factors such as obesity, exercise and stress.

Soy and hot flashes; the bottom line.

My take on this is that soy isoflavones should not be thought of as a “magic bullet” that will make hot flashes go away by themselves, but rather as a proven part of a holistic approach that encompasses a healthy diet, exercise, weight control and stress reduction

The Bottom Line

  • A recent meta-analysis of 19 published clinical studies showed that soy isoflavones reduced the frequency of hot flashes by 21% and the severity of hot flashes by 26%.
  • The results were highly statistically significant, but 21-26% reduction in symptoms is not a huge effect.
  • When they looked at the individual clinical studies it was apparent that the response is highly variable. Some women experienced major relief from hot flashes and other menopause symptoms, while other women experienced little or no relief.
  • My take on this is that soy isoflavones should not be thought of as a “magic bullet” that will make hot flashes go away by themselves, but rather as a proven part of a holistic approach that encompasses a healthy diet, exercise, weight control and stress reduction

 

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.

Iron and Brain Development

Written by Dr. Steve Chaney on . Posted in Food and Health, Nutritiion, Supplements and Health

Iron and the Teen Brain
Author: Dr. Steve Chaney

 

iron and brain development in teensFor those of you with teenagers – or who have had teenagers in the past – you may suspect that there’s nothing between their ears. But actually there is a lot going on between their ears, and some of the neural contacts laid down in the brain during the teen years influence the health of their brain during their adult life.  Let’s look at the association between iron and brain development.

And – no surprise here – what they eat can affect the health of their brain as well.

Which brings me to a study published in the Proceedings of the National Academy of Sciences January 9, 2012 (doi: 10.1073/pnas.1105543109) that looks at the adequacy of dietary iron intake during the teenage years and their brain health as adults.

Basics of Iron Metabolism

Before I describe the study perhaps a little bit of what I call Biochemistry 101 is in order.

Free iron is toxic to living cells. For that reason, our body produces multiple proteins to bind and transport the iron. The protein that binds and transports iron through the bloodstream is called transferrin. Under normal conditions 2/3 of the transferrin in our bloodstream has iron bound to it and 1/3 does not. And that is the ideal ratio of bound and unbound transferrin for delivery of iron to brain cells and other cells in our body.

When our diet is iron deficient (or we have excessive blood loss) the percent iron saturation of transferring decreases. The body tries to compensate by producing more transferrin, but this doesn’t really help since the problem was inadequate iron supply, not inadequate transferrin supply. As a consequence elevated transferrin levels are generally indicative of an iron-deficient diet.

Iron and Brain Development in Teens

iron and brain developmentThe study was led by Dr. Paul Thompson of the UCLA Department of Neurology. He and his team performed brain scans on 631 healthy young adults with an average age of 23. The brain scans were of a type that measured strength and integrity of the connections between the nerves in the brain – in other words, the brain’s wiring. They then went back and looked at the amount of iron available to each subject’s brain during adolescence by looking at their blood transferrin levels from routine physical exams performed at ages 12, 14 and 16 (blood transferrin levels are often measured as part of routine physical exams).

The results were pretty clear cut. Elevated transferrin levels during the teenage years were associated with reduced brain-fiber integrity in regions of the brain that are known to be vulnerable to neurodegeneration. These individuals did not show any cognitive impairments as young adults, but the concern is that they might be more likely to develop cognitive impairments as they age.

Dr. Thompson summarized his team’s findings by saying that “Poor iron levels in childhood erode your brain reserves which you need later in life to protect against aging and Alzheimer’s. This is remarkable, as we were not studying iron deficient people, just around 600 normal healthy people. It underscores the need for a balanced diet in the teenage years, when your brain command center is still actively maturing.”

Questions Every Parent Should Ask

If you have teenagers you might want to ask yourself questions like:

  • What is your teenager’s diet like?
  • Is it balanced?
  • Are you sure that it meets their nutritional needs?
  • Should you consider supplementation to make sure that they are getting all of the nutrients that they need?

 

The Bottom Line

  • A recent study suggested that inadequate iron intake in the teenage years may affect how our brains are wired in our adult years. The authors of the study interpreted the study as suggesting that an inadequate diet during the teen years could predispose us to cognitive decline and Alzheimer’s as adults.
  • This study only looked at structural differences in the brain circuitry. We can’t conclude from this study alone that inadequate iron intake as a teenager will doom somebody to cognitive impairment and increased Alzheimer’s risk as they age. But we can conclude that adequate iron intake during adolescence is required for normal brain development.
  • And it’s probably not just iron. This study focused on iron status because transferrin levels are routinely measured during physical exams so it was easy to go back and determine what each subject’s iron status was during their teenage years. Many other important nutrients are required for normal brain development, but we don’t have an easy way of going back and determining what someone’s nutritional status was for those nutrients in their teen years. What was shown to be true for iron in this study is likely to be true for other nutrients as well.
  • These were normal teens eating a normal American diet. They weren’t from a third world country and there was nothing weird about what they were eating. But, clearly some of the subjects in the study weren’t getting the iron that they needed from diet alone.
  • The teen years are a time of rapid growth and maturation. It’s not just the brain that needs the proper balance of nutrients during the teen years. All of their tissues require proper nutrition.

 

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 All Calories Created Equal?

Written by Dr. Steve Chaney on . Posted in current health articles, Food and Health, Nutritiion

Are Food Choices More Important Than Calories?Author: Dr. Stephen Chaney

 

Most adult Americans gain a pound or two each year. That may not sound like much on a yearly basis, but over a lifetime it is huge – if you’ll pardon the pun.

are all calories created equalBecause the health consequences of weight gain are so devastating, everyone has their favorite dietary advice for keeping those extra pounds away. For some it is diet plans – low fat, low carb, paleo, Mediterranean – you name it. For others it is counting calories or avoiding sugars of all kinds. The list goes on. Are all calories created equal?

But what if all of these approaches were wrong? What if we could keep our weight under control solely based on the foods we eat? A recent study seemed to suggest that we just might.

How Was The Study Designed?

A group of scientists from Tufts University and Harvard decided to look at how the food choices we make on a daily basis influence our weight gain or loss over time (Smith et al, AJCN 101: 1216-1224, 2015). However, they designed their study in a very unique way, and it is important that I explain the study design so that you can understand the strengths and limitations of the study.

Most studies of this kind look at what foods people are eating and compare that to how much they weigh. These scientists looked at changes that people made in their diets and correlated that with how much weight they gained or lost over time.

When you think of it, that’s the information most of us really want to know. We are less interested in why the foods we used to eat got us into trouble in the first place than we are in how the changes we make in our diet might influence future weight loss or gain.

This study combined the data from three very large, long term studies – the Nurses’ Health Study, the Nurses’ Health Study II, and the Health Professionals Follow-Up Study. Altogether that is a group of 120,784 men and women who were followed for 16-24 years. All three of these studies measured weight and evaluated dietary habits using food-frequency questionnaires every 4 years.

The scientists conducting the study measured changes in food choices and changes in weight for each individual in 4-year increment over the total time duration of the studies. In analyzing the data, they looked at choices of protein foods, total carbohydrate, and the glycemic load (GL) of the carbohydrates.

Glycemic load is the glycemic index (effect on blood sugar) of the carbohydrates in a particular food times the total amount of carbohydrate in that food. You can think of glycemic load as a measure of carbohydrate quality. For example, white bread, pastries, muffins, pancakes, white rice, chocolates, candy bars, cookies, brownies, cakes, pies, and pretzels would all be examples of foods with a high glycemic load. Fruits, whole grain foods and starchy vegetables would be examples of foods with a moderate glycemic load. Vegetables and beans would be examples of foods that generally have a low glycemic load.

The authors of the study did not measure calories or fat intake for this study, but those factors are indirectly included in food choices – more about that later.

Are All Calories Created Equal?

Now let’s get to the good stuff – the results of this study. When the authors analyzed the data they found that:

  • Most of the subjects did not exchange one protein food for another over the course of the study. They exchanged protein foods for carbohydrate-rich foods and vice versa.

This was a surprise. Since many experts have been recommending that people substitute chicken and fish for red meat, they had expected to see that kind of dietary shift when they analyzed the data. Apparently, people have not been listening to the experts!

  • high carbohydratesWhen the subjects replaced a serving of carbohydrate-rich foods with a serving of red meats, processed meats, chicken with skin or most cheeses they gained between 0.5 to 2.3 pounds per year. Within this category the greatest weight gain was seen when hamburgers were substituted for carbohydrates, and the least weight gain was seen when cheese was substituted for carbohydrates.
  • When the subjects replaced a serving of carbohydrate-rich foods with a serving of milk, peanuts or eggs there was no net change in weight. These appear to be substitutions that are good for weight maintenance.
  • When the subjects replaced a serving of carbohydrate-rich foods with a serving of yoghurt, peanut butter, beans, walnuts, other nuts, chicken without skin, low-fat cheese or seafood they lost between 0.5 and 1.5 pounds/year. Within this category the greatest weight loss was seen when plain yoghurt was substituted for carbohydrates, and the least weight loss was seen when low-fat cheese was substituted for carbohydrates.
  • When they focused on carbohydrate-rich foods, replacing one serving of high glycemic load foods with low glycemic load foods was associated with one pound of weight loss per year. Simply put, if you switch from cookies, pastries and candies to fruits and vegetables, you are likely to lose weight. No surprise here.

The study really got interesting when they looked at the effect of adding different proteins in the context of the carbohydrate-rich foods that the subjects were eating. For example,

  • When the subjects added a serving of red meat to a diet containing carbohydrate foods with a high glycemic load, they gained an average of 2.5 pounds per year. When they added that same serving of red meat to a diet containing carbohydrate foods with a low glycemic index, they gained only around 1.5 pounds per year.

Simply put, that means eating a hamburger on a white flour bun with fries is going to pack on more pounds than a hamburger patty with brown rice and a green salad.

  • The effect of glycemic load was particularly interesting when you looked at the protein foods that were good for weight maintenance overall. For example, adding a serving of eggs to a high glycemic load diet resulted in a 0.6 pound/year weight gain, while adding that same serving of eggs to a low glycemic load diet resulted in a 1.75 pound/year weight loss. The results were similar for cheeses.
  • Finally, glycemic load also influenced the effectiveness of protein foods associated with weight loss. For example, addition of a serving of beans to a high glycemic load diet resulted in 0.5 pound/year weight gain loss, but adding a serving of beans to a low glycemic load diet resulted in a 1.5 pound/year weight loss.

New Insights From This Study

good proteinThis study broke new ground in several areas. For example,

  • We have heard over and over that substituting beans, chicken and fish for red meats is healthier. This is the first study I have heard of that says those same substitutions can prevent or reverse weight gain.
  • Many people advocate a high protein diet for weight control or weight loss, but many of them will tell you the type of protein doesn’t matter. This study suggests that the type of protein foods we eat are important in determining whether we lose or gain weight.
  • Everyone knows that switching from white grains, pastries and candy to whole grains, fruits and vegetables will help you lose weight, but this is the first study I’m aware of that suggests those same changes will influence whether the protein foods we eat lead to weight gain or weight loss.
  • Many people focus on fats and calories when trying to avoid weight gain. While this study is not really fat and calorie neutral (see below), it does suggest that if we focus on eating healthy foods we don’t need to be counting every fat gram and every calorie.
  • Finally, this study suggests that if we forget all of those crazy diets and focus on eating healthy foods, our weight will take care of itself. Not exactly a novel concept, but one worth repeating.

Limitations of the Study

The head author of this study stated in an interview “The idea that the human body is just a bucket for calories is too simplistic. It’s not just a matter of thinking about calories or fat. What’s the quality of the foods we are eating? And how do we define quality.” This has been picked up by the media with statements like “not all calories are created equal”.

That is a bit of a hyperbole, because this study is not really fat and calorie neutral. The protein foods (red and processed meats) that pack on the most calories are higher in fat and calories per serving than those protein foods (skinless chicken, fish and beans) that cause the least weight gain. Similarly, the carbohydrate foods with the highest glycemic load (pastries, cakes and candy) are higher in fat and calories per serving than those carbohydrate foods with the lowest glycemic load (fruits and vegetables).

The real message is not that fat content and calories don’t count. Nor is it that calories in some foods count more than the same calories in other foods. The take home lesson from this study should be that we don’t have to focus on fat and calories. If we focus on healthy foods, the fat and calories tend to take care of themselves.

But, even that message is a bit too simplistic. Choosing healthy foods is not all that there is for weight control. We also need consider:

  • Portion sizes. Half a chicken could easily add more calories than a small hamburger.
  • How the food is cooked. Fish cooked in a cream sauce may not be any better for weight control than a slab of red meat.
  • Exercise. We need to maintain muscle mass to keep metabolic rate high.

 

The Bottom Line

  • A recent study has broken new ground and provided some new insights into how to prevent those extra pounds from sneaking up on us over time. This study evaluated how some simple changes we could make in the foods we eat can influence whether we gain or lose weight.
  • One part of the study looked at the effects of replacing a serving of carbohydrate rich foods with a serving of protein rich foods. If that protein rich food were a hamburger, we could expect to gain about 2.3 pounds/year. If that protein rich food were seafood, we could expect to lose about 1.5 pounds/year. Other protein foods fall in between those extremes. The specifics are covered above.

This a new insight. Many people advocate a high protein diet for weight control or weight loss, but many of them will tell you the type of protein doesn’t matter. So, are all calories created equal?  This study suggests that the type of protein foods we eat are important in determining whether we lose or gain weight.

  • Another part of the study looked at the effect of different carbohydrate foods based on their glycemic load (the effect they have on blood sugar). Simply replacing 1 serving of high glycemic load foods (refined grain foods, cookies, cakes, candy) with low glycemic load foods (whole grains, fruits and vegetables) was associated with a one pound/year weight loss. This should surprise no one.
  • Finally, one part of the study looked at the influence of glycemic load on the effect that various proteins have on weight gain or loss. For example, adding a serving of eggs to a high glycemic load diet resulted in a 0.6 pound/year weight gain, while adding that same serving of eggs to a low glycemic load diet resulted in a 1.75 pound/year weight loss. Other examples are given above.

This is also a new insight. Everyone knows that switching from white grains, pastries and candy to whole grains, fruits and vegetables will help you lose weight, but this is the first study I’m aware of that suggests those same changes will influence whether the protein foods we eat lead to weight gain or weight loss.

  • Some in the media have interpreted this study as saying that fat and calories don’t count. However, this study was not really fat and calorie neutral. The protein and carbohydrate rich foods that packed on the most calories were also the foods highest in fat and calories. The real take home message from this study is that we may not need to focus so much on fat and calories. When we focus on eating healthy foods the fat and calories tend to take care of themselves.
  • Even that message is a bit too simplistic. It is not enough to just focus on healthy foods. We need to consider things like portion size, how the food is prepared, and our exercise habits among other things.

 

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 Is Epigenetics

Written by Dr. Steve Chaney on . Posted in current health articles, Food and Health, Nutritiion, Obesity

Can What We Eat Affect Our Kids?

Author: Dr. Stephen Chaney

 

what is epigeneticsWhat is epigenetics?  For me, the first stages of understanding came a while back.  When I was a young graduate student (which is more than just a few years ago), I was taught that all genetic information resided in our DNA. During conception, we picked up some DNA from our dad and some from our mom, and that DNA was what made us a unique individual.

We knew that environmental influences such as diet, lifestyle and exposure to toxic chemicals could affect our health personally. However, we never dreamed that the effects of those environmental influences could actually alter our gene expression, and that those genetic alterations could be passed on to our children.

Today we know that environmental influences can actually modify our DNA and that those modifications can be passed on to our offspring – a process called epigenetics.

What Is Epigenetics & How Does It Affect Gene Expression?

Simply put, epigenetics involves modifications to our DNA. DNA can be methylated or acetylated and the proteins that bind to our DNA can be modified in multiple ways. That is important for two reasons:

  • These alterations can turn genes on and off. That means that epigenetic modifications can alter gene expression.
  • These alterations can be influenced by our environment – diet, lifestyle, and exposure to environmental chemicals

In a previous “Health Tips From the Professor” article titled “Can Diet Alter Your Genetic Destiny?”  I discussed recent research suggesting that a healthy diet and lifestyle causes epigenetic changes in the DNA that may reduce your risk of heart disease, cancer and diabetes.

That alone was a monumental discovery. Even more monumental is the recent discovery that at least some of those epigenetic changes can be passed on to our children, which brings me to the question I posed in the title of this article: “Can what we eat affect our kids?”

Animal Studies Showing That Epigenetic Changes Can Be Inherited

epigenetic changes are inheritedAs is often the case, the first definitive study showed that epigenetic changes were heritable was an animal study. This study was done with a mouse strain called agouti (Waterman and Jirtle, Mol. Cell. Biol. 23: 5193 – 5300, 2003). Agouti mice can have two remarkably distinctive phenotypes. They can either have a yellow coat, become obese as adults and be prone to cancer and diabetes as they age or they can have a brown coat and grow up to be lean and healthy.

It had been known for some time that these phenotypic differences were controlled by the epigenetic methylation of a specific gene called the agouti gene. The agouti gene codes for a genetic regulator that controls coat color, feeding behavior, and body weight set-point, among other things. When the agouti gene is under methylated it is active. As a consequence the mice have yellow coats and are prone to obesity. When the agouti gene is highly methylated it is inactive. The mice have brown coats and are lean and healthy.

Moreover, methylation of the agouti gene is not a purely random event. Mothers with the yellow, obese phenotype tended to produce a preponderance of offspring with the same phenotype and vice-versa. In short, the epigenetic methylation pattern of the agouti gene could be passed from generation to generation. It was heritable.

Waterman and Jirtle’s research broke new ground by showing that the methylation of the agouti gene could be strongly influenced by what the mother ate while the fetal mice were still in the womb.

When they fed agouti mothers a diet with extra folic acid, B12, betaine and choline (all nutrients that favor DNA methylation) during conception and pregnancy the agouti gene of their offspring became highly methylated. A high percentage of those offspring had brown coats and grew up to be lean and healthy.

However, when Waterman and Jirtle put agouti mothers on a diet that was deficient in folic acid, B12, betaine and choline during conception and pregnancy the agouti gene of their offspring was under methylated. Many of those offspring had yellow coats and grew up to be fat and unhealthy.

Subsequent studies from the same laboratory have shown that:

  • Addition of genistein, a phytonutrient from soy, to the maternal diet also favors methylation of the agouti gene and protects against obesity in agouti mice (Dolinoy et al, Environmental Health Perspective, 114: 567-572, 2006).
  • The addition of the environmental toxin bisphenol A to maternal diets causes under methylation of the agouti gene and predisposes to obesity in agouti mice, but this effect can be reversed by also feeding the mother genistein or folic acid and related nutrients during pregnancy (Dolinoy et al, PNAS, 13056-13061, 2007).

The agouti mice studies provide a dramatic example of how diet and environmental exposure during pregnancy can cause epigenetic changes in fetal DNA that have long term health consequences for the offspring. However, they are animal studies. Does the same hold true for humans?

Diet, Epigenetic Changes, and Obesity in Humans

diet-epigenetic-changes-obesityWith humans, it is really difficult to determine whether epigenetic changes that occur during conception and pregnancy affect our children. That is because when you measure an epigenetic effect in a child or adult, it is difficult to sort out how much of that effect was caused by what the mom ate during pregnancy and how much was caused by how the family ate as the kids were growing up.

Unfortunately, there is a tragic human experiment that shows that the same kind of epigenetic changes are heritable in humans. I’m referring to what is known as the “Dutch Hunger Winter”. This was a period of starvation during 1944-1945, the final year of World War II, when the Germans set up a blockade that prevented food from reaching western Holland. During that few months even pregnant women were forced to live on food rations providing a little as 500 calories a day.

This was an event without parallel in human history. Holland is not a third world country. Once the blockade was lifted children born during the Hunger Winter had the same plentiful supply of food as every other Dutch citizen. This has allowed generations of research scientists to ask what were the effects of a brief exposure to malnutrition during conception and pregnancy.

The health consequences were dramatic. 50 years later individuals who were conceived during the Hunger Winter weighed about 14 pounds more, had waists about 1.5 “ larger, and were three times more likely to have heart disease than those born to mothers who were in their second or third trimester of pregnancy during that time. By the time they reached age 63, they experienced a 10% increase in mortality.

What caused those health consequences? Could the cause have been epigenetic? Recent research suggests that the answer might be yes.

A recent study analyzed epigenetic changes in DNA from blood samples of survivors born during the Hunger Winter that had been collected when they were 59 years old (Tobi et al, Int. J. Epidemiology, doi: 10.1093/ije/dyv043, 2015). This study showed:

  • A distinct pattern of DNA methylation was observed in survivors who were conceived during the Hunger Winter. This pattern of DNA methylation was not observed in survivors who were in their second or third trimester during the Hunger Winter. It was also not seen in people who were conceived immediately before or after the Hunger Winter.
  • Some of the genes with distinctive methylation patterns were genes that affected things like cholesterol levels and insulin sensitivity, which have the potential to increase disease risk.
  • Other genes with distinctive methylation patterns were genes that affected metabolism. They were “thrifty” genes that increased the efficiency of metabolism. Increased efficiency of metabolism is beneficial when calories are scarce, but can lead to obesity when calories are plentiful.

That is a truly remarkable finding when you think about it. If these data are true, they suggest that starvation during early pregnancy caused the fetus to make epigenetic changes to its DNA that allowed it to become more efficient at energy utilization, and those epigenetic changes have lasted a lifetime – even when food was abundant throughout the rest of that lifetime.

What Is Epigenetics And Can What We Eat Affect Our Kids?

can what we eat affect our kidsThe studies I featured in this article are powerful “proof of concept” that diet and environmental exposure during conception and pregnancy can result in epigenetic changes to the DNA of the offspring that can persist throughout their life and dramatically affect their health. However, it is not yet clear how they apply to you and me.

  • Agouti mice are a very special strain of mice. It is not yet clear what effect folic acid, genistein and bisphenol A have on epigenetic modification of specific human genes, and whether those epigenetic modifications will have health consequences in humans.
  • The specific circumstances of the Dutch Hunger Winter are unlikely to be repeated on any significant scale. The closest approximation I can envision would be a woman who becomes pregnant while on a very low calorie fad diet.

There are, of course, many other examples of heritable epigenetic modifications. For example:

  • When female rats are maintained on a “junk-food diet” high in fat and sugar during pregnancy and lactation their offspring show a marked preference for high fat foods (Ong & Muhlhausler, FASB J, 25: 2167-2179, 2011). They also show epigenetic alterations of the central reward pathways that may pre-condition them to require higher intakes of fat to experience pleasure from eating.
  • When rats are fed diets deficient in omega-3 fatty acids, adolescent rats from the second and subsequent generations display marked increases in hyperactivity and anxiety (For more details, see my “Health Tips from the Professor” article titled “The Seventh Generation Revisited”.
  • In a clinical trial of 162 obese Canadian mothers who had children before and after weight loss surgery, the children born after weight loss surgery were half as likely to grow up overweight or obese as the children born before the weight loss surgery (Smith et al, Journal of Clinical Endocrinology & Metabolism 94: 4275-4283, 2009), and this correlated with epigenetic modification of genes that play a role in obesity, diabetes, cancer and heart disease (Guernard et al, PNAS 110: 11439-11443, 2013).

Taken together, the existing data suggest that our diet and environmental exposure during conception and pregnancy can cause epigenetic changes to our children’s DNA that may affect their future health in ways that we can only begin to understand at present. It is a sobering thought.

 

The Bottom Line

 

  • The term epigenetics describes modifications to our DNA that turn our genes off and on.
  • In this article I discussed two powerful “proof of concept” studies, one in rats and the other in humans, showing that diet and environmental exposure during conception and pregnancy can result in epigenetic changes to the DNA of the offspring that can persist throughout their life and dramatically affect their health.
  • The health consequences of these epigenetic modifications include obesity, diabetes, cancer, heart disease, hyperactivity, anxiety and many more.
  • This is a new paradigm. Most prenatal nutrition advice is currently based on what it takes to have a healthy baby – not on what it might take for your child to experience better health throughout their life.
  • Of course, the science of epigenetics is relatively new. It will be many years before we will be able to make specific recommendations as to what your diet should be like during pregnancy and lactation if you wish to make beneficial modifications to your baby’s DNA.
  • However, you should be aware that what you eat during pregnancy & lactation may influence the health of your children – not just at the time of their birth – but throughout their life, and that a high calorie, “junk-food” diet or a fad weight loss diet just may not be your best choice.

*The agouti mice picture is by Randy Jirtle and Dana Dolinoy (E-mailed by author) [CC BY 3.0 (http://creativecommons.org/licenses/by/3.0)], via Wikimedia Commons.

 

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.

Do Women Get Enough Omega-3 During Pregnancy?

Written by Dr. Steve Chaney on . Posted in Food and Health, Healthy Living, Nutritiion, Supplements and Health

Should Pregnant Women Take Omega-3 Supplements?

Author: Dr. Stephen Chaney

 

  • omega-3 during pregnancyLong Chain Omega-3 Fatty Acids, Especially DHA, Are Essential For Normal Brain Development

Long chain omega-3 fatty acids, especially DHA, have been shown to be very important during pregnancy, especially during the third trimester when DHA accumulates in the fetal brain at a very high rate. It is during that third trimester that the fetus forms the majority of brain cells that they will have for an entire lifetime.

Inadequate intake of long chain omega-3 during pregnancy and lactation has been shown to be associated with poor neurodevelopmental outcomes. These include poor developmental milestones, problem solving, language development and increased hyperactivity in the children (Coletta et al, Reviews in Obstetrics & Gynecology, 3, 163-171, 2010).

  • The Current Recommendation is 200 mg DHA/day During Pregnancy & Lactation.

In order to support brain development in the fetus, some experts have recommend intake of 300 mg per day of DHA during pregnancy. The best dietary sources of long chain omega-3 fatty acids such as DHA are fish and fish oil supplements. However, because of concerns about seafood contamination with heavy metals and PCBs (both of which are neurotoxins), the FDA recommended in 2004 that pregnant women limit seafood consumption to two servings a week, which amounts to about 200 mg/day of DHA – and this has been subsequently adopted by the American College of Obstetricians and Gynecologists and the European Union as the amount of DHA recommended during pregnancy and lactation (Coletta et al, Reviews in Obstetrics & Gynecology, 3, 163-171, 2010).

Even that recommendation for DHA from seafood could be overly generous. A recent study using the EPA risk assessment protocol concluded that some farmed salmon were so contaminated with PCBs that they should be eaten no more than once a year (Hites et al, Science, 303: 226-229, 2004).

  • Most Pregnant & Lactating Women In The US Are Probably Not Getting The Recommended Amount of DHA In Their Diet

Many pregnant women avoid seafood because of concerns about mercury and PCBs. Unfortunately, the other food sources of omega-3 fatty acids in the American diet, even many omega-3 fortified foods and supplements, are primarily composed of the short chain omega-3 fatty acid linolenic acid (also called alpha-linolenic acid or ALA), and only 1-4% of linolenic acid is converted to DHA in the body (Coletta et al, Reviews in Obstetrics & Gynecology, 3, 163-171, 2010).

Consequently, experts have been concerned for some time that American and Canadian women may not be getting enough DHA during pregnancy and lactation, but it was not clear how serious an issue this was.

Do Women Get Enough Omega-3 During Pregnancy?

women take enough dha omega-3 during pregnancyA group of scientists decided to test the adequacy of DHA intake by comparing DHA intake with the recommended 200 mg/day in a group of 600 pregnant and lactating women enrolled in the Alberta Pregnancy Outcomes and Nutrition study (Jia et al, Applied Physiology, Nutrition & Metabolism, 40: 1-8, 2015). The average age of the women in this study was 31.6. They were primarily Caucasian and married. 92% of them breastfed their infants. Most of them were taking a multivitamin or prenatal supplement on a daily basis. Approximately 1/3 of them were also taking a long chain omega-3 supplement.

The majority of women had completed college and had annual household incomes in excess of $100,000/year. In short, this was a very affluent, well-educated group of women. This is the kind of group one might consider most likely to be getting enough DHA from their diet.

DHA intake was based on 24 hour food recalls and supplement intake questionnaires collected in face-to-face interviews 2-3 times during pregnancy and again 3 months after delivery. The DHA content of the diet was determined from these data using well established methods.

The results were both dramatic and concerning.

  • Only 27% of pregnant women and only 25% of postpartum women who were breastfeeding met the recommendation of 200 mg of DHA/day. In short, nearly three-quarters of the women in the study were not getting enough (DHA) omega-3 during pregnancy and lactation.
  • When the women who were taking DHA-containing supplements were excluded from the data analysis, only 13% of pregnant and lactating women were getting enough DHA from their diet. In short, nearly 90% of the women relying on diet alone were not getting enough DHA.
  • Taking a DHA-containing supplement increased the likelihood of achieving the recommended 200 mg DHA/day by 10.6 fold during pregnancy and 11.1 fold during breastfeeding.
  • Not surprisingly, seafood, fish and seaweed products were the major contributors to the total dietary DHA intake.

The authors concluded “Our results suggest that the majority of participants in the cohort were not meeting the EU recommendations for DHA during pregnancy and lactation, but taking a supplement significantly improved the likelihood that they would meet the recommendations.”

 

The Bottom Line

  • Long chain omega-3 fatty acids, especially DHA, are essential for normal brain development. Inadequate DHA intake during pregnancy and lactation is associated with poor developmental milestones, problem solving, language development and increased hyperactivity in the children.
  • There is no established Daily Value for omega-3 fatty acids. However, the American College of Obstetricians and Gynecologists and the European Union recommend 200 mg DHA/day during pregnancy and lactation.
  • This recommendation is based partly on the amount of DHA needed for brain development and partly on the FDA warning that pregnant women should not consume more than 2 servings of fish/week due to heavy metal and PCB contamination.
  • This recommendation can be met by 1-2 six ounce servings/week of fish or a fish oil supplement containing 550 – 600 mg of omega-3 fatty acids.
  • Many pregnant women avoid fish because of concerns about contamination with heavy metals and PCBs, both of which are neurotoxins. Therefore, the major source of omega-3s in the American and Canadian diets are short chain omega-3 fatty acids that are only inefficiently (1-4%) converted to DHA.
  • Consequently, experts have been concerned for some time that American and Canadian women may not be getting enough DHA during pregnancy and lactation, but it was not clear how serious an issue this was.
  • A recent study done with a group of 600 women enrolled in the Alberta Pregnancy Outcomes and Nutrition study found that:
  • Only 27% of pregnant women and only 25% of postpartum women who were breastfeeding met the recommendation of 200 mg of DHA/day. In short, nearly three-quarters of the women in the study were not getting enough (DHA) omega-3 during pregnancy and lactation.
  • When the women who were taking DHA-containing supplements were excluded from the data analysis, only 13% of pregnant and lactating women were getting enough DHA from their diet. . In short, nearly 90% of the women relying on diet alone were not getting enough DHA.
  • Taking a DHA-containing supplement increased the likelihood of achieving the recommended 200 mg DHA/day by 10.6 fold during pregnancy and 11.1 fold during breastfeeding.
  • This was a very affluent, well-educated group of women. If any women anywhere are getting enough DHA during pregnancy and lactation, this should have been the group that was.
  • The authors concluded “Our results suggest that the majority of participants in the cohort were not meeting the EU recommendations for (DHA) omega-3 during pregnancy and lactation, but taking a supplement significantly improved the likelihood that they would meet the recommendations.”

 

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.

Food Ingredients To Avoid List

Written by Dr. Steve Chaney on . Posted in current health articles, Food and Health, Health Current Events, Nutritiion

Food Ingredients to Avoid Part 2: The Good, The Bad & The Ugly

Author: Dr. Stephen Chaney

 

food additivesIt is getting really hard to find a food or food supplement that doesn’t have any ingredients on the internet “naughty list”. The problem is that many of the internet warnings about food ingredients are what I call “urban nutrition myths”.  Want to know the truth about which additives should be on the  food ingredients to avoid list?

Last week I identified the top 25 food ingredients on the internet “naughty list” and told you which ones were actually “good” – OK for most people most of the time. This week I’m going to tell which ones are “bad” and which ones are truly “ugly”.

Food Ingredients to Avoid List?  The Bad

food ingredients to avoid badThe term “bad” for the food ingredients in this list is a bit of a misnomer. These are food ingredients that some people will want to avoid, but are perfectly OK for many people. In some cases, the type of food the ingredients are added to determines whether the ingredient is OK or should be avoided.  So, the following could possibly be on your food ingredients to avoid list.

Sodium Nitrate and Nitrite: This is a topic I have covered in a previous article titled “Nitric Oxide Benefits and Side Effects” . It is a perfect example of a food ingredient that can be “bad” in certain foods and “good” in others. Briefly:

  • When sodium nitrate and/or sodium nitrate are added to processed meats, they can combine with the amino acids from the meat in the intestine to form cancer-causing nitrosamines. As you might suspect, this is not a good thing.
  • On the other hand, when sodium nitrate or sodium nitrite are found in fruits are vegetables or combined with natural antioxidants such as vitamin C, they are converted to nitric oxide, which has a number of beneficial effects in the body. So when they are present in these foods or food supplements, they are actually beneficial.

Sugar & High Fructose Corn Syrup: As I said in my video “The Truth About Sugar” , there are no sugar villains and there are no sugar heroes. For example, high fructose corn syrup has been particularly vilified in recent years, but its chemical composition is not significantly different from honey and agave nectar, which are considered to be “good” sugars.

The problems associated with sugars of all types in the American diet are related to the amount of sugar in our diet (too much) and the kinds of foods they are found in. Let’s focus on that last one for a minute.

  • When sugars are consumed as a part of foods that are rich in fiber and/or protein they have much less of an effect on blood sugar levels (a lower glycemic index) than when they are consumed in sodas, juices and highly processed foods. That’s important because the bad health consequences of sugars are primarily caused by foods that lead to high blood sugar levels. See, for example, my article “Can Soft Drinks Cause Heart Disease?” .
  • Consequently, we should be focusing on the glycemic index (the effect on blood sugar levels) of the foods we eat rather than obsessing about the amount or kinds of sugar on the label.

MSG: MSG, or monosodium glutamate, is a particularly interesting case. MSG is the sodium salt of the amino acid glutamate.

Glutamate is a neurotransmitter.

  • When MSG is used as a flavor enhancer in foods with a low protein content, the glutamate is very rapidly taken up by the brain and can overstimulate some neurons.
  • For most people this is no problem, but a small number of people experience what used to be called “Chinese Restaurant Syndrome” due to the large amounts of MSG used in some Chinese foods.
  • The common symptoms associated with “Chinese Restaurant Syndrome” are headache, sweating, skin flushing, nausea & fatigue. Allergic reactions to MSG can even be life threatening in some individuals.

Glutamate is also found in every protein we eat. Consequently, we create lots of MSG in our intestine every time we eat and digest protein. In this situation it is no more harmful than any other amino acid in the proteins we eat.

  • The most logical explanation for this phenomenon is that when all of the amino acids are in our bloodstream simultaneously they compete with glutamate for uptake into the brain. This slows the entry of glutamate into the brain and prevents overstimulation of neurons.

The bottom line is that MSG as a flavor enhancer is harmless for most people, but problematic for some. MSG as a component of hydrolyzed vegetable protein or sodium caseinate is harmless because it is in balance with the other naturally occurring amino acids. Some websites claim that MSG is found in maltodextrin and citric acid. It is not.

Salt (Sodium): I could, and probably should, write a whole article on sodium intake. Suffice it to say that 1) most of us consume too much sodium, 2) most of that sodium is hidden in the foods we eat rather than added at the table, and 3) some people are more sensitive to the bad effects of sodium than others.

Refined Grains: Again, this could be a whole article. Suffice it to say that 1) whole grains are better than refined grains and 2) most of us would benefit from eating fewer grains in any form and more fruits and vegetables in their place.

Food Ingredients to Avoid List: The Ugly

Finally, there are some food ingredients that most experts (except for those in the food industry) agree should be avoided. I call them the dirty dozen. All should be on everyone’s food ingredients to avoid list.  They are:

food ingredients to avoid ugly

  • Trans fats (also known as partially hydrogenated vegetable oils).
  • Aspartame
  • Acesulfame-K
  • Sucralose
  • Artificial colors
  • Artificial flavors
  • BHA & BHT
  • Propyl gallate
  • Sodium and potassium benzoate
  • Potassium bromate
  • Potassium sorbate
  • Polysorbate 80

 

The Bottom Line

If you were to believe everything you read on the internet about food ingredients that you should avoid, you could end up spending most of your day reading food labels and still find very few foods that you could eat. Some of those warnings are true, some are partially true, and some are mostly myths.

To help you determine which to place on your food ingredients to avoid list,  I have identified the top 25 food ingredient warnings and have divided them into the good, the bad and the ugly.

  • The “good” are those food ingredients that are perfectly OK for most people, most of the time. Here are some examples (see the article above for a full explanation).
  • Soy: The supposed dangers of soy have been disproven by numerous clinical studies, but the myths persist. I do recommend that you choose non-GMO soy protein.
  • GMO: GMO foods and proteins are a concern but purified food ingredients obtained from GMO foods pose no health risks. There are, however, possible environmental concerns due to the overuse of Roundup.
  • Carrageenan and Caramel Color: In this case it is contaminants rather than the food ingredients themselves that are the problem. As long as you choose a manufacturer who performs rigorous quality control tests on their ingredients, you need not be concerned about these ingredients.
  • Canola Oil, Maltodextrin and Soy lecithin: The supposed dangers of these food ingredients are myths. They are not backed up by credible clinical studies. However, they are generally derived from GMO foods, so there is a possible environmental concern.
  • The “bad” are the food ingredients that do pose a problem for some people, particularly when those ingredients are found in the wrong kinds of foods. However, those same ingredients are OK for many people when they are in the right foods.
  • Sodium nitrate and nitrite: Those ingredients are a concern when added to processed meats, but are actually healthy when found in fresh fruits and vegetables or combined with antioxidants such as vitamin C.
  • Sugar and High Fructose Corn Syrup: We definitely need to reduce the amount of sugar in our diet. However, when looking at individual foods we should focus more on glycemic index than on the amount or kind of sugar.
  • MSG: MSG is a concern for some individuals when used as a flavor enhancer in low protein foods. However, it poses no risk when it is present as a component of partially digested proteins such as hydrolyzed vegetable protein or sodium casseinate.
  • The “ugly” are those ingredients that most experts agree we should avoid. They include trans fats, artificial sweeteners, artificial colors, artificial flavors, artificial preservatives and a few others listed 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.

Food Ingredients To Avoid

Written by Dr. Steve Chaney on . Posted in current health articles, Food and Health, Nutritiion

Food Ingredients to Avoid-Part 1: The Good, The Bad & The Ugly

Author: Dr. Stephen Chaney

 

I have been getting a lot of questions lately about food ingredient labels. That’s because in today’s internet world everyone is an “expert” wanting to be heard. Couple that with the fact that old news is boring, and we have a problem. All of these experts have to keep coming up with information that is novel and scary. It doesn’t need to be true – just novel and scary.

food ingredients to avoidThe warnings about which food ingredients to avoid are a perfect example. A few years ago it was pretty simple to know which ingredients to avoid. If you avoided foods with sugar, refined flour, trans fats and all that artificial stuff, you were OK. However, in recent years the list of additives to avoid keeps getting longer and longer.

It has reached the point where it is getting really hard to find a food or food supplement that doesn’t have any of the ingredients on the “naughty list”. You may even be wondering if there is anything besides organic fresh fruits and vegetables that you actually can eat. How did we get to this point?

The answer is obvious. All the internet “experts” needed something new to warn us about so they took molehills and turned them into mountains. They took food ingredients that might cause a few problems for a limited number of people and characterized them as ingredients that were dangerous for everyone. Their posts were picked up and repeated by other “experts” and pretty soon everyone thought they had to be true. The warnings about food ingredients became what I call “urban nutrition myths”.

It is time for a myth buster to come along and help you sort through all of the ingredient warnings so that you know which ones are true and which are myths. That’s something I enjoy doing. Let me be your guide.

Which Food Ingredients Should You Avoid?

My “research” for this article began by Googling “Food Ingredients to Avoid” to see what was on the internet. Starting from the top of the list that came up on Google, here are the articles I found:

Men’s Fitness: “The 9 Scariest Food Additives You Are Eating Right Now “ (http://www.mensfitness.com/nutrition/avoid-these-9-worst-food-ingredients)

Waking Times: “20 Ingredients to Memorize and Avoid In Any Food You Consume (http://www.wakingtimes.com/2013/03/04/20-ingredients-to-memorize-and-avoid-in-any-food-you-consume/)

Women’s Health: “7 Ingredients Nutritionists Always Avoid” (http://www.womenshealthmag.com/nutrition/avoid-these-ingredients)

Reader’s Digest: “4 Most Harmful Ingredients In Packaged Foods” (http://www.rd.com/health/diet-weight-loss/4-most-harmful-ingredients-in-packaged-foods/)

Huffington Post: “10 Of The Worst Toxic Food Ingredients” (http://www.huffingtonpost.ca/2013/04/17/worst-toxic-food-ingredients_n_3101043.html)

WebMD did not even weigh in on the issue of food ingredient warnings. Reader’s Digest and the Huffington Post included mostly the ingredient warnings that we have been hearing about for years. The other three articles included some of the newcomers to the ingredient warning list. By combining all 5 of those articles, I came up with 25 of the most frequently mentioned “dangerous” food ingredients to avoid and have divided them into 3 categories. I call them “The Good, The Bad and the Ugly”.

This week I will help you identify the “good ones” – those food ingredients that are on many of the internet “naughty lists”, but are actually OK for most people most of the time. Next week, I’ll be back with the bad and the ugly lists.

Food Ingredients: The Good

good food ingredientsI would be the first to admit the using the word “good” as a descriptor for food ingredients is a bit of a misnomer. The word “good” should really be reserved for organic fresh fruits and vegetables along with other whole, unprocessed foods. Of course, the problem is that most of us don’t eat enough of those foods, so we need to know which ingredients in the processed foods and food supplements we eat are OK.

The list of food ingredients that are perfectly OK for most of us would be a long one, so let me just mention a few that have inadvertently slipped onto the online “naughty lists” that you may have seen.

GMO: Let me be perfectly clear. I am no fan of GMO foods, but ingredients derived from GMO foods are a very different story. I have covered this topic in detail in my previous articles “Should GMO Labeling Be Required For All Food Ingredients?” (https://healthtipsfromtheprofessor.com/gmo-labeling-required-food-ingredients/) & “Will Non-GMO Foods Be Less Nutritious?” (https://healthtipsfromtheprofessor.com/will-non-gmo-foods-be-less-nutritious/) and my webinar “The Truth About Genetically Modified Foods” (https://healthtipsfromtheprofessor.com/videos/), so let me just summarize the key points here.

  • GMO foods and proteins derived from GMO foods can be a problem because of food sensitivities to the modified proteins. That risk is real, but is difficult to quantify.
  • All other food ingredients derived from genetically modified foods contain no genetic information or proteins. They are chemically & biologically indistinguishable from the same ingredients derived from non-GMO foods. Consequently, there are no health risks associated with these food ingredients.
  • I am aware of the recent internet chatter about the WHO declaring that Roundup can cause cancer. What is missed in these discussions is that Roundup is also approved for use just prior to harvest for non-GMO foods such as wheat and beans. That means that some non-GMO foods are more likely to be contaminated with Roundup residues than are GMO foods.
  • That just leaves the environmental issue. Roundup does break down relatively quickly in the environment, but I do have concerns about spraying tons of the stuff on our crops every year. However, I must acknowledge that many of my scientific colleagues do not share this concern, and they are not all in bed with Monstanto.

Soy: This is another topic I have covered extensively in my previous articles such as “Soy and Breast Cancer Recurrence” (https://healthtipsfromtheprofessor.com/soy-and-breast-cancer-recurrence/) & “Soy and Breast Cancer” (https://healthtipsfromtheprofessor.com/soy-breast-cancer/) and my video “The Truth About Soy” (https://healthtipsfromtheprofessor.com/videos/). Once again, I will just give a brief summary.

  • The myths that soy consumption causes breast cancer or any other cancer, lowers testosterone levels in men and interferes with thyroid metabolism have been disproven by multiple clinical studies.
  • The idea that soy has to be fermented to be healthy is also a myth. Most soy products are processed in such a manner that the toxins in the soy bean are removed.
  • For ingredients made from soy such as soy lecithin, there are no health risks associated with sourcing them from GMO soy (see above). If you are consuming a soy protein product, however, I do recommend that you choose non-GMO soy.

CarrageenanCarrageenan: Carrageenan comes from seaweed and red algae. It has been used in foods for thousands of years because of its gelling properties. In the supplement world it is used to improve consistency and the disintegration of tablets.

There is a lot to like about carrageenan. It is natural, organic and non-GMO. Why then has it become an internet villain in the food ingredient world? The problem is that most of the internet “experts” who are vilifying carrageenan are not distinguishing between carrageenan and its breakdown product poligeenan. Here are the facts:

  • In some animal studies poligeenan at very high doses has been shown to cause diarrhea, hemorrhaging & ulcerations of the colon and even colon cancer. Not all animal studies agree, but this does raise the possibility that high doses of poligeenan might cause the same effects in humans.
  • Food grade carrageenan contains <5% poligeenan and does not raise the same concerns.
  • Food grade carrageenan does not cause gastrointestinal problems in most animal studies. Nor has it been shown to cause cancer in any animal study.
  • The FDA, USDA and WHO have reviewed all available studies and have concluded that food grade carrageenan is safe.
  • The International Agency for Research on Cancer (IARC) has concluded that carrageenan does not cause cancer.

Caramel Color: I won’t go into detail here, but the argument is similar to carrageenan. It is a minor impurity of caramel coloring that is the concern. However, caramel coloring itself should not be a concern for products made by any reputable manufacturer that employs rigorous quality control tests on their ingredients.

Canola Oil: Canola oil is an excellent source of monounsaturated fats and polyunsaturated fats, especially the beneficial omega-3 polyunsaturated fats. In supplements it is primarily used as a source of healthy fats and to improve taste, aroma or texture. There are some legitimate concerns with canola oil, but they have been considerably overhyped. This is a perfect example of a molehill being turned into a mountain. Let’s look at the myths that are simply untrue and the facts that have been overhyped.

  • Myth #1: Canola oil contains the same toxins as the original rapeseed oil. Fact: The toxins found in rapeseed oil has been removed through conventional plant breeding. Canola oil is toxin free.
  • Myth #2: Canola oil is toxic in animal studies. Fact: When you look at those studies carefully they were either done with rapeseed oil or were done under conditions where almost any vegetable oil would have been problematic.
  • Fact #1: Canola oil is highly processed. That’s true, but so are most other vegetable oils. If you want a less processed oil, choose virgin olive oil. (Unfortunately, it is not found in many processed foods or food supplements – probably because of cost). Some experts recommend palm oil or coconut oil, but they have their own problems because of their high saturated fat content.
  • Fact #2: Most canola oil comes from GMO plants. That is true, but canola oil is a highly purified food ingredient. As described above, that means there are no health concerns from eating GMO canola oil, only a possible environmental concern.

Maltodextrin: Maltodextrin is a natural food ingredient made from enzymatically digesting starch. It is used as a stabilizer and thickener in foods. It is also combined with glucose and fructose in sports drinks to provide sustained energy.

  • Myth #1: The internet is filled with claims that maltodextrin causes gastrointestinal problems or that it is unsafe. There is very little evidence to back that up, and we need to consider those claims in light of the fact that we produce lots of maltodextrin in our intestines every day as we digest the starches in our diet.
  • Myth #2: “Maltodextrin is just another sugar. It is just another way for food manufacturers to hide the total amount of sugar in their products.” Maltodextrin is actually less sweet than most sugars. As described above, it is primarily added to foods for reasons other than to impart sweetness.
  • Fact: Most of the maltodextrin in the US does come from GMO corn. Once again, it is a highly purified food ingredient. As with canola oil that means there are no health concerns, only possible environmental concerns.

Just because these ingredients are on my “good list” doesn’t mean that they won’t cause problems for some people. Lots of people have food allergies. My dad, for example, was allergic to chocolate, which has to be one of the cruelest food allergies that someone could have. Sometimes food allergies can be quite severe. Just ask someone with severe peanut allergies what life can be like if they even come near a peanut.

My point is that any natural food or food ingredient can cause allergic reactions in some people. That doesn’t make them bad. It is just part of normal living.

Next week I will be back with “the bad and the ugly” food ingredients. Stay tuned.

 

The Bottom Line

If you were to believe everything you read on the internet about food ingredients that you should avoid, you could end up spending most of your day reading food labels and still find very few foods that you could eat. Some of those warnings are true, some are partially true, and some are mostly myths.

To help you sort through this confusing information I have identified the top 25 food ingredient warnings and have divided them into the good, the bad and the ugly. This week I covered the “good ones”.

The “good” are those food ingredients that are perfectly OK for most people, most of the time. Here are some examples (see the article above for a full explanation).

  • Soy: The supposed dangers of soy have been disproven by numerous clinical studies, but the myths persist. I do recommend that you choose non-GMO soy protein.
  • GMO: GMO foods and proteins are a concern, but purified food ingredients obtained from GMO foods pose no health risks. There are, however, possible environmental concerns due to the overuse of Roundup when those GMO foods were grown.
  • Carrageenan and Caramel Color: In this case it is contaminants rather than the food ingredients themselves that are the problem. As long as you choose a manufacturer who performs rigorous quality control tests on their ingredients, you need not be concerned about these ingredients.
  • Canola Oil, Maltodextrin and Soy lecithin: The supposed dangers of these food ingredients are myths. They are not backed up by credible clinical studies. However, they are generally derived from GMO foods, so there is a possible environmental concern.
  • Just because these food ingredients made my good list doesn’t mean they are OK for everyone. People can be allergic to certain food ingredients, just as they can be allergic to certain foods so for some, these can still be food ingredients to avoid.

 

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.

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What Is The Best Diet For You?

Posted May 23, 2017 by Dr. Steve Chaney

Sorting Through The Dueling Diets

Author: Dr. Stephen Chaney

battle over best dietDiets are a lot like politics in today’s world. Everyone is absolutely convinced their diet is the best and absolutely convinced the other diets are terrible.

Remember the nursery rhyme: “Jack Sprat could eat no fat. His wife could eat no lean…”? Today’s diets remind me of that. They run the gamut from no fat to no carbohydrates. Surely, both extremes couldn’t be healthy. Or could they?

Some diets eliminate whole food groups. That couldn’t be a good thing. Or, could it?

So, what is the best diet for you?

In today’s article, I will give you the pros and cons of these dueling diets. Before I do that, however, let me give you some principles to put things into perspective.

General Principles For Evaluating Diets

How do you sort out the claims and counterclaims associated with the various diets? More importantly, how do you know which of the claims are true and which are misleading? Here are some general principles to help you separate the wheat from the chaff.  What’s the right diet for you?

We are omnivores. We can adapt to a wide variety of diets and do reasonably well. That means most people will do well on any of these diets short term.

wings proteinAnything is better than the standard American diet (SAD). It is high in sugar and refined carbohydrates. It is also high in saturated and trans fats. That is why proponents of every diet can claim that you will feel better and be healthier when you switch to their diet.

Processed and convenience foods are part of the problem. Most diets recommend “clean eating” (elimination of processed and convenience foods). Any diet that eliminates processed and convenience foods is likely to help you lose weight and get healthier. Caution: As soon as a diet becomes popular, food manufacturers rush in to provide pre-packaged, convenience foods to support that diet. Avoid the temptation to use those foods. Big Food Inc. does not have your best interests in mind. They are not your friends.

Most diets lead to a fairly rapid initial weight loss. This is because they restrict food choices and eliminate processed foods. When you eliminate familiar foods from someone’s diet, they instinctively eat less without even thinking about it. This rapid initial weight loss is part of the allure of almost every diet program. However, over time most people start adding back some of their favorite foods or find new foods they like, and the weight comes back.

Weight loss leads to improved blood parameters irrespective of diet composition. That is why every diet, no matter how bizarre, can claim it lowers your blood pressure, improves your blood sugar, lowers your cholesterol, and lowers your triglycerides.

Long term weight loss is virtually identical on every diet. Numerous clinical studies have compared long term weight loss on low fat diets, low carbohydrate diets, and virtually everything in between. Initial weight loss is more rapid on the low-carbohydrate diets. However, at the end of one or two years there is not a dime’s worth of difference in weight loss between any of the diets. The exception is the Vegan diet. Long term Vegans typically weigh less than their meat-eating counterparts, probably because the foods in the Vegan diet have low caloric density (fewer calories per serving).

Healthy carbs and healthy fats are more important than low carb or low fat diets. Ignore the claims and counter claims about low fat and low carb diets. Focus instead on diets that provide moderate amounts of whole grains instead of refined grains & sugar. Also focus on diets that provide moderate amounts of monounsaturated and polyunsaturated fats, especially the omega-3 polyunsaturated fats, instead of saturated and trans fats.

Focus on well balanced meals rather than individual foods. For example, moderate amounts of healthy carbohydrates will have relatively little effect on blood sugar and triglyceride levels as part of a plant-based meal that provides plenty of fiber and protein. However, those same carbohydrate-rich foods by themselves may cause a spike in both blood sugar and triglycerides.

best diet for youPlant-based diets rule. The Ornish diet (a very restrictive form of the Vegan diet) is the only diet that has been shown to reverse atherosclerosis in some people. The Vegan diet and the Mediterranean diet, which is largely plant-based, have been shown to be healthy long term. On the other hand, we simply don’t know whether low carbohydrate diets are healthy long term. Those clinical studies have not been done.

Saturated and trans fats are not your friends. They increase inflammation, which can have many serious long-term health consequences. In addition, the foods that are rich in saturated fats are often acid-forming foods, which can upset your acid-base balance.

We have 5 food groups for a reason. Each food group provides valuable nutrients (vitamins a & minerals) and phytonutrients. You may be able to replace the missing nutrients with supplementation, but you are unlikely to replace the phytonutrients with supplements – even those supplements that claim to be made from whole foods. You should be concerned about the long-term health consequences of any diet that eliminates whole food groups.

Low fat diets aren’t necessarily healthy. Whole food, low-fat diets like the Vegan diet are extremely healthy. However, as soon as health experts started recommending low-fat diets, Big Food Inc. stepped in to offer convenient low fat options. They simply replaced the fat with refined carbohydrates, sugar, and a witch’s brew of chemicals (Remember the part about Big Food Inc. not being your friend?). As a result, the low-fat diet consumed by most Americans is anything but healthy.

The supposed advantages of low carbohydrate diets are misleading. Low carbohydrate diets look very good when you compare them to the Big Food Inc version of the low-fat diet. However, when you compare them to something like the Vegan diet the advantages disappear.

Avoid sugar-sweetened and diet beverages. This should go without saying. Choose water instead. Add carbonation and/or a little lemon or lime juice for flavoring if necessary. Fortunately, most of the major diets exclude sugar-sweetened and diet beverages.

 

The Pros and Cons Of The Major Diets

It is not possible to cover each diet in depth in a single article, so this is meant to be a very brief overview of the major diets.

Low Fat Diets

The Dean Ornish Diet. This is a variation of the Vegan Diet that eliminates all oils, even vegetable oil.

Pros:

  • Whole food, plant-based diet.
  • All the advantages of the Vegan diet, plus it is the only diet shown to reverse atherosclerosis.

Cons:

  • Very restrictive.
  • Long-term adherence is low.

 

vegetablesThe Vegan Diet. This is a whole food, plant based diet. It uses plant proteins instead of meat and plant substitutes for dairy and eggs.

Pros:

  • Whole food, plant-based diet.
  • Associated with lower blood pressure, blood sugar, cholesterol, triglycerides, and inflammation.
  • Clinical studies show that the onset of major diseases like heart disease, cancer, and diabetes are delayed by at least 5-10 years. People on this diet live healthier, longer.

Cons:

  • Long-term adherence is relatively low, but some people stick with this diet for a lifetime.

 

Healthy Fat, Healthy Carb Diets

The Mediterranean Diet. This diet emphasizes fresh fruits & vegetables, whole grains, fish, nuts, seeds, legumes and olive oil. It includes cheese, poultry and eggs in moderation.

whole food dietPros:

Cons:

  • Not designed specifically for weight loss. You will need to watch portion sizes and track calories if you want to lose weight on this diet.

 

The DASH Diet. This diet was specifically designed to help reduce the risk of hypertension and stroke. It is similar to the Mediterranean diet except that it restricts sodium and includes a wider range of lean meats and low-fat dairy products. It does not specifically include olive oil.

Pros:

  • Whole food diet.
  • Clinically proven to lower blood pressure  as effectively as some blood pressure medications.
  • Relatively easy to follow. Includes foods familiar to Americans.

Cons:

  • Not designed specifically for weight loss. You will need to watch portion sizes and track calories if you want to lose weight on this diet.

 

Low Carb Diets

meat protein dietThe Paleo Diet. The Paleo diet is supposedly based on the diet of our paleolithic hunter-gatherer ancestors. The diet is high in protein & fat, and low in carbohydrates. The diet eliminates grains, sugars, refined oils, dairy, legumes, and starchy fruits & vegetables. Most of the protein comes from meats, but the animals must be grass-fed. This reduces, but does not eliminate, saturated fat and gives a modest increase in omega-3 polyunsaturated fat. Thus, the meats included in this diet are healthier than the meats in other low carbohydrate diets. However, it does not turn red meats into health foods.

Anthropologists tell us that the premise of the Paleo diet is faulty. The diet of our paleolithic ancestors was highly dependent on the foods available in their environment. Some were hunters and gatherers. Others lived in areas where fruits & vegetables were prevalent and game was scarcer. Still others lived in areas where starchy root vegetables were an important part of their diet. Furthermore, the enzymes required for digestion of starches are inducible. We can easily adapt to the introduction of grains into our diet.

Pros:

  • Whole food diet.
  • The Paleo diet is associated with several short-term benefits including weight loss, improved blood sugar control and reduced cholesterol, triglycerides & blood pressure.

Cons:

The Atkins Diet. The Atkins diet is the granddaddy of the low-fat diets. It is a very low carbohydrate diet that restricts sugars, grains, high carbohydrate fruits and vegetables. The allure of the diet is that it includes as much fatty meats and saturated fats as you want.

Pros:

  • The Atkins diet is associated with several short-term benefits including weight loss, improved blood sugar control and reduced cholesterol, triglycerides & blood pressure.

Cons:

  • There are no studies evaluating the long-term benefits and risks of the Atkins diet.
  • Weight loss at the end of one or two years is no better than for the low-fat diets.
  • The high intake of saturated fat has the potential to increase the risk of heart disease and cancer.
  • It is a very restrictive diet. Long-term adherence to this diet is poor.

The Ketogenic Diet. The Ketogenic diet is even more restrictive than the Atkins diet. I have covered the pros and cons of the Ketogenic diet in a recent post, so I will refer you to that article, Is the Ketogenic Diet Safe for details. In short, the Ketogenic diet has some short-term benefits and some potential long-term risks. Ketone supplements mimic some, but not all, of the short-term benefits of the Ketogenic diet. Their long-term health risks are unknown.

 

What Is The Best Diet For You?

what diet is right for youWe are all different, so there is no perfect diet for everyone. Want to know how to find a diet that works for you?  Here are some things to think about.

  • If you are like most Americans, almost any of these diets is better than your current diet.
  • The good thing about all the diets reviewed in this article is:
    • They replace refined carbohydrates & sugars with healthier alternatives (The best of the diets also replace saturated & trans fats with healthier alternatives).
    • They emphasize whole foods rather than processed and convenience foods.
    • They eliminate sugar-sweetened and diet beverages.
    • They emphasize fresh vegetables and most include fresh fruit.
  • If you are looking for rapid initial weight loss:
    • The very restrictive diets at either extreme (very low fat or very low carb) are best because they eliminate familiar foods from the diet.
    • The very low carb diets are slightly more effective than low fat diets initially because of water loss, but weight loss on most low carb and low fat diets is identical after 1-2 years.
    • Because both the Mediterranean and DASH diets involve many familiar foods, you will need to pay more attention to portion sizes and total calories on these diets if your primary goal is to lose weight.
  • If you are looking for long term weight control, the Vegan diet is best, probably because most foods in the Vegan diet have low caloric density. Multiple studies have shown that Vegans weigh less than their meat-eating counterparts.
  • If you are looking for long term health benefits:
    • The Vegan and Mediterranean diets are clearly your best choices. They are backed by multiple clinical studies showing they reduce the risk of heart disease, cancer, diabetes, dementia and other diseases.
    • The DASH diet is probably equally healthy. However, because it was designed to control blood pressure, most clinical studies have focused only on how well it reduces blood pressure.
    • There is no evidence that the low carb diets have any long-term health benefits, and there is reason to suspect they may have some long-term health risks.
  • I have serious concerns about long-term health risks for any diet that:
    • Eliminates whole food groups.
    • Is high in saturated and trans fats.
  • The effectiveness of any diet is dependent on how well you stick with it:
    • The long-term adherence to any of the very restrictive diets (either low carb or low fat) is low, although some people do stick with the Vegan diet for a lifetime.
    • Adherence is best with the Mediterranean and DASH diets, probably because many of the foods are familiar and readily available.

 

The Bottom Line

 

In this article I have reviewed the major low fat diets (the Dean Ornish diet and the Vegan diet), the major healthy carb, healthy fat diets (the Mediterranean diet and the DASH diet), and the major low carb diets (the Paleo diet, the Atkins diet, and the Ketogenic diet). In summary:

 

  • If you are like most Americans, almost any of these diets is better than your current diet.
  • The good thing about all these diets is:
    • They replace refined carbohydrates & sugars with healthier alternatives (The best of the diets also replace saturated & trans fats with healthier alternatives).
    • They emphasize whole foods rather than processed and convenience foods.
    • They eliminate sugar-sweetened and diet beverages.
    • They emphasize fresh vegetables and most include fresh fruit.
  • If you are looking for rapid initial weight loss:
    • The very restrictive diets at either extreme (very low fat or very low carb) are best because they eliminate familiar foods from the diet.
    • The very low carb diets are slightly more effective than low fat diets initially because of water loss, but weight loss on most low carb and low fat diets is identical after 1-2 years.
    • Because both the Mediterranean and DASH diets involve many familiar foods, you will need to pay more attention to portion sizes and total calories on these diets if your primary goal is to lose weight.
  • If you are looking for long term weight control, the Vegan diet is best, probably because most foods in the Vegan diet have low caloric density. Multiple studies have shown that Vegans weigh less than their meat-eating counterparts.
  • If you are looking for long term health benefits:
    • The Vegan and Mediterranean diets are clearly your best choices. They are backed by multiple clinical studies showing they reduce the risk of heart disease, cancer, diabetes, dementia and other diseases.
    • The DASH diet is probably equally healthy. However, because it was designed to control blood pressure, most clinical studies have focused only on how well it reduces blood pressure.
    • There is no evidence that the low carb diets have any long-term health benefits, and there is reason to suspect they may have some long-term health risks.
  • I have serious concerns about long-term health risks for any diet that:
    • Eliminates whole food groups.
    • Is high in saturated and trans fats.
  • The effectiveness of any diet is dependent on how well you stick with it:
    • The long-term adherence to any of the very restrictive diets (either low carb or low fat) is low, although some people do stick with the Vegan diet for a lifetime.
    • Adherence is best with the Mediterranean and DASH diets, probably because many of the foods are familiar and readily available.
  • 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.

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