Does Obesity Cause Cancer?

Written by Dr. Steve Chaney on . Posted in Diets, Exercise, Healthy Lifestyle, Lose Weight, Obesity, Obesity and Cancer

Is The Obesity Epidemic Killing Us?

Author: Dr. Stephen Chaney

Does obesity cause cancer?

does obesity cause cancerYou probably already know that we are in the midst of a world-wide obesity epidemic. If not, here are some of the alarming statistics that characterize that epidemic:

  • The global prevalence of obesity has increased by 27.5% between 1980 and 2013.
  • 35% of the adult population worldwide is now overweight (BMI ≥ 25), including 12% who are classified as obese (BMI ≥30).
  • According to the NIH the situation is even worse in developed countries like the US where 75.1% of adults are now overweight, including 35.7% who are obese, and 6.3% who are very obese (BMI ≥40).

Unfortunately, overweight and obesity are not benign. You probably already knew that those excess pounds increase your risk of diabetes, heart disease, kidney failure and much more. You probably also knew that those excess pounds increase your risks of certain types of cancer such as colon, rectal, kidney, pancreatic, postmenopausal breast, ovarian and uterine cancer.

It’s been a little more difficult to determine just how much obesity increases cancer risk. However, a recent study suggests that the increased risk could be quite significant. In fact, if this study is correct, obesity may only be second to smoking as a preventable cause of cancer. The truth might just scare you skinny!

Does Obesity Cause Cancer?

cancer epidemicThe International Agency For Research On Cancer did a worldwide study, (Arnold et al, The Lancet Oncology 16: 36-45, 2015),  in which they looked at the effect of BMI on cancer incidence in adults aged 20 years or older. The BMI data was collected in 2002 and was segregated by sex and age groups. Recognizing that cancer takes decades to develop, they then collected data on newly diagnosed cancers in adults 30 and older in the same countries in 2012.  They were determined to get closer to answering the question, does obesity cause cancer?

By comparing BMIs in 2002 with the incidence of newly diagnosed cancers 10 years later they were able to calculate the effect of excess body weight (BMI ≥25) on cancer incidence. The results were startling:

  • They estimated that 481,000 new cases of cancer in 2012 in adults over 30 were attributable to excess weight.
  • That represents 3.6% of all new cancer cases, which makes overweight second only to smoking as a preventable cause of cancer.
  • Uterine cancer, postmenopausal breast cancer, and colon cancer accounted for 63.6% of all cancers caused by overweight. Other cancers affected by excess weight were rectal cancer, pancreatic cancer, kidney cancer, gallbladder cancer, and ovarian cancer.
  • The effect of excess weight on cancer risk was almost 3-fold greater for women (5.4% of new cancer cases) than for men (1.9% of new cancer cases).
  • In North America 111,000 new cases of cancer in 2012 for adults over 30 were attributable to excess weight. That represents 3.5% of all new cancers in men and 9.4% of all new cancers in women.
  • A quarter (about 118,000) of the worldwide cancer cases related to high BMI in 2012 could be attributed to the increase in BMI that has occurred since 1982.

The authors concluded “These findings emphasize the need for a global effort to abate the increasing numbers of people with high BMI. Assuming that the association between the high BMI and cancer is causal, the continuation of current patterns of population weight gain will lead to continuing increases in the future burden of cancer.”

What Does This Study Mean For You?

We have to stop kidding ourselves. That excess flab isn’t harmless. It is killing us, and cancer is a particularly gruesome way to go. It’s time to get serious about weight loss. Here are my top 5 tips for lasting weight loss.

  • fad dietsEat healthy low calorie meals and snacks with plenty of protein so that you maintain muscle mass while you are losing fat.
  • Avoid the fad diets. You don’t need to restrict carbohydrates or fats. You just need to focus on fresh fruits and vegetables, healthy proteins and modest amounts of healthy fats and healthy carbohydrates.
  • Find an exercise program you like and stick with it every day.
  • Focus on true lifestyle change rather than short term diets. A good strategy is to make one healthy change at a time rather than trying to do everything at once.
  • Change how you think about food, think about exercise, and think about your ability to make the kinds of changes that will lead to permanent weight loss. Don’t think of yourself as a fat person who is trying to lose weight. Think of yourself as a skinny person who happens to have a few extra pounds that are on their way out.

Of course, getting to a healthier weight isn’t the only change you want to make if you are trying to reduce your risk of cancer. Here are my top 7 lifestyle change suggestions (besides weight loss) for reducing cancer risk.

  • healthy eatingIf you smoke, stop. No ifs, ands, or buts. Smoking is still the #1 cause of cancer.
  • Eat a healthy diet (including supplements to fill the gaps).
  • Eat plenty of fresh fruits and vegetables, especially those that are good sources of cancer-fighting antioxidants, carotenoids, flavonoids, and polyphenols.
  • Eat fish and fish oil supplements to make sure that you get plenty of omega-3 fatty acids.
  • Minimize saturated fats and avoid trans fats. Substitute olive oil for vegetable oils whenever possible.
  • If you drink alcohol, drink it in moderation.
  • Avoid sun exposure as much as possible, and use sunscreen when outdoors.
  • Eat healthy proteins.
  • Minimize consumption of red meats and processed meats.
  • Use chicken, fish and vegetable proteins whenever possible.
  • Soy protein is particularly helpful for reducing the risk of breast cancer. (Yes, those scary blogs about soy and breast cancer are wrong. For accurate information, just go to https://healthtipsfromtheprofessor.com and type soy in the search box).
  • Get plenty of exercise.
  • Get regular check-ups.

So, does obesity cause cancer?  I think you now know the answer.

 

The Bottom Line

 

  • A recent study has shown:
  • 481,000 new cases of cancer worldwide each year are attributable to excess weight.
  • That represents 3.6% of all new cancer cases, which makes overweight second only to smoking as a preventable cause of cancer.
  • Uterine cancer, postmenopausal breast cancer, and colon cancer accounted for 63.6% of all cancers caused by overweight.
  • The effect of excess weight on cancer risk was almost 3-fold greater for women (5.4% of new cancer cases) than for men (1.9% of new cancer cases).
  • In North America 111,000 new cases of cancer for adults over 30 are attributable to excess weight. That represents 3.5% of all new cancers in men and 9.4% of all new cancers in women.
  • That excess flab isn’t harmless. It is killing us, and cancer is a particularly gruesome way to go. For my top 5 tips for lasting weight loss and my top 7 tips for reducing your risk of cancer, 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.

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.

Does Genetics Determine Weight?

Written by Dr. Steve Chaney on . Posted in Health Current Events, Healthy Lifestyle, Obesity

Does Genetics Cause Obesity?

Author: Dr. Stephen Chaney

Overweight & Skinny WomenIt’s frustrating. Try as hard as you might, you just can’t seem to lose weight. Even worse you suspect that your friends – and maybe your doctor – assume that you are cheating on your diet. It just doesn’t seem fair.

Perhaps there is a simple explanation. Maybe your genes are keeping you from losing weight. Does genetics determine weight?  It has been hypothesized that some of us have a “thrifty” phenotype when it comes to weight loss while others are “spendthrifts”. The theory is that people with a “thrifty” phenotype hold on to weight more tightly when they are “fasting” (i.e. trying to lose weight) and gain weight more readily when they are “feasting” (i.e. eating excess calories).

The metabolism of the “spendthrifts” is exactly the opposite. They lose weight rapidly when fasting and gain weight slowly when feasting. Those would be all of your skinny friends who just can’t seem to understand why you have such difficulty losing weight.

Those experts who favor the “thrifty” phenotype hypothesis point out that it would have provided a tremendous survival advantage in prehistoric times when food was scarce. That’s why some of those same experts think that up to 80% of the population has the “thrifty” phenotype. When you couple the thrifty phenotype with the typical American diet and lifestyle it becomes easy to understand why we have an obesity epidemic in this country.

Is the “thrifty” phenotype hypothesis true? Could it explain why you have such difficulty losing weight? A recent study suggests the answer to those two questions may be yes. I will outline the evidence below.

Then I will address what are probably the two most important questions for you: “If the thrifty phenotype hypothesis is true and you have the thrifty phenotype, are you destined to be overweight? Is there anything you can do about it?

How The Study Was Designed

medical studyThis study (Reinhardt et al, Diabetes, 64: 2859-2867, 2015) was truly a remarkable study. 15 healthy, but obese volunteers were put in a metabolic ward for a total of 11 weeks. In the metabolic ward every aspect of their metabolism was closely controlled and measured.

  • They were given diets that were precisely calibrated to provide a predetermined caloric (energy) input.
  • Urine and feces were collected and analyzed in an instrument called a bomb calorimeter to determine calorie (energy) output.
  • They were limited to primarily sedentary activity for the duration of the experiments, and the temperature of the metabolic ward was maintained constant. This eliminated variation in energy expenditures due to activity and temperature.
  • Metabolic energy expenditure was calculated by placing them in a special room designed to precisely measure oxygen consumption and CO2 production by the subjects over a 24 hour period. Don’t worry about the details. Just know that this is the gold standard for measuring energy expenditure.

Here is what the subject’s 11 weeks in the metabolic ward looked like:

  • During the first 3 weeks the subjects were provided with a diet designed with just enough calories to maintain their weight based on their weight and sex. If weight gain or loss was observed the calories were adjusted accordingly.
  • During one 24 hour period in week 3 the subjects were place on a diet that decreased their calories by 50%, (defined as “fasting” in this study) and the resulting decrease in metabolic energy expenditure was measured as described above.
  • During another 24 hour period in week 3 the subjects were place on a diet that increased their calories by 200% (defined as “overfeeding” in this study), and the resulting increase in metabolic energy expenditure was measured.
  • During the next 6 weeks the subjects were placed on calorie restricted diet that only provided 50% of the calories they needed to lose weight.
  • During the final 2 weeks the subjects were placed on a diet designed to provide the calories needed to maintain their new weight, whatever it was.

How Does Genetics Determine Weight?

do genetics cause obesityThe results of the study were quite interesting:

  • All of the subjects lost weight, but the amount of weight loss ranged from 5% to 12% of the original body weight.
  • Their starting weight did not influence their rate of weight loss during calorie restriction, but their metabolic response to fasting and overfeeding significantly affected their rate of weight loss. Specifically:
  • The subjects with the smallest decrease in energy expenditure during fasting and the largest increase in energy expenditure during overfeeding (the spendthrifts) lost significantly more weight during the 6 week caloric restriction period (what most of us call a diet).
  • The subjects with the largest decrease in energy expenditure during fasting and the smallest increase in energy expenditure during overfeeding (the thrifty) lost significantly less weight during the 6 week caloric restriction period.
  • The amount of caloric restriction needed to lose one pound of weight ranged from 1,558-2,993 depending on whether the subjects displayed the spendthrift or thrifty phenotype. That’s almost a 2-fold difference.

What Does This Study Mean For You?

life-is-sometimes-unfairLife isn’t fair. You probably already suspected that. Your skinny friends actually do have a much easier time losing weight than you do. In fact, they may be able to lose up to twice the amount of weight with exactly the same amount of caloric restriction.

However, the good news is that weight loss is possible – even for you. Everyone in the study lost weight – even those subjects with the thriftiest phenotype. So the question becomes what can you do to lose weight successfully? Here are 5 simple tips.

#1: Don’t give up. Stick with it. Pounds may come off slowly for you, but this study shows they will come off. You just have to keep the faith and be consistent.

#2: Watch what you eat very carefully. The researchers in this study controlled every morsel of food the subjects ate. People always lose weight more rapidly when they are in a metabolic ward. My recommendation is to track what you eat daily using one of the many available tracking apps.

#3: Be consistent with your exercise. The subjects in this study were not allowed to exercise, but that is one of the best ways to increase energy expenditure. Aerobic exercise gives you a small increase in energy expenditure during and immediately following the exercise. Weight bearing exercise gives a long term increase in energy expenditure because it increases muscle mass, and muscle burns calories faster than any other tissue.

#4: Choose a diet that preserves muscle mass (High Protein Diets and Weight Loss ) while you are losing weight.

#5: Avoid all those diets with herbal and pharmaceutical stimulants. They are dangerous and they may just kill you.  Check out  Are Dietary Supplements Safe.

 

The Bottom Line

A recent study (Reinhardt et al, Diabetes, 64: 2859-2867, 2015) did a very careful metabolic analysis and divided subjects into what they characterized as either a “thrifty” or “spendthrift” phenotype based on their changes in metabolic energy expenditure in response to fasting and overfeeding. They then looked at how those phenotypes affected weight loss during a 6 week period of caloric restriction. Does genetics cause obesity or help determine weight?  Here’s what they found:

  • All of the subjects lost weight, but the amount of weight loss ranged from 5% to 12% of the original body weight.
  • Their starting weight did not influence their rate of weight loss during caloric restriction, but their metabolic response to fasting and overfeeding significantly affected their rate of weight loss. Specifically:
  • The subjects with the smallest decrease in energy expenditure during fasting and the largest increase in energy expenditure during overfeeding (the spendthrifts) lost significantly more weight during the 6 week caloric restriction period (what most of us call a diet).
  • The subjects with the largest decrease in energy expenditure during fasting and the smallest increase in energy expenditure during overfeeding (the thrifty) lost significantly less weight during the 6 week caloric restriction period.
  • If you struggle to lose weight, this is a good news – bad news study.
  • The bad news is that life isn’t fair. You probably already suspected that. Your skinny friends actually do have a much easier time losing weight than you do.
  • The good news is that weight loss is possible – even for you. Everyone in the study lost weight – even those subjects with the thriftiest phenotype. So the question becomes what can you do to lose weight successfully? I’ve given you 5 simple tips 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.

Artificial Sweeteners And Diabetes

Written by Dr. Steve Chaney on . Posted in Food and Health, Health Current Events, Obesity

Another Myth Bites The Dust

Author: Dr. Stephen Chaney

 

artificial sweeteners and diabetesArtificial sweeteners and diabetes; is there a relationship?

Once again, artificial sweeteners have come up empty. They were supposed to help you lose weight, but several recent clinical studies have suggested that artificially sweetened beverages are just as likely to lead to weight gain as sugar sweetened beverages, see  Do Diet Sodas Make You Fat.

What about type 2 diabetes? There have been several clinical trials that have suggested that excess consumption of sugar sweetened beverages may increase your risk of developing type 2 diabetes (For example, Basu et al, Am J Pub Health, 103: 2071-2077, 2013; Malik et al, Diabetes Care, 33: 2477-2483, 2010).

As a consequence if you are at risk of developing type 2 diabetes, you’ve probably been advised by your doctor or dietitian to switch from sugar sweetened beverages to artificially sweetened beverages or natural fruit juices. But, does that really work? Maybe not.

In fact, some studies have suggested that excess consumption of artificially sweetened beverages or fruit juice may be just as likely to lead to type 2 diabetes as consuming sugar sweetened beverages (For example, Greenwood et al, Br J Nutr, 112: 725-734, 2014; Xi et al, PloS One, 9:e93471, 2014).

A Systematic Study Of Beverage Consumption And Diabetes Risk

However, this has been a very controversial topic. The problem is that it is devilishly difficult to design studies that provide definitive answers to these important questions.

To start with there are problems with confounding factors. For example,

  • It is pretty well established that consumption of sugar sweetened beverages leads to obesity and obesity leads to type 2 diabetes, but many of the studies did not adjust the data for obesity.
  • In addition, many people who are overweight often switch to artificially sweetened beverages in the mistaken belief that they will help them lose weight. Once again, many of the published studies did not correct for that.

There are also problems with study design. For example, many of the studies did not directly compare sugar sweetened and artificially sweetened beverages in the same population group. If the population groups are different enough between studies, it can be a little like trying to compare apples to oranges.

Because of these limitations an international team of experts designed a major systematic review and meta-analysis (Imamura et al, Br J Med, doi: 101136/bmj.h3576, 2015) of all reasonably well designed prospective studies that measured the effect of beverage consumption on the development of type 2 diabetes over time.

They evaluated the data from 17 studies that represented 38,253 people who developed type 2 diabetes over a period of at least two years. They used the most rigorous statistical analysis methods available, and they interpreted their results very cautiously.

In short, this was a major study. So, what did the study show?

Is There a Relationship Between Artificial Sweeteners And  Diabetes?

On face value, the data appeared to be fairly clear:

  • prevent diabetesAn additional one serving per day of a sugar-sweetened beverage increases your risk of developing type 2 diabetes by 18%. When you correct for obesity, the increased risk is 13%. (Note: we are talking about an 8 ounce serving here, not a 32 ounce Big Gulp or 64 ounce Double Gulp).
  • An additional one serving per day of an artificially-sweetened beverage increases your risk of developing type 2 diabetes by 25%. When you correct for obesity, the increased risk is 8%.
  • An additional one serving per day of fruit juice increases your risk of developing type 2 diabetes by 5%. When you correct for obesity, the risk actually increases to 7%.

In short, if you want to decrease your risk of developing type 2 diabetes, none of these options is a particularly good choice.

How Were These Data Interpreted

Of course, the strength of any meta-analysis is limited by the quality of the studies that were included in the meta-analysis. It is the old GIGO (garbage in, garbage out) principle. The authors acknowledged that limitation and analyzed in great detail the quality of the individual studies included in their meta-analysis. Their conclusions were as follows:

  • garbage in garbage outThe quality of the data on sugar sweetened beverages was strong enough that they could conclude that “habitual consumption of sugar sweetened beverages is associated with a greater incidence of type 2 diabetes, independent of obesity”. In short, you want to stay away from sugar sweetened beverages. They can cause obesity AND they can cause type 2 diabetes.
  • They also said that “…artificially sweetened beverages and fruit juice also showed positive associations with incidence of type 2 diabetes”, but did not feel the existing data were strong enough to make a definitive conclusion. They felt that more studies are needed.
  • However, they did feel that the existing data were strong enough to conclude that “neither artificially sweetened beverages nor fruit juice are suitable alternatives to sugar sweetened beverages for the preventing of type 2 diabetes.” In short, consumption of artificially sweetened beverages and fruit juice may not cause type 2 diabetes, but they clearly don’t prevent it.

 

The Bottom Line

If you are overweight or otherwise at risk of developing type 2 diabetes, you have probably been advised to switch from sugar-sweetened beverages to either artificially sweetened beverages or fruit juices. A major study has just turned that advice on its head!

This study (Imamura et al, Br J Med, doi: 101136/bmj.h3576, 2015) was a systematic review and meta-analysis of 17 previously published clinical studies that measured the effect of beverage consumption on the development of type 2 diabetes over time. Based on a very careful analysis of the data from this meta-analysis the authors concluded:

  • The quality of the data on sugar sweetened beverages was strong enough that they could unequivocally state that “habitual consumption of sugar sweetened beverages is associated with a greater incidence of type 2 diabetes, independent of obesity”. In short, you want to stay away from sugar sweetened beverages. They can cause obesity AND they can cause type 2 diabetes.
  • They also said that “…artificially sweetened beverages and fruit juice also showed positive associations with incidence of type 2 diabetes”, but did not feel the existing data were strong enough to make a definitive conclusion. They felt that more studies are needed.
  • However, they did feel that the existing data were strong enough to conclude that “neither artificially sweetened beverages nor fruit juice are suitable alternatives to sugar sweetened beverages for the preventing of type 2 diabetes.” In short, consumption of artificially sweetened beverages and fruit juice may not cause type 2 diabetes, but they clearly don’t prevent it.

So what kind of beverages should you consume if you don’t want your beverage intake to contribute to type 2 diabetes?

  • Water is always the first choice.
  • Milk, protein shakes and similar beverages can also be an excellent choice as long as you take the calories into account. The protein content of those beverages generally slows the rate of sugar uptake. Look for products with a low glycemic index.
  • High intensity or long endurance exercise requires a lot of carbohydrate, so sugars in rehydration or recovery sports supplements are well tolerated. However, those same sports drinks would be a concern if used as part of a sedentary lifestyle.
  • Finally, tea, coffee, and non-caffeinated herbal teas are excellent choices as long as you learn to enjoy them without adding sugar or artificial sweeteners.

 

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.

7 Easy Ways To Spot Fad Diets

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

dietIf It Sounds Too Good To Be True…

Author: Dr. Stephen Chaney

 

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

You’ve seen the weight loss ads touting:

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

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

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

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

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

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

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

 

7 Easy Ways To Spot Fad Dietsfad diet

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

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

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

 

The Bottom Line

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

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

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 Diets Work?

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

dietingObesity in America?

Author: Dr. Stephen Chaney

If you are like most Americans, you are either overweight yourself or have close friends and family who are overweight. That’s because 69% of Americans are currently overweight, and 36% of us are obese. Worldwide the latest estimates are that 1.5 billion adults are overweight or obese.

A new report, How The World Could Better Fight Obesity,  estimates that obesity is a $2 trillion drain on the world’s economy. That is equivalent to the global cost of war & terrorism and of smoking – and is double the global costs of alcoholism and global warming!

If you are like most Americans you have tried a number of diets over the years. All of them promised that they had the “secret” to permanent weight loss. You lost some weight initially, but here you are a few years later weighing as much as ever.

You are probably beginning to wonder whether any diets work long term. According to the latest study, the answer may just be “no”.

Really, Do Diets Work?

This study (Atallah et al, Circulation Cardiovascular Quality and Outcomes, 7: 815-827, 2014) was a systemmatic review of all of the randomized controlled studies of the four most popular diet plans – Weight Watchers, Akins, Zone and South Beach.

In case, you are unfamiliar with these diets, here is their philosophy:

  • Weight watchers is a food, physical activity and behavior modification plan that utilizes a point system to control calorie intake and features weekly group sessions.
  •  Atkins is based on very low carbohydrate intake, with unlimited fat and protein consumption.
  •  South Beach is relatively low carbohydrate, high protein diet that focuses on low-glycemic index carbohydrates, lean proteins, and mono- and polyunsaturated fats.
  • Zone is a low carbohydrate diet that focuses on low-glycemic load carbohydrates, low-fat proteins and small amounts of good fats.

The investigators restricted their analysis to studies that were greater than 4 weeks in duration and either compared the diets to “usual care” or to each other. (The term usual care was not defined, but most likely refers to a physician giving the advice to eat less and exercise more).

Twenty six studies met their inclusion criteria. Fourteen of those studies were short-term (< 12 months) and 12 were long-term (>12 months). Of the long-term studies, 10 compared individual diet plans to usual care and 2 were head-to-head comparisons between the diet plans (1 of Atkins vs Weight Watchers vs Zone and 1 of Weight Watchers vs Zone vs control). The majority of participants in these studies were young, white, obese women. Their average age was 45 years and their average weight at the beginning of the studies was 200 pounds.

What Did This Study Show?

If you have struggled with your weight in the past, you probably won’t be surprised by the result of the study.

  •  Short-term weight loss was similar for Atkins, Weight Watchers and Zone in the two head-to-head studies.
  •  At 12 months, the 10 studies comparing individual diets to usual care (physician’s advice to eat less and exercise more) showed that only Weight Watchers was slightly more effective than usual care (physician’s advice to lose weight). The average weight loss at 12 months was 10 pounds for Weight Watchers and 7 pounds for usual care. That is a 3 pound difference for all of the additional effort and expense of Weight Watchers!
  • When they looked at the two head-to-head studies at 12 months, there was no significant differences between the diets. Average weight loss in these studies was 7 pounds for Weight Watchers, 7 pounds for Atkins, 5 pounds for Zone and 5 pounds for usual care. There was only one study comparing the South Beach diets with usual care. It was a study comparing the results with severely obese patients following gastric bypass surgery, and it also found no difference between the diet program and usual care. Based on hype about these diets, you were probably expecting more than a 5 to 7 pound weight loss 12 months later!
  •  By 24 months 30-40% of the weight had been regained for the Atkins and Weight Watchers diets, which was comparable to the results for patients who were just told to eat less and exercise more. Not only was the weight loss modest, it also did not appear to be permanent.
  •  Finally, many of the studies included in this review also looked at improvement in other health parameters such as HDL cholesterol levels, LDL cholesterol levels, triglycerides, blood pressure and blood sugar control. The Atkins diet gave slightly better results with HDL levels, triglyceride levels and blood pressure in the short-term studies, but there was no significant differences for any of these parameters in the long-term head-to-head studies. None of the diets were any healthier than the others.

The investigators concluded: “Our results suggest that all 4 diets are modestly efficacious for short-term weight loss, but that these benefits are not sustained long-term.

A similar study in 2005 compared the Weight Watchers, Jenny Craig and LA Weight Loss diets (Tsai et al, Annals of Internal Medicine, 142: 56-66, 2005) and concluded “…the evidence to support the use of major commercial and self-help weight loss programs is suboptimal”.

weight loss and obesityA Weight Loss Diet That Actually Works?

My personal recommendation for the initial weight loss is a high protein diet – one that provides about 30% of calories from healthy protein and moderate amounts of healthy carbohydrates and healthy fats. The protein should be high enough quality so that it provides 10-12 gram of the essential amino acid leucine because leucine specifically stimulates muscle growth. The combination of high protein and leucine preserves muscle mass while you are losing weight. That is important because it keeps your metabolic rate high without dangerous herbs or stimulants.

However, the high protein, high leucine diet is still just a diet. It is an excellent choice for the initial weight loss, but what about long-term weight control?

The authors of this study said: “Comprehensive lifestyle interventions aimed at curbing both adult and childhood obesity are urgently needed. Interventions that include dietary, behavioral and exercise components…may be better suited to [solve] the obesity epidemic.” I agree.

The Bottom Line:

Your suspicions are correct. Diets don’t work!

A recent systematic review of 26 randomized controlled clinical trials of the Weight Watchers, Atkins, Zone & South Beach diets compared to the usual standard of care (recommendations to eat less and exercise more) concluded:

1) Contrary to what the advertisements promise, after 12 months all four diets gave comparable and very modest (5-7 pounds) total weight loss. The results with the diets were not significantly different than for patients who were simply told to eat less and exercise more.

2) By 24 months 30-40% of the weight had already been regained.

3) A previous systematic review of the Weight Watchers, Jenny Craig, and LA Weight Loss diet programs came to a similar conclusion.

4) My personal recommendation for the initial weight loss is a diet that is high in protein and the amino acid leucine because that type of diet preserves muscle mass.

5) For permanent weight control the authors of the recent systematic review recommended comprehensive lifestyle interventions that include permanent changes in diet, behavior and exercise. I agree. Diets never work long term – lifestyle change does!

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.

bacteria

Can Gut Bacteria Make You Fat?

Written by Dr. Steve Chaney on . Posted in Food and Health, Issues, Obesity

bacteria

Gut Bacteria, Diet and Obesity

Author: Dr. Stephen Chaney

 

 

Can gut bacteria make you fat? It has been known for some time that the types of bacteria found in the intestines of obese people are different than those found in the intestines of lean individuals. But no one really knew the significance, if any, of that observation. Did obesity favor certain types of intestinal bacteria, or did certain types of intestinal bacteria favor obesity?

Obese individuals are often insulin resistant, and insulin resistance can cause higher sugar levels in the blood, urine and intestine. So it was easy to assume that obesity simply favored the growth of different types of bacteria in the intestine. However, recent studies have suggested that certain types of bacteria in our intestines may actually cause obesity.

Can Gut Bacteria Make You Fat?

For example, one study (Vijay-Kumar et al, Science, 328: 228-231, 2010) compared a strain of mice that are genetically predisposed to obesity with wild type (genetically lean) mice. They first looked at the intestinal bacteria. It turned out that the obese mice and lean mice had the same differences in intestinal bacteria that obese and lean humans have. And just like obese humans the obese mice ate more, displayed insulin resistance, and had elevated levels of triglycerides, cholesterol and blood sugar (They were pre-diabetic).

The investigators then decided to test the hypothesis that the particular bacterial strains found in the intestines of genetically obese mice might be causing their insulin resistance and obesity.

In the first experiment they killed off the intestinal bacteria in the genetically obese mice by putting high dose antibiotics in their food. Depleting the intestinal bacteria created some health problems for the mice, but it completely prevented the insulin resistance, overeating and obesity normally observed with this strain of mice.

In the second experiment they sterilized the intestines of the genetically lean mice and then colonized their intestines with intestinal bacteria from the genetically obese mice. When they did this, the genetically lean mice developed many of the characteristics of the genetically obese mice including insulin resistance, overeating, obesity and hyperglycemia.

insulin resistanceIn short, when their guts became colonized with bacteria from obese mice, the genetically lean mice became overweight and developed diabetes. Based on these experiments and other studies the scientists hypothesized that the wrong kinds of intestinal bacteria can make a significant contribution to insulin resistance, which in turn can lead to overeating and obesity. In short, they concluded that bad gut bacteria may make you fat.

The Battle of The Bacteria

In a second study (Walker et al, Science, 341: 1079-1089, 2013) the intestines of germ free mice were colonized with gut bacteria from lean and obese humans. The results were essentially the same as in the first study. That is, the mice who received gut bacteria from lean humans stayed lean and those who received gut bacteria from obese humans became obese.

But then the investigators asked two really interesting questions:

1) If you mixed the two types of bacteria, which one would win “the battle of the bacteria”?

For this experiment they took mice that had received gut bacteria from lean humans and mice that had received gut bacteria from obese humans and put them in the same cage. It turns out that since mice eat each other’s poop, they pick up each other’s intestinal bacteria. (No, I am not suggesting that you…)

The results of this experiment were (envelop please): The “lean” bacteria won out. They became the predominant bacteria in the intestines of all of the mice in the cage. Furthermore, none of the mice became obese – even the ones that had originally been inoculated with gut bacteria from obese humans.

2) Are the types of bacteria in the intestine influenced by diet?

In the previous experiment the mice were eating standard mouse chow – which is pretty healthy if you are a mouse. So the investigators decided to ask what would happen if they ate foods that were similar to really good and really bad human diets. They devised two types of diets for the mice – one that was high in fresh fruits & vegetable and low in fat (the good diet) and one that was high in fat and low in fresh fruits and vegetables (the bad diet).

On the good diet, the results were the same as in the previous experiment. On the bad diet the “lean” bacteria never grew in the intestines of the mice inoculated with bacteria from obese humans and those mice went on to become obese.

This study confirmed that the wrong kind of gut bacteria can cause obesity, but it also showed that diet can influence the type of bacteria that can grow in the intestine – something I talked about in an earlier issue of “Health Tips From the Professor”  Our Gut Bacteria Are What We Eat.

The Bottom Line

1) Does this mean that you should rush out and buy some probiotics (good bacteria) as part of your weight loss strategy? The simple answer is no. That would be premature. These studies were performed in mice. Although similar results have been reported in humans (for example, Jumpertz et al, Am. J. Clin. Nutr., 94: 58-65, 2011), those studies are very preliminary at present. In addition, genetics and diet obviously played a role in the results. In short, we are a long way from knowing to what extent intestinal bacteria might contribute to obesity in humans.

2) However, there are many very good reasons to make sure that you supply friendly bacteria to your intestinal track on a regular basis. For example, we know that bad bacteria in your intestine can compromise your immune system, convert foods that you eat to cancer causing chemicals, and cause chronic inflammation – which contributes to a number of major diseases.  Can gut bacteria make you fat?  We can’t yet say whether good bugs will help keep you slim, but we do know that they can help keep you healthy.

3) Finally, while we can’t yet say whether probiotic supplements can help you lose weight, it is becoming increasing clear that healthy diets (low fat, high fiber diets with lots of fresh fruits and vegetables) support the type of intestinal bacteria that can make you slim. This is yet one more reason why a healthy diet is so important if you want to stay slim and healthy.

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

Can Chocolate Help You Lose Weight?

Written by Dr. Steve Chaney on . Posted in Food and Health, Issues, Obesity

A Candy a Day Keeps The Weight Away?

Author: Dr. Stephen Chaney

chocolateSometimes you come across news that just seems too good to be true. The recent headlines saying that you can lose weight just by eating chocolate are a perfect example. Your first reaction when you heard that was probably “Sure, when pigs fly!”

But, it’s such an enticing idea – one might even say a deliciously enticing idea. And, in today’s world enticing ideas like this quickly gain a life of their own. Two popular books have been written on the subject. Chocolate diet plans are springing up right and left. A quick scan of the internet even revealed a web site saying that by investing a mere $1,250 in a training course you could become a “Certified Chocolate Weight Loss Coach” earning $50,000/year.

If you like chocolate as much as most people you are probably wondering could it just possibly be true?

Can Eating Chocolate Help You Lose Weight?

The idea that chocolate could help you lose weight does have some support. There are actually three published clinical studies suggesting that chocolate consumption is associated with lower weight (European Journal of Clinical Nutrition, 62: 247-253, 2008; Nutrition Research, 31: 122-130, 2011; Archives of Internal Medicine, 172: 519-521, 2012).

While that sounds pretty impressive, they were all cross-sectional studies. That means they looked at a cross section of the population and compared chocolate intake with BMI (a measure of obesity). Cross sectional studies have a couple of very important limitations:

1)    Cross sectional studies merely measure associations. They don’t prove cause and effect. Was it the chocolate that caused the lower weight, or was it something else that those populations were doing? We don’t really know.

2)    Cross sectional studies don’t tell us why an association occurs. In many ways this is the old chicken and egg conundrum. Which comes first? In this case the question is whether the people in the studies became obese because they ate less chocolate – or did they eat less chocolate because they were obese and were trying to control their calories? Again, we have no way of knowing.

If Pigs Could Only Fly

If Pigs Could FlyChocolate is relatively rich in fat and high in calories. It’s not your typical diet food. On the surface it seems fairly implausible that eating chocolate could actually help you lose weight.

Scientists love to poke holes in implausible hypotheses, so it is no surprise that a recent study (PLOS ONE, 8(8) e70271) has poked some huge holes in the “chocolate causes weight loss” hypothesis.

This study analyzed data from over 12,000 participants in the Atherosclerosis Risk in Community (ARIC) Study. This was also a cross sectional study, but it was a prospective cross sectional study (That’s just a fancy scientific term which means that the study followed a cross section of the population over time, rather than just asking what that population group looked like at a single time point).

The authors of the study assessed frequency of chocolate intake and weight for each individual in the study at two separate time points 6 years apart. The results were very interesting:

  • When they looked at a cross section of the population at either time point, their results were the same as the previous three studies – namely those who consumed the most chocolate weighed less. So the data are pretty consistent. Overweight people consume less chocolate. But, that still doesn’t tell us why they consume less chocolate.
  • However, when they followed the individuals in the study over 6 years, those who consumed the most chocolate gained the most weight. The chocolate eaters were skinnier than the non-chocolate eaters at the beginning of the study, but they gained more weight as the study progressed. And, the more chocolate they consumed the more weight they gained over the next 6 years. [No surprise here. Calories still count.]
  • When they specifically looked at the population who had developed an obesity related illness between the first and second time point, they found that by the end of the study those participants had:

– Decreased chocolate intake by 37%

– Decreased fat intake by 4.5%

– Increased fruit intake by 20%

– Increased vegetable intake by 17%

  • In short, this study is more consistent with the “obesity causes reduced chocolate intake” model than the “reduced chocolate intake causes obesity” model. Simply put, if you are trying to lose weight, sweets like chocolate are probably among the first things to go.

Of course, even prospective cross sectional studies have their limitations. Double blind, placebo controlled studies are clearly needed to resolve this question. The only published study of this type has reported a slight weight gain associated 25 g/day of dark chocolate, but the study was too small and too short in duration to draw firm conclusions.

In summary, more studies are needed, but the current evidence does not support the “miracle diet food” claims for chocolate.

The Bottom Line:

1)    Pigs still haven’t learned how to fly. As enticing as it may sound, the weight of current evidence does not support the claims that chocolate is a miracle diet food or that eating chocolate every day is a sensible strategy for losing weight.

2)    On the other hand, dark chocolate is probably one of the healthier dessert foods. There is no reason not to enjoy an occasional bite of chocolate as part of a healthy, calorie-controlled diet.

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.

Does Obesity Begin In Kindergarten?

Written by Dr. Steve Chaney on . Posted in Issues, Obesity

Is Obesity Caused By Bad Genes Or Bad Lifestyle?

 Author: Dr. Stephen Chaney

 In past issues of “Health Tips From the Professor” I have shared some common sense weight loss tips. But what if it is all for naught? What if there is nothing you can do about your weight?

Fat ChildYou may have seen the headlines suggesting that obesity in kindergarten is a very strong predictor of obesity later in life. If so, you are probably wondering what that means for your kids or grandkids – and what it means for you. You are probably asking questions like:

  • Should you be worrying about that your toddler’s baby fat?
  • What can you do as parents and grandparents to protect the ones you love from a lifetime of obesity and all of the health challenges that involves?
  • Is there anything you can do about overweight and obesity? Are some people just fated to be obese from childhood on?

What Does the Study Actually Show?

This was a very well done study. It followed 7738 children of all socioeconomic classes who were enrolled in kindergarten (mean age 5.6) in the US in 1998 and followed them through the 8th grade (mean age 14.1) (Cunningham et al, New England Journal of Medicine, 370: 403-411, 2014).

When the children entered kindergarten, 12.4% of them were obese, and another 14.9% of them were overweight. By the time they reached the 8th grade 20.8% were obese and 17% were overweight. Those results didn’t make the headlines. They are similar to many previous studies.

The results that made the headlines were:

  • Overweight 5 year olds were 4 times more likely to become obese by age 14 than normal weight 5 year olds.
  • 87% of obese 8th graders (14 year olds) had a body mass index above the 50th percentile in kindergarten, and 75% had a body mass index above the 70th percentile.
  • Only 13% of overweight 8th graders had been normal weight (<50th percentile) in kindergarten, and only 13% of the normal weight 8th graders had been overweight in kindergarten.

These results are fully consistent with earlier studies showing that overweight toddlers are likely to become overweight teens, and overweight teens are likely to become overweight adults. What was unique about this study (and generated the headlines) was the precision of the statistics.

Does Obesity Begin In Kindergarten?

The answer to that question is clearly yes. However, the more important question is what message we, as responsible health advocates, should be sharing with the general public. Let me break that down to some of the most important questions that you are probably asking.

Is Obesity Caused By Bad Genes Or Bad Lifestyle?

Bad GenesTaken on face value, the results of this study might seem to suggest that genetics is the primary cause of obesity. However, if that is the message we convey to the public, it is likely to simply fuel the perception that most overweight individuals are genetically destined to be obese. There is nothing they can do about it. So, why even bother trying?

However, the authors of the study also noted that the percentage of children aged 6 to 11 who are above the 95% percentile of weight has increased 4-fold between 1963 and 2000. Genetics does not change in a mere 37 years (37 generations maybe). That 4-fold increase in severe childhood obesity is clearly driven by lifestyle changes over the past 30 or 40 years.

While nobody knows the exact percentages, a reasonable interpretation of recent research in this area might be:

  • 10-15% of us are genetically destined to be obese. There is little we can do to change our weight, but a healthy lifestyle can significantly reduce our risk of disease.
  • 10-15% of us are genetically predestined to be lean no matter what we eat (Yes. Your suspicions are true). Once again, lifestyle has relatively little influence on our weight, but a healthy lifestyle can significantly reduce our risk of disease.
  • The other 70-80% of us are genetically predisposed to become obese if we adapt the typical American lifestyle. For most of us lifestyle choices can make a big difference in our weight as well as our health.

So the answer to this question is BOTH. For most of us, obesity is caused by bad genes AND bad lifestyle.

When Should We Intervene?

You probably already know that any extra fat cells we develop in childhood never go away. They are always with us, looking for those extra calories they can store as fat.

This study suggests that by the time we are in kindergarten, the die may already be cast. Those extra fat cells may have already developed.

And, for many people, the time to intervene may be even sooner. This study also showed that birth weight plays an important role as well. Children who weighed 9 pounds or more at birth were 2-fold more likely to be obese in kindergarten than children who weighed less than 9 pounds at birth.

Once again, a small percentage of overweight babies is due to genetics, but it is lifestyle choices during pregnancy that lead to the majority of overweight babies.

The authors of the study noted that most public health initiatives (school lunch programs, lifestyle education programs, etc.) are targeted at school aged children. The authors went on to say that by then it may be too late to have any significant effect on the incidence of obesity in our children.

They suggested that we need to place a stronger emphasis on influencing lifestyle changes that affect the weight of babies at birth and are likely to influence whether or not they become obese by the time they reach kindergarten.

That’s not the realm of public health policy. That’s our responsibility.

What Should We Do?

If You Are Pregnant:

  • The old adage “You are eating for two” was never true.
  • Aim for an extra 150 calories during the 1st trimester, 300 during the 2nd and 3rd trimesters (That’s 1 or 2 servings of healthy foods).
  • Aim for little or no weight gain during the 1st trimester and a total of 20-26 pounds during the last two trimesters (a bit less if you are overweight).

If You Have a Young Child Who Is Overweight:

  • Don’t restrict calories. Restricting calories can stunt growth and interfere with normal mental and physical development.
  • Encourage your kids to exercise rather than watching TV and playing video games. You may need to set the example, and that’s a good thing for you as well as for them.
  • Provide your kids with a healthy diet. For most kids, that means more fruits and vegetables and less sugary beverages, fruit juices, and processed snack foods. That may simply mean that you don’t bring those kinds of foods into your house. Again, that would probably be a good thing for everyone in the family.

I know some of you are saying “My kids won’t eat healthy stuff”. Let me give you my take on that.

When I was a kid, my mom had a pretty simple policy. If I didn’t like what she cooked, I didn’t have to eat it. I could simply wait until the next meal – when she would be serving the same kinds of healthy foods again.

I got the message pretty quick. It wasn’t eat healthy or eat junk food. It was eat healthy or go hungry. I decided early on that healthy was better than hungry.

Now, let me step down from my soapbox and summarize.

The Bottom Line:

1)     The latest research suggests that if a child is overweight by kindergarten, they are likely to be overweight for the rest of their lives. So if you want to spare your kids and grandkids  from a lifetime of obesity, you want to intervene early.

2)     A small percentage of those kids are destined to be obese no matter what they do. However, for the vast majority of them obesity can be prevented by a healthy lifestyle.

3)     If you are pregnant, don’t “eat for two”. That is terrible advice. If your pre-pregnancy weight is stable (neither increasing or decreasing), you only need to add a serving or two of healthy foods to your diet during pregnancy. Check with your doctor about the amount of weight gain that is right for you and follow their advice.

4)     If you have a young child who appears to be overweight, don’t restrict their calories. Instead, provide them with healthy food choices and encourage them to exercise.

5)     Finally, if you have been overweight since childhood, don’t despair. For most of us obesity is a combination of genetic predisposition and lifestyle choices. You can’t your genes, but you can change your lifestyle.

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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Latest Article

Omega-3 Benefits: Lower High Blood Pressure

Posted July 16, 2019 by Dr. Steve Chaney

What Does the FDA Say About Omega-3 Benefit Claims?

Author: Dr. Stephen Chaney

 

 

Among omega-3 benefits is lower high blood pressure.  That claim can be made according to the FDA. 

lower high blood pressureHeart Disease is still the number 1 cause of death in this country. And, while deaths from heart disease have been declining in recent years, deaths due to high blood pressure have been increasing.  That is concerning because:

High blood pressure is a killer! It can kill you by causing heart attacks, strokes, congestive heart failure, kidney failure and much more.

High blood pressure is a serial killer. It doesn’t just kill a few people. It kills lots of people. The American Heart Association estimates that high blood pressure directly or indirectly caused 410,000 deaths in 2014. That is almost 1 person every second and represents a 41% increase from 2000. It’s because high blood pressure is not a rare disease.

  • 32% of Americans have high blood pressure, also called hypertension, (defined as a systolic blood pressure of 140 mm Hg or more or a diastolic blood pressure of 90 mm Hg or more).
  • Another 33% of Americans have prehypertension (systolic blood pressure of 120-139 mm Hg or diastolic blood pressure of 80-89 mm Hg).

That’s over 65% of Americans with abnormal blood pressure!

High blood pressure is a silent killer. That’s because it is a very insidious disease that sneaks up on you when you least expect it. Systolic blood pressure increases 0.6 mm Hg/year for most adults over 50. By age 75 or above 76-80% of American adults will have high blood pressure.  Even worse, many people with high blood pressure have no symptoms, so they don’t even know that their blood pressure is elevated. For them the first symptom of high blood pressure is often sudden death.

Blood pressure medications can harm your quality of life. Blood pressure medications save lives. However, like most drugs, blood pressure medications have a plethora of side effects – including weakness, dizziness, fainting, shortness of breath, chest pain, nausea, diarrhea or constipation, heartburn, depression, heart palpitations, and even memory loss. The many side effects associated with blood pressure medications lead to poor compliance, which is probably why only 46% of patients with high blood pressure are adequately controlled.

You do have natural options. By now you are probably wondering whether there are natural approaches for controlling your blood pressure that are both effective and lack side effects. The answer is a resounding YES! I’ll outline a holistic natural approach for keeping your blood pressure under control in a minute but let me start with the FDAs recent approval of what they call “qualified claims” that omega-3s lower blood pressure.

 

What Does the FDA Say About Omega-3 Benefits?

omega-3 benefitsIn my book “Slaying The Supplement Myths” I talk about the “dark side” of the supplement industry. There are far too many companies who try to dupe the public by making outrageous and unsubstantiated claims about their products.

Only the FDA stands between us and those unscrupulous companies, and they take their role very seriously. That is why it is big news whenever the FDA allows companies to make health claims about their products.

Even then, the FDA is very cautious. They allow what they call “qualified” health claims. Basically, that means they are saying there is enough evidence that the health claim is probably true, but not enough evidence to say it is proven.

Of course, if you understand the scientific method, you realize there will always be some studies on both sides of every issue. That is why the only health claims the FDA allows are qualified health claims.

With that background in mind, let’s look at the qualified health claims the FDA allows for omega-3 benefits.

  • Since 2004 the FDA has allowed the qualified claim “Supportive but not conclusive research shows that consumption of EPA and DHA omega-3 fatty acids may reduce the risk of coronary heart disease.”
  • A few weeks ago, they added five qualified health claims about omega-3s and blood pressure. The 5 claims are very similar, so I will only list two below for the sake of brevity.
  • “Consuming EPA and DHA combined may reduce blood pressure and reduce the risk of hypertension, a risk factor for CHD (coronary heart disease).”
  • Consuming EPA and DHA combined may reduce the risk of CHD (coronary heart disease) by lowering blood pressure.
  • Of course, they add the usual wording about the evidence being inconsistent and inconclusive.

 

Omega-3 Benefits?

measure omega-3 benefits levelWe’ve known for some time that omega-3 fatty acids help lower blood pressure, but two recent studies were instrumental in convincing the FDA to allow these qualified health claims. These studies have highlighted just how strong the effect of omega-3s on lowering blood pressure is.

The first study was a meta-analysis of 70 randomized, placebo-controlled clinical trials of long chain omega-3 (EPA + DHA) supplementation and blood pressure (Miller et al, American Journal of Hypertension, 27: 885-896, 2014 ).

This study showed:

  • In the group with normal blood pressure at the beginning of the study EPA + DHA supplementation decreased systolic blood pressure by 1.25 mm Hg.
  • Given that systolic blood pressure rises an average of 0.6 mm Hg/year in adults over 50, the authors estimated that omega-3 supplementation alone would delay the onset of age-related high blood pressure by 2 years.
  • In the group with elevated blood pressure not taking medication at the beginning of the study, EPA + DHA supplementation decreased systolic blood pressure by an impressive 4.51 mm Hg and diastolic blood pressure by 3.05 mm Hg.
  • The authors noted that this decrease in systolic blood pressure could “prevent an individual from requiring medication [with all its side effects] to control their hypertension” or decrease the amount of medication required.

However, the doses of omega-3s used in these studies ranged from 1 to over 4 grams/day (mean dose = 3.8 grams/day). That sparked a second study (Minihane et al, Journal of Nutrition, 146: 516-523, 2016) to see whether lower levels of omega-3s might be equally effective. This study was an 8-week double-blind, placebo-controlled study comparing the effects of 0.7 or 1.8 grams of EPA + DHA per day (versus an 8:2 ratio of palm and soybean oil as a placebo) on blood pressure.

This study showed:

  • In the group with normal blood pressure at the beginning of the study, EPA + DHA supplementation caused no significant decrease in blood pressure. This could be due to the smaller number of subjects or the lower doses of EPA + DHA used in this study.
  • In the group with elevated blood pressure not taking medication at the beginning of the study, EPA + DHA supplementation decreased systolic blood pressure by 5 mm Hg and, the effect was essentially identical at 0.7 grams/day and 1.8 grams/day.
  • The authors concluded “Our data suggest that increased EPA + DHA intakes of only 0.7 grams/day may be an effective strategy for blood pressure control.”

 

A Holistic Approach to Lower High Blood Pressure

holistic approach to lower high blood pressureThe FDA’s allowed claims about omega-3s are good news indeed, but that’s not the only natural approach that lowers blood pressure. You have lots of other arrows in your quiver. For example:

  • The DASH diet (A diet that has lots of fresh fruits and vegetables; includes whole grains, low fat dairy, poultry, fish, beans, nuts and oils; and is low in sugar and red meats) reduces systolic blood pressure by 5-6 mm Hg. [Low fat, low carb and Mediterranean diets also lower blood pressure, but not by as much as the DASH diet].
  • Reducing sodium by about 1,150 mg/day reduces systolic blood pressure by 3-4 mm Hg.
  • Reducing excess weight by 5% reduces systolic blood pressure by 3 points.
  • Doing at least 40 minutes of aerobic exercise 3-4 times/week reduces systolic blood pressure by 2-5 mm Hg.
  • Nitrates, whether derived from fresh fruits and vegetables or from supplements probably also reduce blood pressure, but we don’t yet know by how much.

If you’ve been keeping track, you’ve probably figured out that a holistic lifestyle that included at least 0.7 grams/day of long chain omega-3s (EPA + DHA) plus the other omega-3 benefits in the list above could reduce your systolic blood pressure by a whopping 18-22 mm Hg.  What

That’s significant because, the CDC estimates that reducing high systolic blood pressure by only 12-13 mm Hg could reduce your risk of:

  • Stroke by 37%.
  • Coronary heart disease by 21%.
  • Death from cardiovascular disease by 25%.
  • Death from all causes by 13%.

 

A Word of Caution

While holistic approaches have the potential to keep your blood pressure under control without the side effects of medications, it is important not to blindly rely on holistic approaches alone. There are also genetic and environmental risk factors involved in determining blood pressure. You could be doing everything right and still have high blood pressure. Plus, you need to remember that high blood pressure is a silent killer that often doesn’t have any detectable symptoms prior to that first heart attack or stroke.

My recommendations are:

  • Monitor your blood pressure on a regular basis.
  • If your blood pressure starts to become elevated, consult with your doctor about starting with natural approaches to bring your blood pressure back under control. Doctors are fully aware of the side effects of blood pressure medications, and most doctors are happy to encourage you to try natural approaches first.
  • Continue to monitor blood pressure as directed by your doctor. If natural approaches are insufficient to bring your blood pressure under control, they will prescribe the lowest dose of blood pressure medication possible to get your blood pressure where it needs to be.
  • Don’t stop making holistic lifestyle choices to reduce blood pressure just because you are on medication. The more you do to keep your blood pressure under control with a healthy diet and lifestyle, the less medication your doctor will need to use (That means fewer side effects).

 

The Bottom Line

Heart Disease is still the number 1 cause of death in this country. And, while deaths from heart disease have been declining in recent years, deaths due to high blood pressure have been increasing. That is why anything we can do lower blood pressure naturally is important. What does the FDA say about omega-3s and blood pressure?

  • Since 2004 the FDA has allowed the qualified claim “Supportive but not conclusive research shows that consumption of EPA and DHA omega-3 fatty acids may reduce the risk of coronary heart disease.”
  • A few weeks ago, they added qualified health claims about omega-3s and blood pressure. For example, they now allow the following claims.
  • “Consuming EPA and DHA combined may reduce blood pressure and reduce the risk of hypertension, a risk factor for CHD (coronary heart disease).”
  • Consuming EPA and DHA combined may reduce the risk of CHD (coronary heart disease) by lowering blood pressure.

For more information on the studies that convinced the FDA to allow claims about omega-3s and blood pressure and for a discussion of holistic natural approaches for lowering blood pressure, 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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