Can Supplements Help You Live Longer?

Written by Dr. Steve Chaney on . Posted in Live Longer, Supplements and Health

Are Supplements The Fountain Of Youth?

Author: Dr. Stephen Chaney

 

It is buyer beware in the supplement industry. I have discussed the dark side of the supplement industry in the first half of my book “Slaying The Supplement Myths.”

I called that section of my book “The Lies of the Charlatans.”  In it, I detailed many of the false claims that some manufacturers make for their supplements. There are claims that their supplements will…

  • Cure what ails you (Just fill in the disease of your choice. Some company will try to tell you they have the cure).
  • Make the pounds melt away.
  • Make you smarter.
  • Make you stronger.
  • Improve your sex life.

Can supplements help you live longer?

The list seems endless…Except for one! I don’t know of any supplement company claiming their supplements make you live longer. Nobody is claiming their supplements are the “Fountain of Youth.”

However, many of you have been asking me about headlines claiming that a recent study showed that supplements don’t extend lives. Could it be that the study generating the recent headlines was designed to disprove a claim nobody was making?

In this issue of “Health Tips From The Professor” I will analyze the study and answer two questions:

  • Is it true?
  • Is it important?

How Was The Study Done?

Every few years the National Center for Health Statistics (a division of the CDC) conducts a massive survey of factors affecting the health of the American population. This survey is called the National Health and Nutrition Examination Survey (NHANES). The NHANES survey includes interviews and examinations of thousands of people across the country.

The interview includes dietary, health-related, demographic, and socioeconomic questions. The examination component includes laboratory tests plus medical, dental, and physiological measurements. The NHANES database is used for many studies such as this one.

The current study (F Chen et al, Annals of Internal Medicine, doi:10.7326/M18-2478, published April 9, 2019) used data from 30,899 US adults aged 20 years or more who participated in 6 cycles of the NHANES survey from 1999 to 2010. The dietary portion of the survey taken by these participants contained questions on the dietary supplements they had used in the 30 days prior to the survey.

The NHANES data were linked to the National Death Index mortality data so that the effect of nutrient intake and supplement use on mortality could be assessed. The median follow-up for the participants in the study was 6.1 years. During that time, 3613 deaths occurred, 945 from heart disease and 805 from cancer.

Of the participants:

  • 71% were white, 11% were non-Hispanic black, and 13% were Hispanic.
  • 9% were female, 49.1% were male.
  • 2 % of the participants reported supplement use in the 30 days preceding the survey.
  • Among the supplement users, the major supplements reported were:
    • Multivitamin/multimineral (74.8%).
    • Vitamin C (40.3%).
    • Calcium (38.6%).
    • Vitamin D (37.6%).
    • Zinc (34.5%).
    • Magnesium (33.3%).

When they compared supplement users with non-supplement users, the supplement users were:

  • More likely to be female and non-Hispanic white.
  • Have higher levels of family education and income.
  • Eat a healthier diet and be more physically active.
  • Less likely to be current smokers, heavy drinkers, or obese.

These are all factors that favor a longer lifespan.  However, the supplement users were also:

  • Older (average age = 50.7 versus 42.8 for non-supplement users).
  • Sicker (They were more likely to have cancer, heart disease, diabetes, high blood pressure, and high cholesterol levels).

These are factors that favor a shorter lifespan.

These are what statisticians refer to as confounding variables. They can influence the results of a study in unexpected ways.

 

Can Supplements Help You Live Longer?

When they looked at the raw data, supplemental use of most-individual nutrients was associated with a lower risk for all-cause death. In simple terms, supplementation appeared to increase lifespan.

However, when the data were statistically adjusted for all of the confounding variables (age, sex, race/ethnicity, education, physical activity, smoking, alcohol intake, diet quality, BMI [a measure of obesity], and diseases the participants had when they entered the study), the effect of supplementation on lifespan became non-significant.

The authors concluded: “Use of dietary supplements was not associated with mortality benefits among a nationally representative sample of U.S adults.”  Those are the headlines you saw from your favorite news source.

What Does This Study Mean For You?

Let’s go back to the two questions I posed about the study at the beginning of this article.

  • Is it true? Can supplements help you live longer?  The study had many weaknesses, which the authors identified in their discussion. Of course, the people writing the headlines never bothered to read the paper, so they were unaware of its weaknesses. Here are some of the major weaknesses reported by the authors:
  • The NHANES questionnaire only asked about supplement use over the preceding 30 days. We have no idea how long the participants had been using those supplements. It could have been years, or it could have been a month. In the words of the authors: “Dietary supplement use was assessed in the previous 30 days, which may not reflect habitual use or capture changes in use [before or] after the baseline assessment.”
  • The supplement users were more likely to have been diagnosed with health conditions such as cancer, heart disease, diabetes, and high blood pressure. It is well documented that diagnosed health conditions motivate some people to initiate supplement use.
  • Finally, there were multiple confounding variables in this study. The conclusion of the study rested on a statistical adjustment of the data to correct for those confounding variables. In the words of the authors: “Residual confounding may still be present.”

That last point reminds me of the famous Mark Twain quote: “There are lies. There are damn lies. And then there are statistics.” Don’t misunderstand me. I am not accusing the study authors of lying. They are some of the top scientists in the field. What Mark Twain and I are saying is that when you rely on statistics, sometimes bad things happen. You can come to erroneous conclusions.

  • Is it important? Even if the conclusion of this study is true, we should ask if it is important. If there had been widespread claims that supplements make you live longer, this would be an important finding. However, nobody I know is making that claim. This study simply reaffirms what most people assumed anyway. There is no fountain of youth.

By the way, the situation is similar for diets. There have been a few claims in the past that healthy diets will help you live longer. However, when those claims have been rigorously evaluated, there is very little effect of diet on lifespan. There have been some studies that have reported a decrease in premature death due to heart disease or cancer. However, death from all causes usually remains unchanged. Once again, the fountain of youth has eluded us.

You may be asking, if supplements don’t increase lifespan, what good are they? The answer is simple. They increase healthspan. Simply put, that means you spend a greater portion of your lifespan in good health.

Of course, now you are probably really confused. You’ve read all those headlines saying that supplements don’t have any effect on your health. The problem is that the studies generating those headlines are flawed. They aren’t asking the right questions. When you look at populations with poor diets, increased needs, genetic predisposition, and/or pre-existing disease, supplementation is often beneficial. I cover this in the second half of my book, “Slaying the Supplement Myths.”  That section is called “The Myths Of The Naysayers.”

 

The Bottom Line

 

A recent study reported that supplements do not reduce mortality. They won’t make you live longer. In this article I provide a detailed analysis of that article. The two important take-aways are:

  • There are several weaknesses in the study. The conclusion may not be accurate.
  • Even if it is accurate, it may not be important. If there had been widespread claims that supplements make you live longer, this would be an important finding. However, nobody I know is making that claim. This study simply reaffirms what most people assumed anyway. There is no fountain of youth. Could it be that the study generating the recent headlines was designed to disprove a claim nobody was making?

The real benefit of supplementation isn’t in increasing your lifespan. It is increasing your healthspan. I cover that in my book, “Slaying The Supplement Myths.”

For more details read the article above.

 

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

Do You Need Supplements?

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

Supplements As Part of a Holistic Lifestyle

Author: Dr. Stephen Chaney

 

do you need supplementsDo you need supplements?

The headlines about supplementation are so confusing. Are they useful, or are they a waste of money? Will they cure you, or will they kill you? I feel your pain.

I will answer these questions in depth in my upcoming book, but let me give you a quick overview today. I call it: “Do You Need Supplements?” I created the graphic on the left to illustrate why I feel responsible supplementation is important for most Americans. Let me give you specific examples for each of these categories.

 

Examples of Poor Diet

do you need supplements dietDo you need supplements if you have a poor diet? You have heard the saying that supplementation fills in the nutritional gaps in our diets.  So what are the nutritional gaps? According to the USDA’s 2015-2020 Dietary Guidelines for Americans, many Americans are consuming too much fast and convenience foods. Consequently, we are getting inadequate amounts of calcium, magnesium, and vitamins A, D, E and C. Iron is also considered a nutrient of concern for young children and pregnant women. According to a recent study, regular use of a multivitamin is sufficient to eliminate all these deficiencies except for calcium, magnesium and vitamin D (J.B. Blumberg et al, Nutrients, 9(8): doi: 10.3390/nu9080849, 2017 ). A well-designed calcium, magnesium and vitamin D supplement may be needed to eliminate those deficiencies.

In addition, intake of omega-3 fatty acids from foods appears to be inadequate in this country. Recent studies have found that American’s blood levels of omega-3s are among the lowest in the world and only half of the recommended level for reducing the risk of heart disease (K.D. Stark et al, Progress In Lipid Research, 63: 132-152, 2016 ;S.V. Thuppal et al, Nutrients, 9, 930: doi: 10.3390/nu9090930, 2017 ). Therefore, omega-3 supplementation is often a good idea.

In previous editions of “Health Tips From the Professor” I have talked about our “mighty microbiome”, the bacteria and other microorganisms in our intestine. These intestinal bacteria can affect our tendency to gain weight, our immune system, inflammatory diseases, chronic diseases such as diabetes, cancer, and heart diseases, our mood—the list goes on and on. This is an emerging science. We are learning more every day, but for now it appears our best chances for creating a health-enhancing microbiome are to consume a primarily plant-based diet and take a probiotic supplement.

Finally, diets that eliminate whole food groups create nutritional deficiencies. For example, vegan diets increase the risk of deficiencies in vitamin B12, vitamin D, calcium, iron, zinc and long chain omega-3 fatty acids.  A recent study reported that the Paleo diet increased the risk of calcium, magnesium, iodine, thiamin, riboflavin, folate and vitamin D deficiency (A. Genomi et al, Nutrients, 8, 314; doi: 10.3390/nu8050314, 2016. The Keto diet is even more restrictive and is likely to create additional deficiencies.

 

Examples of Increased Need

do you need supplements increasedDo you need supplements if you have an increased need?  We have known for years that pregnancy and lactation increase nutritional requirements. In addition, seniors have increased needs for protein, calcium, vitamin D and vitamin B12. In previous issues of “Health Tips From the Professor” I have also shared recent studies showing that protein requirements are increased with exercise.

Common medications also increase our need for specific nutrients. For example, seizure medications can increase your need for vitamin D and calcium. Drugs to treat diabetes and acid reflux can increase your need for vitamin B12. Other drugs increase your need for vitamin B6, folic acid, and vitamin K. Excess alcohol consumption increases your need for thiamin, folic acid, and vitamin B6. These are just a few examples.

Vitamin D is a special case. Many people with apparently adequate intake of vitamin D have low blood levels of 25-hydroxy vitamin D. It is a good idea to have your blood 25-hydroxy vitamin D levels measured on an annual basis and supplement with vitamin D if they are low.

More worrisome is the fact that we live in an increasing polluted world and some of these pollutants may increase our needs for certain nutrients. For example, in a recent edition of “Health Tips From the Professor” I shared a study reporting that exposure to pesticides during pregnancy increases the risk of giving birth to children who will develop autism, and that supplementation with folic acid during pregnancy reduces the effect of pesticides on autism risk. I do wish to acknowledge that this is a developing area of research. This and similar studies require confirmation. It is, however, a reminder that there may be factors beyond our control that have the potential to increase our nutritional needs.

 

Examples of Genetics Influencing Nutritional Needs

do you need supplements geneticsDo you need supplements if your genetics call for specific nutritional needs?  The effect of genetic variation on nutritional needs is known as nutrigenomics. One of the best-known examples of nutrigenomics is genetic variation in the methylenetetrahydrofolate reductase (MTHFR) gene.  MTHFR gene mutations increase the risk of certain birth defects, such as neural tube defects. MTHFR mutations also slightly increase the requirement for folic acid. A combination of food fortification and supplementation with folic acid have substantially decreased the prevalence of neural tube defects in the US population. This is one of the great success stories of nutrigenomics. Parenthetically, there is no evidence that methylfolate decreases the risk of neural tube defects.

Let me give you a couple of additional examples:

One of them has to do with vitamin E and heart disease (A.P. Levy et al, Diabetes Care, 27: 2767, 2004 ). Like a lot of other studies, there was no significant effect of vitamin E on cardiovascular risk in the general population. But there is a genetic variation in the haptoglobin gene that influences cardiovascular risk. The haptoglobin 2-2 genotype increases oxidative damage to the arterial wall, which significantly increases the risk of cardiovascular disease. When the authors of this study looked at the effect of vitamin E in people with this genotype, they found that it significantly decreased heart attacks and cardiovascular deaths.

This has been confirmed by a second study specifically designed to look at vitamin E supplementation in that population group (F. Micheletta et al, Arteriosclerosis, Thrombosis and Vascular Biology, 24: 136, 2008 ). This is an example of a high-risk group benefiting from supplementation, but in this case the high risk is based on genetic variation.

Let’s look at soy and heart disease as a final example. There was a study called the ISOHEART study (W.L. Hall et al, American Journal of Clinical Nutrition, 82: 1260-1268, 2005 ; W.L. Hall et al, American Journal of Clinical Nutrition, 83: 592-600, 2006 ) that looked at a genetic variation in the estrogen receptor which increases inflammation and decreases levels of HDL. As you might expect, this genotype significantly increases cardiovascular risk.

Soy isoflavones significantly decrease inflammation and increase HDL levels in this population group. But they have no effect on inflammation or HDL levels in people with other genotypes affecting the estrogen reception. So, it turns out that soy has beneficial effects, but only in the population that’s at greatest risk of cardiovascular disease, and that increased risk is based on genetic variation.

These examples are just the “tip of the iceberg.” Nutrigenomics is an emerging science. New examples of genetic variations that affect the need for specific nutrients are being reported on a regular basis. We are not ready to start genotyping people yet. We don’t yet know enough to design a simple genetic test to predict our unique nutritional needs. That science is 10-20 years in the future, but this is something that’s coming down the road.

What the current studies tell us is that some people are high-risk because of their genetic makeup, and these are people for whom supplementation is going to make a significant difference. However, because genetic testing is not yet routine, most people are completely unaware that they might be at increased risk of disease or have increased nutritional requirements because of their genetic makeup.

 

Examples of Disease Influencing Nutritional Needs

do you need supplements diseaseFinally, let’s consider the effect of disease on our nutritional needs. Do you need supplements because of disease?  If you look at the popular literature, much has been written about the effect of stress on our nutritional needs. In most cases, the authors are referring to psychological stress. In fact, psychological stress has relatively minor effects on our nutritional needs.

Metabolic stress, on the other hand, has major effects on our nutritional needs. Metabolic stress occurs when our body is struggling to overcome disease, recover from surgery, or recover from trauma. When your body is under metabolic stress, it is important to make sure your nutritional status is optimal.

The effects of surgery and trauma on nutritional needs are well documented. In my upcoming book, I will discuss the effects of disease on nutritional needs in some detail. Let me give you a brief overview here. It is very difficult to show beneficial effects of supplementation in a healthy population (primary prevention). However, when you look at populations that already have a disease, or are at high risk for disease, (secondary prevention), the benefits of supplementation are often evident.

For example, studies suggest that vitamin E, B vitamins, and omega-3s each may reduce heart disease risk, but only in high-risk populations. Similarly, B vitamins (folic acid, B6 and B12) appear to reduce breast cancer risk in high risk populations.

 

Do You Need Supplements?

 

With this information in mind, let’s return to the question: Do you need supplements? Here is my perspective.

  • The need for supplementation is greatest when these circles overlap, as they do for most Americans.
  • The problem is that while most of us are aware that our diets are not what they should be, we are unaware of our increased needs and/or genetic predisposition. We are also often unaware that we are at high risk of disease. For too many Americans the first indication they have heart disease is sudden death, the first indication of high blood pressure is a stroke, or the first indication of cancer is a diagnosis of stage 3 or 4 cancer.

So, let’s step back and view the whole picture. The overlapping circles are drawn that way to make a point. A poor diet doesn’t necessarily mean you have to supplement. However, when a poor diet overlaps with increased need, genetic predisposition, disease, or metabolic stress, supplementation is likely to be beneficial. The more overlapping circles you have, the greater the likely benefit you will derive from supplementation.

That is why I feel supplementation should be included along with diet, exercise, and weight control as part of a holistic approach to better health.

So, do you need supplements?

 

The Bottom Line

 

In this article I provide a perspective on who needs supplementation and why. There are four reasons to supplement.

  • Fill nutritional gaps in our diet
  • Meet increased nutritional needs due to pregnancy, lactation, age, exercise, many common medications, and environmental pollutants.
  • Compensate for genetic variations that affect nutritional needs.
  • Overcome needs imposed by metabolic stress due to trauma, surgery, or disease.

With this information in mind, let’s return to the question: “Do you need supplements? Here is my perspective.

  • A poor diet alone doesn’t necessarily mean you have to supplement. However, when a poor diet overlaps with increased need, genetic predisposition, or metabolic stress, supplementation is likely to be beneficial. The more overlap you have, the greater the likely benefit you will derive from supplementation.
  • The problem is that while most of us are aware that our diets are not what they should be, we are unaware of our increased needs and/or genetic predisposition. We are also often unaware that we are at high risk of disease. For too many Americans the first indication they have heart disease is sudden death, the first indication of high blood pressure is a stroke, or the first indication of cancer is a diagnosis of stage 3 or 4 cancer.

For more details, read the article above.

 

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

Is The Jellyfish Memory Supplement A Hoax

Written by Dr. Steve Chaney on . Posted in jellyfish memory supplement, Supplements and Health

Are The Claims Too Good To Be True?

Author: Dr. Stephen Chaney

jellyfish memory supplementDid another phony nutritional supplement, the jellyfish memory supplement, just bite the dust? You’ve seen the TV ads reminding us that our memory starts to fade as we age. You’ve heard the claims about a protein derived from a jellyfish improving your memory. You’ve seen graphs summarizing a clinical study proving the product works. It all sounds so compelling. Are those claims too good to be true? According to the FTC and the New York Attorney General’s Consumer Protection Division, the answer is yes.

Is The Jellyfish Memory Supplement A Hoax?

On January 9th 2017, the FTC and the New York Attorney General’s office sued the makers of the “jellyfish memory supplement,” accusing the company of making false and unsubstantiated claims that the product improves memory, provides cognitive benefits, and is “clinically shown” to work.The FTC complaint alleged that the marketers relied on a study that failed to show that their product works better ftcthan a placebo on any measure of cognitive function. In their joint press release the FTC said “The marketers of [the jellyfish supplement] preyed on the fears of older consumers experiencing age-related memory loss. But one critical thing these marketers forgot is that their claims need to be backed up by real scientific evidence.” The New York Attorney General said “The marketing for [the jellyfish supplement] is a clear-cut fraud, from the label on the bottle to the ads airing across the country. It’s particularly unacceptable that this company has targeted vulnerable citizens like seniors in its advertising for a product that costs more than a week’s groceries, but provides none of the health benefits that it claims.”

Why Were The Clinical Study Results So Misleading?

clinical studyI am a strong supporter for innovation in supplement development. However, innovative products should be backed up by published clinical studies showing significant benefit before being marketed to the public. Unfortunately, the clinical study cited for the “jellyfish memory supplement” does not meet this standard.

  • The study has not been published in a peer-reviewed scientific journal. That means the study has not been independently reviewed by anyone not associated with the manufacturer.
  • When you actually analyze the data, it turns out that the improvement in memory was inconsistent from subject to subject, and the overall results were not statistically significant.
  • The graph shown on TV shows a 20% improvement in memory in just 90 days. In fact, that degree of improvement was only experienced by a very small subset of users. Most users experienced either no improvement or an insignificant 5-10% improvement. The graph the company used to market their product was clearly misleading.

Why Was The Scientific Rationale For The Product So Misleading?

misleading studyApoaequorin, the jellyfish protein in question, is a calcium binding protein. The manufacturer claims that it improves calcium balance in the body, which improves brain function. There are numerous fallacies in that model. For example:

  • Apoaequorin is not found in humans. In fact, the manufacturer does not even use the protein found in jellyfish. They use a synthetic version produced through genetic engineering.
  • Calcium balance is very tightly regulated in the human body. There is no evidence that the addition of apoaequorin, or any other calcium binding protein, improves calcium balance or brain function in humans.
  • Proteins do not enter our bloodstream intact. They have to be degraded to individual amino acids before they can be absorbed. That means when you take a pill containing apoaequorin protein, all you get is a release of amino acids into your bloodstream.
  • Finally, even if you were magically able to get apoaequorin protein into your bloodstream, it couldn’t cross the blood-brain barrier. The only reliable means of getting proteins into the brain is by cranial injection, and I don’t think anyone is going to be doing that for mild cognitive impairment.

The emperor has no clothes! Don’t get me wrong. As someone who is moving into my “golden years,” I would love to see this product succeed. I would love for them to produce clinical evidence that their product makes a statistically significant improvement in memory. I would love for the data to be good enough that it could be published in a peer reviewed journal. I would love for the jellyfish memory supplement to be legitimate. However, I suspect the FTC will win this one. I suspect another bogus product is about to bite the dust.

What Does This Mean For You?

This is just one of many examples of supplements that have first rate marketing, but second rate science. As a consumer, you need to be eternally vigilant. Unfortunately, most of you are not scientists, so it is very difficult for you to evaluate the claims. The FDA does it’s best to shut down products that are dangerous to your health. The FTC does it’s best to shut down products that make unfounded claims. I will do my best to warn you about about bogus products. However, none of us can keep up with all the dangerous and bogus products that flood the marketplace. At the end of the day, your best defense is to remember that famous quote “If it sounds too good to be true…” The jellyfish memory supplement sounds too good to be true.

The Bottom Line

  • The FTC and New York Attorney General have sued the manufacturers of the “jellyfish memory supplement” that has been so widely advertised on TV. The FTC alleges that the claims for that product are “false and unsubstantiated.”
  • The clinical study cited by the manufacturer was flawed because:
    • The results had not been published in a peer reviewed scientific journal. That means the study has not been independently reviewed by anyone not associated with the manufacturer.
    • The results were not statistically significant.
  • The scientific rationale for the product was flawed because:
    • The “jellyfish protein” is not found in humans. In fact, the manufacturer does not even use the protein found in jellyfish. They use a synthetic version produced through genetic engineering.
    • Proteins must be degraded to individual amino acids before they can be absorbed into the bloodstream. That means when you take a pill containing “jellyfish protein”, all you get is a release of amino acids into your bloodstream.
  • Even if you were magically able to get the protein into your bloodstream, it couldn’t cross the blood-brain barrier. The only reliable means of getting proteins into the brain is by cranial injection, and I don’t think anyone is going to be doing that for mild cognitive impairment.
  • I will do my best to alert you about bogus supplements. The FDA and FTC will do their best to protect you. However, none of us can keep up with all the dangerous and bogus products that flood the marketplace. At the end of the day, your best defense is to remember that famous quote “If it sounds too good to be true…”

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.

Deceptive Food Labels

Written by Dr. Steve Chaney on . Posted in Deceptive Food Labels, Healthy Lifestyle, Supplements and Health

What The Food And Supplement Industries Don’t Want You To Know

Author: Dr. Stephen Chaney

 

deceptive food labelsHealthy Eating Is In. We are told we need more fiber, whole grains, fruits & vegetables, nuts and omega-3s in our diet. We are being told that we should be eating “super foods” we’ve never heard of because of their amazing health benefits. As a consequence, more and more Americans are reading labels to be sure that the foods and supplements they are buying are healthy.  We trust the FDA and others not to allow us to be had by deceptive food labels.

But what if those food labels were deceptive? What if the food labels were more about marketing than about real health benefits? Is it possible that BIG FOOD Inc. and the supplement industry could actually be lying to us? Could it be that the manufacturers care more about their profits than about our health?

Deceptive Food Labels? 

Vegetable & Fruit Follies In The Supermarket

Everyone knows that fruits and vegetables are good for us. They are chock-full of vitamins, minerals, and phytonutrients as well as fiber. But who wants to spend the time peeling an orange or washing the pesticides off that broccoli? It’s much more fun to get our fruits and vegetables from chips, pasta, and breakfast cereals.

companies that use deceptive food labelsFood manufacturers are only too happy to oblige. The chemical companies make a variety of fruit and vegetable powders that food manufacturers can add to their products. For example, Powder Pure tells food manufacturers “Whether you want to add nutrition to your label, infuse full color, or formulate a specific flavor profile for your discerning consumers, Powder Pure has the right powder to enhance your presence in the marketplace.”  You will notice they are talking about adding nutrition to the label, not to the food. They are talking about “enhancing your presence in the marketplace,” not making your food healthier.

The problem is that sprinkling a little fruit and vegetable powder into a processed food will never provide the full range of nutrients that those fruits and vegetables would have provided.

Most manufacturers can’t (or won’t) specify the amounts of nutrients and phytonutrients you get from the fruit & vegetable powders they add to their processed foods, but that doesn’t stop them from making label claims like “We pop a flavorful blend of nine veggies…[in our chips]” or there is “half serving of vegetables in a 2 oz serving…[of our pasta].”  Is this using deceptive food labels?

The Fruits & Vegetables in a Capsule Con

One of my pet peeves is the food supplement manufacturers who try to tell you that they have concentrated a cornucopia of fresh fruits and vegetables in a capsule. For example, one company claims that their capsules contain apple, barley, broccoli, beet, cabbage, carrot, cranberry, date, garlic, kale, oats, orange, parsley, peach, pineapple, prunes, spinach, plant enzymes, fiber, and acidophilus.  All this in one capsule!  Does that sound like the use of deceptive food labels?

While this list sounds impressive, you need to ask whether they are providing meaningful amounts of those fruits and vegetables.  For example, the product claims to have oats.  A serving of oats is equal to 1/3 cup dry oats and weighs about 28 grams.  A capsule typically weighs about 0. 5 grams. Therefore, to get the equivalent of one serving of oats from a capsule, you would have to consume 56 capsules!  And that’s assuming that the entire capsule was filled with oats.

Broccoli is another claimed ingredient.  A serving of fresh broccoli weighs 88 grams, but roughly 80 grams of that is water.  So if you dehydrated the broccoli you would be left with about 8 grams of material. Therefore, to get a single serving of dehydrated broccoli you would have to consume 16 capsules. Again, that’s assuming that the capsules were completely filled with just broccoli.

You can do this kind of calculation with each ingredient they claim is in their capsules.  But when you add up the number of capsules needed to get a reasonable amount of each of these ingredients, the capsule total is staggering.

deceptive food labels marketingAs for essential nutrients, when you read the labels on some of these products you discover that their capsules only contain small amounts of a few essential nutrients. They simply do not provide significant amounts of the vitamins, minerals, and phytonutrients you would have been getting if you ate the real foods.

On the other hand, if the label does list significant amounts of the essential nutrients, that’s usually because purified vitamins and minerals have been added to the final product. Those products are no different from any other multivitamin supplement except that they contain insignificant quantities of fruit and vegetable powders that provide no additional health benefits. Once again, it’s all about using deceptive food labels marketing, not your good health.

Faux Protein Supplements

The same deceptive marketing practices have also entered the lucrative protein supplement marketplace. You are being told about protein products that are full of fruits & vegetables, super foods and herbs. It all sounds wonderful, but once again it is all smoke and mirrors. These companies are just mixing a little fruit and vegetable powders in with their protein powder.

You are being told that these products contain dozens of fruits and vegetables that provide vitamins and antioxidants in their natural form. However, when you read the label it is obvious that many of the vitamins and minerals in that product never saw a fruit or vegetable. They were synthesized in a chemical laboratory and added to the final product along with the fruit and vegetable powders.

You are being told that these products contain super foods that provide important phytonutrients, but none of those phytonutrients is present in sufficient quantities to be featured on the nutrition label. You are told that these products contain herbal ingredients with amazing healing powers, but none of the active ingredients of the claimed herbs are present in high enough quantities to be included on the nutrition label.

fruits and vegetablesOnce again, it is all about marketing. Manufacturers are adding fruit and vegetable powders and a pinch of herbal ingredients to their protein powders so that they can make marketing claims, but those fruit and vegetable powders and herbal ingredients aren’t present in large enough quantities to make any significant impact on your health.

Allowed Label Claims

Many of you have asked me about companies that claim their supplement has the amount of vitamin C found in 7 oranges or the amount of folic acid found in 4 cups of cooked green peas.  Those are allowed claims and are generally accurate. Just don’t assume that the vitamin C actually came from 7 oranges (it didn’t) or that their supplement has all the nutrients found in 7 oranges (it doesn’t).  Again, these companies find ways to use deceptive food labels to make sales.

 

The Bottom Line

  • We are being told that we should read labels to make sure that the foods and supplements we buy are good for us. We are also being told that we should be eating more fruits and vegetables. Food manufacturers know an emerging trend when they see one, so many of them are adding fruit and vegetable powders to the foods and supplements they manufacture. This increases the marketing appeal of their products, but does nothing to make their products healthier. It is label deception, pure and simple.

If you want to avoid being deceived by deceptive food labels, you should:

  • Ignore the label claims of fruits and vegetables added to the processed foods you see in the market. The fruit and vegetable powders added to those foods provide no proven benefit. The best place to get your fruits and vegetables is to [surprise] eat your fruits and vegetables.
  • Leave those supplements claiming to have concentrated lots of fruits and vegetables into a single capsule on the shelf. Those claims are grossly deceptive because the capsules do not contain significant amounts of the fruits and vegetables listed on the label. They do not provide the nutrients you would have gotten if you had eaten the real foods. Once again, the best way to get the fruits and vegetables you need in your diet is to actually eat fresh fruits and vegetables.
  • Forget those protein supplements that make amazing claims based on all the fruits, vegetables, super foods, and herbal ingredients they have. Once again, the fruit and vegetable powders and herbal ingredients in these products are not present in sufficient quantities to provide any significant health benefits. It is the marketing that is amazing, not the health benefits.
  • Finally, many of you have asked me about companies that claim their supplement has the amount of vitamin C found in 7 oranges or the amount of folic acid found in 4 cups of cooked green peas. Those are allowed claims and are generally accurate. Just don’t assume that the vitamin C actually came from 7 oranges (it didn’t) or that their supplement has all the nutrients found in 7 oranges (it doesn’t).

 

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.

American Omega-3 Deficiency

Written by Dr. Steve Chaney on . Posted in Food and Health, Health Current Events, Omega-3 Deficiency, Supplements and Health

Is There an American Omega-3 Deficiency?

Author: Dr. Stephen Chaney

omega 3 deficiencyOmega-3s have been controversial in recent years.  However, virtually everyone agrees that omega-3 intake in North American is low. But, would you believe that the United States and Canada are dead last with respect to omega-3 status – that we are among the countries with the lowest omega-3 status in the world? Is there an American omega-3 deficiency?  That is what a recent study suggests!

Omega-3 Deficiency in Americans

Previous studies have suggested that the American and Canadian diets were deficient in long chain omega-3s like EPA and DHA, but those studies were based on 24-hour diet recalls or food frequency surveys which might underrepresent the true amount of omega-3s in the diet. Therefore, a group of investigators from the United States and Canada decided to look at blood levels of EPA and DHA.

This study (Stark et al, Progress In Lipid Research, 63: 132-152, 2016) was a meta-analysis of 298 studies that recorded blood levels of EPA and DHA. These studies were from 36 counties and distinct regions around the world. They converted all of the measurements to a common unit expressed as percent by weight of EPA + DHA relative to the total weight of fatty acids in the blood.

American omega-3 deficiencyThey combined all studies from a given country or region to give an average value of percent EPA + DHA and then divided the countries and regions into four groupings based on the average weight percentage of EPA + DHA in the blood. If all that seems confusing, the figure on the right (taken from Stark et al, Progress In Lipid Research, 63: 132-152, 2016) should clear things up.

  • Red = very low (< 4%) EPA + DHA levels
  • Orange = low (4-6%) EPA + DHA levels
  • Yellow = moderate (6-8%) EPA + DHA levels
  • Green = adequate (>8%) EPA + DHA levels
  • Grey = no valid measurements in those countries

It is clear from this study that most Americans and most Canadians don’t do a very good job of incorporating omega-3 fatty acids into their diet, as several previous dietary surveys have suggested.  This could contribute to omega-3 deficiency.

Is The United States Dead Last In Omega-3 Status?

The global map of EPA + DHA blood levels certainly suggests that the United States is among a handful of countries with the very lowest omega-3 status. There are a few caveats, however.

  • As the large areas of grey indicate, there are a number of countries with no valid omega-3 blood measurements. The United States might have lots of company in the very low omega-3 status category.
  • There are some very large countries like Russia which have relatively few omega-3 blood measurements, and those measurements are only from a few regions of the country. The average omega-3 status for the entire country might be lower than indicated in this map.

On the other hand, there are lots of omega-3 blood measurements from countries like Japan, so it is clear that there are countries with much better omega-3 status than the United States.

What Does This Study Mean To You?

The important questions are, of course:Does it matter? What do these blood levels of EPA + DHA actually mean? Is < 4% EPA + DHA low enough to matter? What are the health consequences of low omega-3 status?  If you have an omega-3 deficiency, what are the risks?

Let’s start with the first question: How do we translate a blood level of EPA + DHA into how much we should be getting in our diet? While there is no established Dietary Reference Intake for EPA + DHA, several expert panels and international organizations have made recommendations for EPA + DHA intake. Those recommendations generally range from 250 mg/day to 500 mg/day for general health and 500 mg/day to 1,000 mg/day for heart health. Unfortunately, most people in the United States and Canada consume less than 200 mg/day of omega-3 fatty acids, and most of those are short chain omega-3s that are inefficiently converted to the long chain EPA and DHA.

More importantly, a recent study (Patterson et al, Nutrition Research, 35: 1040-1051, 2015) has examined how much additional EPA + DHA must be consumed by someone eating a typical North American diet to significantly improve their omega-3 status. It showed that:

  • 200 mg/day of EPA + DHA is required to improve omega-3 status from very low to low.
  • 500 mg/day of EPA + DHA is required to improve omega-3 status from very low to moderate.
  • 1250 mg/day of EPA + DHA is required to improve omega-3 status from very low to adequate.

omega-3 for heart healthIt is no surprise that these numbers correlate so well. My recommendation would be to consume at least 500 mg/day of EPA + DHA for general health and at least 1,000 mg/day for heart health.

Now let’s look at the last question: What are the health consequences of low omega-3 status? There are multiple health benefits associated with optimal omega-3 status, but the best evidence is for the beneficial effects of omega-3s on fetal and infant neurodevelopment and heart health. For example:

  • In case you have been confused by recent studies suggesting that omega-3s have no effect on heart health you should know that most of those studies were looking at the effect of EPA + DHA in patients who were already taking 3 or 4 heart medications. The studies actually concluded omega-3s provided no additional benefits in people already taking multiple heart medications. That is a totally different question.

Where Should You Get Your Omega-3s?

fish oil supplementsNow that you know how important the long chain omega-3s, EPA and DHA, are for your health, and you know that most of us have a very poor omega-3 status and therefore have an omega-3 deficiency , your next questions are likely to be: “What’s the best way to improve my omega-3 status?” and “Where can I find EPA and DHA in my diet?” The answer is complicated.

  • Cold water, oily fish like salmon are a great source of EPA and DHA. Unfortunately, our oceans are increasingly polluted and some of those pollutants are concentrated even more in farm raised fish. A few years ago a group of experts published a report in which they analyzed PCB levels in both wild caught and farm-raised fish from locations all around the world (Hites et al, Science 303: 226-229, 2004) . Based on PCB levels alone they recommended that some wild caught salmon be consumed no more than once a month and some farm raised salmon be consumed no more than once every other month!

Unfortunately, when you buy salmon in the grocery store or your favorite restaurant, you can ask whether the salmon is wild or farm-raised, but you have no idea where the salmon came from. You have no idea how safe it is to eat. I love salmon and still eat it on occasion, but not nearly as frequently as I used to.

As an aside, the buzzword nowadays is sustainability. I support sustainability. However, the easiest way to assure that fish are sustainable is to raise them in fish farms. When a waiter tells me how sustainable the “catch of the day” is, I ask them how polluted it is. If they can’t answer, I don’t buy it. My health is more important to me than sustainability.

  • Nuts, seeds, and canola oil are good sources of ALA, a short chain omega-3 fatty acid. These food sources are less likely to be contaminated, but the efficiency of conversion of ALA to EPA and DHA is only around 5-10%. In other words, you need to eat a lot of ALA-rich foods to enjoy the health benefits associated with EPA and DHA.
  • That leaves fish oil supplements, but you need to remember that the EPA + DHA supplements you purchase in the health food store come from polluted fish. Unfortunately, many manufacturers have inadequate purification and quality control standards. In other words, neither you nor they know whether their omega-3 products are pure. You need to make sure that the omega-3 supplement you purchase is made by a manufacturer with stringent quality control standards.

 

The Bottom Line

 

  • A recent study has shown that most Americans are deficient in long chain omega-3s like EPA and DHA. In fact, the mainland United States and Canada were tied with half a dozen other countries for the lowest omega-3 status in the world.  Omega-3 deficiency in Americans seems to be the worst.
  • That is unfortunate because recent studies have shown that optimal blood levels of EPA and DHA are associated with a number of health benefits, especially fetal and infant neurodevelopment and heart health.
  • Other studies suggest that most Americans should consume an extra 500 mg/day of EPA + DHA for general health and at least 1,000 mg/day for heart health.
  • Unfortunately, it is not easy get those levels of EPA and DHA from our diet:
  • Oily, cold water fish are a great source of EPA and DHA, but our oceans are increasingly polluted and experts recommend that some fish that are the best sources of EPA and DHA be consumed no more than once a month. The situation is even worse for farm-raised fish.
  • Of course, nowadays the buzzword for fish is sustainability, but sustainability does not guarantee purity. Sustainable fish can be just as polluted as the worst of the farm raised fish.
  • seeds and canola oil are great sources for ALA, a short chain omega-3 fatty acid. This source of omega-3s is less likely to be contaminated, but the efficiency of conversion of ALA to EPA and DHA in our bodies is only around 5-10%.
  • Fish oil supplements can be a convenient source of the EPA and DHA you need, but the fish oil often comes from polluted fish and many manufacturers have inadequate purification methods and quality control standards. If you choose fish oil supplements as your source of omega-3s, be sure to choose a manufacturer with stringent quality control standards. Otherwise, neither you nor the manufacturer will know whether their omega-3 supplement is pure.

 

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.

Calcium and Breast Cancer Prevention

Written by Dr. Steve Chaney on . Posted in Calcium and Breast Cancer, Supplements and Health, Vitamins and Health

Author: Dr. Stephen Chaney

 

calcium and breast cancerIs there a connection between calcium and breast cancer prevention?  There has been lots of confusion about calcium supplements lately. Just a few years ago most health professionals were recommending calcium supplementation for women to prevent osteoporosis. Now that recommendation has become controversial. That’s because some studies have suggested that increasing calcium intake doesn’t actually prevent osteoporosis. Other studies have suggested that calcium supplementation may actually cause heart disease.

As if all this wasn’t confusing enough, the latest headlines are claiming that increased calcium intake will reduce breast cancer risk. What are we to believe about the value of calcium for our health? Should we take that calcium supplement we threw away out of the trash can and start using it again?

I have previously evaluated the studies behind the previous headlines and debunked the headlines. For example, I reported that previous studies suggesting that calcium supplementation might increase heart attack risk were followed by a much larger, better designed study showing that, if anything, calcium supplementation actually decreases heart attack risk in Do Calcium Supplements Increase Heart Attack Risk?. I also reported that the study claiming calcium supplements did not prevent osteoporosis was fatally flawed in Do Calcium Supplements Prevent Bone Fractures?.

Now it is time to evaluate the study behind the latest calcium headline. Is this headline myth or is it true?  What is the connection between calcium and breast cancer.

 

Calcium and Breast Cancer Risk Reduction

calcium reduces breast cancer riskThis study (Hidayat et al, British Journal of Nutrition, 116: 158-166, 2016) was a meta-analysis of 11 previous clinical studies published between 2002 and 2013 with a total of 872,895 women subjects which measured calcium intake and breast cancer. Follow up ranged from 7 to 25 years in these studies, during which time 26,606 of the women developed breast cancer.

Dietary plus supplemental calcium intake was determined at the beginning of each study using either a 24-hour diet recall or a food frequency questionnaire. Calcium intakes ranged from 203 mg/day to 1,750 mg/day.

In short this was a very large and well done study. Because of the large number of subjects and the large number of cancer cases, this study had the sensitivity to detect even small effects of calcium on breast cancer risk – something that was not possible in previous studies. In addition, the investigators were able to conduct a dose-response evaluation of the effect of calcium and breast cancer risk reduction. This was also had not been possible in previous studies.

When the women with the highest calcium intakes were compared to the women with the lowest calcium intakes:

  • Calcium reduced breast cancer risk by 8%.
  • The effect was much larger for premenopausal women than postmenopausal women:
  • Calcium reduced breast cancer risk by 25% in premenopausal women.
  • Calcium reduced breast cancer risk by 6% in postmenopausal women.
  • The dose response effect was fairly linear over the entire dose range with a 2% decreased risk of breast cancer for every 300 mg/day increase in calcium intake.

 

What Does This Study Mean For You?

As I said in the beginning, when you read the headlines proclaiming that increasing your calcium intake could decrease your breast cancer risk, you probably had two questions:

Is it true?  The answer appears to be yes. This was a very large, very well done study and it showed there is a connection between calcium and breast cancer risk reduction. It was capable of detecting even small effects of calcium on breast cancer risk – something that previous studies simply could not do.

Does it matter?  Here the answer is more complicated. If you’re a postmenopausal woman, increased calcium intake only decreases your risk of breast cancer by 6%.  If you are a premenopausal woman, increased calcium intake decreases your risk of breast cancer by a more robust 25%. However, in both cases you should think of calcium as only one component of a holistic approach to reducing breast cancer risk – something I’ll discuss in more detail below.

Now that you know the answer to those two questions you probably have a third question:

How much calcium do I need?   That’s pretty simple. The calcium DV for adults is 1,000 mg/day, increasing to 1,200 mg/day for women over 50.

How Can You Reduce Breast Cancer Risk?

In a previous article Preventing Osteoporosis,  I reported that while calcium supplementation alone had only a very modest effect on reducing osteoporosis risk, it played an important role as part of a holistic bone-healthy lifestyle. The role of calcium in reducing breast cancer risk is no different.

Most experts estimate that between 30 and 60% of breast cancer cases could be prevented by diet and lifestyle changes. In addition to calcium, both the Mayo Clinic  and the American Cancer Society make the following recommendations for reducing breast cancer risk:

  • calcium supplementsLimit or avoid hormone therapy. This is the single most important step you can take to reduce breast cancer risk.
  • Eat a plant-based diet with plenty of fresh fruits and vegetables, whole grains, legumes and nuts. Use fats in moderation and choose healthy fats such as olive oil and omega-3 fats. Limit the amounts of red meat and processed meats.
  • Control your weight.
  • Be physically active.
  • Don’t smoke
  • Limit alcohol intake.
  • Avoid exposure to radiation and environmental pollution.
  • Breast feed.

Where Should You Get Your Calcium?

Many experts recommend that you get your calcium only from food. Is that the best advice?  I always like to start with food as the source of essential nutrients, but in the case of calcium that usually isn’t sufficient. Here are some facts to ponder:

  • Plain, nonfat yoghurt is the calcium champion, with an 8 ounce serving supplying 42% of the DV (the calcium DV = 1,000 mg/day). However, most yoghurt cups in the market these days are 4 ounces or less.
  • Milk and a few cheeses supply around 30% of the DV. However, many people can’t or don’t consume the 3 or more servings needed to reach the DV.
  • Green leafy vegetables are often mentioned as another good food source. However, a serving of them only provides around 10% of the DV, and many leafy greens contain oxalates which decrease calcium absorption.
  • Beyond that,  most food sources of calcium supply only 1-8% of the DV for calcium. If you don’t drink lots of milk, you need to be a dietitian with an advanced degree to figure out how to get enough calcium from foods alone.
  • If that isn’t bad enough, many foods contain substances that interfere with calcium absorption. In addition to the oxalates in leafy greens, these substances include phytates from whole grains, phosphate from sodas, and saturated fat from red meats.

 

Experts often also recommend getting calcium from calcium fortified foods such as calcium fortified orange juice. That can help you reach the recommended calcium intake, but in my opinion calcium-fortified foods are likely to be more expensive and no better than regular foods plus a calcium supplement.

I recommend getting as much calcium as possible from food and adding a calcium supplement for the rest. Here are my tips on calcium supplementation:

  • If you do use a calcium supplement, make sure it is complete. Don’t just settle for calcium and vitamin D. At the very least you will want your supplement to contain magnesium and vitamin K. I personally recommend that it also contain zinc, copper, and manganese as well.
  • Your calcium supplement will be best utilized if taken between meals.
  • Your calcium supplement will be best utilized if you don’t take more than 500 mg at a time.
  • In most cases there is no need for more than the DV of calcium.

Let’s review the connection between calcium and breast cancer risk reduction.

 

The Bottom Line

  • A recent study has shown that increasing calcium intake reduces the risk of breast cancer. The effect of calcium intake on breast cancer risk was much greater for premenopausal women (25% risk reduction) than it was for postmenopausal women (6% risk reduction).
  • While the effect of calcium alone on breast cancer risk was relatively modest,  it is likely to be an important component of a holistic approach for reducing breast cancer risk.  Additional recommendations of the Mayo Clinic and American Cancer Society for reducing breast cancer risk are contained in the article above.
  • While many experts recommend getting your calcium from food alone, a careful analysis of food sources of calcium clearly shows how difficult that is for most people.
  • Calcium supplements are a safe and effective way to make sure you are getting the calcium you need. In the article above, I describe the optimal design of a calcium supplement and how to take a calcium supplement for optimal utilization.

 

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.

Omega-3 And Blood Pressure: The Good News

Written by Dr. Steve Chaney on . Posted in current health articles, Diets, Food and Health, Health Current Events, Omega-3s and Blood Pressure, Supplements and Health, Vitamins and Health

Will Fish Oil Lower Your Blood Pressure?

Author: Dr. Stephen Chaney

 

omgega-3 and blood pressureIs there a relationship between omega-3 and blood pressure we should understand to for health benefits?

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 363,000 deaths in 2010. 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.

  • 31% 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 30% of Americans have prehypertension (systolic blood pressure of 120-139 mm Hg or diastolic blood pressure of 80-89 mm Hg).

That’s over 61% 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 47% 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 good news about omega-3 fatty acids.

 

The Good News About Omega-3 and Blood Pressure

omega-3s lower blood pressureWhat’s the good news about omega-3 and blood pressure?  We’ve known for some time that omega-3 fatty acids helped lower blood pressure, but two recent studies have really highlighted just how strong the effect of omega-3s on lowering blood pressure is.

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

Here are the results of this study:

  • 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.

Here are the results of this study:

  • 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 Blood Pressure Control

 

lower blood pressure dietThe latest information about omega-3 and blood pressure is 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 sodium, low sodium/high-potassium, low-sodium/low-calorie, low-calorie 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.

benefits of nitratesIf 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 everything else in the list above could reduce your systolic blood pressure by a whopping 18-22 mm Hg.

That’s significant because,as the graphic on the right shows, the CDC estimates that reducing high systolic blood pressure by only 12-13 mm Hg could substantially decrease your risk of disease.

 

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, the less medication your doctor will need to use (That means fewer side effects).

 

The Bottom Line

 

  • Recent studies have shown that supplementation with as little as 0.7 grams of long chain omega-3s (EPA + DHA) per day is sufficient to decrease systolic blood pressure by ~ 5 mm Hg in people with untreated hypertension (high blood pressure). If your blood pressure is currently in the normal range, it is not yet clear how much EPA + DHA you need to keep it there. That may require a higher dose.
  • When you combine that with other natural approaches such as the DASH diet, reducing sodium, losing weight, and increasing exercise you can decrease blood pressure by 18-22 mm Hg.
  • The CDC estimates that is enough to substantially decrease your risk of stroke, coronary heart disease, memory loss, kidney disease, erectile dysfunction, death from cardiovascular disease, and death from any cause.
  • The authors of these recent studies concluded that holistic lifestyle changes including substantially increasing omega-3 intake have the potential to significantly delay the onset of age-related hypertension and may allow people with elevated blood pressure to eliminate or substantially reduce the use of blood pressure medications – with their many side effects.
  • High blood pressure is a silent killer. It is important to monitor your blood pressure regularly. If it becomes elevated, work with your doctor to find the balance of natural approaches and medication that is right for you.

 

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.

PAHs Contaminate Supplements?

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

Do Your Supplements Contain Carcinogens?

Author: Dr. Stephen Chaney

 

pahs in supplementsMost of us take supplements to improve our health. We count on those supplements being pure and effective. We don’t expect the supplements we take to contain carcinogenic (cancer causing) contaminants. However, that expectation appears to be unfounded. A recent study found that 72% of supplements tested were contaminated with a particularly dangerous class of cancer causing chemicals called polycyclic aromatic hydrocarbons (PAHs)

Where Do PAHs Come From  andWhy Are TheyDeadly?

Polycyclic aromatic hydrocarbons (PAHs) are produced by incomplete combustion of organic materials. Major environmental sources of PAHs are incomplete burning of gasoline, coal and other fuels. Unfortunately, automobile exhaust, coal burning power plants, and exhaust from factories are almost ubiquitous in today’s world, resulting in significant PAH contamination of our air, water, and soil. The unfortunate truth is that we all live in an increasingly dirty and toxic environment.

pahs can come from highwayAs you might imagine, cigarette smoke is the #1 source of PAHs in humans. However, foods are a major route for PAH exposure in humans as well. There are many food sources of PAHs. For example,

  • Grilling, roasting and frying foods, especially meats, at high temperatures creates PAHs.
  • Smoking fish or meats creates PAHs.
  • Barbecuing meats creates PAHs.
  • Even plant-based foods can contain PAHs if the soil, air or water they were grown in was contaminated.
  • PAHs can be introduced into supplements if any of their ingredients are dried at high temperatures as part of the processing procedure.

By now you are probably realizing that it is not just our environment that is increasingly being contaminated with PAHs. We are all becoming contaminated with PAHs as well. Our bodies are becoming toxic waste dumps.

Unfortunately, PAHs are not innocuous chemicals. Perhaps the best studied and deadliest of the PAHs is a compound called benzo[a]pyrene. It is classified as a class 1 carcinogen and mutagen by the IARC (International Agency for Research on Cancer). Perhaps some explanation is in order:

  • The IARC is an international organization that is charged with evaluating the scientific evidence for the carcinogenicity of various chemicals. It also sets upper limits for safe exposure to those chemicals.
  • Class 1 carcinogens are compounds that the IARC has classified as definitely carcinogenic to humans. Simply put, the IARC considers the scientific evidence to be overwhelming that those compounds are carcinogens.

To date only 118 compounds have been blacklisted by the IARC as class 1 carcinogens and benzo[a]pyrene is one of them. However, many of the other, less studied, PAHs are classified as probable carcinogens by the IARC.

Unfortunately, in most countries of the world (including the United States), PAH limits in food and supplements are unregulated. Because they are unregulated, many supplement companies don’t even test for them. That is unfortunate because a recent study shows that many supplements are contaminated with high levels of PAHs, and their manufacturers didn’t even know it.

Do Your Supplements Contain PAHs or Other Carcinogens?

carcinogens in supplementsThe European Union has taken the lead in regulating PAH levels. They have used the IARC guidelines to create upper allowable limits for PAHs in food and supplements. Separate standards were set for benzo[a]pyrene and the total of the four most common PAH contaminants (benzo[a]anthracene, benzo[a]pyrene, benzo[b]fluoranthrene, and chrysene). Those new regulations just went into effect April 1st 2016.

To gauge the impact of these new regulations on the supplement industry, the EU asked the European Union Reference Laboratory to measure the levels of PAH contamination in supplements sold in the EU prior to the implementation of the new regulations. Because vitamin and mineral supplements are seldom contaminated with PAHs, they were excluded from the study.

The EU Reference Laboratory started collecting a wide range of herbal and botanical supplements, fish and edible oil food supplements, and propolis and other bee supplements sold in the EU in 2013. The Reference Laboratory analyzed 94 different supplements for PAH contamination, and the results of these analyses were published in October 2015 (Z. Zelinkova and T. Wenzyl, Food Additives & Contaminants: Part A, 32: 1914-1926, 2015).

[In case you, like me, were wondering what propolis is, it is a resin like substance that bees use as a glue to hold their hives together. WebMD states that it may have some use as a topical agent for cold sores, genital herpes, and after mouth surgery, but that any other uses are unproven. However, if you visit websites for propolis products you find it in capsules and liquids for internal consumption. You are told that it cures bacterial and fungal infections, cures viral infections like AIDs, cures cancer, and removes warts.]

The results of their analysis were pretty scary:

  • 72% of the supplements tested exceeded EU limits for the four most common PAH contaminants, and 52% exceeded EU limits for benzo[a]pyrene.
  • Propolis and spirulina were the most heavily contaminated supplements. Valerian and St. John’s Wort had moderately high levels of contamination, and some samples of bee pollen, sea buckthorn oil, barley greens, Echinacea, and Ginko far exceeded EU standards.
  • If consumers took the recommended dosage of the two most contaminated products (Premium Spirulina and Propolis Intense) they would more than double their daily intake of PAHs and far exceed what the IARC considers safe.
  • Fish oils generally had low levels of PAH contamination. The authors speculated this may be because fish have the ability to metabolize PAHs. However, other edible oils, particularly sea buckthorn oil and a mixture of garlic oil with soybean and sunflower oils did exhibit significant PAH contamination. The authors speculated that this PAH contamination may have been introduced during the processing of these oils.

Why The PAH and Contamination Problem Is Worse Than You Thought

worseYou might be thinking what could be worse than 72% of supplements being contaminated with cancer causing PAHs? Here is some food for thought.

  • PAHs are just the tip of the iceberg. Many supplements are also contaminated with PCBs and heavy metals. For example:
  • Fish oil is often contaminated PCBs.
  • Rice protein and other rice-derived ingredients are often contaminated with lead and/or mercury.
  • The US regulates PAHs in our water supply, but does not currently regulate PAHs in our supplements. That means that manufacturers that make products primarily for consumption in the US have no incentive to test their products for PAH contamination. Most of them have no idea whether their products are safe or not.
  • There is no guarantee that even products labeled Certified Organic and Non-GMO are free of PAH contamination. For example:
  • Organic certification just means that the crop was raised using organic methods. No analysis of purity is required to assure that the crop had not been inadvertently contaminated. The same is true of non-GMO certification. No analysis of purity is required.
  • Organically grown, non-GMOcrops that are used as ingredients for supplements can still be contaminated if the air, soil or water is contaminated from any nearby pollution source. For example, ground water pollution is the major source of the heavy metal contamination often seen in rice-derived ingredients.
  • Organically grown, non-GMO crops can even become contaminated by PAHs if they are grown next to a busy highway.
  • Even if the ingredients are pure to begin with, PAH contamination can be introduced during processing.

What does all of this mean to us? It means that it is absolutely imperative that we do our due diligence and only choose supplement manufacturers whose quality control standards far exceed what is required of the industry. Our health just may depend on it.

 

The Bottom Line

 

  • A recent study has reported that 72% of herbal and botanical supplements, fish and edible oil food supplements, and supplements derived from bees sold in the EU were contaminated with high levels of cancer causing polycyclic aromatic hydrocarbons (PAHs).
  • The levels of PAHs in many of these products far exceeded standards recently enacted by the EU. If those supplements were taken as recommended, the daily intake of PAHs by people consuming them would also far exceed the safe limits of exposure to these toxic chemicals set in place by the International Agency for Research on Cancer.
  • While all of this sounds bad enough, the news is even worse for most of us living in the US.
  • PAHs are just the tip of the iceberg. Many supplements are also contaminated with PCBs and heavy metals.
  • The US regulates PAHs in our water supply, but does not currently regulate PAHs in our supplements. That means that manufacturers that make products primarily for consumption in the US have no incentive to test their products for PAH contamination. Most of them have no idea whether their products are safe or not.
  • There is no guarantee that even products labeled Certified Organic and Non-GMO are free of PAH contamination.
  • What does all of this mean to us? It means that it is absolutely imperative that we do our due diligence and only choose supplements manufacturers whose quality control standards far exceed what is required of the industry. Our health just may depend on it.  Remember, PAHs are not the only potential problem.

 

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 Supplementation Improve Teen Behavior?

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

Author: Dr. Stephen Chaney

 

can supplementation improve teen behaviorAll teenagers can be a handful at times. Experts tell us that their raging hormones are to blame, but could their junk food diets play a role as well? If so, would something as simple as supplementation improve teen behavior?

This has been a controversial issue, with some studies saying yes and other studies saying no. With that in mind I thought I would share a recent study that concludes supplementation may improve behavior in teens. While this one study will not resolve the controversy, it does provide some insight into why the results of previous studies have been so contradictory.

Can Supplementation Improve Teen Behavior?

This study (Tammam et al, British Journal of Nutrition, 115: 361-373, 2016) enrolled 196 healthy teens aged 13-16 from a large public school in London. The school was located in an economically depressed area of London where a large proportion of the adults were out of work and had no formal education. Many of the children attending that school had adverse home environments and poor nutrition.

This is an important point. The scientists running the study had specifically chosen a teenage school population that was likely to have poor nutritional status. This poor nutritional status was confirmed by blood samples taken at the beginning of the study which showed the teens were low in iron, folate, vitamin D, vitamin C and omega-3 fatty acids – all of which are important for brain health.

teen behvaviorThe students were given either a comprehensive multivitamin plus 541 mg of omega-3 fatty acids (containing 165 mg EPA and 116 mg DHA) or matched placebos for one school term (12 weeks). The study was fully blinded in that neither the students nor their teachers knew who had received the supplements and who had received the placebo.

Blood test taken at the end of the study showed that students taking the supplements had significantly higher blood levels of folate, vitamin C, vitamin D, and omega-3 fatty acids (iron levels remained unchanged) while those nutrient levels were unchanged in the placebo group.

Teachers rated the student’s behavior using the Connors Clinical Index Teacher Rating Scale before the study began and again during the last week of the study. The results were clear cut. Behavior improved in the group receiving the supplements and worsened in the group receiving the placebo.

The researchers also looked at disciplinary infringement logs (you can think of those as disciplinary problems severe enough to send the kids to the principal’s office), but the number of disciplinary incidents per child were too low to draw any statistically significant conclusions.

Why Are Supplementation and Teen Behavior Studies So Contradictory?

diet and behaviorAs I said at the beginning of this article, previous nutritional intervention trials looking at teen behavior problems have been conflicting. Some, like this study, have shown a clear benefit of supplementation on teenage behavior. Others have shown no benefit at all.

Most experts tend to treat all studies on a particular topic as equal. They throw all of the studies into a statistical pot and look at the average effect. When studies are contradictory, as is the case for studies looking at the effect of supplementation on teenage behavior, the positive and negative studies cancel each other out and the net effect is often close to zero. When that happens experts generally consider the intervention as “unproven”.

That is a valid approach, but I also like to look for patterns. I like to ask why the studies have come to such contradictory conclusions.

When you evaluate the studies on supplementation and teenage behavior carefully, a pattern starts to emerge. If most of the teenagers in the study have poor nutritional status or have severe behavior problems (such as teenagers in prison), the studies generally show a benefit of supplementation. If most of the teens in the study have good nutritional status at the beginning of the study, the results of supplementation are very difficult to detect. Similarly, if most of the teens in the study are well behaved to begin with, supplementation appears to have little effect.

What Does This Mean For Your Teenager(s)?

The causes of teenage behavior problems are many. Poor nutrition may play a significant role, but genetics, hormones, home environment and school environment are important as well. However, teen eating habits are often less than ideal. If you have a teenager with behavior problems and poor eating habits, supplementation is an inexpensive intervention that may just contribute to better behavior.   So, can supplementation improve teen behavior?  Maybe.

 

The Bottom Line

  • The study was performed in an economically depressed school district where many children suffered from poor nutritional status. Blood test taken at the beginning of the study showed that the students were low in iron, folate, vitamin C, vitamin D, and omega-3 fatty acids. Blood tests taken at the end of the study showed improved nutritional status for every nutrient except iron in the group taking supplements.
  • When you combine this study with previous studies, a pattern emerges.  If most of the teenagers in the study have poor nutritional status or have severe behavior problems (such as teenagers in prison), the studies generally show a benefit of supplementation. If most of the teens in the study have good nutritional status at the beginning of the study, the results of supplementation are difficult to detect. Similarly, if most of the teens in the study are well behaved to begin with, supplementation appears to have little effect.
  • What does all of this mean to the general public? Nutritional status is just one component of teenage behavior. Hormones, genetics, home environment and school environment are important as well. However, teen eating habits are often less than ideal. If you have a teenager with behavior problems and poor eating habits, supplementation is an inexpensive intervention that may just contribute to better behavior.

 

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.

Antioxidants and Aging

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

Author: Dr. Stephen Chaney

 

antioxidant agingModern medicine has helped mankind greatly extend our lifespan, but what about our “healthspan”? Aging is often associated with major degenerative diseases and loss of physical and mental functioning. As the saying goes: “Aging isn’t for sissies”. But, what if you could live healthy into your 80s and 90s? What if you had the health to truly enjoy the wisdom that comes with your years of experience?  In this article we will explore antioxidants and aging.

While healthy aging is a very personal issue for all of us in our golden years, it is a very important societal issue as well. The United Nations estimates that by 2050 more than 1/3 of the population of developed countries will be over 60. Unless we can find a way to preserve the health of these older adults, health care costs will bankrupt even the richest of countries.

That’s why the recently published study on the effect of antioxidant supplements on healthy aging in French adults (Assmann et al, American Journal of Epidemiology, 182: 694-704, 2015) is so interesting.

How Was The Study Designed?

studyThis study was a follow-up to the “Supplementation With Antioxidant Vitamins and Minerals” study that was conducted in France during 1994-2002. That was a double blind, placebo controlled study in which participants were given either a placebo or a supplement containing 120 mg of vitamin C, 6 mg of beta-carotene, 30 mg of vitamin E, 100 ug of selenium, and 20 mg of zinc every day for an eight-year period. These nutrient levels were designed to be equivalent to the quantities provided by a balanced diet rich in fruits and vegetables.

The follow-up study was conducted approximately 5 years later with 3,996 of the original participants. The investigators specifically selected participants who were disease free when they entered the original study. These study participants were equally divided between men and women and had an average age of 65.3 years.

The participants were put through a battery of screens and assigned a “healthy aging score” based on:

  • Absence of cancer, heart disease and diabetes
  • Good physical and cognitive function
  • No limitations in activities associated with daily living
  • No depressive symptoms
  • No health-related limitations in social life
  • Good overall perceived health
  • No function-limiting pain

In short those participants with a high healthy aging score had good health and good quality of life.

Are Antioxidants the Secret to Healthy Aging?

antioxidant nutrientsWhen the investigators looked at the group as a whole, the results were pretty discouraging:

  • Antioxidant supplementation provided no significant benefit to the population as a whole.
  • Antioxidant supplementation also provided no significant benefit to the women in the group.

However, when they looked at subgroups, the results were much more encouraging:

  • Antioxidant supplementation increased the probability of healthy aging by 18% for the men in the study.
  • For those participants with low serum vitamin C levels at the beginning of the study antioxidant supplementation increased the probability of healthy aging by 28%
  • For those participants with low serum zinc levels at the beginning of the study antioxidant supplementation increased the probability of healthy aging by 26%
  • For those participants consuming very few fruits and vegetables at the beginning of the study, antioxidant supplementation increased the probability of healthy aging by 17%

The conflicting results for men and women were puzzling, but the investigators pointed out that very few women had low serum vitamin C status at the beginning of the study, while 25% of the men had low serum vitamin C levels at the beginning of the study. The investigators speculated that supplementation may have been less effective in women simply because they had better diets than the men in the study. That certainly wouldn’t surprise me.

What Are The Strengths And Weaknesses Of This Study?

Let’s start with the strengths. This is the very first double-blind, placebo-controlled study to look at the role of antioxidant nutrients in healthy aging. A number of previous studies looking at the effect of antioxidant nutrients on individual components of aging have given conflicting results. The investigators pointed out that this study may have shown more beneficial effects of antioxidants than previous studies because:

  • Most previous studies have been relatively short in duration. This was an 8-year study with a 5-year follow-up period (total study length = 13 years).
  • Most previous studies did not measure baseline intake of the nutrients. This study shows that individuals with low baseline intake or low serum levels at the beginning of the study are significantly more likely to benefit from supplementation.
  • Most previous studies have measured the effects of single antioxidant nutrients, or at most combinations of 2 or 3 antioxidant nutrients. This study used a combination of 5 different antioxidant nutrients. The synergy between these nutrients may have increased the magnitude of the observed benefits.

The weaknesses of the study are also pretty apparent.

  • Since it is the first study of its kind, it does need to be validated by additional studies.
  • There is no universally accepted index for healthy aging (This is a problem for aging research as a whole, not just this study).
  • The participants in the study were not evaluated for healthy aging criteria at the beginning of the study so we have no idea how their healthy aging score changed over time.
  • The beneficial effect of antioxidant nutrients, while significant, were relatively small. You are obviously not going to live healthy to 100 by consuming antioxidant supplements alone.

Antioxidants and Aging:  Will Antioxidant Nutrients Help You?

aging gracefullyThis study does suggest that antioxidant supplements may help you achieve healthy aging. This study also makes three other very important points:

  • A holistic approach to supplementation – one involving multiple antioxidant nutrients – is much more likely to be beneficial than individual antioxidant supplements.
  • Supplementation is most likely to be beneficial for those individuals who are consuming a poor diet.
  • Supplementation is also most likely to be beneficial for those individuals who have low serum level of essential nutrients. This can be due to poor diet, but low serum levels of individual nutrients can also be caused by individual differences in metabolism or genetic make-up.

However, as noted above:

  • The study has some weaknesses and needs to be repeated.
  • The beneficial effects of antioxidant nutrients were relatively small.

That means that holistic approaches to healthy aging are more likely to be beneficial than individual supplements. Based on what we currently know a holistic approach to healthy aging includes:

  • Consuming a combination of a balanced diet and supplementation that provides sufficient levels of all the essential nutrients, not just the antioxidant nutrients. This would include things like omega-3 fatty acids and polyphenols.
  • Avoiding saturated and trans fats, excess sugar, red and processed meats, which may have bad effects on your health.
  • Controlling your weight.
  • Staying mentally and physically active.
  • Maintaining strong social networks.
  • Maintaining a positive outlook on life.

 

The Bottom Line

  • A recent study suggests that antioxidant supplements may help you achieve healthy aging. This study also makes two other very important points:
  • A holistic approach to supplementation – one involving multiple antioxidant nutrients – is much more likely to be beneficial than individual antioxidant supplements.
  • Supplementation is most likely to be beneficial for those individuals who are consuming a poor diet and/or have low serum levels of essential nutrients.
  • Since the beneficial effect of antioxidant nutrients on healthy aging was relatively small, this suggests the antioxidant nutrients are just one part of a holistic approach to healthy aging that includes.
  • Consuming a combination of a balanced diet and supplementation that provides sufficient levels of all the essential nutrients, not just the antioxidant nutrients. This would include things like omega-3 fatty acids and polyphenols.
  • Avoiding saturated and trans fats, excess sugar, red and processed meats, which may have bad effects on your health.
  • Controlling your weight.
  • Staying mentally and physically active.
  • Maintaining strong social networks.
  • Maintaining a positive outlook on life.

 

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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Can Plant-based Diets Be Unhealthy?

Posted September 10, 2019 by Dr. Steve Chaney

Do Plant-Based Diets Reduce Heart Disease Deaths?

Author: Dr. Stephen Chaney

 

plant-based diets vegetablesPlant-based diets have become the “Golden Boys” of the diet world. They are the diets most often recommended by knowledgeable health and nutrition professionals. I’m not talking about all the “Dr. Strangeloves” who pitch weird diets in books and the internet. I am talking legitimate experts who have spent their life studying the impact of nutrition on our health.

Certainly, there is an overwhelming body of evidence supporting the claim that plant-based diets are healthy. Going on a plant-based diet can help you lower blood pressure, inflammation, cholesterol and triglycerides. People who consume a plant-based diet for a lifetime weigh less and have decreased risk of heart disease, diabetes, and cancer.

But, can a plant-based diet be unhealthy? Some people consider a plant-based diet to simply be the absence of meat and other animal foods. Is just replacing animal foods with plant-based foods enough to make a diet healthy?

Maybe not. After all, sugar and white flour are plant-based food ingredients. Fake meats of all kinds abound in our grocery stores. Some are very wholesome, but others are little more than vegetarian junk food. If you replace animal foods with plant-based sweets, desserts, and junk food, is your diet really healthier?

While the answer to that question seems obvious, very few studies have asked that question. Most studies on the benefits of plant-based diets have compared population groups that eat a strictly plant-based diet (Seventh-Day Adventists, vegans, or vegetarians) with the general public. They have not looked at variations in plant food consumption within the general public. Nor have they compared people who consume healthy and unhealthy plant foods.

This study (H Kim et al, Journal of the American Heart Association, 8:e012865, 2019) was designed to fill that void.

 

How Was The Study Done?

plant-based diets studyThis study used data collected from 12,168 middle aged adults in the ARIC (Atherosclerosis Risk in Communities) study between 1987 and 2016.

The participant’s usual intake of foods and beverages was assessed by trained interviewers using a food frequency questionnaire at the time of entry into the study and again 6 years later.

Participants were asked to indicate the frequency with which they consumed 66 foods and beverages of a defined serving size in the previous year. Visual guides were provided to help participants estimate portion sizes.

The participant’s adherence to a plant-based diet was assessed using four different well-established plant-based diet scores. For the sake of simplicity, I will include 3 of them in this review.

  • The PDI (Plant-Based Diet Index) categorizes foods as either plant foods or animal foods. A high PDI score means that the participant’s diet contains more plant foods than animal foods. A low PDI score means the participant’s diet contains more animal foods than plant foods.
  • The hPDI (healthy plant-based diet index) is based on the PDI but emphasizes “healthy” plant foods. A high hPDI score means that the participant’s diet is high in healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, coffee and tea) and low in animal foods.
  • The uPDI (unhealthy plant-based diet index) is based on the PDI but emphasizes “unhealthy” plant foods. A high uPDI score means that the participant’s diet is high in unhealthy plant foods (refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts) and low in animal foods.

For statistical analysis the scores from the various plant-based diet indices were divided into 5 equal groups. In each case, the group with the highest score consumed the most plant foods and least animal foods. The group with the lowest score consumed the least plant foods and the most animal foods.

The health outcomes measured in this study were heart disease events, heart disease deaths, and all-cause deaths. Again, for the sake of simplicity, I will only include 2 of these outcomes (heart disease deaths and all-cause deaths) in this review. The data on deaths were obtained from state death records and the National Death Index. (Yes, your personal information is available on the web even after you die.)

 

Do Plant-Based Diets Reduce Heart Disease Deaths?

plant-based diets reduce heart deathsThe participants in this study were followed for an average of 25 years.

The investigators looked at heart disease deaths over the 25 years and compared people with the highest intake of plant foods to people with the highest intake of red meat and other animal foods. The results were:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, coffee and tea) had a 19-32% lower risk of dying from heart disease than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods (refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts) had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

When the investigators looked at all-cause deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had an 11-25% lower risk of dying from any cause than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

What Else Did The Study Show?

The investigators made a couple of other interesting observations:

  • The association of the overall diet with heart disease and all-cause deaths was stronger than the association of individual food components. This underscores the importance of looking at the effect of the whole diet on health outcomes rather than the “magic” foods you hear about on Dr. Strangelove’s Health Blog.
  • Diets with the highest amount of healthy plant foods were associated with higher intake of carbohydrates, plant protein, fiber, and micronutrients, including potassium, magnesium, iron, vitamin A, vitamin C, folate, and lower intake of saturated fat and cholesterol.
  • Diets with the highest amount of unhealthy plant foods were associated with higher intake of calories and carbohydrates and lower intake of fiber and micronutrients.

The last two observations may help explain some of the health benefits of plant-based diets.

 

Can Plant-Based Diets Be Unhealthy?

plant-based diets unhealthy cookiesNow, let’s return to the question I asked at the beginning of this article: “Can plant-based diets be unhealthy?” Although some previous studies have suggested that unhealthy plant-based diets might increase the risk of heart disease, this study did not show that.

What this study did show was that an unhealthy plant-based diet was no better for you than a diet containing lots of red meat and other animal foods.

If this were the only conclusion from this study, it might be considered a neutral result. However, this result clearly contrasts with the data from this study and many others showing that both plant-based diets in general and healthy plant-based diets reduce the risk of heart disease deaths and all-cause deaths compared to animal-based diets.

The main message from this study is clear.

  • Replacing red meat and other animal foods with plant foods can be a healthier choice, but only if they are whole, minimally processed plant foods like whole grains, fruits, vegetables, nuts, legumes, coffee and tea.
  • If the plant foods are refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts, all bets are off. You may be just as unhealthy as if you kept eating a diet high in red meat and other animal foods.

There is one other subtle message from this study. This study did not compare vegans with the general public. Everyone in the study was the general public. Nobody in the study was consuming a 100% plant-based diet.

For example:

  • The group with the highest intake of plant foods consumed 9 servings per day of plant foods and 3.6 servings per day of animal foods.
  • The group with the lowest intake of plant foods consumed 5.4 servings per day of plant foods and 5.6 servings per day of animal foods.

In other words, you don’t need to be a vegan purist to experience health benefits from adding more whole, minimally processed plant foods to your diet.

 

The Bottom Line

A recent study analyzed the effect of consuming plant foods on heart disease deaths and all-cause deaths over a 25-year period.

When the investigators looked at heart disease deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had a 19-32% lower risk of dying from heart disease than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

When the investigators looked at all-cause deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had an 11-25% lower risk of dying from any cause than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

The main message from this study is clear.

  • Replacing red meat and other animal foods with plant foods can be a healthier choice, but only if they are whole, minimally processed plant foods like whole grains, fruits, vegetables, nuts, legumes, coffee and tea.
  • If the plant foods are refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts, all bets are off. You may be just as unhealthy as if you kept eating a diet high in red meat and other animal foods.

A more subtle message from the study is that you don’t need to be a vegan purist to experience health benefits from adding more whole, minimally processed plant foods to your diet. The people in this study were not following some special diet. The only difference was that some of the people in this study ate more plant foods and others more animal foods.

For more details on the study, 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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