Premature Death: Reduce Your Risk by 31%

Written by Dr. Steve Chaney on . Posted in Premature Death

Add 3.4 Disease-Free Years To Your Life

Author: Dr. Stephen Chaney

reduce premature deathIf you could reduce your risk of:

  • Heart Disease (primarily heart attack) by 24%,
  • Stroke by 33%,
  • Cancer by 14%
  • Premature death by 31% (That would add approximately 3.4 years of disease-free years to your lifespan),

Would you be interested in knowing more?

What if you could enjoy all these benefits:

  • Without it costing you an extra penny?
  • Without any side effects?
  • And you felt great?

Would you like to know the secret?  The secret is a diet rich in fruits and vegetables – probably a lot more fruits and vegetables than you are currently eating. Let’s look at the evidence.

How Was The Study Done?

reduce heart attacksYou may be saying “That’s not news. I’ve heard that before.” Yes, there have probably been hundreds of clinical studies looking at the benefits of diets rich in fruits and vegetables. There have also been several meta-analyses that have combined the data from many individual studies to improve that statistical power of their conclusions.

However, this study (Aune et al, International Journal of Epidemiology, DOI: 10.1093/ije/dyw319 ) is unique.

  • It is the largest and most comprehensive meta-analysis looking at the benefits of fruit & vegetable consumption ever undertaken.
  • It analyzed 142 published clinical studies with over 2.1 million subjects from around the globe.
  • There were 43,000 cases of heart disease, 47,000 cases of stroke, 112,000 cases of cancer, and 94,000 deaths in these studies.
  • It had enough statistical power to determine even minor effects of fruit and vegetable intake.
  • It is the first meta-analysis with enough data to accurately determine the optimal intake of fruits and vegetables.

 

Premature Death:  Reduce Your Risk By 31%

reduce premature death by eating fruits and vegetablesFor most of the health outcomes examined in this study, the optimal intake of fruits and vegetables was 10 servings a day. When they compared people who were consuming 10 servings a day to people who were consuming less than one serving a day,

  • Heart disease was reduced by 28%.
  • Stroke was reduced by 33%.
  • Premature death was decreased by 31%.
  • The fruits and vegetables most strongly associated with this benefit were apples, pears, citrus fruit, green leafy vegetables, and cruciferous vegetables.

For cancer, the optimal intake of fruits and vegetables was 6 servings a day. When they compared people who were consuming 6 servings a day to people who were consuming less than one serving a day,

  • Cancer was reduced by 14%.
  • The fruits and vegetables most strongly associated with reduced cancer risk were green vegetables such as green beans, yellow vegetables such as peppers and carrots, and cruciferous vegetables.

The authors speculated that the relatively small reduction in cancer risk they observed may have been because they were looking at total cancer cases rather than looking at individual cancers. Previous studies have suggested that fruits and vegetables reduce the risk of some cancers much more than others.

Finally, the authors estimated that:

  • 6 million premature deaths/year worldwide could be prevented if people consumed 6 servings of fruits and vegetables a day, and…
  • 8 million premature deaths/year worldwide could be prevented if people consumed 10 servings of fruits and vegetables a day.

What Does This Mean For You?

When the USDA rolled out the “Food Guide Pyramid” in 1992, they recommended 2-4 servings of fruit and 3-5 servings of vegetables a day. They tried educating the American public for almost a decade to no avail. Only 3% of Americans even came close to that recommendation.

In 2011 they threw in the towel and introduced “My Plate”, which recommended 5 servings (2 fruits and 3 vegetables). This is also the current recommendation of the WHO and England. “How well are we doing with this recommendation?”, you might ask.

good news bad newsThe answer is “not very well.”  The bad news is the CDC estimates that less than 13% of Americans eat 2 servings of fruit and 2-3 servings of vegetables a day. An average American eats one serving of fruit a day and less than 2 servings of vegetables a day. Clearly, we have a long way to go.

My guess is that only vegans come close to the recommended 10 servings a day, and that’s only if they skimp on beans, nuts, and grains so they can load up on fruits and vegetables.

The good news is every added serving of fruits and vegetables is beneficial. The authors of the study estimate that for every increase of 2.5 servings a day:

  • Heart disease would be reduced by 8%
  • Stroke would be reduced by 13%
  • Cancer would be reduced by 3%.
  • Premature death would be reduced by 10%

If we were to increase our intake of fruits and vegetables to even 6 servings a day:

  • Heart disease would be reduced by 16%
  • Stroke would be reduced by 22%
  • Cancer would be reduced by 13%.
  • Premature death would be reduced by 27%.

What About Supplementation?

The authors of the study stated: “Most likely it is the whole package of beneficial nutrients you obtain by eating fruits and vegetables that is crucial to health. This is why it is important to eat whole plant foods to get the benefit, instead of taking antioxidant or vitamin supplements…”

I agree in principle. It is impossible to duplicate the myriad of nutrients found in whole foods in a supplement. More importantly, we can do better. We should all work towards increasing the amount of fruits and vegetables in our diet.

However,

  • When there is such a huge gap between what Americans are eating and the optimal intake of fruits and vegetables, and…
  • The USDA has tried for decades to get Americans to eat more fruits and vegetables without success, and…
  • We know many of the beneficial nutrients found in those fruits and vegetables…

Supplementation also makes sense. Choose a company that you can trust and try to fill the gap between what you need and what you are getting from your diet.  And, increase your intake of fruits and vegetables to decrease your risk of premature death.

 

The Bottom Line

 

  • A new meta-analysis that combined the data from 142 published clinical studies with over 2.1 million subjects has concluded that increasing our intake of fruits and vegetables to 10 servings a day would:
    • Reduce heart disease (primarily heart attacks) by 24%.
    • Reduce strokes by 33%.
    • Reduce cancer by 14%.
    • Reduce premature death by 31% (That would add approximately 3.4 years of disease-free years to your lifespan).
    • Result in 7.8 million fewer premature deaths/year worldwide.
  • The bad news is that:
    • The CDC estimates that less than 13% of Americans eat even 2 servings of fruit and 2-3 servings of vegetables a day.
    • The CDC also estimates that the average American eats one serving of fruit and less than 2 servings of vegetables per day.
  • My guess is that only vegans come close to the recommended 10 servings a day, and that’s only if they skimp on beans, nuts, and grains so they can load up on fruits and vegetables.
  • The good news is every added serving of fruits and vegetables is beneficial. The authors of the study estimate that for every increase of 2.5 servings a day:
    • Heart disease would be reduced by 8%
    • Stroke would be reduced by 13%
    • Cancer would be reduced by 3%.
    • Premature death would be reduced by 10%
  • We can do better. We should all work towards increasing the amount of fruits and vegetables in our diet.
  • However,
    • When there is such a huge gap between what Americans are eating and the optimal intake of fruits and vegetables, and…
    • The USDA has tried for decades to get Americans to eat more fruits and vegetables without success, and…
    • We know many of the beneficial nutrients found in those fruits and vegetables…
  • Supplementation also makes sense. Choose a company that you can trust and try to fill the gap between what you need and what you are getting from your diet.

 

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

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Is Our Microbiome Affected By Exercise?

Posted November 6, 2018 by Dr. Steve Chaney

Microbiome Mysteries

Author: Dr. Stephen Chaney

is our microbiome affected by exerciseIn a recent post,  What is Your Microbiome and Why is it Important,  of “Health Tips From The Professor” I outlined how our microbiome, especially the bacteria that reside in our intestine, influences our health. That influence can be either good or bad depending on which species of bacteria populate our gut. I also discussed how the species of bacteria that populate our gut are influenced by what we eat and, in turn, influence how the foods we eat are metabolized.

I shared that there is an association between obesity and the species of bacteria that inhabit our gut. At present, this is a “chicken and egg” conundrum. We don’t know whether obesity influences the species of bacteria that inhabit our gut, or whether certain species of gut bacteria cause us to become obese.

Previous studies have shown that there is also an association between exercise and the species of bacteria that inhabit our gut. In particular, exercise is associated with an increase in bacteria that metabolize fiber in our diets to short chain fatty acids such as butyrate. That is potentially important because butyrate is a primary food source for intestinal mucosal cells (the cells that line the intestine). Butyrate helps those cells maintain the integrity of the gut barrier (which helps prevent things like leaky gut syndrome). It also has an anti-inflammatory effect on the immune cells that reside in the gut.

However, associations don’t prove cause and effect. We don’t know whether the differences in gut bacteria were caused by differences in diet or leanness in populations who exercised regularly and those who did not. This is what the present study (JM Allen et al, Medicine & Science In Sports & Exercise, 50: 747-757, 2018 ) was designed to clarify.  Is our microbiome affected by exercise?

 

How Was The Study Designed?

is our microbiome affected by exercise studyThis study was performed at the University of Illinois. Thirty-two previously sedentary subjects (average age = 28) were recruited for the study. Twenty of them were women and 12 were men. Prior to starting the study, the participants filled out a 7-day dietary record. They were asked to follow the same diet throughout the 12-week study. In addition, a dietitian designed a 3-day food menu based on their 7-day recall for the participants to follow prior to each fecal collection to determine species of gut bacteria.

The study included a two-week baseline when their baseline gut bacteria population was measured, and participants were tested for fitness. This was followed by a 6-week exercise intervention consisting of three supervised 30 to 60-minute moderate to vigorous exercise sessions per week. The exercise was adapted to the participant’s initial fitness level, and both the intensity and duration of exercise increased over the 6-week exercise intervention. Following the exercise intervention, all participants were instructed to maintain their diet and refrain from exercise for another 6 weeks. This was referred to as the “washout period.”

VO2max (a measure of fitness) was determined at baseline and at the end of the exercise intervention. Stool samples for determination of gut bacteria and concentrations of short-chain fatty acids were taken at baseline, at the end of the exercise intervention, and again after the washout period.

In short, this study divided participants into lean and obese categories and held diet constant. The only variable was the exercise component.

 

Is Our Microbiome Affected By Exercise?

is our microbiome affected by exercise fitnessThe results of the study were as follows:

  • Fitness, as assessed by VO2max, increased for all the participants, and the increase in fitness was comparable for both lean and obese subjects.
  • Exercise induced a change in the population of gut bacteria, and the change was comparable in lean and obese subjects.
  • Exercise increased fecal concentrations of butyrate and other short-chain fatty acids in the lean subjects, but not in obese subjects.
  • The exercise-induced changes in gut bacteria and short-chain fatty acid production were largely reversed once exercise training ceased.

The authors concluded: “These findings suggest that exercise training induces compositional and functional changes in the human gut microbiota that are dependent on obesity status, independent of diet, and contingent on the sustainment of exercise.” [Note: To be clear, the exercise-induced changes in both gut bacteria and short-chain fatty acid production were independent of diet and contingent on the sustainment of exercise. However, only the production of short-chain fatty acids was dependent on obesity status.]

 

What Does This Study Mean For You?

is our microbiome affected by exercise gut bacteriaThere are two important take home lessons from this study.

  • With respect to our gut bacteria, I have consistently told you that microbiome research is an emerging science. This is a small study, so you should regard it as the beginning of our understanding of the effect of exercise on our microbiome rather than conclusive by itself. It is consistent with previous studies showing an association between exercise and a potentially beneficial shift in the population of gut bacteria.

The strength of the study is that it shows that exercise-induced changes in beneficial gut bacteria are probably independent of diet. However, it is the first study to look at the interaction between obesity, exercise and gut bacteria, so I would interpret those results with caution until they have been replicated in subsequent studies.

  • With respect to exercise, this may be yet another reason to add regular physical activity to your healthy lifestyle program. We already know that exercise is important for cardiovascular health. We also know that exercise increases lean muscle mass which increases metabolic rate and helps prevent obesity. There is also excellent evidence that exercise improves mood and helps prevent cognitive decline as we age.

Exercise is also associated with decreased risk of colon cancer and irritable bowel disease. This effect of exercise has not received much attention because the mechanism of this effect is unclear. This study shows that exercise increases the fecal concentrations of butyrate and other short-chain fatty acids. Perhaps, this provides the mechanism for the interaction between exercise and intestinal health.

 

The Bottom Line

A recent study has reported that:

  • Exercise induces a change in the population of gut bacteria, and the change was comparable in lean and obese subjects.
  • Exercise causes an increase in the number of gut bacteria that produce butyrate and other short-chain fatty acids that are beneficial for gut health.
  • These effects are independent of diet, but do not appear to be independent of obesity because they were seen in lean subjects but not in obese subjects.
  • The exercise-induced changes in gut bacteria and short-chain fatty acid production are largely reversed once exercise training ceases.

The authors concluded: “These findings suggest that exercise training induces compositional and functional changes in the human gut microbiota that are dependent on obesity status, independent on diet, and contingent on the sustainment of exercise.”

For more details and my interpretation of the data, 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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