Dr. Steve Chaney

Are Omega-3s Needed For Strong Bones?

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Why Are Omega-3s Needed For Strong Bones?

Author: Dr. Stephen Chaney

fish and fish oilOsteoporosis is one of the dreaded diseases associated with aging.

  • Over 50% of women and 25% of men will develop osteoporosis in their lifetime.

And the risk of osteoporosis is highest for Caucasians.

  • Over 40% of white women and 13% of white men will develop an osteoporotic fracture in their lifetime.

And osteoporotic fractures can be deadly. Bone fractures increase the risk of death 3-5-fold within the next few months. Moreover, the quality of life is diminished, and the risk of death is elevated for years after the fracture occurs.

So, if you are like many people, you are doing all you can to keep your bones strong so you will minimize your chances of developing osteoporosis. You probably even have a check list:

  • Resistance exercise (strengthens the bones you pull on)……Check
  • Walking (strengthens hip and leg bones)………………………Check
  • Adequate calcium & vitamin D (essential for strong bones)…Check
  • Magnesium & vitamin K (also important for strong bones)…..Check
  • Adequate protein (Muscle pulling on bone strengthens it)…..Check
  • Adequate omega-3s………………………………………………What!!!

You probably didn’t know about omega-3s. But recent research suggests they may also play a role in building strong bones and preventing osteoporosis. For example, studies show that omega-3s may influence bone metabolism by:

  • Enhancing absorption of calcium from the intestine.
  • Reducing the rate at which bone is broken down.
  • Increasing the rate at which new bone is built.

But large-scale population studies showing that omega-3 intake influences the risk of developing osteoporosis are lacking. The study ( Z Liu et al, Frontiers In Nutrition, 11: 1467559, 2023) I am discussing today was designed to fill that gap.

But before I describe the study, I should give you a quick review of bone metabolism.

Biochemistry 101: Bone Metabolism

bone metabolism osteoporosisTo truly understand osteoporosis and how to prevent it, you need to know a bit about bone metabolism. We tend to think of our bones as solid and unchanging, much like the steel girders supporting an office building. Nothing could be further from the truth. Our bones are dynamic organs that are in constant change throughout our lives.

Cells called osteoclasts constantly break down old bone (a process called resorption), and cells called osteoblasts replace it with new bone (a process called accretion). Without this constant renewal process our bones would quickly become old and brittle.

In short, our bones are not inert. They are in constant flux. If we exercise regularly and get enough calcium, vitamin D, magnesium, and vitamin K from our diet, bone metabolism looks like this as we age.

  • When we are young, osteoblast activity predominates, so accretion (the bone building process) exceeds bone resorption, and our bones grow in size and density.
  • When we are adults, osteoblast and osteoclast activity are in balance. Thus, bone accretion and resorption are in balance, and our bone density stays constant. The top portion of the picture above depicts what happens when osteoclast and osteoblast activity are in balance.
  • However, as we age osteoclast activity predominates, and we start to lose bone density. Eventually our bones look like Swiss cheese and break very easily. This is called osteoporosis. The bottom portion of the picture depicts this.

We should also think of our bones as calcium reservoirs.  We need calcium in our bloodstream 24 hours a day for our muscles, brain, and nerves to function properly, but we only get calcium in our diet at discrete intervals. Consequently:

  • When we eat our body tries to store as much calcium as possible in our bones.
  • Between meals, we break down bone material so that we can release the calcium into our bloodstream that our muscle, brain & nerves need to function.

If we lead a “bone healthy” lifestyle, all of this works perfectly. We build strong bones during our growing years, maintain healthy bones during our adult years, and only lose bone density slowly as we age – maybe never experiencing osteoporosis. We always accumulate enough calcium in our bones during meals to provide for the rest of our body between meals.

I should note that this is the current paradigm for bone metabolism. The study I am discussing today is asking whether omega-3 fatty acids should also be considered as part of a bone-healthy lifestyle.

How Was This Study Done?

clinical studyThe investigators used data from NHANES (National Health And Nutrition Examination Survey), an ongoing study to assess the health and nutritional status of adults and children in the United States. Specifically, this study combined data from participants from the 2005-2010, 2013-2014, and 2017-2018 NHANES surveys.

The participants included in the survey:

  • Were greater than 50 years old.
  • Had completed two 24-hour dietary recall surveys to determine the omega-3 content of their diet (The average omega-3 intake of the two surveys was used for this study).
  • Had a bone mineral density (BMD) test performed using dual-energy X-ray absorptiometry (DXA) scans.

Participants were excluded from the study if they had incomplete diet or bone mineral density data or if they had a disease that affects bone metabolism.

A total of 8,889 participants were included in the study. They were divided into 3 categories based on their bone density:

  • Normal bone density (4,421 participants)
  • Osteopenia (3,952 participants)
  • Osteoporosis (516 participants)

Finally, the participants were divided into quartiles based on their omega-3 intake, and omega-3 intake was correlated with bone density.

Are Omega-3s Needed For Strong Bones?

Healthy BoneThe study results were as follows:

  • Omega-3 intake was inversely related to bone density. Simply put, that means:
    • The highest intake of omega-3s was observed in the group with normal bone density, and…
    • The lowest omega-3 intake was observed in the osteoporosis group.

When the participants were divided into quartiles based on their omega-3 intake:

  • Participants with the highest omega-3 intake were 29% less likely to develop osteoporosis than participants with the lowest omega-3 intake.

When the investigators looked at subgroups, they found stronger effects of omega-3s on osteoporosis risk for women, people under 60, and non-smokers. Specifically:

  • Women with the highest omega-3 intake were 35% less likely to develop osteoporosis.
  • People under 60 were 49% less likely to develop osteoporosis.
  • Non-smokers were 36% less likely to develop osteoporosis.

The investigators concluded, “This study demonstrates a significant inverse relationship between dietary omega-3 fatty acid intake and osteoporosis risk, suggesting omega-3s play a crucial role in bone health. However, further longitudinal studies are needed to confirm these studies and refine dietary recommendations for osteoporosis prevention.”

Why Are Omega-3s Needed For Strong Bones?

QuestionsYou are probably thinking,

  • “Calcium and magnesium are part of bone structure. Vitamin D and vitamin K facilitate the incorporation of calcium into bone. So, it is logical that these nutrients would be important for strong bones.”
  • “But what role do omega-3s play? They aren’t incorporated into bone, and they don’t affect calcium metabolism.”

Here is what the authors said about that:

  • Omega-3s are anti-inflammatory. They decrease production of the pro-inflammatory cytokines that stimulate osteoclasts – the cells that break down bone.
  • EPA and DHA are also converted to prostaglandins that stimulate osteoblasts – the cells that build new bone.
  • Finally, the authors said, “Omega-3 fatty acids, especially EPA and DHA, have been shown to enhance calcium absorption in the gut – a process crucial for maintaining optimal bone mineral density…Omega-3s …do this by altering the lipid composition of cell membranes, thereby affecting calcium channels and enhancing calcium availability for bone tissue.”

Let me help you understand that statement.

  • While we might think of our cell membranes as rigid structures, they are quite fluid. The closest analogy I can think of is a large lake. You may not see any waves or ripples, but if a leaf drops on the surface it doesn’t stay in one place. It moves. We can think of calcium channels in our membrane like leaves on the water. They move across the cell membrane.
  • How fast they move depends on the fluidity of the cell membrane. This is determined by the lipids (fats) in the cell membrane, which in turn is determined by the fats in our diet. This is the one case where it is literally true that we are what we eat.
    • When we have lots of saturated fats in our cell membranes, fluidity is low, and calcium channels move slowly across the membrane.
    • When we have omega-3 fats in our cell membrane, fluidity is high, and calcium channels move quickly across the cell membrane.
  • Calcium channels work best when they cluster together, and this works best with highly fluid, omega-3-rich cell membranes.

What Does This Mean For You?

Question MarkThis study strongly suggests that omega-3s play a role in bone health, and they may be important for reducing our risk of osteoporosis. The authors concluded, “The findings suggest that omega-3 fatty acids play a critical role in bone health, supporting the need for dietary recommendations that encourage omega-3 consumption as a preventative measure against osteoporosis.”

However, this is the first study of its kind, which is why the authors said, “Further longitudinal studies are needed to confirm these findings.”

However, my biggest concern with the study is that it did not include information on the intake of the other nutrients essential for bone health (calcium, vitamin D, magnesium, and vitamin K). We don’t know at present the importance of omega-3s for preventing osteoporosis relative to dietary intake of other bone-healthy nutrients. For example:

  • Are omega-3s important for bone health when intake of calcium and/or the other bone-healthy nutrients are low?
  • Or are omega-3s equally important for bone health under all conditions?

However, the good news is that omega-3s have many proven health benefits such as heart health, controlling blood pressure, and reducing inflammation. If they are also important for bone health, we can consider it an unexpected benefit.

With that in mind, there are two important takeaways for you:

  • Omega-3s were most effective at preventing osteoporosis in people under 60. That is entirely consistent with what we know about preventing osteoporosis. The best prevention strategy is to build strong bones while you are young and maintain strong bones as long as possible in your adult years.
  • The optimal reduction of osteoporosis risk in this study was seen with an omega-3 intake of 1.86 g/d. While more studies are needed to define the optimal dose of omega-3s for reducing osteoporosis risk, this dose is within the “sweet spot” for the other omega-3 benefits I mentioned.

The Bottom Line 

A recent study asked whether omega-3 fatty acids reduce the risk of osteoporosis.

The study found:

  • Omega-3 intake was inversely related to bone density.
  • When the participants were divided into quartiles based on their omega-3 intake:
  • Participants with the highest omega-3 intake were 29% less likely to develop osteoporosis than participants with the lowest omega-3 intake.
  • When the investigators looked at subgroups, they found stronger effects of omega-3s on osteoporosis risk for women, people under 60, and non-smokers.

The investigators concluded, “This study demonstrates a significant inverse relationship between dietary omega-3 fatty acid intake and osteoporosis risk, suggesting omega-3s play a crucial role in bone health. This supports the need for dietary recommendations that encourage omega-3 consumption as a preventative measure against osteoporosis.”

For more information on this study, why omega-3s reduce osteoporosis risk, and what this study means for you, 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.

 _____________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”. Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading Biochemistry textbooks for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

The Alcohol Myth

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How Were We Led Astray?

Author: Dr. Stephen Chaney 

You have probably heard that moderate alcohol consumption is healthier than complete abstinence from alcohol. It is certainly a popular viewpoint.

It is also a scientific paradigm. By that I mean:

  • It is supported by multiple clinical studies.
  • Elaborate metabolic explanations have been proposed to support this paradigm.
  • It is the official position of most medical societies, scientific organizations, and health information sites on the web.
  • It is the recommendation of most health professionals.
  • It has been repeated so often from so many trusted sources that everyone assumes it must be true.

But is it a myth? You may have been surprised when you saw recent headlines saying, “Having an alcoholic drink or two per day is not healthier than abstaining.”

Today I will review the study (J Zhao et al, JAMA Network Open, 6(3): e236185, 2023) behind the headlines and tell you what it means for you.

But first, I want to explain to you how the scientific method works. That’s because this study is a perfect example of the scientific method in action.

How Were We Led Astray?

I have described the scientific method in detail in my books “Slaying The Food Myths” and “Slaying The Supplement Myths”, which you will find here.

Today, I will just give you a brief synopsis of the scientific method.

1) Most scientific studies are designed to disprove existing scientific paradigms. This is such a study.

  • In the scientific world, there is no glory in being the 10th person to prove that a scientific paradigm is correct. The glory comes from being the first person to disprove a scientific paradigm and create a new paradigm in the process.
  • This constant testing of existing paradigms is one of the most important strengths of the scientific method.

2) There is no perfect study. Every study has its flaws.

  • “Confounding variables” are flaws that can be the Achilles Heel of any association study.

Now let me explain the significance of these statements in the context of the current study:

  • All the studies supporting the current paradigm were association studies. Association studies measure the association between a selected variable and an outcome. For these studies, the selected variable was alcohol consumption, and the outcome was increased mortality.
    • Association studies try to statistically correct for other variables known to affect the outcome. For example, diseases like heart disease, diabetes, and cancer increase the risk of premature death. These are known variables that would be corrected for in any well-designed study of alcohol consumption and mortality.
    • “Confounding variables” are unknown variables that also affect the outcome of the study. But since they are unknown, they are not corrected for.

Let me give you a simplistic example of a confounding variable. Let’s say you were doing a study of dietary habits, and you found an association between ice cream consumption and mortality. You might conclude that ice cream consumption is bad for you. It increases your risk of dying.

But then you might remember that ice cream consumption increases during the summer. And then you might reason that people swim more during the summer, and there is a correlation between swimming and drowning deaths.

Swimming could be a confounding variable. To make sure that your initial conclusion that ice cream increases the risk of dying was correct, you would need to correct your data for swimming deaths during the summer and see if you still found a correlation between ice cream consumption and mortality.

Could The Current Paradigm Be Incorrect?

SkepticYou might be thinking, “What does this have to do with studies on the correlation between alcohol consumption and increased mortality?” Let me explain.

The baseline group for these comparisons was the abstainers – the group consuming no alcohol. Previous studies have compared the mortality risk associated with various amounts of alcohol consumption with the mortality risk of the abstainer group. This sounds like a reasonable approach.

But the investigators challenging the current paradigm noted that the “abstainer group” in previous studies included both lifetime abstainers and former drinkers who had become abstainers. They hypothesized that the “former drinkers” group may have become abstainers because of health issues related to excess alcohol consumption.

In short, they hypothesized that the “former drinkers” group was a confounding variable that biased the results of the previous studies. They hypothesized that the “lifetime abstainers” group was a more appropriate baseline group for this kind of study. They then set out to prove their hypothesis.

How Was This Study Done?

clinical studyThe investigators searched the literature and found 107 studies with 4.8 million participants published between 1980 and July 21, 2021, that:

  • Assessed the correlation between alcohol consumption and mortality.
  • Had data that allowed the investigators to separate lifetime abstainers from former drinkers who had become abstainers.

The investigators divided alcohol consumption into low, moderate, high, and very high categories based on the ounces of alcohol consumed per day. Since ounces of alcohol is not an easy measure for most of us, I have converted ounces/day to drinks/day based on the CDC definition of a drink (a 12-ounce beer, 5-ounce glass of wine, or 1.5 ounces of a distilled spirit like gin or vodka). And to make it even simpler, I have rounded to the nearest whole number. With that said, here are the classifications.

  • Low alcohol intake = 1-2 drinks/day.
  • Moderate alcohol intake = 2-3 drinks/day.
  • High alcohol intake = 3-4 drinks/day.
  • Very high alcohol intake = >4 drinks/day.

The risk of death associated with each of these intake levels was compared the risk of death of their preferred baseline group, the “lifetime abstainers”.

Finally, the data were corrected for other variables known to influence the correlation between alcohol consumption and mortality, namely age, sex, heart health, social status, race, diet, exercise, BMI, and smoking status. [These are known confounding variables and had been adjusted for in most previous studies.]

The Alcohol Myth

Red WineWhen the investigators compared the mortality risk of former drinkers who had become abstainers with lifetime abstainers:

  • The former drinkers were 31% more likely to die, and this difference was highly significant.
  • This is consistent with their hypothesis that the “former drinkers” group was a confounding variable that may have biased the conclusions of previous studies.

When they compared the mortality risk of various levels of alcohol consumption with lifetime abstainers instead of all abstainers, they found:

  • The risk of mortality associated with low (1-2 drinks/day) and moderate (2-3 drinks/day) alcohol intake was statistically identical to the risk of mortality for lifetime abstainers.
  • The high alcohol intake group (3-4 drinks/day) was 24% more likely to die than the lifetime abstainers.
  • The very high alcohol intake group (>4 drinks/day) was 39% more likely to die than the lifetime abstainers.

In short, when lifetime abstainers were used as the baseline group, low to moderate alcohol intake did not reduce the risk of dying, as previous studies had suggested. This study suggests the idea that low to moderate alcohol consumption is good for us may not be accurate. It may be a myth.

Finally, there was a significant gender difference in the effect of alcohol consumption on mortality.

For women:

  • Even moderate alcohol consumption was associated with an increased risk of mortality. Only low alcohol consumption posed no increase in mortality.
  • The increased risk of mortality for women was significantly higher than for men with every level of alcohol consumption.

The authors concluded, “In this…meta-analysis, daily low or moderate alcohol intake was not significantly associated with all-cause mortality risk, while increased risk was evident at higher consumption levels, starting at lower levels for women than for men.”

Of course, this isn’t the end of the story. The scientific method will continue. Old paradigms don’t die easily. Other investigators will challenge the conclusions of this study. Stay tuned. I will give you updates as future studies are published.

What Does This Study Mean For You?

QuestionsIf you like to imbibe, there are two important takeaways from this study.

The bad news is that you can no longer claim that a drink or two a day is healthier than total abstinence from alcohol.

The good news is that this and every study preceding it have found that a drink or two a day is no less healthy than total abstinence. The studies found no increase in mortality associated with low to moderate alcohol intake.

[However, low to moderate alcohol intake may increase your risk of specific diseases. For example, many studies suggest that even low alcohol intake is associated with an increased risk of breast cancer.]

This study also agrees with previous studies that high alcohol intake increases your risk of death, and women are more susceptible to adverse effects of alcohol intake than men.

So, while this study challenges the existing paradigm that low to moderate alcohol intake is beneficial, it does not change the current recommendations on alcohol intake by most health organizations.

For example, the current CDC guidelines are:

  • Adults of legal drinking age should limit alcohol intake to 2 drinks or less per day for men and one drink or less per day for women.
  • Adults who do not drink alcohol should not start. [The current study strengthens this recommendation because it takes away the excuse that low to moderate alcohol consumption is healthier than abstinence.]
  • Drinking less is better than drinking more.

The CDC guidelines also note that the risk of some cancers increases even at very low levels of alcohol consumption.

Finally, the CDC recommends that some people never consume alcohol, including:

  • Women who are pregnant or might become pregnant.
  • Anyone younger than 21.
  • Anyone with medical conditions or medications that interact with alcohol.
  • Anyone recovering from an alcohol use disorder or who has trouble controlling the amount they drink.

The Bottom Line 

A recent study is a perfect example of the scientific method in action. Scientists are constantly challenging the existing scientific paradigms, and this is an important strength of the scientific method.

A group of scientists recently published a study challenging the paradigm that low to moderate alcohol intake is healthier than total abstinence from alcohol.

They hypothesized that previous studies supporting this paradigm had a common methodological flaw, corrected for the flaw, and reanalyzed the data from 104 studies with a total of 4.8 million participants.

The revised data showed no health benefit of low to moderate alcohol consumption compared to total abstinence. When you look at the data more closely, the current paradigm may be a myth.

  • This is a major change to the existing paradigm because it removes the justification for low to moderate alcohol consumption.

However, the revised data did not differ from previous studies in the following ways:

  • There is no health risk associated with low to moderate alcohol intake compared to total abstinence.
  • High alcohol intake (>3 drinks/day) is associated with increased mortality.
  • Women are more sensitive to the adverse effects of alcohol than men.

So, this study does not change current guidelines for alcohol consumption.

For more information on this study, what it means for you, and the CDC guidelines on alcohol consumption 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.

______________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”. Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading Biochemistry textbooks for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

The Methyl B12 Myths

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How Is The Vitamin B12 For Supplements Produced?

Author: Dr. Stephen Chaney

Vitamin B12Vitamin B12 (also called cobalamin) is a complex molecule whose structure is shown on the left. It has a cobalt atom in its center which is essential for its functioning (more about that in a minute).

It was first discovered in 1947 and shown to be an essential nutrient for humans in 1948. It has been used in nutritional supplements since then.

The deficiency of vitamin B12 leads to a disease called pernicious anemia.

  • The initial symptoms are like other forms of anemia, namely:
    • Fatigue and weakness.
    • Pale skin.
    • Low red blood cell count.
  • If the deficiency persists long enough, neurological symptoms also appear including:
    • Numbness and tingling in hands and feet.
    • Lack of fine motor skills.
    • Difficulty maintaining balance and coordination.
    • Cognitive issues and mood changes.

Vitamin B12 is found naturally in animal foods such as meat (liver is a particularly good source), fish, poultry, eggs, and dairy.

Vitamin B12 deficiency is most frequently observed in vegetarians (Plant foods contain no vitamin B12) and the elderly (As we age, we tend to lose a protein called intrinsic factor in our intestine that is important for vitamin B12 absorption).

In our bodies, vitamin B12 occurs in two forms, methylcobalamin (popularly referred to as methyl B12) and adenosylcobalamin.

  • Adenosylcobalamin is important for energy production, especially the generation of energy from protein and fat.
  • Methylcobalamin is important for nerve function, DNA and RNA synthesis, and gene regulation among other things.
  • Both adenosylcobalamin and methylcobalamin are required to produce red blood cells.

How Is The Vitamin B12 For Supplements Produced? 

bacteriaWhile it is theoretically possible to extract enough vitamin B12 for a B12 supplement from B12-rich foods such as liver, the extraction process is complex and inefficient. If a supplement company claims their methyl B12 supplement comes from food, they are probably lying to you.

And the structure of vitamin B12 is so complex it is almost impossible to synthesize chemically.

For years most of the vitamin B12 (cobalamin) for supplements has been generated by growing certain B12-producing bacteria and related organisms in large vats and purifying the vitamin B12 they produce. However, these bacteria were inefficient at incorporating cobalt into the cobalamin they made resulting in an excess of cobalt in the growth medium. Since large amounts of cobalt can be toxic, the remaining liquid had to be treated as a hazardous material and disposed of properly.

Recently this problem has been solved by genetically engineering the bacteria, so they are more efficient at utilizing cobalt. This is fast becoming the method of choice for making vitamin B12 for supplements.

In either case, the cobalamin is usually precipitated out of the growth medium as cyanocobalamin crystals and the crystals washed to remove impurities. Cyanocobalamin has been the primary source of vitamin B12 in supplements for the past 77 years (since 1948).

The methylcobalamin in most methyl B12 supplements is produced by reducing cyanocobalamin with sodium borohydride followed by the addition of methyl iodide or by directly adding methyl iodide to the bacterial cultures and using an alternate purification process.

The Methyl B12 Myths

Myth Versus FactsSome supplement manufacturers are now claiming that methyl B12 (methylcobalamin) is more natural and more effective than the cyanocobalamin that has been used in supplements for the past 77 years. Let’s look at the myths propagated by methyl B12 supplement manufacturers and compare them to the facts.

 

Myth: Methyl B12 (methylcobalamin) is more natural than cyanocobalamin. We get the methyl B12 in our supplements from foods.

Fact: As I said above, it would be impossible to extract enough methylcobalamin from foods, so this claim is false.

Some of the methylcobalamin in supplements is chemically synthesized from cyanocobalamin. It can never be more natural than its starting ingredients.

However, in today’s world both cyanocobalamin and methylcobalamin are most likely to be made by chemically altering the cobalamin produced by genetically modified bacteria. In one case a cyano group is added. In the other case a methyl group is added.

 

Myth: Cyanocobalamin is toxic.

Fact: You get much more cyanide from common foods such as almonds, lima beans, any fruit with a pit such as peaches, and even some fruits with seeds, such as apples. For example, a single almond contains 200 times more cyanide than a supplement providing the RDA of cyanocobalamin.

Does that mean you need to avoid almonds and other cyanide-containing foods? The answer is no. God has designed our bodies to thrive on the natural foods He created for us. We have an enzyme called rhodanese in our mitochondria that can convert the small amounts of cyanide found naturally in foods to thiocyanate. And thiocyanate can be harmlessly excreted in the urine.

In short, we can eat almonds safely and we can take cyanocobalamin supplements safely. Our bodies are designed to handle them.

 

Myth: Because methylcobalamin is one of the active forms of B12 inside cells (adenosylcobalamin is the other), it is better utilized by cells than cyanocobalamin.

Fact: Cyanocobalamin and methylcobalamin are equally well absorbed by the intestine and equally well transported to our cells. At the cell membrane, the cyano and methyl groups are stripped off and cobalamin (B12) binds to a transport protein called transcobalamin II. Once inside the cell either a methyl group or adenosyl group is added back to cobalamin.

In short, methylcobalamin offers no advantage over cyanocobalamin because its methyl group is removed before it enters our cells. Once the methyl and cyano groups have been removed, the cell has no way of knowing whether B12 started out in the methyl or cyano form.

 

Myth: Methylcobalamin is better utilized than cyanocobalamin for people with methylation defects.

Fact: A methylation defect would only affect methylation of cobalamin once it is released from transcobalamin II inside the cell. Once again, because the methyl and cyano groups are removed before cobalamin binds to transcobalamin II, methylcobalamin offers no advantage over cyanocobalamin.

What Does This Mean For You?

questionsThe claims that everyone would benefit from methylcobalamin (methyl B12) instead of cyanocobalamin is outrageous. Anyone who takes the time to research how B12 enters our cells would realize that the claim is biochemically impossible.

In short, cyanocobalamin has been used for 77 years. There are hundreds of clinical studies showing it is safe and effective, even in individuals with a MTHFR deficiency. I can’t tell you whether the companies selling methyl B12 are ignorant of basic metabolism and the published studies refuting their claims or whether they are purposely trying to deceive the public—but neither is a good thing.

The Bottom Line

Some supplement manufacturers are now claiming that methyl B12 (methylcobalamin) is more natural and more effective than the cyanocobalamin that has been used in supplements for the past 77 years. In this issue of “Health Tips From the Professor” I debunk the methyl B12 myths used by the supplement manufacturers to sell their methyl B12 products.

I can’t tell you whether the companies selling methyl B12 are ignorant of basic metabolism and the published studies refuting their claims or whether they are purposely trying to deceive the public—but neither is a good thing.

For more specifics, 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.

______________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

 _______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

Do Artificial Food Colors Cause ADHD?

by

Is This Just The Tip Of The Iceberg?

Author: Dr. Stephen Chaney

Artificial colors are in the news again. And, unfortunately, what should solely be a health question has become political. Politics aside, most people fall into one of 3 camps:

  • Artificial colors are bad for us and should be removed from the food supply.
  • The fears about artificial colors are overblown.
  • What are artificial colors and why should I care?

Let me start with the third camp. Every nutrition expert worth their salt will tell you that whole, unprocessed foods are best for us. The problem is that they have a low profit margin.

The food industry makes most of their money from highly processed foods (50-60% profit from highly processed foods versus 8.5% for unprocessed foods).

And the market for highly processed foods is very competitive. Let me give you some metrics to help you understand just how competitive the market is:

  • In the average supermarket, unprocessed foods are located around the edge. The vast interior is mostly highly processed foods.
  • The most recent studies report that 60-70% of the foods Americans consume are highly processed.

With so much competition, the food industry needs to make their brand of processed foods stand out.

  • There are artificial preservatives to give processed foods long shelf life.
  • There are artificial flavors and flavor enhancers to make them taste yummy.
  • There are ingredients added to give them mouth appeal (how they feel in your mouth).
  • And finally, there are artificial colors (also known as synthetic food dyes) for eye appeal. Those are added to make them “pop” – to make them say “eat me”.

The seven most common food colors are Blue #1, Blue #2, Green #3, Red #3, Red #40, Yellow #5, and Yellow #6. They make processed foods look good.

But there are also health concerns associated with artificial food colors. The two most common are:

  • Cancer. Several studies have suggested that artificial food colors may increase the risk of cancer. However, because artificial food colors are added to foods of low nutritional value (candy, soft drinks, sugary cereals, etc.), it has been difficult to determine whether the increased cancer risk is due to the artificial colors or the foods they are found in.
  • ADHD. The studies are a bit stronger for this category. Because artificial colors can be hidden in chocolate cookies (when you mix all the colors together you get brown anyway), it has been possible to perform double-blind, placebo-controlled studies. And since both the food color and placebo groups are getting chocolate cookies, the only difference between the groups is whether the cookies contain artificial colors.

So, in today’s “Health Tips From the Professor” I will summarize what we know about artificial food colors and ADHD. But first, let’s start with a brief overview of ADHD.

A Brief Overview Of ADHD

adhd symptoms childrenWhat is ADHD? ADHD is a broad term that encompasses two types of behaviors.

  • The AD portion of ADHD stands for attention deficit.
    • Children with attention deficit have difficulty focusing and staying on task.
    • This can affect their learning in standard classroom settings. I underlined standard classroom settings for a reason, which I will come back to later.
  • The H portion of ADHD stands for hyperactivity.
    • Children with hyperactivity “bounce off walls” (I will define hyperactivity more precisely below.)
    • This can lead to problems at home, in the classroom, and in relationships.
  • Some children have both. If you are their parents, I can only say, “Lucky you”.
  • The final D stands for disorder, implying that these conditions are not normal.

The ADHD epidemic.

  • ADHD has increased by 89% in the United States in just 25 years (1997-2022).
  • In 2022 11.5% of US children aged 3-17 were diagnosed with ADHD. That’s 7.1 million children.

Some experts claim that’s because of better diagnosis. Let’s examine that claim.

How is ADHD diagnosed?

Child With ADHDThe American Psychiatric Society diagnoses attention deficit based on 3 or more of the following criteria:

  • Has problems staying focused.
  • Doesn’t pay attention to details.
  • Doesn’t seem to listen.
  • Doesn’t follow instructions.
  • Has problems organizing tasks.
  • Avoids sustained mental effort.
  • Is easily distracted.

For those of you who are parents or grandparents, I would simply ask, “Does any of this sound familiar? Doesn’t every child have some of these behaviors?”

 

The American Psychiatric Society diagnoses hyperactivity based on 3 or more of the following criteria:what causes adhd in kids

  • Fidgets, taps hands, squirms in seat.
  • Not able to stay seated.
  • Runs around where it is inappropriate.
  • Unable to play quietly.
  • Always “on the go”.
  • Talks too much.
  • Has difficulty waiting for their turn.
  • Interrupts or intrudes on others.

Again, for those of you who are parents or grandparents, I would simply ask, “Does any of this sound familiar?”

Even worse, the final diagnosis is based primarily on the subjective reporting of symptoms by teachers and parents. The psychiatric evaluation is done primarily to eliminate other mental or physical diseases as causes of the symptoms.

Is ADHD Overdiagnosed?

So. perhaps we should ask whether teachers and parents might be tempted to overestimate the severity of the symptoms.

For teachers,

  • Class sizes are large, and there aren’t enough teacher’s aides.
  • They don’t have the time to deal with a child that requires extra attention.
  • It is easier to request an ADHD assessment, so that child can be put on drugs.

But there are other options. There are schools in which children with ADHD thrive, and many public schools have programs set up for ADHD children.

For parents,

  • Parents don’t have the time they used to have to supervise their children.
    • In most cases, both parents are working.
    • Some are working from home. In theory that could give them flexibility to take care of their children. But remote work often involves online meetings and strict deadlines that leave little time for their children.
    • And then there is social media. In today’s world, many parents are glued to their phones 24/7.
  • It’s easier to request a hyperactivity assessment, so that child can be put on drugs.

Could the increase in ADHD diagnoses be real?

Most experts agree that the causes of ADHD are complex, with the top 4 causes being genetics, diet, family & social environment, and physical environment (environmental pollutants).

The simplest way to think about it is that genetics cocks the gun and one or more of the other causes pulls the trigger.

With that in mind, we need to ask ourselves, “Has diet, family and social environment, or our physical environment gotten worse over the past 25 years?” The answer is a clear yes for all three.

So, while part of the increase in ADHD could be due to overdiagnosis, part of it is likely to be real.

Why is the increase in ADHD diagnoses a concern?

drug side effectsThe answer is simple. The use of ADHD drugs has increased by 58% since 2012. Today over 50% of children diagnosed with ADHD are put on drugs. That’s a concern because:

  • Most of these drugs are stimulants.
  • Many are amphetamines.
  • They have serious side effects. For example:
    • Loss of appetite and weight loss.
    • Difficulty sleeping.
    • Upset stomach and nausea.
    • Feeling irritable, depressed, anxious, or tense.
  • Many children don’t like how the drugs make them feel.
  • They can be gateway drugs.
  • They lose effectiveness over time. So, unless you have figured out the cause of the problem, the symptoms will return.

Because of this many parents are searching for natural solutions. One approach is to change their child’s diet. In today’s “Health Tips From the Professor” I will discuss the effect of one dietary change – the removal of artificial food colors from the diet.

Do Artificial Food Colors Cause ADHD?

The idea that food additives – specifically artificial colors and preservatives – might be responsible for hyperactivity was first raised by Dr. Ben Feingold 50 years ago. He devised the Feingold Diet – a diet that was free of artificial food colors and preservatives.

Some small-scale clinical studies suggested that the diet might be successful, and millions of parents used the diet for their hyperactive children with great success.

But the medical authorities pooh-poohed the Feingold Diet. They pointed out that when parents are putting their child on a special diet, they are also giving that child more attention – and it might be the parent’s increased attention that decreased the child’s hyperactive behavior.

They also pointed out that when you eliminate food additives from the diet you are decreasing the “junk” food and increasing fresh fruits and vegetables – in short, the child’s diet is much healthier.

They did a double-blind, placebo-controlled study and reported only 5% of the children with an ADHD diagnosis benefited from removing artificial food colors and preservatives from the diet. They considered 5% to be an artifact – just random noise in the statistical analysis of the data. Headlines proclaimed, “The Feingold Diet doesn’t work.”

So eventually the Feingold Diet lost popularity – but the idea that artificial food colors & preservatives might trigger hyperactivity has refused to go away.

The first inkling that the Feingold hypothesis might hold some water came from studies looking at the 5% of children whose ADHD symptoms improved when artificial colors were removed. When these children were evaluated in a second double-blind, placebo-controlled study, over 85% of them showed improvement in symptoms when artificial food colors were removed from their diet.

In short, this told us that artificial food colors and preservatives do cause ADHD symptoms in some children. The percentage of children is small, but these children are true responders.

This has led to further studies designed to provide a better estimate of the percentage of children whose ADHD symptoms are triggered by artificial food colors.

In 2004 a meta-analysis of 15 double-blind, placebo-controlled studies (DW Schah et al, Journal of Developmental & Behavioral Pediatrics, 25: 423-434, 2004) estimated that 28% of children with ADHD benefited from removal of artificial colors from their diet.

A more recent meta-analysis (IT Nigg et al, Journal of the American Academy of Child and Adolescent Psychiatry, 51: 86-97, 2012) estimated that 8% of ADHD children benefited from removal of artificial food colors from their diet.

And a pilot study published three years ago (AE Kirkland et al, Nutritional Neuroscience, 25: 159-168, 2022) suggests the effect of artificial food colors on ADHD symptoms may not be limited to children. They found a similar effect of artificial food colors on college students with ADHD.

In summary, the current evidence suggests:

  • Artificial food colors (and other artificial ingredients) can trigger ADHD symptoms in both children and adults.
  • The percentage of children and adults with ADHD who will benefit from removing artificial food colors from their diet is small (5-28%) but reproducible.
  • If you or your child happen to be sensitive to artificial food colors, relief from ADHD symptoms could be as simple as eliminating artificial food colors from their diet.

Is This Just The Tip Of The Iceberg?

Earlier in this article I used the analogy that genetic predisposition to ADHD cocked the gun, but it was diet, family & social environment, and/or physical environment that pulled the trigger.

Then I summarized the evidence that artificial colors are one dietary component that “pulls the trigger” (causes ADHD) in sensitive individuals. But that leads to two questions:

  • Is that all there is, or is that just the “tip of the iceberg”?
  • Have there been other changes in our diet that might explain the rapid increase in ADHD cases?

Let’s examine the data:

  • In the 1970s when Dr. Feingold introduced his diet food additives were used sparingly.
    • Today over 50% of the foods in the American diet contain more than 3 food additives.
  • In the 1970s there were a few thousand food additives in the American food supply.
    • Today there are more than 10,000 additives, and less than 5% of them have been tested for their effects on brain development in children.
  • In the 1970s 10-15% of foods in the American diet were ultra-processed.
    • Today 60-70% of the foods Americans eat are ultra-processed.

In short, in 1975 Dr. Feingold showed that artificial food colors and a handful of other additives triggered ADHD symptoms in a small percentage of children. Today our children’s diets are far worse, and they are exposed to thousands of untested food additives that did not exist in the 1970s.

Is this a coincidence or is this deterioration in diet and explosion of food additives driving the ADHD epidemic. Nobody knows.

But Pediatrics Professor Dr. Herbert Needleman has been quoted as saying, “We are conducting a vast toxicologic experiment in our society, in which our children and our children’s children are the experimental subjects.”

What Does This Mean For You?

questionsIf you are the parent or grandparent of a child with ADHD, the simplest thing you can do is to remove foods with artificial colors and preservatives from their diet whenever possible. If the child is sensitive to food colors, that one simple change may reduce their symptoms dramatically.

But, as I said above, artificial food colors and preservatives may just be the tip of the iceberg. My recommendation is to switch to a whole, unprocessed food diet for the entire family. Everyone in the family will be healthier, and you will have an even better chance of reducing your child’s ADHD symptoms.

The Bottom Line 

ADHD cases are skyrocketing. Drugs work, but they have serious side effects. If you are the parent or grandparent of a child with ADHD, you may be searching for natural approaches to help that child control their ADHD symptoms. In this article, I discuss:

  • The causes of ADHD and how it is diagnosed.
  • Whether the rapid increase in ADHD cases is caused by overdiagnosis or the deterioration of our children’s diets.
  • The evidence that artificial food colors and preservatives trigger ADHD symptoms in sensitive children.
  • Other natural approaches that may reduce ADHD symptoms.

For more information on this topic and what it means for you, 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.

 ____________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

 _______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”. Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading Biochemistry textbooks for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

 

 

 

 

Increasing GLP-1 Levels Naturally

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What Is GLP-1 And What Does It Do?

Author: Dr. Stephen Chaney

I don’t need to tell you that GLP-1 (glucagon-like peptide 1) drugs are all the rage. Total spending on GLP-1 drugs in the United States exceeded $71 billion in 2023, a 500% increase in just 5 years. There are 15 million Americans on GLP-1 drugs at any one time. And most of this increase has been driven by the weight-loss market.

Let me be clear. These drugs work. For people with poorly controlled type 2 diabetes or severe obesity-related health issues, they can be a godsend. But like any “quick fix” weight loss drug they are overprescribed.

And when you have millions of people taking a drug, you need to take a serious look at side effects. The most frequent side effects are:

  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Increased heart rate.
  • Hypoglycemia
  • Allergic reactions

These are side effects that aren’t life threatening and are easily detected. When someone experiences these side effects, they usually give their doctor a call, and their doctor either takes them off the drug or modifies the dosage.

However, more recent studies have identified two additional side effects that are much more troubling.

  • The first is depression, anxiety, and suicidal thoughts.
    • These are symptoms that many patients may not associate with the drug, especially if they already have these tendencies.
    • And the consequences can be life threatening. There have already been reports of suicides of people on GLP-1 medications.
  • The second is loss of muscle mass.
    • This is a particular concern for seniors who struggle to maintain muscle mass as they age.
    • And this is a silent symptom. Most seniors don’t realize they are losing muscle mass until it significantly affects their quality of life.

And, of course, the biggest drawback of GLP-1 drugs is that they are only a temporary fix. Unless someone changes their lifestyle, the weight comes roaring back as soon as they quit using GLP-1.

So. It’s no wonder some people are asking whether it is possible to increase their GLP-1 levels naturally without the side effects associated with GLP-1 drugs. I will discuss this below, but first I should review what GLP-1 is and what it does.

What Is GLP-1 And What Does It Do? 

ProfessorLet me start by reviewing the hormones insulin and glucagon to create a proper perspective for understanding the role of GLP-1.

Insulin: Almost everyone has heard of insulin. It is released by the pancreas whenever we eat, and blood sugar levels start to rise. Its role is to lower blood sugar levels. It does this by:

  • Increasing glucose uptake by our cells. In the fed state almost all our cells use glucose as an energy source.
  • Converting any glucose in excess of immediate energy needs to storage forms.
    • In the muscle and liver, it is converted to a glucose polymer called glycogen. Our ability to create glycogen stores is limited.
    • In muscle it is also converted to amino acids, and it stimulates the use of those amino acids to make new protein. Our ability to increase muscle stores is also limited, but it can be increased by exercise.
    • In adipose tissue, it is converted to fat. As you may have noticed, our ability to create fat stores is unlimited. Even worse, when we become obese, fat starts accumulating in muscle and liver, which has severe health consequences.

Glucagon: Glucagon is less well known, but you can think of it as the Yin to insulin’s Yang. It is released by the pancreas when blood sugar levels fall and continues to be present until the next meal. Its role is to increase blood sugar levels and make sure that our cells get the food they need until the next meal.

Most tissues in our bodies switch to fat as an energy source in the fasting state. However, our red blood cells, kidney medulla, and brain continue to require glucose [Note: The brain can adapt to ketone bodies as an energy source after several days of glucose deprivation, but that’s another discussion for another time.] Glucagon supports our tissues by:

  • Signaling the liver to break down its glycogen stores and release glucose into the bloodstream. These stores are limited, but they can supply enough glucose to keep blood sugar levels constant for a few hours.
  • However, the brain uses lots of glucose, so the glycogen stores are rapidly depleted. When this happens, glucagon signals our muscles to break down muscle protein and convert the amino acids to glucose. We have enough muscle tissue to supply our brain with glucose for weeks. But we are using that muscle protein for other important things.
  • Finally, glucagon signals adipose tissue to break down its fat stores and release fat into the bloodstream to feed all our tissues that no longer depend on glucose.

GLP-1: GLP-1 stands for glucagon-like peptide 1. With a name like that, you might expect GLP-1 to have significant sequence homology with glucagon, bind to the same receptors, and have a similar effect on our metabolism. You would be wrong!

Both peptide hormones are derived from a much larger peptide called proglucagon. This is the only way that GLP-1 is “like” glucagon.

One portion of proglucagon is processed to give glucagon in pancreatic alpha cells. Another portion is processed to give GLP-1 in intestinal L cells. [L cells are endocrine (hormone producing cells) found in the intestinal mucosa.] There is very little sequence or structural homology between glucagon and GLP-1.

Their function is also very different. You can think of GLP-1 as a partner to insulin. It is released by intestinal L cells in response to the presence of nutrients (primarily protein, fat, and carbohydrate) in the intestine. It binds to GLP-1 receptors on the…

  • Pancreas to stimulate insulin release and inhibit glucagon release. This is why it helps type 2 diabetics control their blood sugar levels.
  • Stomach and reduces the rate of gastric emptying. This prolongs the feeling of fullness after each meal.
  • Small intestine and reduces gut motility, which increases transit time through the small intestine. This prolongs the feeling of fullness after a meal. But it can also lead to gastrointestinal side effects.
  • Brain and turns down your “appestat”. This reduces feelings of hunger between meals. But at high doses, it can affect the brain in negative ways (anxiety, depression, and suicidal thoughts).

Increasing GLP-1 Levels Naturally 

At the beginning of this article, I asked the question, “Is it possible to increase GLP-1 levels naturally without side effects?” The answer is clearly, “Yes”. Every time you eat a meal, your GLP-1 levels increase naturally.

GLP-1 levels rise within 10 minutes after consuming a meal and remain elevated for 1-2 hours. Then enzymes present in the bloodstream digest GLP-1 and it disappears. This is the way nature intended. There are no side effects to the natural rise and fall of GLP-1 after a meal.

“What makes the GLP-1 drugs different?”, you might ask.

  • In the first place significantly higher doses of GLP-1 are used.
  • More importantly, GLP-1 drugs have been genetically modified to make them resistant to enzymatic digestion. They can stay in the bloodstream for up to 24 hours.

This is what makes them so effective as weight loss drugs. But it’s not nice to fool with mother nature. This is also why they have side effects.

What Does This Mean For You?

Questioning WomanLet’s start by remembering that while GLP-1 drugs are effective, you will need to take them for the rest of your life unless you change your diet and lifestyle. And with long-term usage of the drugs, you are likely to experience one or more of their side effects at some point.

So, if you are willing to change your diet and lifestyle, it may be worthwhile looking at increasing your GLP-1 levels naturally. You have lots of options.

  • Every time you eat a meal your GLP-1 levels increase. And the bigger the meal, the bigger the increase. But the bigger the meal, the greater the calories. So, that’s not an optimal way to increase GLP-1 levels.
  • The macronutrients fat, carbohydrate, and protein all increase GLP-1 levels.
    • But if you are trying to lose weight, you want the greatest increase in GLP-1 with the fewest calories. That leaves out fatty foods.
    • You could try high carbohydrate meals, but there are lots of reasons why that’s not a good choice.
    • That leaves protein. And since you are trying to maximize GLP-1 levels with the minimum calories, I recommend a 20–40-gram protein supplement with a minimum of carbohydrate and fat. Just be sure the manufacturer has done a clinical study to demonstrate their protein supplement raises GLP-1 levels.

The Bottom Line

In this article I asked the question, “Is it possible to increase GLP-1 levels naturally without the side effects of GLP-1 drugs?” The answer is, “Yes”. In this article I tell you:

  • What GLP-1 is and what it does.
  • Why GLP-1 drugs have side effects.
  • How to raise your GLP-1 levels naturally without the side effects of GLP-1 drugs.

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.

_______________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

_______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

 

Natural Approaches For Controlling ADHD

by

Are Natural Approaches Better Than Drugs?

Author: Dr. Stephen Chaney 

diet for children with adhdSeveral years ago, I came across a headline in our local newspaper that said, “Try Nutrition, Not Drugs, for ADHD”. The article made claims like “No good evidence exists to support the ADHD disease hypothesis” and “…on numerous occasions we have seen ADHD symptoms completely disappear without medication”.

As a scientist, I am always a little skeptical about bold claims that run counter to established scientific wisdom. However, the authors of this article implied that their claims were based on a 2012 article in Pediatrics, which is a highly respected journal in its field, so I decided to investigate the article (Millichap and Yee, Pediatrics, 129: 1-8, 2012).

The article was written by two pediatricians with extensive experience treating children with ADHD. The article turned out to be a thorough review of the literature on nutritional approaches for controlling ADHD. It did not approach the rigor of a meta-analysis study. Rather, it is what I refer to as an “interpretive review”. By that I mean that the clinical studies were interpreted in part based on their clinical experience in treating children with ADHD.

Interpretive reviews can be either good or bad, depending on the objectiveness of the reviewers. In this case, I was familiar with many of the clinical studies they reviewed and found their interpretations to be accurate, so I decided to share their conclusions with you. But first I should probably talk about our ADHD epidemic and ask two important questions:

  1. Is ADHD over diagnosed?
  1. Are drugs always the best solution for controlling ADHD symptoms?

Are Natural Approaches Better Than Drugs? 

Increase The ADHD epidemic.

  • ADHD has increased by 89% in the United States in just 25 years (1997-2022).
  • In 2022 11.5% of US children aged 3-17 were diagnosed with ADHD. That’s 7.1 million children.

Some experts claim that’s because of better diagnosis. But let me point out what many experts miss.

Is ADHD Over Diagnosed?

Perhaps we should be asking whether teachers and parents might be tempted to overestimate the severity of the symptoms.

For parents,

  • Parents don’t have the time they used to have to supervise their kids.
    • In most cases, both parents are working.
    • Some are working from home. In theory that could give them flexibility to take care of their children. But remote work often involves online meetings and strict deadlines that leave little time for their children.
    • And then there is social media. In today’s world, many parents are glued to their phones 24/7.
  • It’s easier to request a hyperactivity assessment, so that child can be put on drugs.

For teachers,

  • Class sizes are large, and there aren’t enough teachers’ aides.
  • They don’t have the time to deal with a child that requires extra attention.
  • It is easier to request an ADHD assessment, so that child can be put on drugs.

But there are other options. There are schools in which children with ADHD thrive, and many public schools have programs set up for ADHD children.

Why is the increase in ADHD diagnoses a concern?

drug side effectsThe answer is simple. The use of ADHD drugs has increased by 58% since 2012. Today over 50% of children diagnosed with ADHD are put on drugs. That’s a concern because:

  • Most of these drugs are stimulants.
  • Many are amphetamines.
  • They have serious side effects. For example:
    • Loss of appetite and weight loss.
    • Difficulty sleeping.
    • Upset stomach and nausea.
  • Many children don’t like how the drugs make them feel. They make them feel irritable, depressed, anxious, or tense.
  • They can be gateway drugs.
  • They lose effectiveness over time. So, unless you have figured out the cause of the problem, the symptoms will return.

Because of this many parents are searching for natural solutions.

Natural Approaches For Controlling ADHD 

The pediatricians reviewed all the major nutritional approaches that have been used over the years to control ADHD. Let me start by saying that they are not wild-eyed proponents of “a nuts and berries diet cures all”. In fact, they use medications as the primary intervention for most of their ADHD patients. They advocate dietary approaches when:

  • Medicines fail or there are adverse reactions (side effects).
  • The parents or the patients prefer a more natural approach.
  • There are symptoms or signs of a mineral deficiency (more about that below).
  • There is a need to substitute an ADHD-free healthy diet for an ADHD-linked diet (Simply put, if the child’s diet is bad enough, there are multiple benefits from switching to a healthier diet – a possible reduction in ADHD symptoms is just one of them.)

I will summarize their key findings below: 

Omega-3 Fatty Acids

Child Raising HandThe authors reported that many studies have shown that children with ADHD tend to have low levels of essential fatty acids, especially the omega-3 fatty acids. They cite several studies which showed significant improvement in reading skills and reductions in ADHD symptoms when children with ADHD were given omega-3 supplements but also noted that other studies showed no effect. They postulated that some children may benefit more from omega-3 supplementation than others.

They routinely use doses of 300-600 mg of omega-3s with their ADHD patients. They find that this intervention reduces ADHD symptoms in many children but does not completely eliminate the need for medications.

My Two Cents: I have recently reported) on a study that strengthens the association between omega-3 supplementation and a reduction in ADHD symptoms. Whether omega-3 supplements will help your child is anyone’s guess. However, it is a natural approach with no side effects. It is certainly worth trying.

Food Additives

The current interest in food additives and ADHD originated with the Feingold diet. The Feingold diet eliminated

food additives, foods with salicylates (apples, grapes, luncheon meats, sausage, hot dogs and drinks containing artificial colors and flavors), and chemical preservatives (e.g. BHA and BHT).

It was popularized in the 1970s when some proponents claimed that it reduced ADHD symptoms in 50% of the children treated. After clinical studies showed that only a small percentage of children benefitted from this diet, it rapidly fell out of favor.

However, Millichap and Yee pointed out that more recent studies have shown that the subset of children who responded to the Feingold diet were not a “statistical blip”. A recent review of the literature reported that when children with suspected sensitivities to food additives were challenged with artificial food colors, 65–89% of them displayed ADHD symptoms.

My Two Cents: I have recently reported) on more recent studies documenting the effects of artificial food colors on ADHD. The studies I reviewed in that article reported that up to 28% of children with ADHD were sensitive to the amount of artificial food colors in the typical western diet and that removing those food colors resulted in a significant improvement in ADHD symptoms. Plus, those studies were just looking at food colors – not the hundreds of other food additives in the average American child’s diet.

I consider food additives to be problematic for many reasons. Even if removing them doesn’t reduce their ADHD symptoms, eliminating as many of those food additives as possible is probably a good idea. It doesn’t need to be complicated. Just replacing processed foods and sodas with fresh fruits and vegetables and with low fat milk and natural fruit juices diluted with water to reduce their sugar content might make a significant difference in your child’s ADHD symptoms.

Food Sensitivities

Even natural foods can be a problem for children with food sensitivity, and it appears that there may be a large percentage of hyperactive children with food sensitivities. Millichap and Yee reported that elimination diets (diets that eliminate all foods which could cause food sensitivity) improve behavior in 76-82% of hyperactive children.

Even though this approach can be very effective Millichap and Yee don’t normally recommend it for their patients because it is difficult and time-consuming. The elimination diet is very restrictive and needs to be followed for a few weeks. Then individual foods need to be added back one at a time until the offending food(s) are identified. (They reported that antigen testing is not a particularly effective way of identifying food sensitivities associated with hyperactivity)

My Two Cents: I have previously reported on the link between food sensitivities and hyperactivity. I agree with Millichap and Yee that elimination diets are difficult and view this as something to be tried after all other natural approaches have failed. However, if there is a particular food that causes hyperactivity in your child, identifying it and eliminating it from their diet could just be something that will benefit them for the rest of their life.

Sugar

sugar cubesThis is a particularly interesting topic. Many parents are absolutely convinced that sugary foods cause hyperactivity in their children, but the experts are saying that clinical studies have disproven that hypothesis. They claim that sugar has absolutely no effect on hyperactivity.

Millichap and Yee have an interesting perspective on the subject. They agree that clinical studies show that a sugar load does not affect behavior or cognitive function in small children, but they point to numerous clinical studies showing that the reactive hypoglycemia that occurs an hour or two after a sugar load adversely affects cognitive function in children, and that some children are more adversely affected than others.

My Two Cents: Reducing intake of refined sugars in your child’s diet makes sense for many reasons, especially considering the role of sugar intake in obesity. If your child has a tendency towards reactive hypoglycemia, it may also reduce ADHD symptoms.

Iron and Zinc Deficiency

Millichap and Yee reported some studies suggested that iron and zinc deficiencies may be associated with ADHD symptoms and recommend supplementation with an iron or zinc supplement when there is a documented deficiency.

My Two Cents: A simpler and less expensive approach would be a children’s multivitamin to prevent the possibility of iron or zinc deficiency. Of course, I would recommend that you choose one without artificial colors, preservatives and sweeteners.

A Healthy Diet

Millichap and Yee closed their review by discussing a recent study in Australia that reported a significant reduction in ADHD symptoms in children eating “Healthy” diets (fish, vegetables, tomato, fresh fruit, whole grains & low-fat dairy products) compared to children eating “Western” diets (Fast foods, red meat, processed meats, processed snacks, high fat dairy products & soft drinks). This is the dietary approach, along with omega-3 supplementation, that they recommend most frequently for their patients.

My Two Cents: I wholeheartedly agree. In fact, if you and your family were to follow a “Healthy” diet instead of a “Western” diet it would likely have numerous health benefits. Plus, you are automatically removing ADHD triggers like food additives and sugar from your child’s diet.

The Bottom Line

This review of natural approaches for controlling ADHD symptoms (Millichap and Yee, Pediatrics, 129: 1-8, 2012) is both good news and bad news. The good news is that there are multiple natural approaches that can significantly reduce ADHD symptoms. These include:

  • Use of omega-3 supplements. They recommended 300-600 mg/day.
  • Removal of food additives (particularly food colors) from the diet.
  • Identification of food sensitivities and removal of those foods from the diet.
  • Reducing the amount of simple sugars in the diet.
  • Elimination of iron and zinc deficiencies if they exist (Iron deficiency is relatively common in American children. Zinc deficiency is not.) Alternatively, I recommend a children’s multivitamin to prevent iron and zinc deficiencies in the first place.
  • Eating a healthy diet rather than a Western diet. This also has the benefit of reducing the amount of food additives and sugars in the diet.

The bad news is that each of these approaches seems to work only in a subset of children with ADHD.

  • If you are a parent who is interested in a natural alternative to ADHD stimulant medications this means you may need to be patient and try several natural approaches until you find the one(s) that work(s) best for your child. The benefit of making the effort is that all these approaches will also improve the health of your child in other important ways, and none of them have any side effects.
  • Unfortunately, physicians with only about 10 minutes to spend with each patient (which is increasingly the medical model in this country), may not have time to explore natural options. Medications are much easier to prescribe. You may need to be the one who takes the responsibility of exploring natural alternatives for your child.

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.

 _____________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

 

Are GLP-1 Users Getting Enough Nutrients?

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What Does This Mean For Your Future Health?

Author: Dr. Stephen Chaney

Most people want to lose weight so they can get trimmer and healthier. I don’t know of anyone who wants to be leaner and less healthy. But if they are not getting the essential nutrients their body needs while they are losing weight, they may well end up both lean and unhealthy.

I don’t need to tell you that GLP-1 (glucagon-like peptide 1) drugs are all the rage. Total spending on GLP-1 drugs in the United States exceeded $71 billion in 2023, a 500% increase in just 5 years. There are 15 million Americans on GLP-1 drugs at any one time. And most of this increase has been driven by the weight-loss market.

GLP-1 drugs do work. They target the intestine and the brain, increasing satiety (feeling of fullness) and decreasing appetite.

However, like any other drug, they have side effects. The most frequent are:

  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Increased heart rate.
  • Hypoglycemia
  • Allergic reactions

In a previous issue of “Health Tips From the Professor” I discussed a serious side effect that is often overlooked, namely increased risk of depression, anxiety, and suicidal thoughts. My recommendations were:

  • If you suffer from depression, anxiety, or suicidal thoughts, GLP-1 drugs may not be the best choice for you. At the very least you should discuss the risks and benefits with your doctor before using them.
  • If you are using GLP-1 drugs and experience an increase in depression, anxiety, or suicidal tendencies, you should discontinue the drug immediately and report your side effects to your doctor.

Another question that has not been addressed previously is whether people using GLP-1 drugs are getting the essential nutrients their bodies need for optimal health. Today’s study (B Johnson et al, Frontiers in Nutrition, published online in April 2025) was designed to measure the nutritional adequacy of GLP-1 user’s diets.

How Was This Study Done? 

clinical studyThe investigators enrolled 69 people who had been using a GLP-1 drug for at least a month in their study using an online research platform through the University of Turin in Italy.

The characteristics of the study participants were:

  • Weight:
    • 5% normal weight
    • 27% overweight
    • 18% Obese Class I
    • 20% Obese Class II
    • 30% Morbidly Obese
  • Age = 49.6 ± 12.3
  • Ethnicity:
    • 82% Caucasian
    • 6% Hispanic
    • 8% African American
    • 1% Asian
    • This is similar to the ethnic distribution of GLP-1 users in this region.
  • Length of GLP-1 use:
    • 7% <3 months
    • 29% 4-6 months
    • 25% 7-12 months
    • 39% >1 year

The participants were trained on how to use an online dietary recall instrument and then recorded their dietary intake for 3 consecutive days.

Are GLP-1 Users Getting Enough Nutrients?

Question MarkThe results of the 3-day dietary recalls from the GLP-1 users were:

  • Their diets were high in fat (39% of calories) and saturated fat (13%).
  • Their diets were low in fruit, vegetables, grains, and dairy foods.
  • Their diets were low in fiber (14 grams). This is half the recommended intake of fiber.
  • Their diets were sufficient for B-vitamins, copper, phosphorous, selenium, and zinc.
  • Their diets were deficient for calcium, iron, magnesium, potassium, choline, vitamin A, vitamin C, vitamin K, vitamin D, vitamin E, and fiber. For example:
    • 99% of participants were not getting enough Vitamins D and K from their diet.
    • 94% weren’t getting enough choline.
    • 90% weren’t getting enough magnesium.
    • 88% weren’t getting enough iron.

The study did not report the intake of omega-3 fats, but the participants were likely deficient in that as well.

The study participants averaged 0.8 gm/kg of protein, which is the recommended intake for sedentary adults who are not on a weight loss diet. However, 0.8 gm/kg of protein is not sufficient for maintaining muscle mass on weight loss diets, especially weight loss diets aided by GLP-1 drugs. Most experts recommend 1.2gm/kg to 1.6 gm/kg to prevent loss of muscle mass, with a few recommending as high as 2 gm/kg.

Most of the participants in this study did not meet the increased protein recommendations for weight loss.

  • Only 43% consumed at least 1.2 gm/kg of protein.
  • Only 10% consumed at least 1.6 gm/kg of protein.
  • Only 5% consumed at least 2.0 gm/kg of protein.

The authors concluded, “Participants on a GLP-1 drug are not meeting the DRI [daily recommended intake] for several vital nutrients through their diet or the higher protein needs during weight loss. Patient-centered nutritional guidance is essential to optimize health outcomes and prevent unintended health consequences.

What Does This Mean For Your Future Health?

QuestionsThe results of this study are both appalling and expected. Weight loss diets often result in nutritional insufficiencies. However, GLP-1-aided weight loss is worse.

That’s because GLP-1 is a drug, not a diet plan. It’s dispensed like any other drug.

  • Your doctor gives you a GLP-1 prescription. If you are lucky, they may give you a “one-size-fits-all” handout on how to lose weight while you are using it. For example, in this study:
    • Only 51% of participants received information from their doctor on how to manage side effects of GLP-1.
    • Only 20% were referred to a dietitian. The other 80% received no information on how to change their diet and lifestyle.
  • When you pick up the drug from the pharmacy, you get a package insert listing the side effects but no information on how to change your diet.

The results were predictable:

From a medical point of view the results were a big success:

  • The participants in the study reduced their caloric intake by 20%.
  • Most of the participants in the study felt the GLP-1 drug was helping them lose weight.

But from a nutritional point of view the study raises a red flag. Most of the participants were not told to change their diet or lifestyle, and they didn’t. Their diet was still:

  • High in total fat and saturated fat and probably low in healthy fats, although that was not assessed.
  • Low in fruits, vegetables, grain, dairy, and fiber.

The typical American diet is bad enough as it is. But when you eat the same diet and decrease calories, the nutritional inadequacies of the American diet are magnified. That is why the diets of the GLP-1 users were deficient in fiber plus 10 essential vitamins and minerals and did not contain enough protein to prevent loss of muscle mass.

Most (52%) of the participants were planning to be on GLP-1 drugs for a short period of time – just long enough to reach their weight loss goals. But the reality is far different.

Studies show that when people lose weight on GLP-1 drugs without changing their diet and lifestyle, the weight comes roaring back as soon as they get off the drugs. The reality is that those people will need to stay on GLP-1 drugs for a lifetime if they want to keep the weight off.

That’s when the nutritional inadequacies shown in this study start to have real health consequences. For example,

  • Long term inadequacies of calcium, magnesium, and vitamin D increase the risk of osteoporosis.
  • Long term muscle loss due to inadequate protein intake leads to frailty and metabolic diseases as we age.

I could go on, but you get the point. GLP-1 drugs are not a panacea. Without diet and lifestyle change, they are just a temporary and expensive solution to weight loss.

The Bottom Line

A recent study looked at the nutritional intake of GLP-1 users. It found:

  • Their diets were high in fat (39% of calories) and saturated fat (13%).
  • Their diets were low in fruit, vegetables, grains, and dairy foods.They were deficient in fiber plus 10 essential vitamins and minerals.

 

  • They were not getting enough protein to prevent the loss of muscle mass associated with GLP-1 use for weight loss.

The authors concluded, “Participants on a GLP-1 drug are not meeting the DRI [recommended intake] for several vital nutrients through their diet or the higher protein needs during weight loss. Patient-centered nutritional guidance is essential to optimize health outcomes and prevent unintended health consequences.

For details about the study and the health consequences of these nutrient deficiencies, 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.

______________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

_____________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

The Methylfolate Myths

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The Lies Of The Supplement Industry

Author: Dr. Stephen Chaney

Pinochio

How do the myths of the food supplement industry originate? Some of them start innocently enough. They are often based on a kernel of truth which is misinterpreted by some well-meaning medical doctors.

It’s not their fault. We teach future doctors what I call “metabolism light” in medical school. There simply isn’t room in the medical curriculum to teach all the details and nuances of human metabolism.

We also try to teach them the basics of how to interpret scientific literature. However, it takes years of experience to get good at picking out the strengths and weaknesses of clinical studies.

The doctors form their hypothesis and test it on a few patients. If it works, they publish a paper. At that point their idea is picked up by the “sensationalist” bloggers. These are the bloggers who like to focus on the sensational. They delight in writing about “new findings” that go against what the medical profession has been telling you for years.

The bloggers don’t stop there. They usually expand the claims. They ‘cherry pick” the scientific literature by quoting only studies that support their viewpoint and ignoring studies that refute it. In short, they put together a very compelling story. Soon the story is picked up by other bloggers who embellish it further. After it appears in enough sites, people start believing it. A myth is born.

Then supplement companies get in the act. They sense there is money to be made. They manufacture supplements to provide nutrients supported by the myths. They embellish the mythology even more and put together a compelling story to market their products.

This is where the mythology becomes deception. Companies have the responsibility to design their products based on the best science. They have an obligation to tell the truth about their products. When they make claims they know cannot be true, they are lying to you.

The saga of methylfolate is a perfect example of how observations based on a kernel of truth became myths and eventually became downright lies. Let me share that story with you.

The Kernel Of Truth About Methylfolate

Let’s start with one of the “kernel of truth” that launched the whole methyl folate saga. It started with a doctor who was having a very difficult time finding a solution for a patient with some significant health issues. The doctor ordered a genetic test and discovered the patient had a deficiency in the methylene tetrahydrofolate reductase (MTHFR) gene.

MTHFR ReactionThe doctor remembered the reaction catalyzed by MTHFR, and a light bulb went off. “Eureka”, he said. His patient must be unable to make N5-methyltetrahydrofolate (commonly referred to as methylfolate or methyl folate), and methylfolate is required for some very important methylation reactions in the cell.

He gave his patient methylfolate, and the patient’s symptoms got better. The doctor leapt to the conclusion that other patients with MTHFR deficiency needed methylfolate as well. Many of those patients responded to methylfolate as well. He didn’t bother to check whether they responded equally well to folic acid. He just assumed methylfolate was the magic elixir.

He wrote a paper on his clinical observations, and the methylfolate story was launched. It all seemed so logical.

However, the story was not nearly as straight forward as the doctor and the people publicizing his findings assumed. Let me walk you through some “Metabolism 101”. Don’t worry. There won’t be a quiz.

Why The Original Assumptions About Methylfolate Were Misleading

MTHFR mutants only have a partial loss of activity.

  • Individuals with 2 copies of a mutation from A to C at position 1298 of the MTHFR gene (A1298C homozygotes) comprise about 5% of the US population. They have 60% enzyme activity and appear to be normal in clinical studies.
  • Individuals with 2 copies of a mutation from C to T at position 677 of the MTHFR gene (C677T homozygotes) have 30% enzyme activity. They comprise about 10% of the US population. C677T homozygotes often have elevated homocysteine levels. The homozygous C677T mutation is associated with depression, anxiety, and mood swings in some people, but not in others (I will come back to the significance of that qualifying statement later).
  • C677T heterozygotes (one mutant gene) have 65% activity and are normal.

We Don’t Need 100% MTHFR Activity

Our human body is wonderfully designed. For many of our most essential metabolic reactions we have built in redundancy. We don’t require 100% activity of key enzymes. This helps protect us from bad effects of mutations as they arise.

The best analogy I can think of is the US space program. Most space vehicles had built in redundancy so that if one system failed, the mission could go on. For example, you may remember the Hubble space telescope. It was launched with four gyroscopes to keep the telescope pointed in the right direction.After a few years, one gyroscope gave out. That was not a problem because there were three left. A few years later the second gyroscope gave out. Again, there was no problem because there were still two gyroscopes left.

It was only after the third gyroscope gave out that Hubble became a bit “wonky”, and a space shuttle was sent up to replace the gyroscopes. It is the same with MTHFR. Only when you get down to around 30% activity, does it become a bit wonky”. (That’s about as non-technical as I get.)

Not Everyone With MTHFR Deficiency Experiences Symptoms

This is due to a phenomenon my geneticist friends refer to as penetrance. Simply put, that means that not everyone with the same mutation experiences the same severity of symptoms. That is because the severity of a mutation is influenced by diet, lifestyle, and genetic background.

Let me start with genetic background. In terms of MTHFR mutants you can think of genetic background as being mutations in a related methylation pathway. People who have a mutation in both MTHFR and a gene in a related pathway will experience more severe symptoms and are more likely to require methylfolate. Once you understand penetrance, you realize that individuals requiring methylfolate may represent only a small subset of people with MTHFR mutations.

Penetrance is a concept that most proponents of the methylfolate hypothesis completely ignore. The most severe MTHFR mutation (C677T homozygote) increases the probability that individuals will exhibit symptoms, but some individuals with that mutation are completely normal. Now that you understand the concepts of redundancy and penetrance, you can understand why that is.

When Did The Kernel of Truth Become A Myth?

Up to this point the hype around methylfolate could be chalked up to an honest misunderstanding.

  • The doctors who published the original papers may not have known that MTHFR mutations only resulted in a partial reduction in enzyme activity.
  • They probably didn’t know the concepts of redundancy (our cells don’t need 100% enzyme activity) or penetrance (the same mutation may cause severe symptoms in some patients and have no effect in others).
  • It seemed logical to assume that everyone with a MTHFR mutation might do better with methylfolate supplementation. That was incorrect, but it was an honest mistake.

However, the message was picked up by the bloggers who specialize in sensational stories, especially stories that contradict what experts have been telling you for years. They picked up the methylfolate story and distorted it beyond recognition.

  • They knew that “natural” is a buzz word, so they told you that methylfolate was natural and folic acid is synthetic.
  • They told you that methylfolate was better utilized than folic acid.
  • They told you that methylfolate was more effective than folic acid.
  • They told you folic acid was toxic. It was going to increase your risk of cancer.
  • Suddenly, it was no longer about people with MTHFR deficiency. You were told that everyone should avoid folic acid and use methylfolate instead.

On the surface, these pronouncements should not have passed the “If it sounds too good to be true…” test, or in this case, the “If it sounds too bad to be true…” test. You were being asked to believe that folic acid, which has been in use for over 80 years and is backed by hundreds of studies showing it is safe and effective, was neither safe nor effective. You were asked to believe that the government was poisoning you by fortifying foods with folic acid.cherry picking studies

However, to make their blogs sound more convincing, they listed clinical studies supporting their stories. The problem is they “cherry picked” the studies that supported their story and ignored the rest. Their bias was particularly outrageous when it came to the “story” that folic acid increases cancer risks. They ignored 10 or 20 studies showing no cancer risk and reported one suggesting it might increase risk. I call that deceptive.

Unfortunately, the myths created by the bloggers have been repeated often enough that many people now believe they are true. It is time for me to debunk the methylfolate myths.

The Methylfolate Myths 

Myth Versus FactsMyth: Methylfolate is natural. It comes from whole food. Folic acid is synthetic.

Fact: Methylfolate is chemically synthesized from folic acid. It is physically impossible to extract enough from whole foods. Here are the facts:

  • Methyfolate is only one of several naturally occurring folates in foods.
  • The best food sources of folates are beans, leafy greens, and broccoli.
  • To obtain the RDA of methyfolate for a single tablet you would need to start with 1 cup of lentils, two cups of cooked spinach, or 4 cups of broccoli.
  • You do the math! It just isn’t possible.

 

Myth: Methylfolate is better utilized by the body than folic acid.

Fact: This claim is based on levels of methylfolate in the blood after taking supplements providing equivalent amounts of methylfolate and folic acid. However, methylfolate has no biological activity in our blood. The measurement that matters is total folate levels (methylfolate plus other folates) in our cells.

If you take equivalent amounts of folic acid and methylfolate, you end up with identical folate levels in your cells (B.J. Venn et al, The Journal of Nutrition, 132: 3333-3335, 2002) In short, there is no difference in our ability to utilize methylfolate and folic acid.

 

Myth: If you have a mutation in the MTHFR gene, folic acid isn’t effective.

Clinically ProvenFact: MTHFR slightly increases the need for folic acid (from 400 ug to between 600 and 800 ug), but multiple studies show that folic acid supplementation is effective in people with MTHFR mutations.

For example, homocysteine levels are easily measured and are a reliable indicator of methylfolate status.

  • One study has shown that folic acid and methylfolate were equally effective at lowering plasma homocysteine in people who were MTHFR C677T homozygotes (P. Fohr et al, American Journal of Clinical Nutrition, 75: 275-282, 2002).
  • That study also showed that folic acid was more effective than methylfolate at lowering homocysteine in people who were C677T heterozygotes and in people with normal MTHFR activity.
  • Another study showed folic acid was just as effective as a diet providing equivalent quantities of folate from foods at lowering homocysteine levels in people with various MTHFR mutations (A. Ashfield-Watt et al, American Journal of Clinical Nutrition, 76: 180-186, 2002).

At present, lowering of homocysteine levels is the only indicator of methylfolate status for which methylfolate and folic acid have been directly compared. However, there are other studies suggesting that folic acid is likely to be effective for people with MTHFR defects. For example:

  • Folic acid has been shown in multiple studies to be effective in preventing neural tube defects (M. De-Regil et al, Cochrane Database Systematic Reviews 2010 Oct 6;(10):CD007950. PMID: 20927767), which are highly associated with the C677T MTHFR gene defect.
  • Three studies have shown that supplementation with folic acid, B12, and B6 slowed cognitive decline in older people with elevated homocysteine levels ( Durga et al, The Lancet, 369: 208-216, 2007; A.D. Smith et al, PLoS ONE 5(9): e12244. doi:10.1371/journal.pone.0012244, 2010; G. Douaud et al, Proceedings of the National Academies of Sciences, 110: 9523-9528, 2013).
  • In contrast, the one study that substituted methylfolate for folic acid showed no effect (A. McMahon et al, New England Journal of Medicine, 354: 2764-2769, 2006).

 

CancerMyth: Folic acid causes cancer.

Fact: The few studies suggesting that folic acid supplementation might increase the risk of cancer were “outliers”.  By that I mean they contradicted many other studies showing no increased risk.

Scientists are accustomed to this. We know that studies sometimes come up with conflicting results. In some cases, we can point to an error in experimental design or statistical analysis as the cause of the aberrant results.

In other cases, we never know the reason for the differences, so we go with the weight of experimental evidence (what the majority of studies show). The weight of evidence clearly supports the safety of folic acid,

However, that is not enough. If there is the slightest possibility that something causes cancer, we investigate it further. Consequently, the scientific community followed up with larger studies.

Those studies showed either reduced cancer risk or no difference in cancer risk with folic acid supplementation. None of the studies found any evidence that folic acid increased cancer risk. I have covered this in detail for folic acid and colon cancer risk in a previous issue of “Health Tips From The Professor”.

There have also been a couple of small studies suggesting that folic acid might increase the risk of prostate and breast cancer. Although these were small, individual studies, they have been widely hyped by the methylfolate advocates. Once again, the definitive study has been done (S.E. Vollset et al, The Lancet, 381: 1029-1036, 2013).

It was a meta-analysis of 13 placebo-controlled studies involving over 50,000 subjects. The results were clear cut. Folic acid supplementation caused no increase in overall cancer risk, and no increase in the risk of colon cancer, prostate cancer, breast cancer, or any other individual cancer. Moreover, the average dose of folic acid in those studies was 2 mg/day, which is 5 times the RDA.

Of course, the bloggers and the companies selling methylfolate supplements ignore the definitive studies showing folic acid does not increase cancer risk. The myths and lies continue.

 

Myth: Folic acid can mask a B12 deficiency.

Fact: True but irrelevant if you use a supplement with folic acid and B12 in balance.

The Lies Of The Supplement Industry

deceptionIf you are writing a blog, you are covered by “freedom of speech”. You can say whatever you want. It doesn’t have to be true. However, if you are a supplement manufacturer, you are held to a higher standard. Ignorance is no longer an excuse. You can no longer cherry pick the “facts” you like and ignore the rest. You are ethically obligated to research all the available literature and be guided by the best scientific evidence.

Reputable companies have been guided by scientific evidence and have not jumped on the methylfolate bandwagon. They know folic acid is both safe and effective in a wide variety of clinical situations. They also know that, while methylfolate may be just as effective as folic acid, it has not been shown to be superior to folic acid for any clinical application.

They may offer a methylfolate option for people who believe they need it. But they make no claim that it is superior to their products containing folic acid.

Less reputable companies, however, sensed money to be made by capitalizing on the buzz around methylfolate. They repeated the myths of the bloggers and claimed their products were superior to others on the market. They call it marketing. I call it lying. They have an obligation to fact check their claims and only make claims that are true.

Let me give you an example. In preparing for this article, I looked at the claims of several companies that were promoting their methylfolate supplements. One in particular claimed they had studies showing:

  • Their methylfolate supplement was effective at reducing the risk of adverse pregnancy outcomes.
  • Their methylfolate supplement was twice as bioavailable as folic acid.
  • Their methylfolate supplement was able to lower homocysteine levels better than conventional folic acid supplementation.

All three studies were bogus.

  • With respect to the first study, it was likely true that their methylfolate supplement decreased adverse pregnancy outcomes. But there are dozens of studies showing that folic acid does the same thing.

And because they did not compare methylfolate and folic acid supplementation in their studies, they have no basis for claiming their supplement was superior.

  • The second study compared levels of methylfolate and folic acid in the blood. As I mentioned above, methylfolate has no biological activity in our blood. The measurement that matters is total folate levels (methylfolate plus other folates) in our cells. And previous studies have shown that equivalent amounts of methylfolate and folic acid give identical amounts of methyfolate in our cells.
  • The third study compared their supplement, which contained B6, B12, zinc, and betaine in addition to methylfolate, to folic acid alone. That’s comparing apples to oranges. That is because there are three pathways for lowering homocysteine levels, and B6, B12, and betaine play important roles in each of these pathways.
    • B12 is an integral part of the enzyme methionine synthase, an enzyme that converts homocysteine to the amino acid methionine. Methylfolate transfers its methyl group to the enzyme-bound vitamin B12, and methyl B12 transfers the methyl group to homocysteine, which converts it to methionine. In other words, methylfolate cannot lower homocysteine levels by itself. It needs vitamin B12.
    • Betaine also serves as a methyl donor in another pathway for converting homocysteine to methionine by an enzyme called betaine-homocysteine methyltransferase.
    • B6 is essential for yet another pathway that lowers homocysteine levels by converting homocysteine to the amino acid cysteine.

You might argue that the company was simply ignorant of the importance of B6, B12, and betaine for lowering homocysteine levels. However, that is unlikely. Why else would they have included B6, B12, and betaine in their supplement?

They must have known the study they designed was bogus. That suggests they conducted the study with the sole purpose of deceiving you, the consumer. I call that lying.

Finally, in case you were wondering, I am not recommending you select a single supplement with folic acid, B6, and B12. I do recommend you get your folic acid from a multivitamin or B complex supplement that provides all three B vitamins in balance.

Betaine deficiency is very rare, so I don’t include betaine in my recommendations.

What Does This Mean For You?

Questioning WomanMTHFR mutations only result in partial loss of activity. Most individuals with MTHFR defects remain symptom free with the RDA, or slightly above the RDA, of folic acid.

However, there may be some individuals with a MTHFR defect and additional gene defects in metabolic pathways involving methylation who might benefit from methylfolate. This is due to a phenomenon that geneticists call penetrance and would likely represent a small subset of the population with MTHFR defects.

Finally,the claims that everyone would benefit from methylfolate instead of folic acid are false. They are contradicted by human metabolism and multiple published clinical studies.

In short, folic acid has been used for over 80 years. There are hundreds of clinical studies showing it is safe and effective, even in most individuals with a MTHFR deficiency. I can’t tell you whether the companies selling methylfolate are ignorant of basic metabolism and the published studies refuting their claims or whether they are purposely trying to deceive the public—but neither is a good thing.

The Bottom Line

Some supplement manufacturers are claiming that methylfolate is more natural and more effective than the folic acid that has been used in supplements for the past 80 years. In this issue of “Health Tips From the Professor” I debunk the methylfolate myths used by the supplement manufacturers to sell their methylfolate products.

I can’t tell you whether the companies selling methylfolate are ignorant of basic metabolism and the published studies refuting their claims or whether they are purposely trying to deceive the public—but neither is a good thing.

For more specifics, 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.

 _____________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance 

_____________________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”. Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry textbooks for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

Is Extra Protein Important For Seniors?

by

The Role Of Muscle Protein In Energy Metabolism 

Author: Dr. Stephen Chaney 

We’ve been told, “It’s all downhill after 30.” That may or may not be true depending on the lifestyle choices we make.

But for muscle mass, “It’s all downhill after 50!” Simply put, we start to lose muscle mass at an accelerating pace after 50, a process scientists call sarcopenia.

Sarcopenia should be a major concern for everyone over 50. Loss of muscle mass:

  • Causes unsteadiness which can lead to falls, bone fractures, and death.
  • Increases the risk of obesity because muscle burns more calories than fat. That increases our risk of obesity-related diseases such as heart disease, diabetes, some cancers, osteoarthritis, and other inflammatory diseases.
  • Robs us of the fun activities we would like to enjoy in our golden years.

But sarcopenia is not inevitable. As I have discussed in previous issues of “Health Tips From the Professor”, there are three things we can do to minimize sarcopenia as we age.

  • Get adequate weight-bearing exercise. In other words, pump iron or use your body weight for exercise on a regular basis.
  • Get adequate protein.
  • Get adequate amounts of the branched-chain amino acid leucine.

In this article I will focus on the last two, especially the fact that we need more protein and leucine to prevent loss of muscle mass as we age. To help you understand why that is, I am going to share my favorite topic – Metabolism 101 (Once a biochemistry professor, always a biochemistry professor).

Metabolism 101: The Role Of Muscle Protein In Energy Metabolism 

ProfessorMost people associate muscle mass with strength and endurance. Many understand the important role muscle mass plays in burning off excess calories and keeping us slim. But few people understand the important role that muscle protein plays in our everyday energy metabolism.

Let’s start with an overview of metabolism [Note: If you are not interested the details, you can just skip over the bullets and read the take-home message at the bottom of this section.]

  • We get energy from the carbohydrate, fat, and protein we consume. Excess carbohydrate, fat, and protein in our meals are stored to provide the energy our body needs between meals and during prolonged fasting.
    • We have a virtually unlimited ability to store fat, as some of you may have noticed.
    • We have a very limited ability to store carbohydrates in the form of glycogen in our liver.
    • Muscles are our largest organ system, and we can store some of the protein we eat as increased muscle mass, especially when protein intake is coupled with exercise. But muscle protein plays other very important functions. It is a precious resource.
  • In the fed state most of our energy is derived from blood glucose. This is primarily controlled by insulin. As blood glucose levels fall, we move to the fasting state and start to call on our stored energy sources to keep our body functioning. This process is primarily controlled by a hormone called glucagon.
    • In the fasting state most tissues easily switch to using fat as their main energy source, but…
      • Red blood cells and a few other tissues in the body are totally dependent on glucose as an energy source.
      • Initially our brain is totally dependent on glucose as an energy source, and our brains use a lot of energy. [Note: Our brain can switch to ketones as an energy source with prolonged starvation or prolonged carbohydrate restriction, but that’s another story for another day.]
  • Because our brain and other tissues need glucose in the fasting state, it is important to maintain a constant blood glucose level between meals.
    • Initially, blood glucose levels are maintained by calling on the glycogen reserves in the liver.
    • But because these reserves are limited, our body starts to break down muscle protein and convert it to glucose as well – even in the normal dinner/sleep/breakfast cycle.

You may have found the explanation above was excessive, but I couldn’t think of a simpler way of helping you understand that in addition to its other important role in the body, muscle protein is also an energy store.

When we eat, we make a deposit to that energy store. Between meals we withdraw from that energy store. When we are young the system works perfectly. Unless we fast for prolonged periods of time, we are always adding enough muscle protein in the fed state to balance out the withdrawals between meals.

But as we age, our ability to build muscle in the fed state becomes less efficient. Withdrawals exceed deposits, and we experience age-related muscle loss (sarcopenia).

What We Know About Preventing Age-Related Muscle Loss

As I said above, there are three things needed to prevent age-related muscle loss:

  • Adequate resistance exercise.
  • Adequate amounts of protein.
  • Adequate amounts of the essential, branched-chain amino acid called leucine.

And, as I said above, I am going to focus on the last two.

In previous issues of “Health Tips From the Professor” I have shared articles showing that the amount of both protein and leucine needed to maximize the gain in muscle mass following a meal or a workout increase as we age. For example.

  • For someone in their 30s, 15-25 grams of protein with 1.7 grams of leucine per meal is optimal.
  • But someone in their 60’s and 70s needs 25-30 grams of protein and 2.5-2.7 grams of leucine per meal to achieve the same effect.
  • Most of these studies have been done with men, but a recent study showed the results are identical with post-menopausal women.

However, previous studies have not addressed whether we need protein supplementation to achieve adequate protein intake or what kind of protein supplements were best. The studies I will discuss today were designed to answer these questions.

How Were These Studies Done? 

clinical studyStudy #1: As I said above, previous studies have suggested that 25-30 grams of protein per meal is optimal for preventing age-related loss of muscle mass in seniors. However, many seniors get most of their protein in their evening meal. On average, seniors consume

8-15 grams of protein at breakfast, 15-20 grams of protein at lunch, and 30-40 grams of protein at dinner.

This study (C Norton et al, The Journal of Nutrition, 146: 65-67, 2016) was designed to ask whether optimizing protein intake at each meal by adding a protein supplement at breakfast and lunch would increase lean muscle mass in seniors over a 24 week period.

The investigators recruited 60 adults, aged 50-70 (average age = 61) from the city of Limerick, Ireland. The participants were 73% women and had an average BMI of 25.8 (slightly overweight).

The participants were randomly assigned to receive either a milk-based supplement or an isocaloric, non-protein-containing, maltodextrin control. The protein supplement provided 20 grams of protein. The participants were instructed not to change any other aspect of their diet or activity level.

The protein supplement and placebo were provided in identical sachets, and the participants were told to mix them with water and consume them with breakfast and lunch. The protein supplement and placebo looked and tasted identical, so the subjects did not know which group they were in. Compliance was assessed by collecting the used sachets at the end of the study.

The participants completed 4-day diet recalls under the supervision of a dietitian before and during the study. Lean muscle mass was determined prior to and at the end of the 24-week study.

protein shakesStudy #2: This study (J McKendry et al, The American Journal Of Clinical Nutrition, doi: 10.1016/j.ajcnut.2024.05.009) was designed to determine whether the ability to stimulate muscle protein synthesis depended on the type of supplemental protein.

This study was built on the results of the first study. Specifically, the investigators compared the effect on muscle protein synthesis of adding 25 grams of whey, pea, or collagen protein to breakfast and lunch meals.

The investigators enrolled 31 healthy, older (average age = 72) subjects from the Hamilton, Ontario area. Subjects were excluded from the study if:

  • They had a medical condition or were taking any medication that might influence the results.
  • They used tobacco or tobacco related products.
  • They consumed a vegan or vegetarian diet
  • They used a walking device or were inactive for any reason.

The participants were placed on a standardized diet consisting of prepackaged meals (breakfast, lunch, and dinner) and a mix of fruits, vegetables, snacks, and drinks. They were instructed to only eat the foods provided to them and to maintain their normal activity levels.

The diet was designed to provide the RDA for protein (0.8 gram of protein/kilogram of body weight) and to mimic the habitual dietary patterns of seniors in the United States and Canada.

  • Around 55% carbohydrate, 30% fat, and 15% protein.
  • Uneven distribution of protein throughout the day (19% at breakfast, 26% at lunch, and 55% at dinner).

After one week on the control diet, participants were randomly assigned to receive 25-gram protein supplements of either whey, pea, or collagen protein and instructed to add them to their standardized diet for breakfast and lunch (total daily protein intake was increased by 50 grams/day). They followed this regimen for 7 days.

On day one and 7 of the control phase and day 7 of the intervention phase (when the participants were consuming additional protein) muscle biopsies were obtained 90 minutes after breakfast for determination of the effect of the meal on muscle protein synthesis.

[Note: The participants were consuming a protein supplement containing an additional 25 grams of protein at both breakfast and lunch. But the effect of this additional protein on muscle protein synthesis was only determined after the breakfast meal.]

Is Extra Protein Important For Seniors? 

OptimizeEach of the studies provided important insights for anyone wanting to minimize age-related muscle loss.

Study #1: The effect of the 20-gram whey protein supplement for breakfast and lunch as follows:

  • Protein supplementation at breakfast and lunch resulted in a 1.3-pound gain in lean body mass over 24 weeks compared to the control group using an isocaloric, non-protein containing maltodextrin supplement.

The authors concluded, “Protein supplementation at breakfast and lunch for 24 weeks in healthy older adults resulted in a positive (1.3 pound) difference in lean muscle mass compared with an isoenergetic, non-nitrogenous maltodextrin control. These observations suggest that an optimized and balanced distribution of [supplemental] protein intakes could be beneficial in the preservation of lean tissue mass in the elderly.”

Note:

  • This study did not show that these protein levels were optimal. It only showed that using a protein supplement to increase protein intake at breakfast and lunch was beneficial for seniors consuming most of their protein at dinner.

Study #2: The effect of the three 25-gram protein supplements at breakfast and lunch on protein intake was as follows:

  • Adding 25 grams of either whey or pea protein to a relatively low-protein (15 grams) breakfast increased muscle protein synthesis by ~9%.
  • Adding 25 grams of collagen to the same low-protein breakfast had no effect on muscle protein synthesis.

Note: This study did not measure the effect of adding supplemental protein to lunch meal, but the results were probably similar.

The authors concluded, “We discovered that the RDA [for protein] was insufficient to support higher rates of MPS [muscle protein synthesis] in older adults. Manipulating dietary protein to increase daily consumption of higher quality – whey and pea but not collagen – proteins by targeting the lowest protein-containing meals offers a viable strategy to enhance…MPS [muscle protein synthesis] in older adults.”

“Consuming protein much closer to expert group consensus recommendations [1.2 gm/kg instead of the current 0.8 gm/kg for adults over 50] may help to increase…MPS [muscle protein synthesis] with advancing age and extend health-span – compressing the years of disease and disability commonly experienced by older individuals closer to the end of life.”

My comments are:

  • You may recall from the previous discussion that age-related muscle loss occurs because muscle protein synthesis (MPS) becomes less efficient as we age.
    • Therefore, an increase in muscle protein synthesis following each meal will lead to an increase in muscle mass over time, as was seen in the first study.
  • In our 60’s and beyond we require higher amounts of both protein and leucine to maximize muscle protein synthesis.
    • The collagen supplement used in this study provided enough supplemental protein. But it probably was ineffective because it only provided 0.86 grams of leucine.
      • The amount of leucine in the control diet was not specified, but with only 15 grams of protein for breakfast there was probably enough leucine to make up for the lack of leucine in the collagen supplement.
    • In contrast the whey and pea supplements provided 2.7 and 2.1 grams of leucine, respectively. When added to the leucine in the control diet, this would be more than enough to drive muscle protein synthesis.
  • Not every pea protein supplement may be as effective as the one used in this study. When I looked it up, it was described as an “enriched pea protein designed as a soy and milk alternative.” The manufacturer did not say how it was “enriched”, but I suspect it was enriched by adding extra leucine.

What Do These Studies Mean For You? 

Don’t Leave Out Resistant Exercise. These studies were focused on the timing and quality of protein. But don’t forget that adequate protein and leucine are only two of the requirements for preventing age-related muscle loss. The third, and arguably the most important, is resistance exercise.

Aim for at least three 30-minute resistance exercise sessions per week. If you have physical limitations consult with your health professional about the type, duration, and intensity of resistance exercise that is right for you.

Forget What You Have Been Told About Protein. You have been told that American consume too much protein. That’s probably true for the average couch potato. But it is not true for seniors. The average American does consume too much of the wrong kind of protein, but that’s another story for another day.

You have been told that the average woman only needs 46 grams of protein per day, and the average man needs only 56 grams of protein per day. That’s based on the RDA of 0.8 gm/kg (0.36 gm/pound) and an average weight of 127 pounds for women and 155 pounds for men.

We haven’t weighed that since the 50’s. Today the average woman weighs 170 pounds, and the average man weighs 201 pounds. That means protein intake should be at least 61 gm/day for women and 72 gm/day for men.

But that’s only if you are in your twenties or thirties. The consensus among those who study protein needs in seniors is that the RDA should be 1.2 gm/kg (0.54 gm/pound) for adults over 50. That’s 91 gram/day and 108 grams/day, respectively, for average weight women and men.

With that perspective, it is easy to understand the recommendation that seniors get 25-30 grams of protein and 2.5-2.7 grams of leucine per meal.

These studies did not address leucine intake, but they suggest that optimal protein intake may be closer to 30-40 grams of protein per meal. That’s 90-120 grams of protein day. But that is probably not what you are hearing from your doctor.

Why Is Supplemental Protein Important? It’s easy to say that seniors should get 30-40 grams of protein per meal, but that’s not the way most seniors eat.

When I was a child growing up in Alabama the standard breakfast was eggs, ham, grits with ham gravy and biscuits. I’m not saying that it was a healthy breakfast, but it was the standard breakfast where I lived at the time. And it provided plenty of protein.

In today’s world most seniors have been told to avoid eggs and red meat. Breakfasts are more likely to be some type of cereal with a fruit garnish and perhaps some toast. That’s a much healthier breakfast, but it’s a low-protein breakfast. That’s why most seniors only get 8-15 grams of protein at breakfast time.

I won’t go into lunches, but similar transformations have taken place at lunch time, which is why most seniors only get 15-20 grams of protein at lunch.

CerealAnd many seniors get even less protein at breakfast and lunch. For example:A cup of coffee and a croissant or a “healthier” bowl of cornflakes and skim milk at breakfast only provides 6 grams of protein.

  • A healthy green salad at lunch only provides 2 grams of protein.

In cases like this, the protein supplements may need to provide 30-40 grams of protein rather than the 20-25 grams of protein used in these studies.

So, if you want to avoid age-related muscle loss you have two choices:

  • Completely change your diet and incorporate more healthy protein foods into your breakfast and lunch menus or…
  • Add a protein supplement to your low-protein meals. The studies I have described above suggest that 20-25 grams of supplemental protein may be sufficient to transform a low-protein meal into one that will support muscle protein synthesis and minimize age-related muscle loss.
  • And if your breakfast and lunches are very low in protein, 30-40 grams of supplemental protein may be necessary to optimize protein intake.

Why Is Protein Quality Important? The second study shows that having enough protein is not sufficient to stimulate muscle protein synthesis. It must be high quality protein.

The authors of the study suggested that collagen did not stimulate muscle protein synthesis due to its low leucine content.

And, as I mentioned earlier, the pea protein used in the study was “enriched” so it could be used as a “whey or soy alternate”, and the “enrichment” probably included adding extra leucine.

So, if you are planning to use a plant protein supplement with your low-protein meal(s), I would recommend choosing one with added leucine.

How Much Protein Is Too Much? That depends on your age. If you are in your 20s or 30s, the ability of a protein meal and/or supplement to stimulate muscle protein synthesis begins to plateau at around 30 grams of protein, so there is little advantage to protein intakes above 30 grams at one time.

But if you are a senior, you use protein less efficiently. These and other studies with seniors suggest that 30-40 grams of protein per meal may be optimal.

However, high protein intake can be risky for some. The risk is smaller than you have been told, but it is not zero. Here are my recommendations:

  • If your physician has told you to limit protein intake, follow their advice.
  • If you are unsure about the health of your kidneys, consult with your physician before increasing your protein intake.
  • Keep adequately hydrated. Byproducts of protein metabolism can stress your kidneys if you are dehydrated.

What About An After-Workout Supplement? Previous studies have shown that the numbers are about the same for after-workout supplements.

  • For someone in their 30s, 15-25 grams of protein with 1.7 grams of leucine per meal is enough to maximize muscle gain after a workout.
  • But someone in their 60s or 70s needs at least 25-30 grams of protein and 2.5-2.7 grams of leucine per meal to maximize muscle gain.

One Final Pearl

At the very beginning of this article, I told you that the breakdown of muscle protein to keep blood sugar levels constant during fasting and starvation was driven by a hormone called glucagon.

And the active ingredient in the latest weight loss drugs like Wegovy, Ozempic, and Trulicity is GLP-1, which stands for glucagon-like peptide 1.

So, it should be no surprise that those drugs cause loss of muscle mass. That’s a side effect you probably haven’t been told about.

But the good news is that properly designed protein supplements can help you maintain and (with resistance training) increase muscle mass and also boost GLP-1 levels naturally. When choosing your protein supplement, ask for clinical studies showing that they increase GLP-1 levels.

The Bottom Line 

It’s all downhill after age 50! That’s when we start to experience age-related muscle loss, something called sarcopenia.

Age-related muscle loss can be prevented with resistance exercise, adequate protein, and adequate leucine. And the amount of both protein and leucine we need to prevent muscle loss increases as we age.

Previous studies have defined the amount of protein and leucine we need to prevent muscle loss in our 60s and 70s. The studies described in today’s “Health Tip” show the benefit of adding a protein supplement to our low-protein meals and the importance of a high-quality protein supplement for minimizing age-related muscle loss.

The authors of one of these studies concluded, “Consuming protein much closer to the expert group consensus recommendations [1.2 gm/kg instead of the current 0.8 gm/kg for adults over 50] may help to increase…MPS [muscle protein synthesis] with advancing age and extend health-span – compressing the years of disease and disability commonly experienced by older individuals closer to the end of life.”

For more information on these studies, how much protein you need, and what they mean for you, 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.

_____________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

 _____________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

 

For the past 45 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

 

Are Seed Oils Inflammatory?

by

Rethinking Seed Oils

Author: Dr. Stephen Chaney

You can’t believe everything you read on the internet. Food myths abound. And they sound so convincing. The articles you read quote clinical studies supporting their food myth. And they offer plausible sounding explanations for why their food myth is accurate.

I have written a book, “Slaying the Food Myths”, to help you recognize and avoid food myths.

I started that book by sharing “secrets only scientists” know. The top 2 are particularly relevant.

  • Scientists design their studies to disprove existing paradigms. That guarantees there will be studies on both sides of every issue.
  • Every study has its flaws. But some have more flaws (are lower quality) than others.

Unfortunately, many of the online posts you read “cherry pick” the studies that support their belief.

  • Some of this is innocent. The authors aren’t scientists, so they may not know the studies they quote are of low quality. While their mistake may be innocent, the information they are sharing is still wrong.
  • But I am less tolerant of “experts” who base their posts on studies they know are of low quality. I call them “Dr. Strangeloves”.

New food myths arise every day. And recently, food myths about seed oils have started to proliferate. Seed oils have become the latest food villain. It has gotten to the point where many people scan every label to make sure that no seed oil touches their lips.

To help clarify the situation, I have written a recent “Health Tips From the Professor” article debunking the seed oil myths.

Among the myths I discussed was the “seed oils cause inflammation” myth. In today’s “Health Tips From the Professor”, I will delve into that topic more deeply and share the latest research with you.

But before I do that, I need to return to my professor mode and share some background information.

What Are Omega-6 Fatty Acids And Why Do They Matter?

Professor

  • There are two classes of essential fatty acids – omega-6 and omega-3.
  • In each case there is a shorter fatty acid found in plant foods which is converted to a longer fatty acid which, in turn, is converted to a group of regulatory molecules that control a variety of biological functions including blood clotting and inflammation.
    • For the omega-6 group the shorter fatty acid is linoleic acid (LA), and the longer one is arachidonic acid (AA). Linoleic acid is the major fatty acid found in seed oils.
    • For the omega-3 group, the shorter fatty acid is linolenic acid, and the longer ones are EPA and DHA.
  • Essential fatty acids are the only foods for which it is literally true that, “You are what you eat”.
    • The membrane composition of every cell in your body reflects the relative amount of omega-6 and omega-3 fatty acids in your diet.
    • This means the ratio of omega-6 to omega-3 fatty acids in your cell membranes are identical to the ratio of omega-6 to omega-3 fats in your diet.

The significance of these statements will become apparent as I describe the study and its significance below.

What Do We Know About Omega-6 Fatty Acids And Inflammation?

FlamesThis is an important question because the omega-6 fatty acid linoleic acid (LA) is the major fatty acid in seed oils. So, when someone makes the claim that seed oil causes inflammation, they are saying that omega-6 fatty acids cause inflammation. So, the question becomes, “Is that true?”

For years the answer to this question has been unclear. Some studies have concluded that omega-6 fats decrease inflammation, while other studies suggest they increase inflammation. And, of course, the influencers who warn of the dangers of seed oils have cherry picked the studies showing they increase inflammation while ignoring studies showing they decrease inflammation.

It turns out that studies claiming that omega-6 fats increase inflammation are mostly low-quality studies. So, perhaps we should ask what recent high-quality studies show.

  • In 2012 a systematic review of the effects of linoleic acid (LA) on inflammatory markers stated, “We conclude that virtually no evidence is available from randomized, controlled intervention studies among healthy, non-infant human beings to show that addition of LA to the diet increases the concentration of inflammatory biomarkers”.
  • Two major meta-analyses that pooled the data from multiple studies found that circulating LA levels were inversely correlated with cardiovascular disease and type 2 diabetes [That means that higher levels of LA correlated with lower levels of heart disease and diabetes].
  • A recent report from the UK Biobank study found a strong inverse association between plasma LA levels and both total and cause-specific mortality [Higher levels of LA correlated with a longer life].
  • Based on these and other studies, the American Heart Association concluded, “To reduce omega-6 fat intakes from their current levels [in the American diet] would be more likely to increase rather than decrease coronary heart disease.”

Clearly, recent research is trending towards the conclusion that the omega-6 fat found in seed oils reduces inflammation and the risk of major disease.

But the authors of the current study (HTM Lai et al, Nutrients, 17, 2076, 2025) wanted to test that hypothesis in a more rigorous manner.

They examined the association between red blood cell membrane levels of linoleic acid (LA) and arachidonic acid (AA) and 10 biomarkers representing different phases and pathways of inflammation in a large, community-based sample (The Framingham Offspring Study).

How Was This Study Done?

clinical studyThe investigators used data from the Framingham Offspring Study (children of the original Framingham participants) and the Framingham Omni Cohort (a more ethnically and racially diverse population representing the current Framingham community).

There were a total of 2777 participants (mean age 66 years, 54% women, 9.8% minorities). Blood and urine samples were obtained from these participants during their scheduled examinations between 2005 and 2008.

  • The levels of linoleic acid (LA) and arachidonic acid (AA) were determined from red blood cell membranes.
  • One urinary and nine serum biomarkers of inflammation representing multiple inflammation pathways were measured. (For a list of the biomarkers tested and the rationale for their inclusion in this study, read the article.

Finally, the correlation between the omega-6 fats and biomarkers of inflammation was calculated.

Are Seed Oils Inflammatory?

Question MarkThe results were as follows:

  • Linoleic acid and arachidonic acid combined were inversely correlated with 6 biomarkers of inflammation and had no effect on the other 4.
  • The inverse association of linoleic acid with inflammatory biomarkers was not affected by age, gender, or ethnicity.

The authors concluded, “Our community-based study identified small, but significant, inverse associations between red blood cell linoleic and arachidonic levels and six major biomarkers of inflammation…representing a wide variety of inflammatory pathways. Our results suggest that linoleic acid is more likely to be anti- than pro-inflammatory, and the present efforts to reduce its intake are ill advised.”

Revisiting Seed Oils

Assortment Of Salad Dressing Bottles

You might be wondering what this study has to do with seed oils.

  • The omega-6 fat linoleic acid is a major component of seed oils (60-75%).
    • So, claims that seed oils are inflammatory are based on the claim that omega-6 fats are inflammatory.
  • This study shows omega-6 fats are more likely to be anti-inflammatory than pro-inflammatory.
  • Based on their heart health benefits, the American Heart Association recommends that we not decrease the amount of omega-6 fats in our diet.
    • Seed oils are the major source of omega-6 fats in our diet.
    • So, the American Heart Association recommendation about not decreasing omega-6 fats in our diet means that decreasing our use of seed oils is not a good idea.

I have debunked the other myths about seed oils in my previous “Health Tips From the Professor” article.

The only true concerns about seed oils have to do with processing, storage, and purity.

  • Omega-6 fats are easily oxidized, and the oxidation process can create free radicals. Free radicals can be created through high heat processing and improper storage.
  • Some seed oils contain undesirable impurities in their natural form. So, both the purification process and quality control testing are important.
  • And, as with most foods and supplements, it is “buyer beware”. Some manufacturers use the cheapest source of seed oil rather than the highest quality source.

My recommendations are:

  • Choose your source carefully.
    • For seeds and nuts look for freshness. If they look or taste funny, throw them out.
    • For oils and salad dressings choose reputable brands and choose ones that use low-heat processing.
  • Don’t overheat them.
    • Most vegetable oils are only suitable for use as salad dressings and other room temperature uses.
    • The exceptions are vegetable oils with high smoke points – for example, olive oil for stir fries and avocado oil for higher temperature cooking.
  • Store them safely. Don’t give them a chance to become oxidized.
    • We store sunflower seeds and almonds in our refrigerator and walnuts in our freezer.
    • We buy unsaturated vegetable oils in small quantities (so they are used up quickly) and store them in the refrigerator.
  • For supplements containing seed oil ingredients choose brands with high quality control standards.

The Bottom Line 

Seed oils have become the latest food villain. In a recent “Health Tips From the Professor” I have debunked the seed oil myths.

In today’s article I share the latest studies showing that seed oils are more likely to be anti-inflammatory than pro-inflammatory.

For more information on this study and how to select and use seed oils safely, 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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My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

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About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”. Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading Biochemistry textbooks for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

Health Tips From The Professor