Dr. Steve Chaney

If You Want To Be Green, You Have To Eat Green

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What Is The Planetary Diet?

 Author: Dr. Stephen Chaney

Earth DayEarth Day was last Thursday. You have recommitted to saving the planet. You plan to recycle, conserve energy, and turn in your gas guzzler for an energy efficient car. But what about your diet? Is your diet destroying the planet?

This is not a new question, but a recent commission of international scientists has conducted a comprehensive study into our diet and its effect on our health and our environment. Their report (W. Willet et al, The Lancet, 393, issue 10170, 447-492, 2019) serves as a dire warning of what will happen if we don’t change our ways. I touched on this report briefly in a previous issue of “Health Tips From The Professor”, but this topic is important enough that it deserves an issue all its own.

The commission carefully evaluated diet and food production methods and asked three questions:

  • Are they good for us?
  • Are they good for the planet?
  • Are they sustainable? Will they be able to meet the needs of the projected population of 10 billion people in 2050 without degrading our environment.

The commission described the typical American diet as a “lose-lose-lose diet”. It is bad for our health. It is bad for the planet. And it is not sustainable.

In its place they carefully designed their version of a primarily plant-based diet they called a “win-win-win diet”. It is good for our health. It is good for the planet. And, it is sustainable.

In their publication they refer to their diet as the “universal healthy reference diet” (What else would you expect from a committee?). However, it has become popularly known as the “Planetary Diet”.

I have spoken before about the importance of a primarily plant-based diet for our health. In that context it is a personal choice. It is optional.

However, this report is a wake-up call. It puts a primarily plant-based diet in an entirely different context. It is essential for the survival of our planet. It is no longer optional.

If you care about our environment…If you care about saving our planet, there is no other choice.

How Was The Study Done?

The study (W. Willet et al, The Lancet, 393, issue 10170, 447-492, 2019) was the report of the EAT-Lancet Commission on Healthy Diets from Sustainable Food Systems. This Commission convened 30 of the top experts from across the globe to prepare a science-based evaluation of the effect of diet on both health and sustainable food production through the year 2050. The Commission included world class experts on healthy diets, agricultural methods, climate change, and earth sciences. The Commission reviewed 356 published studies in preparing their report.

If You Want To Be Green, You Need To Eat Green

Factory FarmWhen they looked at the effect of food production on the environment, the Commission concluded:

  • “Strong evidence indicates that food production is among the largest drivers of global environmental change.” Specifically, the commission reported:
    • Agriculture occupies 40% of global land (58% of that is for pasture use).
    • Food production is responsible for 30% of global greenhouse gas emissions and 70% of freshwater use.
    • Conversion of natural ecosystems to croplands and pastures is the largest factor causing species to be threatened with extinction. Specifically, 80% of extinction threats to mammals and bird species are due to agricultural practices.
    • Overuse and misuse of nitrogen and phosphorous in fertilizers causes eutrophication. In case you are wondering, eutrophication is defined as the process by which a body of water becomes enriched in dissolved nutrients (such as phosphates from commercial fertilizer) that stimulate the growth of algae and other aquatic plant life, usually resulting in the depletion of dissolved oxygen. This creates dead zones in lakes and coastal regions where fish and other marine organisms cannot survive.
    • About 60% of world fish stocks are fully fished and more than 30% are overfished. Because of this, catch by global marine fisheries has been declining since 1996.
  • “Reaching the Paris Agreement of limiting global warming…is not possible by only decarbonizing the global energy systems. Transformation to healthy diets from sustainable food systems is essential to achieving the Paris Agreement.”
  • The world’s population is expected to increase to 10 billion by 2050. The current system of food production is unsustainable.

Food ChoicesWhen they looked at the effect of the foods we eat on the environment, the Commission concluded:

  • Beef and lamb are the biggest contributors to greenhouse gas emissions and land use.
    • The concern about land use is obvious because of the large amount of pasture land required to raise cattle and sheep.
    • The concern about greenhouse gas emissions is because cattle and sheep are ruminants. They not only breathe out CO2, but they also release methane into the atmosphere from fermentation in their rumens of the food they eat. Methane is a potent greenhouse gas, and it persists in the atmosphere 25 times longer than CO2. The single most important thing we can do as individuals to reduce greenhouse gas emissions is to eat less beef and lamb. [Note: grass fed cattle produce more greenhouse gas emissions than cattle raised on corn because they require 3 years to bring to market rather than 2 years.]
  • In terms of energy use beef, lamb, pork, chicken, dairy and eggs all require much more energy to produce than any of the plant foods.
  • In terms of eutrophication of our lakes and oceans, beef, lamb, and pork, all cause much more eutrophication than any plant food. Dairy and eggs cause more eutrophication than any plant food except fruits.
  • In contrast, plant crops reduce greenhouse gas emissions by removing CO2 from the atmosphere.

What Is The Planetary Diet?

Planetary DietIn the words of the Commission: “[The Planetary Diet] largely consists of vegetables, fruits, whole grains, legumes, nuts, and unsaturated oils. It includes a low to moderate amount of seafood, poultry, and eggs. It includes no or a very low amount of red meat, processed meat, sugar, refined grains, and starchy vegetables.”

When described in that fashion it sounds very much like other healthy diets such as semi-vegetarian, Mediterranean, DASH, and Flexitarian. However, what truly distinguishes it from the other diets is the restrictions placed on the non-plant portion of the diet to make it both environmentally friendly and sustainable. Here is a more detailed description of the diet:

  • It starts with a vegetarian diet. Vegetables, fruits, beans, nuts, soy foods, and whole grains are the foundation of the diet.
  • It allows the option of adding one serving of dairy a day (It turns out that cows produce much less greenhouse emissions per serving of dairy than per serving of beef. That’s because cows take several years to mature before they can be converted to meat, and they are emitting greenhouse gases the entire time).
  • It allows the option of adding one 3 oz serving of fish or poultry or one egg per day.
  • It allows the option of swapping seafood, poultry, or egg for a 3 oz serving of red meat no more than once a week. If you want a 12 oz steak, that would be no more than once a month.

This is obviously very different from the way most Americans currently eat. According to the Commission:

  • “This would require greater than 50% reduction in consumption of unhealthy foods, such as red meat and sugar, and greater than 100% increase in the consumption of healthy foods, such as nuts, fruits, vegetables, and legumes”.
  • “In addition to the benefits for the environment, “dietary changes from current diets to healthy diets are likely to substantially benefit human health, averting about 10.8-11.6 million deaths per year globally.”

What Else Did The Commission Recommend?

In addition to changes in our diets, the Commission also recommended several changes in the way food is produced. Here are a few of them.

  • Reduce greenhouse gas emissions from the fuel used to transport food to market.
  • Reduce food losses and waste by at least 50%.
  • Make radical improvements in the efficiency of fertilizer and water use. In terms of fertilizer, the change would be two-fold:
    • In developed countries, reduce fertilizer use and put in place systems to capture runoff and recycle the phosphorous.
    • In third world countries, make fertilizer more available so that crop yields can be increased, something the Commission refer to as eliminating the “yield gap” between third world and developed countries.
  • Stop the expansion of new agricultural land use into natural ecosystems and put in place policies aimed at restoring and re-foresting degraded land.
  • Manage the world’s oceans effectively to ensure that fish stocks are used responsibly and global aquaculture (fish farm) production is expanded sustainability.

What we can do: While most of these are government level policies, we can contribute to the first three by reducing personal food waste and purchasing organic produce locally whenever possible.

What Does This Mean For You?

confusionIf you are a vegan, you are probably asking why the Commission did not recommend a completely plant-based diet. The answer is that a vegan diet is perfect for the health of our planet. However, the Commission wanted to make a diet that was as consumer-friendly as possible and still meet their goals of a healthy, environmentally friendly, and sustainable diet.

If you are eating a typical American diet or one of the fad diets that encourage meat consumption, you are probably wondering how you can ever make such drastic changes to your diet. The answer is “one step at a time”. If you have read the Forward to my books “Slaying The Food Myths” or “Slaying the Supplement Myths”, you know that my wife and I did not change our diet overnight. Our diet evolved to something very close to the Planetary Diet over a period of years.

The Commission also purposely designed the Planetary Diet so that you “never have to say never” to your favorite foods. Three ounces of red meat a week does not sound like much, but it allows you a juicy steak once a month.

Sometimes you just need to develop a new mindset. As I shared in my books, my father prided himself on grilling the perfect steak. I love steaks, but I decided to set a few parameters. I don’t waste my red meat calories on anything besides filet mignon at a fine restaurant. It must be a special occasion, and someone else must be buying. That limits it to 2-3 times a year. I still get to enjoy good steak, and I stay well within the parameters of the Planetary diet.

Develop your strategy for enjoying some of your favorite foods within the parameters of the Planetary Diet and have fun with it.

The Bottom Line

is your diet destroying the planet? This is not a new question, but a recent commission of international scientists has conducted a comprehensive study into our diet and its effect on our health and our environment. Their report serves as a dire warning of what will happen to us and our planet if we don’t change our ways.

The Commission carefully evaluated diet and food production methods and asked three questions:

  • Are they good for us?
  • Are they good for the planet?
  • Are they sustainable? Will they be able to meet the needs of the projected population of 10 billion people in 2050 without degrading our environment.

The Commission described the typical American diet as a “lose-lose-lose diet”. It is bad for our health. It is bad for the planet. And it is not sustainable.

In its place they carefully designed their version of a primarily plant-based diet they called a “win-win-win diet”. It is good for our health. It is good for the planet. And, it is sustainable.

In their publication they refer to their diet as the “universal healthy reference diet” (What else would you expect from a committee?). However, it has become popularly known as the “Planetary Diet”.

The Planetary Diet is similar to other healthy diets such as semi-vegetarian, Mediterranean, DASH, and Flexitarian. However, what truly distinguishes it from the other diets is the restrictions placed on the non-plant portion of the diet to make it both environmentally friendly and sustainable (for details, read the article above).

I have spoken before about the importance of a primarily plant-based diet for our health. In that context it is a personal choice. It is optional.

However, this report is a wake-up call. It puts a primarily plant-based diet in an entirely different context. It is essential for the survival of our planet. It is no longer optional.

If you care about global warming…If you care about saving our planet, there is no other choice.

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.

 

Relief From Hip And Knee Pain

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A Common Cause For Pains From Hip To Knee 

Author: Julie Donnelly, LMT –The Pain Relief Expert

Editor: Dr. Steve Chaney

 Happy April! Happy Spring!

spring flowersOne of the best parts of April (other than all the beautiful flowers) is that the weather is great in both the North and the South.  Up north, you are warming up from the bitter cold of winter, and here in the south, we still have low humidity and temps are in the 70’s most of the time.  Perfect!

April Fool’s Day is a fun “holiday” that I loved when I was a child.  It was always a challenge to catch my Mom, but I’m sure she was pretending most of the time when I told her silly things.  I wonder if kids still play jokes on their friends’ and family?

This year the Christian Easter Holiday is on April 4th, and the Jewish Last Day of Passover is also on April 4th.  So, lots of family gatherings are happening everywhere.  And there are lots of ridiculous holidays, like International Pillow Fight Day (April 3rd) and National Grilled Cheese Sandwich Day (April 12th).  What will they think of next!!

Do you like to garden?  Now is the perfect time to get your gardens planted so you’ll have home grown veggies for the entire summer.  For me, it’s also a great time to do some spring cleaning and get the house in order before the summer closes all the windows and the air conditioning becomes our indoor relief.

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Happy, Happy News!

As you know from previous newsletters, I did a TEDx talk on December 6, 2020.  I was so excited. Then the Powers-That-Be decided to decline putting it on YouTube because I dared to question why muscles aren’t ever thought about when searching for the cause of pain.

I jumped through a bunch of hoops, sending peer-reviewed medical journal articles that proved that trigger points are real, and they are known in the medical world.  I had to send my CV to prove that I had background that qualified me to ask the question, and a bunch of other documents for them to ponder.

The good news is, I’ve finally been approved! 

You can either go to YouTube and put in “Julie Donnelly, Pain” so you can also see the 20+ pain explanation videos I’ve done, or you can click on this link: The Pain Question No One is Asking! It’s really important to please Like it, and then Share it with as many people as possible. The parent company, TED, will invite me back to speak if I get enough Likes and Shares.  My next talk would be to explain to people why muscles in your thigh and hip cause low back pain.  People are suffering, and they are looking at the wrong area for relief.  Your low back isn’t really the source of low back pain.

I’m communicating with an animated graphics expert to build a short video that visually explains the “why” and “which” of the muscles that cause low back pain.  It could make a huge difference for millions of people.

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A Common Cause For Pains From Hip To Knee

There are times when I am led to sharing a treatment because I had a run of clients all suffering from the same source muscle.  That is what happened for this newsletter.  In March I had at least six clients come to my office, all having different symptoms, but all stemming from the same source.

My clients complained of hip pain, thigh pain, knee pain, and pain down the outside of the lower leg.

In this case it was the Tensor Fascia Lata and two of the three Gluteal muscles: Medius, Minimus. The Gluteus Medius is directly over the Gluteus Minimus, so treating one will actually treat both.  And the Tensor Fascia Lata is right next to both these muscles.

All these muscles insert into the same area of the hip, and for different reasons, they all cause hip pain.  Also, each muscle refers pain to a different location, so you think you have a problem in these referred pain locations, but they are all coming from your hip.

This is one of the many times when working on one area will solve many different problems.

Take a look at these Trigger Point charts:

To read the charts, look at the shaded area (which shows where pain is felt) and look for the muscle name in the same color.  Then follow the arrow to the same-colored round circles with “x”. This is the trigger point (spasm) that is the source of that pain pattern.

You’ll notice that the spasm (trigger point) for the purple pain pattern is in the Gluteus Minimus at the outside of the hip, but the pain pattern goes to the outside of the thigh, the knee, and all the way down to the ankle.

The spasms for the Tensor Fascia Lata is in the same place on the hip, but the pain pattern is the hip, the thigh, and the outside of the knee.

In each of these cases the pain is being felt along the insertion points for the muscles.

Relief From Hip And Knee Pain

To relieve the muscle spasms that are causing the problem, use my “Perfect Ball” (You can use a baseball or tennis ball, but my Perfect Ball is just the right size and hardness for the job). Then, either lie on the floor or stand up and lean into a wall as shown in the two photos below.  Lean into the ball, easing your pressure onto the ball gradually.  As the muscle releases it will hurt less and less.

Then you can rotate your body, so the ball is pressing into the front of your hip or rotating so the ball is rolling toward the back of your body.  You will likely find multiple painful tender spots.  Each spot is a spasm that is putting pressure on your bones or is pulling on the tendon (called the IlioTibial Band – ITB) that is putting pressure onto your lateral knee joint. 

You can also treat these muscles by using a length of 1” PVC pipe as shown in the picture on the left.

 

This picture was shared with me by an athlete. An avid runner, she couldn’t get down on the ground, nor was there a wall that she could press into, but using the pipe and a street sign pole, she was still able to release the tight muscles that were preventing her from running.

 

This may not be perfect for you, but if you are an athlete, it could be just what you need when you’re unable to treat yourself as shown above.

You REALLY CAN Treat Yourself 

Since 1989 I have been working with people who are experiencing severe &/or chronic pain.  During those years I’ve managed to figure out why they are in pain, and how they can stop the pain by treating themselves.

It is wonderful when someone can come into my office and I can work directly with them, but I’ve found that the key is the self-treatments I teach them to do at home.  With the self-treatments you can release the tension multiple times every day, retraining your muscles to stay relaxed.

Thousands of people have been able to stop pain fast because they have followed the simple techniques I teach.

You can stop pain fast too!  Even chronic pain releases when you treat the source and not just the symptom! 

To enable you to know where to treat, and how to treat the muscles that cause pain, I’ve produced several “How To” books and DVD programs.

Visit my shopping cart to see the full line of pain-relief products that will help you overcome:

  • Shoulder pain
  • Neck pain
  • Carpal tunnel symptoms
  • Trigger finger
  • Low back pain
  • Hip pain
  • Sciatica
  • Knee Pain
  • Plantar Fasciitis

In fact, you can get relief for pains from your head to your feet!

Wishing you well,

Julie Donnelly 

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. 

About The Author

Julie Donnelly

 

Julie Donnelly has been a licensed massage therapist since 1989, specializing in the treatment of chronic pain and sports injuries. She is the author of several books including Treat Yourself to Pain-Free Living, The Pain-Free Athlete, and The 15 Minute Back Pain Solution. She is also often chosen to speak at national conventions, medical schools, and health facilities nationwide.

Julie has also developed a proven self-treatment program for the symptoms of carpal tunnel syndrome.

 

 

Will Plant Proteins Help You Live Longer?

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Is A Vegan Diet Healthiest?

Author: Dr. Stephen Chaney

Fountain Of YouthUnless you are Rip Van Winkle and have been asleep for the past 40 years, you have probably heard that whole food, primarily plant-based diets are good for you.

  • They help you control your weight.
  • They reduce inflammation.
  • They reduce your risk of diabetes and heart disease.
  • They even reduce your risk of some cancers.

But do they help you live longer? If we take that question literally, the answer appears to be no. There is no “Fountain Of Youth”. There are no diets that extend our lives significantly.

However, what if you could reduce your risk of premature death? It would be tragic to have your life cut short by a heart attack or some other major disease. What if you could prevent that?

And what if you could live healthier longer? It would be equally tragic to spend your golden years debilitated by chronic diseases like heart disease, diabetes, or dementia. What if you could delay these diseases and live healthier longer?

The study I discuss this week (Y Sun, Journal of the American Heart Association, 10:e015553, 2021) looks at the effect of different dietary protein sources on premature death.

This study, like many others, suggests that primarily plant-based diets are healthier than meat-based diets. But what does this mean for you? Should you go completely meatless? Is a vegan diet healthier than other plant-based diets? I discuss what we know and what we do not know about the vegan diet compared to other plant-based diets.

How Was This Study Done?

Clinical StudyThe data for this study were drawn from the Women’s Health Initiative (WHI). The Women’s Health Initiative was designed to help identify strategies for preventing heart disease and other diseases in postmenopausal women. It enrolled 161,000 postmenopausal women from 40 sites across the US between 1993 and 1998 and followed them through 2017.

This study excluded women who had heart disease or cancer when they entered the WHI study and women who had incomplete data on either their diet or their use of postmenopausal hormone therapy. They were left with 102,521 women, age 50-79 at time of entry, who were followed for 18 years.

Each woman filed out an extensive dietary survey at the beginning of the study. There were 25,976 deaths during the study. The cause of death was determined by reviewing death certificates, medical records, autopsy reports or by linkage to the National Death Index.

The investigators asked whether women who ate more plant proteins were healthier than those who ate primarily meat protein. To answer this question, they correlated protein sources in the diet with all-cause mortality and deaths from various diseases.

The greatest difficulty with this type of study is that people who eat more plant protein tend to have a healthier diet and a healthier lifestyle. That makes it hard to separate out the benefits of eating plant proteins from benefits associated with other aspects of their diet and lifestyle. So, the authors corrected their data for every factor known to influence the risk of heart disease, diabetes, dementia, and premature death.

Specifically, the data were statistically corrected for age, race/ethnicity, socioeconomic status, hormone use, lifestyle (smoking status, physical activity, and alcohol intake), baseline health status (diabetes and/or high blood cholesterol), family history of heart attack/stroke, dietary factors (calorie intake, dietary fiber intake, whole grain consumption, fruit and vegetable consumption, sugar-sweetened beverage consumption, glycemic load (effect of foods in the diet on blood sugar), and percentage of saturated fats, polyunsaturated fats, monounsaturated fats, and trans fats), and weight (BMI).

In short, the authors corrected for every other factor that could influence disease risk and/or premature death. By doing so, they were able to focus on the effect of protein sources on disease risk and/or premature death.

Will Plant Proteins Help You Live Longer?

Plant ProteinsThe investigators divided the study participants into quintiles with respect the kind and amount of protein they consumed.

  • For animal protein, the intake ranged from 4 ounces/day in the lowest quintile to 9 ounces a day in the highest quintile (For comparison, 3 ounces is roughly equivalent to the size of a deck of cards).
  • For plant protein, the intake ranged from 2 ounces/day in the lowest quintile to 3.5 ounces/day in the highest quintile.
  • When you combine plant and animal protein in these women’s diet, plant protein ranged from 18% of total protein intake in the lowest quintile to 48% of total protein intake in the highest quintile.

When women who had the highest intake for plant protein were compared with women who had the lowest intake of plant protein, the women with the highest plant protein intake had:

  • 12% lower risk of premature death from heart disease.
  • 21% lower risk of premature death from dementia.
  • 9% lower risk of premature death from all causes.

There was an inverse relationship between the amount of plant protein in the diet and premature death. Specifically, every 3 ounces of animal protein that was replaced with 3 ounces of plant protein resulted in:

  • 22% lower risk of premature death from heart disease.
  • 19% lower risk of premature death from dementia.
  • 14% lower risk of premature death from all causes.

The Effect Of Individual Animal Proteins On Mortality

Fatty SteakThe authors also looked at the effect of various animal proteins on premature death. For example:

Red Meat: Women with the highest consumption of red meat had:

  • 14% higher risk of premature death from heart disease.
  • 20% higher risk of premature death from dementia.
  • 10% higher risk of premature death from all causes.

Eggs: Women with the highest consumption of eggs had:

  • 24% higher risk of premature death from heart disease.
  • 14% lower risk of premature death from dementia.
  • 14% higher risk of premature death from all causes.

Dairy: Women with the highest consumption of dairy had:

  • 11% higher risk of premature death from heart disease.

The authors concluded, “In this large prospective cohort study, we found that higher plant protein intake and substitution of animal protein with plant protein were associated with lower risk of all-cause mortality, cardiovascular mortality, and dementia mortality…Our findings support the need for consideration of protein sources, in addition to the amount of protein intake, in future dietary guidelines.”

Is A Vegan Diet Healthiest?

Vegetarian DietYears ago, as my brother-in-law was coming out of anesthesia at the end of quadruple bypass surgery, the first question he asked was, “Does this mean I need to eat tofu?” Obviously, nothing terrified him more than the thought of eating tofu the rest of his life. In the same vein, some of you are probably asking, “Does this mean I need to go vegan?”

The good news is that none of the women in this study were consuming a vegan diet. They were consuming a typical American diet with varying amounts of plant and animal protein. The group with the highest plant protein consumption were still getting 52% of their protein from animal sources.

This study shows that even people consuming a typical American diet can become healthier by simply swapping out some of the animal protein in their diet with plant protein.

However, you are probably thinking, “Plant protein is good for us, and a vegan diet is 100% plant protein. Does that mean a vegan diet is healthier than other plant-based diets?

The answer is………”Maybe”

If the linear relationship between plant protein consumption and risk of premature death could be extrapolated all the way to 100% plant protein, the answer would be obvious. Vegan diets would be healthier than other plant-based diets. But that extrapolation is an assumption. It might not be true.

For example, some recent studies suggest that completely eliminating meat, eggs, and dairy from your diet may slightly increase your risk of heart disease and stroke:

  • One recent study found that adding 1.4 ounces of fish/day to a primarily vegetarian diet decreases the risk of stroke by 20%.
  • Another study reported that adding one egg/day to a primarily vegetarian diet decreases the risk of heart disease by 12% and stroke by 10-26%.

These studies need to be confirmed, but they do suggest we need to be cautious about assuming that vegan diets are healthier than other primarily plant-based diets. This is why, when I recommend primarily plant-based diets, I include everything from vegan through semi-vegetarian, Mediterranean, and DASH.

They are all healthy diets. My advice is to choose the one that best fits your lifestyle and food preferences. And focus on whole foods, not processed foods.

The Bottom Line 

A recent study asked whether women who ate more plant proteins were healthier than those who ate primarily meat protein. To answer this question, the investigators correlated protein sources in the diet with all-cause mortality and deaths from various diseases.

When women who had the highest intake for plant protein were compared with women who had the lowest intake of plant protein, the women with the highest plant protein intake had:

  • 12% lower risk of premature death from heart disease.
  • 21% lower risk of premature death from dementia.
  • 9% lower risk of premature death from all causes.

There was an inverse relationship between the amount of plant protein in the diet and premature death. Specifically, every 3 ounces of animal protein that was replaced with 3 ounces of plant protein resulted in:

  • 22% lower risk of premature death from heart disease.
  • 19% lower risk of premature death from dementia.
  • 14% lower risk of premature death from all causes.

[Note: A 3-ounce serving is roughly equivalent to a deck of cards.]

The authors concluded, “In this large prospective cohort study, we found that higher plant protein intake and substitution of animal protein with plant protein were associated with lower risk of all-cause mortality, cardiovascular mortality, and dementia mortality…Our findings support the need for consideration of protein sources, in addition to the amount of protein intake, in future dietary guidelines.”

Years ago, as my brother-in-law was coming out of anesthesia at the end of quadruple bypass surgery, the first question he asked was, “Does this mean I need to eat tofu?” Obviously, nothing terrified him more than the thought of eating tofu the rest of his life. In the same vein, some of you are probably asking, “Does this mean I need to go vegan?”

I discuss the answer to that question in the article above.

For more details and a discussion about the vegan diet versus other primarily plant-based diets 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.

What Is An Anti-Inflammatory Diet?

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Can Diet Douse The Flames?

Author: Dr. Stephen Chaney

InflammationIf you have arthritis, colitis, bursitis, or any of the other “itis” diseases, you already know that inflammation is the enemy. Chronic, low level inflammation is also a contributing factor to heart disease, cancer, and many other diseases. Clearly, inflammation is a bad actor. It is something we want to avoid.

Obesity and diabetes are two of the biggest contributors to inflammation, but does diet also play a role? With all the anti-inflammation diets circulating on the internet, you would certainly think so. How good is the evidence that certain foods influence inflammation, and what does an anti-inflammatory diet look like?

The Science Behind Anti-Inflammatory Diets

ScientistLet me start by saying that the science behind anti-inflammatory diets is nowhere near as strong as it is for the effect of primarily plant-based diets on heart disease and diabetes. The studies on anti-inflammatory diets are mostly small, short duration studies. However, the biggest problem is that there is no standard way of measuring inflammation.

There are multiple markers of inflammation, and they do not change together. That means that in every study some markers of inflammation are altered, while others are not. There is no consistent pattern from one study to another.

In spite of these methodological difficulties, the studies generally point in the same direction. Let’s start with the strongest evidence and work our way down to the weakest evidence. 

Omega-3 fats are anti-inflammatory (I. Reinders et al, European Journal of Clinical Nutrition, 66: 736-741, 2011). The evidence is strongest for the long chain omega-3s found in fish and fish oil, but the shorter chain omega-3s found in foods like walnuts, flaxseeds, chia seeds and flaxseed oil, soybean oil, and canola oil also appear to be anti-inflammatory. 

Inflammation is directly correlated with glycemic index (L. Qi and F.B. Lu, Current Opinion in Lipidology, 18: 3-8, 2007). This has a couple of important implications.

The most straightforward is that refined carbohydrates and sugars (sodas, pastries, and desserts), which have a high glycemic index, increase inflammation. In contrast, complex carbohydrates (whole grains, most fruits and vegetables) decrease inflammation. No surprise there. The second implication is that it is the glycemic index, not the sugar, that is driving the inflammatory response.

That means we need to look more closely at foods than at sugars. Sodas, pastries and desserts are likely to cause inflammation, but sugar-containing foods with a low glycemic index are unlikely to be inflammatory. 

Fruits and vegetables are anti-inflammatory. This has been shown in multiple studies. At this point most of the research is centered on identifying the nutrients and phytonutrients from fruits and vegetables that are responsible for the reduction in inflammation. I suspect the investigators are hoping to design an anti-inflammatory supplement and make lots of money. I will stick with the fresh fruits and vegetables. 

Saturated fats are inflammatory. At face value, the data on saturated fats appear to be contradictory. Some Fatty Foodsstudies say that saturated fats increase inflammation, while others say they do not. However, similar to my earlier discussion on saturated fats and heart disease), the outcome of the study depends on what the saturated fats are replaced with.

When saturated fats are replaced with refined carbohydrates, sugar and highly processed foods (the standard American low-fat diet), inflammation doesn’t change. This doesn’t mean that a diet high in saturated fat is healthy. It just means that both diets are bad for you. Both are inflammatory.

However, when saturated fat is replaced with omega-3 polyunsaturated fats (J.A. Paniagua et al, Atherosclerosis, 218: 443-450, 2011) or monounsaturated fats (B. Vessby et al, Diabetologia, 44: 312-319, 2001), markers of inflammation decrease. Clearly, saturated fats are not the best fat choice if you wish to keep inflammation in check.

I would be remiss if I did not address the claims by the low-carb diet proponents that saturated fats do not increase inflammation in the context of a low-carb diet. I want to remind you of two things we have discussed previously:

  • The comparisons in those studies are generally with people consuming a diet high in simple carbohydrates and sugars.
  • These studies have mostly been done in the short-term when the participants are losing weight on the low-carb diets. Weight loss decreases inflammation, so the reduction in inflammation on the low-carb diet could be coming from the weight loss.

The one study (M. Miller et al, Journal of the American Dietetic Association, 109: 713-717, 2009) I have found that compares a low-carb diet (the Atkins diet) with a good diet (the Ornish diet, which is a low-fat, lacto-ovo vegetarian diet) during weight maintenance found that the meat based, low-carb Atkins diet caused greater inflammation than the healthy low-fat Ornish diet.

Red meat is probably pro-inflammatory. Most, but not all, studies suggest that red meat consumption is associated with increased inflammation. If it is pro-inflammatory, the inflammation is most likely associated with its saturated fat, its heme iron content, or the advanced glycation end products formed during cooking.

What Is An Anti-Inflammatory Diet?

Colorful fruits and vegetablesAnti-inflammatory diets have become so mainstream that they now appear on many reputable health organization websites such as Harvard Health, WebMD, the Mayo Clinic, and the Cleveland Clinic. Each have slightly different features, but there is a tremendous amount of agreement. 

Foods an anti-inflammatory diet includes: In a nutshell, an anti-inflammatory diet includes fruits and vegetables, whole grains, plant-based proteins (like beans and nuts), fatty fish, and fresh herbs and spices. Specifically, your diet should emphasize:

  • Colorful fruits and vegetables. Not only do they help fight inflammation, but they are a great source of antioxidants and other nutrients important for your health.
  • Whole grains. They have a low glycemic index. They are also a good source of fiber, and fiber helps flush inflammatory toxins out of the body.
  • Beans and other legumes. They should be your primary source of protein. They are high in fiber and contain antioxidants and other anti-inflammatory nutrients.
  • Nuts, olive oil, and avocados. They are good sources of healthy monounsaturated fats, which fight inflammation.
  • Fatty fish. Salmon, tuna, and sardines are all great sources of long chain omega-3 fatty acids, which are fish and fish oilincorporated into our cell membranes. Those long chain omega-3s in cell membranes are, in turn, used to create compounds that are powerful inflammation fighters.

Walnuts, flaxseeds, and chia seeds are good sources of short chain omega-3s. The efficiency of their conversion to long chain omega-3s that can be incorporated into cell membranes is only around 2-5%. If they fight inflammation, it is probably because they replace some of the saturated fats and omega-6 fats you might otherwise be eating.

  • Herbs and spices. They add antioxidants and other phytonutrients that fight inflammation.

Foods an anti-inflammatory diet excludes: In a nutshell, an anti-inflammatory diet should exclude highly processed, overly greasy, or super sweet foods, especially sodas and other sweet drinks. Specifically, your diet should exclude:

  • Refined carbohydrates, sodas and sugary foods. They have a high glycemic index, which is associated with inflammation. They can also lead to weight gain and high blood sugar, both of which cause inflammation.
  • Foods high in saturated fats. This includes fatty and processed meats, butter, and high fat dairy products.
  • Foods high in trans fats. This includes margarine, coffee creamers, and any processed food containing partly hydrogenated vegetable oils. Trans fats are very pro-inflammatory.
  • French fries, fried chicken, and other fried foods. They used to be fried in saturated fat and/or trans fat. Nowadays, they are generally fried in omega-6 vegetable oils. A little omega-6 in the diet is OK, but Americans get too much omega-6 fatty acids in their diet. Most studies show that a high ratio of omega-6 to omega-3 fatty acids is pro-inflammatory.
  • Foods you are allergic or sensitive to. Eating any food that you are sensitive to can cause inflammation. This comes up most often with respect to gluten and dairy because so many people are sensitive to one or both. However, if you are not sensitive to them, there is no reason to exclude whole grain gluten-containing foods or low-fat dairy foods from your diet.

Can Diet Douse The Flames?

FlamesIn case you didn’t notice, the recommendations for an anti-inflammatory diet closely match the other healthy diets I have discussed previously. It should come as no surprise then that both the Mediterranean (L. Gallard, Nutrition in Clinical Practice, 25: 634-640, 2010; L. Schwingshackl and G. Hoffmann, Nutrition Metabolism and Cardiovascular Diseases, 24: 929-939, 2014) and DASH (D.E. King et al, Archives of Internal Medicine, 167: 502-506, 2007) diets are anti-inflammatory.

Vegan and vegetarian diets also appear to be anti-inflammatory as well. The anti-inflammatory nature of these diets undoubtedly contributes to their association with a lower risk of heart disease, diabetes, and cancer.

As for the low-carb diets, the jury is out. There are no long-term studies to support the claims of low-carb proponents that their diets reduce inflammation. The few long-term studies that are available suggest that low-carb diets are only likely to be anti-inflammatory if vegetable proteins and oils replace the animal proteins and fats that are currently recommended.

What does this mean for you if you have severe arthritis or other inflammatory diseases? An anti-inflammatory diet is unlikely to “cure” your symptoms by itself. However, it should definitely be a companion to everything else you are doing to reduce inflammation.

The Bottom Line 

If you have arthritis, colitis, bursitis, or any of the other “itis” diseases, you already know that inflammation is the enemy. Chronic, low level inflammation is also a contributing factor to heart disease, cancer, and many other diseases. Clearly, inflammation is a bad actor. It’s something we want to avoid.

Obesity and diabetes are two of the biggest contributors to inflammation, but does diet also play a role? With all the anti-inflammation diets circulating on the internet, you would certainly think so. In this article I review the evidence that certain foods influence inflammation and describe what an anti-inflammatory diet looks like.

For more details read the article above.

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

Do Omega-3s Oil Your Joints?

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Fish Oil And Osteoarthritis

Author: Dr. Stephen Chaney

Osteoarthritis is not just painful. It is one of the leading causes of disability in this country. And because the joint pain associated with osteoarthritis limits activity levels, it is linked to:

  • Obesity
  • The diseases associated with obesity (diabetes and heart disease).
    • Osteoarthritis increases the risk of heart disease by 50%.
  • Premature death associated with the increased prevalence of obesity, diabetes, and heart disease.
    • Osteoarthritis increases the risk of all-cause mortality by 55%.

If osteoarthritis were rare, these statistics would just be an interesting side note. But osteoarthritis is the most common form of arthritis. It affects more than 32 million Americans. And it is costly. It costs the American economy:

  • $65 billion in health care costs.
  • $17 billion in lost wages.
  • $136 billion in total costs.

Conventional therapy for osteoarthritis is treatment with anti-inflammatory drugs, but they have side effects. They may even increase the risk of premature death in some individuals.

What about natural anti-inflammatory nutrients and phytonutrients? Two that have received a lot of press in recent years are omega-3s (fish oil) and curcumin.

A recent meta-analysis (NK Senftleber et al, Nutrients, 9: 42, 2017) of 42 clinical studies on the effects of omega-3s on various types of arthritis found that:

  • There is moderate quality evidence that omega-3s reduce the pain associated with rheumatoid arthritis. Basically, this means that there is strong, but not definitive, evidence that omega-3s reduce the pain of rheumatoid arthritis. Other general conclusions with respect to rheumatoid arthritis were:
    • The best results were obtained from fish oil preparations with an EPA/DHA ratio of >1.5, suggesting that EPA is more beneficial than DHA.
    • Early studies suggested that the optimal dose of omega-3s was ≥2.6 g/day for ≥12 weeks.
  • There was low quality evidence for an effect of omega-3s on osteoarthritis. Only 5 clinical trials have been published on the topic and the results of those studies are conflicting.

The data for an effect of curcumin on osteoarthritis pain are even more limited. There is some evidence it might be beneficial, but the studies are small and are conflicting.

In this week’s issue of “Health Tips From the Professor” I discuss an exploratory study (JC Kuszewski et al, Rheumatology Advances In Practice 4: 1-9, 2020) on the effect of omega-3s and curcumin on osteoarthritis pain.

How Was The Study Done?

Clinical StudyYou are probably wondering, “What is an “exploratory study?” Let me start by providing you with a little perspective from my years of heading a cancer research laboratory at the University of North Carolina:

Clinical studies are expensive. And if you are trying to study an approach that has not already proven to be successful, the money needed to fund the study can be hard to come by. It is a “Catch 22” situation. You need to conduct an “exploratory study” to show your project is likely to succeed before the funding agency will give you money to fund your project.

But where do you get the money to fund your exploratory project? One way that investigators overcome that barrier is to use data from a previous study that was originally designed for a different purpose. The study I will describe today is an example of that approach.

The study utilized data collected from a clinical trial designed to measure the effect of omega-3s and curcumin on brain function in older adults. The study recruited 152 older adults (average age = 65) who were overweight to obese (average BMI = 31) and sedentary (˂55 min/week of physical activity) from New South Wales, New Australia.

The participants were randomly divided into 4 groups:

  • Placebo group. [Note: The fish oil placebo contained 20 mg of fish oil so it would match the odor of the fish oil supplement, and the curcumin placebo contained yellow food dye so it would match the color of the curcumin supplement.]
  • Fish oil group (2,000 mg DHA & 400 mg EPA per day).
  • Curcumin group (160 mg/day curcumin).
  • Fish oil + curcumin group.

Participants were followed for 16 weeks. At the beginning and end of the study participants filled out questionnaires assessing (among other things):

  • The severity of their chronic osteoarthritis pain.
  • Disabilities caused by osteoarthritis in the participant’s daily life (physical distress, sleep disturbances, psychological distress, loss of productivity, physical limitations, physical deconditioning due to reduction in physical activity, and financial hardship).
  • Their physical and mental wellbeing during the past 4 weeks.
  • Their mood during the past 7 days.

Do Omega-3s Oil Your Joints?

fish and fish oilThe results were as follows:

  • Omega-3 supplementation reduced chronic osteoarthritis pain by 42%.
  • Omega-3 supplementation reduced disability associated with osteoarthritis by 40%.
    • The reduction in pain and disability in participants supplemented with fish oil was greatest in those who reported the highest pain/disability at the beginning of the study.
    • The reduction in pain was associated with an improved perception of physical and mental wellbeing.
    • The reduction in pain was also associated with a decrease in depression and other mood disturbances.
  • Curcumin did not affect pain or osteoarthritis burden either alone or paired with omega-3s.

The authors concluded, “Our findings indicate potential for fish oil supplementation to reduce mild osteoarthritis pain and burden in sedentary overweight/obese older adults…,which was associated with improved wellbeing.”

What Are The Pros And Cons Of This Study?

pros and consPros:

The results for the effects of omega-3s on osteoarthritis were highly significant. In addition, the questionnaires used were well designed to capture the intensity and location of pain, mood, and feelings of wellbeing.

Cons:

This was an exploratory study using data collected from a study designed to measure the effect of omega-3s and curcumin on brain health in older adults. It was not ideally designed to measure the effect of omega-3s and curcumin on osteoarthritis.

If the original study had been intended for investigating the effect of these supplements on osteoarthritis, it would have been designed differently:

  • Participants would have been recruited into the study based on the presence and intensity of osteoarthritis pain.
  • The diagnosis of osteoarthritis would have been confirmed by X-rays.
  • Participants would have been admitted into the study only if they had moderate to severe osteoarthritis pain. Most of the participants in this study had only mild osteoarthritis pain. That may have limited the ability of this study to find an effect of curcumin on osteoarthritis pain.
  • The design of the omega-3 supplement would have been different.
    • Because the original study was designed to determine the effect of omega-3s on brain health, the omega-3 supplement chosen had more DHA than EPA.
    • Had the study been designed to determine the effect on omega-3s on an inflammatory disease like osteoarthritis, the omega-3 supplement would have had more EPA than DHA.
  • The curcumin supplement was also not ideally designed for this study. The curcumin supplement used in this study contained only 160 mg of curcumin and contained no other ingredients. Well-designed curcumin supplements usually contain around 500 mg curcumin standardized to 95% curcuminoids plus piperine to enhance the absorption of the curcumin.

In the words of the authors, “Further studies are warranted to evaluate the benefits of fish oil, alone or as an adjunct to pharmacotherapy, in patients diagnosed with osteoarthritis who suffer moderate-to-severe pain…” In other words, they now intend to use the data from this exploratory study to apply for funds to conduct a larger study specifically designed to measure the effects of omega-3s on osteoarthritis pain.

The study limitations described above, severely restricted the ability of the study to detect any beneficial effect of curcumin on osteoarthritis pain. The effect of curcumin on osteoarthritis pain is probably less than the effect of omega-3s, but it would be premature to conclude that it has no benefit. However, they obtained no data from their “exploratory study” to justify a follow-up study on the effect of curcumin on osteoarthritis pain.

Fish Oil And Osteoarthritis

omega-3 fish oil supplementThis study suggests that 2.4 grams/day of omega-3s may be equally effective at reducing osteoarthritis pain and the effects that osteoarthritis pain has on both physical health and psychological health. However, because this study has several limitations, the evidence cannot be considered definite.

If you have either rheumatoid or osteoarthritis, I recommend trying omega-3 supplementation. Based on the studies described above, you might want to aim for 2-3 g/day of omega-3s with an EPA/DHA ration of 1.5 or greater.

As with any natural approach, this will work better for some people that for others. However, don’t forget that omega-3s are also important for heart health, healthy blood pressure, brain health, and a healthy pregnancy (https://www.chaneyhealth.com/healthtips/omega-3s-during-pregnancy-are-healthy/). If they also happen to reduce your arthritis pain, that is an extra benefit.

As usual, I recommend a holistic approach. You should also:

  • Keep active.
  • Aim for a healthy weight.
  • Add antioxidant and polyphenol supplements.

These lifestyle changes should allow you to reduce or eliminate any pain medication you may be taking.

Finally, if you are on blood thinners, consult with your physician before adding omega-3 supplements to your diet. My preference is to incorporate omega-3s and reduce other medications, but that is a discussion you need to have with your doctor.

The Bottom Line

A recent meta-analysis has concluded there is moderate quality evidence that omega-3s reduce the pain associated with rheumatoid arthritis. Basically, this means that there is strong, but not definitive, evidence that omega-3s reduce the pain of rheumatoid arthritis. Other general conclusions with respect to rheumatoid arthritis were:

  • The best results were obtained from fish oil preparations with an EPA/DHA ratio of >1.5, suggesting that EPA is more beneficial than DHA.
  • Earlier studies suggested that the optimal dose of omega-3s was ≥2.6 g/day for ≥12 weeks.

However, there have been few studies on the effect of omega-3s on osteoarthritis. A new exploratory study looked at the effect of 2.4 g/day of omega-3s for 16 weeks on the pain and disability associated with osteoarthritis. It found:

  • Omega-3 supplementation reduced chronic osteoarthritis pain by 42%.
  • Omega-3 supplementation reduced disability associated with osteoarthritis by 40%.
    • The reduction in pain and disability in participants supplemented with fish oil was greatest in those who reported the highest pain/disability at the beginning of the study.
    • The reduction in pain was associated with an improved perception of physical and mental wellbeing.
    • The reduction in pain was also associated with a decrease in depression and other mood disturbances.

The authors concluded, “Our findings indicate potential for fish oil supplementation to reduce mild osteoarthritis pain and burden in sedentary overweight/obese older adults. Further studies are warranted to evaluate the benefits of fish oil, alone or as an adjunct to pharmacotherapy, in patients diagnosed with osteoarthritis who suffer moderate-to-severe pain…”

If you have either rheumatoid or osteoarthritis, I recommend trying omega-3 supplementation. Based on the studies described above, you might want to aim for 2-3 g/day of omega-3s with an EPA/DHA ration of 1.5 or greater.

As with any natural approach, this will work better for some people that for others. However, don’t forget that omega-3s are also important for heart health, healthy blood pressure, brain health, and a healthy pregnancy. If they also happen to reduce your arthritis pain, that is an extra benefit.

As usual, I recommend a holistic approach. You should also:

  • Follow an anti-inflammatory diet.
  • Keep active.
  • Aim for a healthy weight.
  • Add antioxidant and polyphenol supplements.

These lifestyle changes should allow you to reduce or eliminate any pain medication you may be taking.

Finally, if you are on blood thinners, consult with your physician before adding omega-3 supplements to your diet. My preference is to incorporate omega-3s and reduce other medications, but that is a discussion you need to have with your doctor.

For more details read the article above.

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

Do Diet Sodas Hurt Your Heart?

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Love Your Heart

Author: Dr. Stephen Chaney

confusionHeart healthy diets are confusing.

  • First, we were told that fats, especially saturated fats, were the problem. Then it was carbohydrates.
  • Then, we were told not all carbohydrates were equally bad for us. Sugars were the culprit.
  • Next, we were told not all sugars were bad for us. It was added sugars, especially the sugars added to sodas and other sugary drinks.
  • In fact, most of the clinical studies on the bad effects of sugar have been done with sugar-sweetened sodas.
  • If sugar-sweetened sodas are the problem, then surely diet sodas must be the answer.

Maybe not. In a previous issue of “Health Tips From The Professor” I summarized studies showing that consuming diet sodas was just as likely to be associated with obesity and diabetes as consuming sugar-sweetened sodas.

But what about heart health? Are diet sodas better for your heart than sugar-sweetened sodas? A recent study (E. Chazelas et al, Journal of the American College of Cardiology, 76: 2175-2180, 2020) suggests the answer is no.

How Was The Study Done?

Clinical StudyThis study is part of a much larger French study on the effect of diet on health outcomes called the NutriNet-Sante cohort. The NutriNet-Sante cohort study was started in 2009 and, as the name suggests, makes extensive use of online questionnaires. For example:

  • Participants are asked to fill out online questionnaires on physical activity, socioeconomic status, anthropometric data (height, weight, etc.), and major health events on a regular basis.
  • Every 6 months participants are asked to fill out 3 web-based 24-h dietary records (2 on weekdays and 1 on a weekend).
  • Major health events were validated based on their medical records and France’s national health insurance system (Yes, Big Brother is definitely watching in France).
  • Deaths were validated using France’s national mortality registry.

The study included a total of 104,760 participants with an average age of 42.9 and an average BMI of 23.7 (towards the upper end of the normal range) and followed them for 10 years. [Note: The average BMI for Americans at age 40 is 28.6, which is towards the upper end of the overweight category.]

The study compared consumption of diet drinks and sugary drinks with first-time cases of heart disease events (stroke, heart attack, angina, and angioplasty) during a 10-year period.

  • All first-time cases of heart disease events were combined into a single category for this publication. They will be considered separately in a subsequent publication.
  • Artificially sweetened beverages (diet drinks) were defined as beverages containing non-nutritive sweeteners. Sugary drinks consisted of all beverages containing ≥ 5% sugar (sodas, syrups, 100% juice, and fruit drinks).
  • For both categories of beverages, the participants were divided into non-consumers, low consumers, and high consumers.

Do Diet Sodas Hurt Your Heart?

Fast Food DangersThe results were clear. When high consumers were compared with non-consumers:

  • High consumers of sugary drinks had a 20% increased risk of first-time heart disease events.
  • High consumers of diet drinks had a 32% increased risk of first-time heart disease events.

The authors concluded, “In this cohort, higher intakes of [both] sugary drinks and diet drinks were associated with a higher risk of heart disease, suggesting that artificially sweetened beverages might not be a healthy substitute for sugary drinks.”

I also might point out that if this study had been done in the United States the increased risk of heart disease might have been greater.

That is because the French drink less sugary drinks and diet drinks than Americans.

  • High consumers of both sugary drinks and diet drinks in this study averaged 6 ounces per day.
  • In contrast, the average consumption sugary drinks in the United States is around 17 ounces per day.

Since consumption of sugary drinks is associated with increased incidence of heart disease and we drink more sugary drinks, the increased risk of heart disease in Americans might be greater than the 20% reported in this study.

What Are The Pros And Cons Of This Study?

pros and consOn the plus side, this was a very large and well-designed study.

For example, many studies of this type take a single assessment of the participant’s diet, either at the beginning or end of the study. They have no idea whether the participants changed their diet during the study. This study did a diet assessment every 6 months.

On the minus side, this was an association study. It measured the association of sugary drink and diet drink consumption with heart disease. Association studies have several limitations. Here are the top three:

#1: Confounding variables. Here are a couple of examples:

  • People who are overweight tend to drink more diet drinks than people who are normal weight. Obesity increases the risk of heart disease. Therefore, obesity is a confounding variable. You don’t know whether heart disease increased because the participants drank more diet drinks or because they were obese.
  • People who consume more diet drinks tend also to eat less healthy diets. Unhealthy diets increase the risk of heart disease. Thus, unhealthy diets are also a confounding variable.

The study authors adjusted for confounding variables by statistically correcting the data for:

  • Age, sex, BMI, sugar intake from other dietary sources, smoking status, physical activity, and family history of heart disease.
  • Intakes of alcohol, total calories, fruits & vegetables, red & processed meats, nuts, whole grains, legumes, saturated fat, sodium, and proportion of highly processed food in the diet.
  • Presence of type 2 diabetes, elevated cholesterol or triglycerides, or high blood pressure upon entry into the study.

In short, they did an excellent job of controlling for confounding variables that also affect the risk of heart disease.

#2: Reverse Causation: This is the chicken and egg question. This study measured the association between sugary and diet drink consumption and heart disease. None of the participants in the study had diagnosed heart disease when the 10-year study began.

However, both obesity and sugar consumption have been linked to increased risk of heart disease. What if some participants in the study had been diagnosed with heart disease early in the study and switched to diet drinks to lose weight or reduce sugar intake?

In that case, the diagnosis of heart disease would have caused increased diet drink consumption rather than the other way around. That would be reverse causation.

The study authors took reverse causation into account by excluding participants who experienced a first-time heart disease event in the first 3 years of this 10-year study. In other words, participants had to have been consuming sugary or diet drinks for at least 3 years before their heart disease event for their data to be included in the analysis.

This is considered the gold standard for reducing the influence of reverse causation on the outcome of the study.

#3: Uncertainty About Causation:

Association studies do not provide information on the possible mechanism(s) of the association.

For example, multiple previous studies have shown that people are just as likely to gain weight and develop type 2 diabetes when they consume diet drinks or sugary drinks. However, after years of study, the mechanism(s) of that effect are uncertain.

  • The mechanism may be physiological. However, many physiological mechanisms have been proposed. None have been proven.
  • The mechanism may be psychological. We may feel so virtuous for drinking diet drinks that we think it gives us license to eat more junk food. As a former University of North Carolina colleague once put it, “The problem is that we are using our diet drinks to wash down a Big Mac and fries.”

Association studies also do not prove causation. We cannot say with confidence that diet drink consumption increases our risk of heart disease. Nor can we speculate on the mechanism by which this might occur.

However, as the authors of this study concluded, we can say with confidence that there is no evidence that diet drink consumption decreases the risk of obesity, diabetes, or heart disease.

Love Your Heart

Love Your Heart – Drink Water Rather Than Sugar-Sweetened Or Artificially Sweetened Beverages. 

strong heartIf drinking diet drinks does not decrease your risk of heart disease, what can you do to decrease your risk?

The short answer is to fall in love with water. Water has no calories, no sugar, and no artificial sweeteners. In the study described above, it was the non-consumers of sugary beverages and diet beverages that had the lowest risk of heart disease.

Pure water is, of course, the best alternative. However, if plain water is too boring, try herbal teas. If you crave the fizz of sodas, try unsweetened sparkling water, perhaps infused with a little of your favorite fresh fruit. If you crave the caffeine of sodas, coffee or tea might suit you best, preferably without the sugar and cream. There are just two caveats:

  • Tea and coffee should not be your only source of liquid.
  • It goes without saying that you want to avoid the 500 calorie Starbucks extravaganzas.

Love Your Heart – What About Artificially Sweetened Foods?

If artificially sweetened drinks have no benefit for preventing obesity, diabetes, or heart disease, what about artificially sweetened foods? Do they also have no benefit?

The short answer is that we don’t know. Most of the studies to date have been with artificially sweetened beverages. However, these studies should make us cautious. We should not automatically assume that artificially sweetened foods are beneficial because they contain fewer calories. They may be just as useless as artificially sweetened beverages.

Love Your Heart – A Holistic Approach

With that in mind, here is what the American Heart Association recommends for reducing your risk of heart disease:

  • If you smoke, stop.
  • Choose good nutrition.
    • Choose a diet that emphasizes vegetables, fruits, whole grains, low-fat dairy products, poultry, fish, legumes, nuts, and nontropical vegetable oils (ie, avoid coconut and palm oil).
    • Choose a diet that limits sweets, sugar-sweetened beverages, and red meats.
    • [Note: Don’t substitute artificially sweetened beverages for sugar-sweetened beverages. That doesn’t appear to offer any advantage. Drink water instead.]
  • Reduce high blood cholesterol and triglycerides.
    • Reduce your intake of saturated fat, trans fat and cholesterol and get moving.
    • If diet and physical activity don’t get your cholesterol and triglyceride numbers under control, then medication may be the next step.
    • [Note: The American Heart Association recommends changing your diet and physical activity first and only resorting to medications if lifestyle changes don’t work. Diet and exercise do not have side effects. Medications do.]
  • Lower High Blood Pressure.
  • Be physically active every day.
  • Aim for at least 150 minutes per week of moderate-intensity physical activity per week.
  • Aim for a healthy weight.
  • Manage diabetes.
  • Reduce stress.
  • Limit alcohol.

The Bottom Line 

Previous studies have shown that people are just as likely to gain weight and develop type 2 diabetes when they consume artificially sweetened and sugar-sweetened drinks. In this issue of “Health Tips From the Professor” I shared a study showing that artificially sweetened drinks are just as bad for your heart as sugar-sweetened drinks.

These are all association studies. Association studies do not provide information on the possible mechanism(s) of the association.

That means we don’t know why artificially sweetened drinks are bad for your heart.

  • The mechanism may be physiological. However, many physiological mechanisms have been proposed. None have been proven.
  • The mechanism may be psychological. We may feel so virtuous for drinking diet drinks that we think it gives us license to eat more junk food. As a former UNC colleague once put it, “The problem is that we are using our diet drinks to wash down a Big Mac and fries.”

Association studies also do not prove causation. We cannot say with confidence that diet drink consumption increases our risk of heart disease. Nor can we speculate on the mechanism by which this might occur.

However, we can say with confidence that there is no evidence that diet drink consumption decreases the risk of obesity, diabetes, or heart disease.

The authors of this study concluded, “…higher intakes of [both] sugary drinks and diet drinks were associated with a higher risk of heart disease, suggesting that artificially sweetened beverages might not be a healthy substitute for sugary drinks.”

For more details on the study and information on a holistic approach for reducing heart disease risk 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.

 

Which Diets Are Best In 2021?

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Which Diet Should You Choose?

Emoticon-BadMany of you started 2021 with goals of losing weight and/or improving your health. In many cases, that involved choosing a new diet. That was only 2 months ago, but it probably feels like an eternity.

For many of you the “bloom” has gone off the new diet you started so enthusiastically in January.

  • Perhaps the diet isn’t working as well as advertised…
  • Perhaps the diet is too restrictive. You are finding it hard to stick with…
  • Perhaps you are always hungry or constantly fighting food cravings…
  • Perhaps you are starting to wonder whether there is a better diet than the one you chose in January…
  • Perhaps you are wondering whether the diet you chose is the wrong one for you…

If you are rethinking your diet, you might want to know which diets the experts recommend. Unfortunately, that’s not as easy as it sounds. The diet world has become just as divided as the political world.

Fortunately, you have an impartial resource. Each year US News & World Report invites a panel of experts with different points of view to evaluate popular diets. They then combine the input from all the experts into rankings of the diets in various categories.

If you are still searching for your ideal diet, I will summarize the US News & World Report’s “Best Diets In 2021”. For the full report, click on this link.

How Was This Report Created?

Expert PanelUS News & World Report recruited panel of 25 nationally recognized experts in diet, nutrition, obesity, food psychology, diabetes, and heart disease to review the 39 most popular diets.  They rated each diet in seven categories:

  • How easy it is to follow.
  • Its ability to produce short-term weight loss.
  • Its ability to produce long-term weight loss.
  • its nutritional completeness.
  • Its safety.
  • Its potential for preventing and managing diabetes.
  • Its potential for preventing and managing heart disease.

They converted the experts’ ratings to scores 5 (highest) to 1 (lowest). They then used these scores to construct nine sets of Best Diets rankings:

  • Best Diets Overall combines panelists’ ratings in all seven categories. However, all categories were not equally weighted. Short-term and long-term weight loss were combined, with long-term ratings getting twice the weight. Why? A diet’s true test is whether it can be sustained for years. And safety was double counted because no diet should be dangerous.
  • Best Commercial Diets uses the same approach to rank 15 structured diet programs that require a participation fee or promote the use of branded food or nutritional products.
  • Best Weight-Loss Diets was generated by combining short-term and long-term weight-loss ratings, weighting both equally. Some dieters want to drop pounds fast, while others, looking years ahead, are aiming for slow and steady. Equal weighting accepts both goals as worthy.
  • Best Diabetes Diets is based on averaged diabetes ratings.
  • Best Heart-Healthy Diets uses averaged heart-health ratings.
  • Best Diets for Healthy Eating combines nutritional completeness and safety ratings, giving twice the weight to safety. A healthy diet should provide sufficient calories and not fall seriously short on important nutrients or entire food groups.
  • Easiest Diets to Follow represents panelists’ averaged judgments about each diet’s taste appeal, ease of initial adjustment, ability to keep dieters from feeling hungry and imposition of special requirements.
  • Best Plant-Based Diets uses the same approach as Best Diets Overall to rank 12 plans that emphasize minimally processed foods from plants.
  • Best Fast Weight-Loss Diets is based on short-term weight-loss ratings.

Which Diets Are Best In 2021?

The word WInner in white letters surrounded by a burst of colorful stars in 3d

Are you ready? If this were an awards program I would be saying “Envelop please” and would open the envelop slowly to build suspense.

However, I am not going to do that. Here are the top 5 and bottom 5 diets in each category (If you would like to see where your favorite diet ranked, click on this link). [Note: I excluded commercial diets from this review.]

Best Diets Overall 

The Top 5: 

#1: Mediterranean Diet

#2: DASH Diet (This diet was designed to keep blood pressure under control, but you can also think of it as an Americanized version of the Mediterranean diet.)

#3: Flexitarian Diet (A flexible semi-vegetarian diet).

#4: Mayo Clinic Diet

#5: MIND Diet (This diet is a combination of Mediterranean and DASH but is specifically designed to reduce cognitive decline as we age.)

The Bottom 5: 

#35: Modified Keto Diet

#36: Whole 30 Diet

#37: GAPS Diet (A diet designed to improve gut health).

#38: Keto Diet

#39: Dukan Diet

Best Weight-Loss DietsWeight Loss

The Top 5: 

#1: Flexitarian Diet

#2: Vegan Diet

#3: Volumetrics Diet (A diet based on the caloric density of foods).

#4: Mayo Clinic Diet

#5: Ornish Diet

The Bottom 5: 

#35: Fertility Diet

#36: Whole 30 Diet

#37: Alkaline Diet

#38: AIP Diet (A diet designed for people with autoimmune diseases)

#39: GAPS Diet

Best Diabetes Diets

The Top 5: 

#1: Flexitarian Diet

#2: Mediterranean Diet

#3: DASH Diet

#4: Mayo Clinic Diet

#5: Vegan Diet

The Bottom 5: 

#35: The Fast Diet

#36: AIP Diet

#37: GAPS Diet

#38: Whole 30 Diet (A diet designed for people with autoimmune diseases)

#39: Dukan Diet

strong heartBest Heart-Healthy Diets 

The Top 5: 

#1: DASH Diet

#2: Mediterranean Diet

#3: Ornish Diet (A diet based on the caloric density of foods).

#4: Flexitarian Diet

#5: Vegan Diet

The Bottom 5: 

#35: Keto Diet

#36: AIP Diet

#37: Whole 30 Diet

#38: Modified Keto Diet

#39: GAPS Diet

Best Diets for Healthy Eating

The Top 5: 

#1: DASH Diet

#2: Mediterranean Diet

#3: Flexitarian Diet

#4: TLC Diet (A diet designed to promote heart health)

#5: MIND Diet

The Bottom 5: 

#35: Atkins Diet

#36: Raw Food Diet

#37: Modified Keto Diet

#38: Dukan Diet

#39: Keto Diet 

Easiest Diets to FollowEasy

The Top 5: 

#1: Mediterranean Diet

#2: Flexitarian Diet

#3: MIND Diet

#4: DASH Diet

#5: Fertility Diet

The Bottom 5: 

#35: Keto Diet and Modified Keto Diet (tie)

#36: Whole 30 Diet

#37: Dukan Diet

#38: GAPS Diet

#39: Raw Foods Diet 

Best Fast Weight-Loss Diets

The Top 5 (Excluding Commercial Diets): 

#1: Atkins Diet

#2: Biggest Loser Diet

#3: Keto Diet

#4: Raw Food Diet

#5: Volumetrics Diet

Which Diets Are Best For Rapid Weight Loss?

Happy woman on scaleLet me start with some general principles:

#1: If you are looking for rapid weight loss, any whole food restrictive diet will do.

  • The Atkins and keto diets are meat heavy, low carb diets. They restrict fruits, some vegetables, grains, and most legumes.
  • The Biggest Loser diet relies on restrictive meal plan and exercise programs.
  • The restrictions of the raw food diet are obvious.
  • The volumetrics diet restricts foods with high caloric density.
  • The vegan diet, which ranks #7 on this list, is a very low fat diet that eliminates meat, dairy, eggs, and animal fats.
  • I did not include commercial diets that rated high on this list, but they are all restrictive in one way or another.

#2: Restrictive diets ultimately fail.

  • The truth is 90-95% of people who lose weight quickly on a restrictive diet regain most of that weight in the next two years. The pounds come back and often bring their friends along as well. Many people regain more weight than they lost. This is the famous “Yo-Yo Effect”.
  • If dieters paid for one of the commercial diets, they may as well have burned their money.
  • When I talk with people about weight loss, many of them tell me the Atkins diet is the only one they can lose weight on. That would be impressive if they were at a healthy weight, but most are not. They are overweight. I am starting to see the same thing from overweight people who have used the keto diet to lose weight and have regained their weight.

#3: We should ask what happens when we get tired of restrictive diets and add back some of your favorite foods.

  • If you lose weight on a vegan diet and add back some of your favorite foods, you might end up with a semi-vegetarian diet. This is a healthy diet that can help you maintain your weight loss.
  • If you lose weight on the Atkins or keto diets and add back some of your favorite foods, you end up with the typical American diet – one that is high in both fat and carbs. This is not a recipe for long-term success.
  • Long term weight loss is possible if you transition to a healthy diet after you have lost the weight. In a recent article in “Health Tips From The Professor” I wrote about an organization called the National Weight Control Registry. These are people who have been successful at keeping the weight off. For purposes of this discussion, two points are important.
  • They lost weight on every possible diet.
  • They kept the weight off by following a healthy reduced calorie, low fat diet. (For what else they did, click here).

Which Diet Should You Choose?

Which Diet Is BestWith rapid weight loss out of the way, let’s get back to the question, “Which Diet Should You Choose?” My recommendations are:

  • Choose a diet that fits your needs. That is one of the things I like best about the US News & World Report ratings. The diets are categorized. If your main concern is diabetes, choose one of the top diets in that category. If your main concern is heart health… You get the point.
  • Choose diets that are healthy and associated with long term weight loss. If that is your goal, you will notice that primarily plant-based diets top these lists. Meat-based, low carb diets like Atkins and keto are near the bottom of the lists.
  • Choose diets that are easy to follow. The less-restrictive primarily plant-based diets top this list – diets like Mediterranean, DASH, MIND, and flexitarian.
  • Choose diets that fit your lifestyle and dietary preferences. For example, if you don’t like fish and olive oil, you will probably do much better with the DASH or flexitarian diet than with the Mediterranean diet.
  • Finally, focus on what you have to gain, rather than on foods you have to give up.
    • On the minus side, none of the diets include sodas, junk foods, and highly processed foods. Teose foods should go on your “No-No” list. Sweets should be occasional treats and only as part of a healthy meal. Meat, especially red meat, should become a garnish rather than a main course.
    • On the plus side, primarily plant-based diets offer a cornucopia of delicious plant foods you probably didn’t even know existed. Plus, for any of the top-rated plant-based diets, there are websites and books full of mouth-watering recipes. Be adventurous.

The Bottom Line 

For many of you the “bloom” has gone off the new diet you started so enthusiastically in January. If you are rethinking your diet, you might want to know which diets the experts recommend. Unfortunately, that’s not as easy as it sounds. The diet world has become just as divided as the political world.

Fortunately, you have an impartial resource. Each year US News & World Report invites a panel of experts with different points of view to evaluate popular diets. They then combine the input from all the experts into rankings of the diets in various categories. In the article above I summarize the US News & World Report’s “Best Diets In 2021”.

There are probably two questions at the top of your list.

#1: Which diets are best for rapid weight loss? Here are some general principles:

  • If you are looking for rapid weight loss, any whole food restrictive diet will do.
  • Restrictive diets ultimately fail.
  • We should ask what happens when we get tired of restrictive diets and add back some of our favorite foods.
  • Long term weight loss is possible if you transition to a healthy diet after you have lost the weight.

#2: Which diet should you choose? Here the principles are:

  • Choose a diet that fits your needs.
  • Choose diets that are healthy and associated with long term weight loss.
  • Choose diets that are easy to follow.
  • Choose diets that fit your lifestyle and dietary preferences.
  • Finally, focus on what you have to gain, rather than on foods you have to give up.

For more details on the diet that is best 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.

Update On The “Truth About Vaccines”

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The Four Biggest Unanswered Questions

Author: Dr. Stephen Chaney

newspaper heallinesAs someone who is not normally a proponent of vaccinations, I have done my best to provide a scientifically accurate evaluation of the vaccines for COVID-19. My purpose has not been to change people’s minds.

  • If you have already decided to get vaccinated, I applaud you.
  • If you have decided not to get vaccinated, I respect your opinion.

I have written my articles for those of you who recognize the dangers of COVID-19, want to get vaccinated, but are hesitant because of all the negative chatter about the vaccines you have seen on the internet.

I believe every vaccine should be evaluated on the basis of its risks and benefits.

The benefits are clear. COVID-19 is a deadly disease. It is hard to believe that anyone could look at what has happened in the United States and around the world and not realize COVID-19 is not the common flu. It is the most infectious and deadly disease we have seen in our lifetime. Anything that can help us conquer this deadly disease is tremendously beneficial.

However, every vaccine has risks. The risks are extremely low, but they are not zero. And some past vaccines have had unexpected risks. For that reason, I have evaluated potential risks, including those “risks” you have heard about on the internet, against actual data. I have asked, “Are the risks real?”, “Are they serious?”, and “Do they occur often enough to be of concern?”

The yardstick I use for “Do they occur often enough…?” is the 1 in a million to 1 in 10 million range. The chance of dying in a plane crash is 1 in 10 million. Yet that doesn’t stop us from getting on planes to fly where we want to go.

I think that is an apt analogy. Serious risks from the COVID-19 vaccines are in the 1 in 10 million range. I am willing to take that risk because it will take us to where we want to go – the other side of this pandemic.

I summarized the risks and benefits of the COVID-19 vaccines in a recent “Health Tips From The Professor” article (https://www.chaneyhealth.com/healthtips/the-truth-about-vaccination/). However, science marches on. That article was written just one month ago, but it is time to update the data and also acknowledge what we still don’t know.

Update On The “Truth About Vaccines”

 

Last week I recorded a talk on the “The Truth About Vaccines”. Part of my motivation was to provide people with audio and video files that would be easier to share. However, I also used that opportunity to update the information on vaccines. Here are the files. Consider them a gift you can use to spread the word about the vaccines. 

 

Video Link: 

https://zoom.us/rec/share/WkDiDdygAnsY4-8YO9HvT55jPOOH73xZ2cTy-cIMDBWSEhOOxgrxliUoH7iAtD5l.hVMILee_-bJg0Xvd

Passcode: FUfZ$3F$ 

Audio Link:

https://zoom.us/rec/play/vIXHPtXHzg-WV8KQb7JjZws49J0z_LY2yOKA5fWIN93GKvLUw08ViOpOa9QcLlvzEphIKibSvcwhgmoV.07AjXCj2j8Ac1cQy

Passcode: FUfZ$3F$

Note: If you want to share these audio and video files or the “Health Tips From The Professor” article I wrote a month ago, share the link rather than forwarding this email to them.

Similarly, if you would like to share this article with someone, share the link given at the beginning and end of this article rather than forwarding this email to them.

This is because if you forward this email to someone who unsubscribes because they aren’t in favor of vaccinations, it will unsubscribe you from receiving future issues of “Health Tips From the Professor”.

The Four Biggest Unanswered Questions

questionsIf you feel like the experts have been “flying by the seat of their pants”, that is because we are. When COVID-19 burst on the scene and spread like wildfire, it was a completely unknown entity. We had no idea what to expect or how effective measures to control it would be.

In fact, much of what we thought we knew was plain wrong. That is why:

  • We went from “masks are only important for health care workers” to “masks only protect others” to “masks protect us” to “maybe we need double masks”.
  • That is why a state like California, which has remained mostly locked-down and a state like Florida, which has remained mostly open, have ended up with about the same per capita cases and deaths from COVID-19.

Clearly some mitigation efforts are needed to “flatten the curve” and prevent our hospitals from being overwhelmed. We cannot just let the virus run rampant. But there is no clear agreement among experts as to which mitigation efforts are essential.

So, with perhaps a little humility, let me address the four greatest unanswered questions about COVID-19 and the vaccines. In each case, I will:

  • Give you the facts as we know them.
  • Give you my opinion.
  • Tell you what to watch for and what to do about it.

Here are the questions:

#1: How Long Will Immunity Last? Most headlines you have seen recently are asking this question with strong immune systemregards to the vaccines. But this question is equally important for those of you who have recovered from COVID-19. You also want to know if and how long you are protected from getting infected again.

Studies on this important question have mostly relied on measuring antibodies to COVID-19 in the bloodstream. And the answer appears to be similar for people who have been infected with COVID-19 and people who have been vaccinated, namely:

  • There are significant individual differences.
    • In some people, antibody levels decrease after a few months.
    • In other people, antibody levels appear to remain high for at least 6-8 months.

This is why the CDC is considering recommending a booster shot of the vaccine 6-12 months after you have completed your first round of vaccinations. It is also why some are recommending you get vaccinated even if you have recovered from COVID-19. The theory is that you will need to boost your antibody levels again to maintain full immunity from COVID-19.

But is a booster shot really necessary? As I have written previously:

  • Both the Pfizer and Moderna vaccines create memory cells as well as circulating antibodies.
    • Memory cells reside in the bone marrow and retain the blueprint for making more antibody-producing cells if the virus ever reappears. They are responsible for long-term immunity.
    • For example, many of you may remember a few years ago, a new variant of the flu virus appeared that hit young people much harder than people over 50. The explanation we were given at the time was that the new variant of the virus was similar to a flu virus that had widely circulated 30 years earlier. We had retained significant immunity to the previous virus, and it protected us from the new virus as well.
  • Because of memory cells, I am optimistic that we will retain significant immunity to COVID-19 even after circulating antibody levels have disappeared. But we won’t know for sure until we have accumulated enough data to know how well the vaccines protect us from COVID-19 a year or two down the road.
  • However, the data on patients who have recovered from COVID-19 is encouraging. So far, the reinfection rate seems to be around 1-2% and most of the recurring cases are mild.

So, should you get a booster shot? The risk of the vaccines will not change, so we need to look at the benefit side of the ledger.

  • If I am right and COVID cases are low 6-12 months from now, the benefit of getting a booster shot would be small. I’d give it a pass.
  • If I am wrong and COVID comes back with a vengeance, getting a booster shot might be prudent.

#2: Do We Need To Fear The Variants? You have seen the hype, “The new variants are highly contagious, Fearand vaccines may not work against them.” The first claim is correct, but existing evidence suggests that the second claim is overblown.

  • Tests with antibodies from patients who have recovered from COVID-19 and from patients who have been vaccinated find that these antibodies are 70-90% effective at neutralizing the new variants. To put that into context, 70-90% effectiveness is significantly higher than the average flu vaccine.
  • New data coming out of England, where one of the variants originated, reports that the reinfection rate for people who have recovered from COVID-19 is around 0.7%, and this has not changed since the British variant strain appeared. [If the antibodies produced from the original COVID infection were not effective against the new variant, we would have expected reinfection rates to increase as the new variant became the predominant version of COVID circulating in the country.]

Of course, these data have not deterred the fearmongers. They are telling you that it is only a matter of time until a variant comes along that is unaffected by vaccines. I consider this unlikely, and here is why.

  • Vaccines are directed against the spike protein of the virus. That is the same protein the virus uses to bind to our cells. Any mutations severe enough to eliminate antibody binding to the spike protein are also likely to prevent the spike protein from binding to our cells. If the spike protein can’t bind to our cells, the virus can’t enter our cells. Such mutant viruses would be non-infectious. They would die out spontaneously.
  • Because of that, I am optimistic that the current vaccines will retain significant effectiveness against new variants as they arise.

Once again, the CDC may recommend a booster shot to help protect against the variants. The pharmaceutical companies are also working on vaccines that are specific to the new variants.

Should you get one of these shots? Once again, we won’t know for sure until we see how well the vaccines protect us from the new variants.

  • If I am right and COVID cases are low 6-12 months from now, the benefit of getting a shot would be small. I’d give it a pass.
  • If I am wrong and a new variant causes a massive surge in COVID cases and deaths in people who have been vaccinated, getting another shot might be prudent.

#3: Can I Get My Life Back After Vaccination? You have probably heard the CDC recommendations that we can still get COVID-19 and pass it on to others after we have been vaccinated. We should, therefore, continue to wear masks and socially distance ourselves.

I have had many people say to me, “If that’s true, why should I even bother to get vaccinated?” Let me start by covering what we know and don’t know about this question. Then I will put it into perspective for you.

  • The immune cells in the upper respiratory tract are not in perfect sync with the rest of the immune system. That means that after vaccination we may not get quite the level of protection in our upper respiratory track that we do in the rest of our body.
  • In the initial studies with rhesus monkeys, the animals were vaccinated and subsequently a high titer of live virus was sprayed directly into their noses. Virus was detected in their nasal passages for about 3 days before it disappeared.
    • The animals did not have detectable levels of virus in their bloodstreams. Nor did they develop any disease symptoms.
    • However, the brief presence of live virus in their nasal passages led to the suggestion that one might still be able to pass the virus on to others after vaccination.
  • Small, preliminary studies with a subset of patients enrolled in the vaccine clinical trials suggested that the vaccines might only be around 60% effective at preventing upper respiratory tract infections.
    • That means if you are exposed to COVID-19, you might have a 40% chance of developing an upper respiratory tract infection. In most cases you will be asymptomatic, but you could pass the virus on to others.
    • The good news is that you are still 95% protected against severe disease, hospitalization, chronic long-term symptoms, and death. This is the answer to the “Why bother?” question.
  • However, new data out of Israel gives a more optimistic assessment. The latest study reported that the Pfizer vaccine is 89% effective at preventing even asymptomatic disease.

The bottom line is that the data are still coming in. It may be another 6-12 months before we have an accurate estimate of your risk of developing asymptomatic disease and passing the virus on to someone else if you are exposed to COVID-19 after being vaccinated.

So, what do I recommend? I can’t tell you what you should do, but I will tell you what I plan to do.

  • I still plan to wear a mask and social distance when I am out and about.
  • I am comfortable meeting with small groups of close friends and family without a mask, especially if they have also been vaccinated.
  • I am comfortable going back to church because our church follows an excellent social distancing protocol.
  • I am comfortable traveling to visit our family in California.
  • Once the number of COVID-19 cases has reached a low level, I will be comfortable resuming all my previous activities, subject, of course, to any state mandates.

News Flash: Yesterday the CDC updated their guidelines for people who are fully vaccinated. They now say that fully vaccinated people can:

  • Visit with other fully vaccinated people indoors without wearing masks or physically distancing.
  • Visit with unvaccinated people from a single household who are at low risk for severe COVID-19 disease indoors without wearing masks or physically distancing.
  • Refrain from quarantining and testing following a known exposure to someone with COVID-19 unless you develop symptoms.

The other CDC guidelines remain in place for now but are likely to change once a larger percentage of the population has been vaccinated.

#4: Why Not Rely On Diet And Supplementation? I have friends who tell me they are not going to get Vaccination Perspectivevaccinated. They will rely on diet and supplementation to keep their immune systems strong and protect them from COVID. I respect their choice.

In fact, I have a great deal of sympathy for that choice. When I think of protecting myself from colds and flu, my preference has always been to keep my immune system strong with diet, supplementation, and exercise rather than relying on vaccinations.

However, COVID is different story. It is a far deadlier disease. And even if it doesn’t kill you, it may impact your life for years to come. The long-term health consequences of COVID are perhaps even scarier than the 1% death rate.

Let’s take a realistic look at each of our options to defeat COVID:

  • In a previous issue of “Health Tips From the Professor” I shared some preliminary clinical studies showing that people with adequate vitamin D status were 60-70% less likely to be infected with COVID, hospitalized with COVID, in the ICU from COVID, and dying from COVID. That is impressive, but it is not 100% protection. And if your vitamin D levels are already adequate, you get no additional benefit from adding extra vitamin D to your diet.
  • In another issue of “Health Tips From the Professor” I shared a review written by a group of experts on respiratory diseases. They concluded that, in addition to a good diet, supplementation with a multivitamin and extra vitamin C, vitamin D, and omega-3s reduced the risk of dying from respiratory diseases. But they didn’t say it eliminated the risk. It did not guarantee 100% protection.
  • As for CDC guidelines, wearing a mask gives you somewhere between 30 and 70% protection. Social distancing and handwashing also help, but they don’t offer 100% protection.
  • Vaccination with the Pfizer and Moderna vaccines gives you at least 60% protection against upper respiratory infections from COVID-19 and 95% protection against severe disease, hospitalization, long term health consequences, and death. It is the single most effective tool we have at our disposal, but it does not give 100% protection. As one of my pessimist friends put it, “95% protection means I have a 1 in 20 chance of getting it.”

COVID-19 is throwing everything it has at us. When faced with a deadly disease and several things I can do that offer partial protection, I choose a holistic approach. I choose to use every tool at my disposal. I choose diet, supplementation, CDC guidelines, and vaccination. Everyone should make their own decision about how best to protect themselves from COVID-19, but my choice is clear. I want to do everything in my power to avoid this disease.

The Bottom Line 

In the article above, I have updated my information on vaccines with data from the latest studies, provided you with resources about the vaccines you can share, and have given you updates and perspective on the four biggest unanswered questions about COVID-19 and the vaccines, namely:

  • How long does immunity last?
  • Do we need to fear the new variants?
  • Can I get my life back after vaccination?
  • Why not rely on diet and supplementation?

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.

Does Vitamin D Affect IQ?

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The Importance Of Vitamin D During Pregnancy

Author: Dr. Stephen Chaney

pregnant women taking vitaminAs an expectant mother, you want the best for your child. You want them to be healthy and happy. You probably also want them to be smart.

Your doctor has recommended you take a prenatal supplement. You have probably heard about the importance of folic acid for a successful pregnancy. I have also written about the importance of adequate omega-3s and iodine during pregnancy for the cognitive development of your child.

But what about vitamin D? Vitamin D receptors are expressed in the mammalian brain as early as 12 days into gestation, and vitamin D is thought to be important in neurocognitive development.

Previous studies have shown that vitamin D deficiency during pregnancy is associated with delayed motor-skill and social development during the first few years of childhood. But it is uncertain whether these early deficits translate into long-term deficits in IQ and emotional stability.

This study was designed to answer that question by comparing blood 25-hydroxyvitamin D levels in the mother’s blood during the second trimester and IQ measurements of their children between the ages of 4 and 6.

How Was This Study Done?

Clinical StudyThis study used data from the CANDLE (Conditions Affecting Neurocognitive Development and Learning in Early Childhood) database. This portion of the study measured blood levels of 25-hydroxyvitamin D during the second trimester of pregnancy of 1503 women from the Memphis area of Tennessee. The 25-hydroxyvitamin D levels were compared with the IQ of their children measured between the ages of 4 and 6.

The average age of the mothers was 26 and 63% of them were black.

Of course, there are many other factors that influence mental development during childhood. Accordingly, the data were corrected for the overall quality of the maternal diet, maternal IQ, maternal education, maternal age, marital status, BMI (a measure of obesity), tobacco use during pregnancy, alcohol use during pregnancy, and household income.

Does Vitamin D Affect IQ?

child geniusHere are the results from the study:

  • The average blood level of 25-hydroxyvitamin D at week 23 of pregnancy was 21.6 ng/mL.
    • 45.6% of the women were vitamin D deficient (<20 ng/mL 25-hydroxyvitamin D).
  • The average blood level of 25-hydroxyvitamin D in this study was 19.8 ng/mL for Black women and 25.9 ng/mL for White women.
    • This is consistent with a previous report that 80% of Black pregnant women in this country are vitamin D deficient compared to only 13% of White pregnant women.
  • After adjusting for other variables known to affect IQ, every 10ng/mL increase in 25-hydroxyvitamin D status during pregnancy resulted in an increase of:
    • 1.17 points in overall IQ.
    • 1.17 points in verbal IQ.
    • 1.03 points in nonverbal IQ.
  • The effect of vitamin D status during pregnancy on IQ of the offspring at ages 4-6 was the same for both races.
  • The effect of maternal vitamin D status on childhood IQ plateaued at around 40ng/mL, which is near the top of what is considered an adequate level of 25-hydroxyvitamin D.

The authors of the study concluded: “Gestational vitamin D concentrations were positively associated with IQ at age 4-6, suggesting that vitamin D plays an important role in programming neurocognitive development. Vitamin D status may be an important modifiable factor that can be optimized through appropriate nutritional recommendations and guidance. Vitamin D deficiency was especially prevalent among Black women in this cohort, suggesting a higher need for screening and nutritional intervention in this vulnerable population.”

The authors went on to say: “Vitamin D supplementation may be indicated for women who have poor dietary intake of vitamin D and/or reduced cutaneous synthesis related to skin pigmentation [Simply put, sunlight can catalyze the synthesis of vitamin D in our skin, but skin pigmentation filters out the sunlight and decreases vitamin D synthesis.]…”

The Importance Of Vitamin D During Pregnancy

vitamin dLet me put this study in perspective by first discussing the pros and cons of the study. Then I will close with what I think is the most important takeaway from the study.

The Cons Of The Study:

The cons are obvious:

  1. This study shows that a 10 ng/mL increase in 25-hydroxyvitamin D during pregnancy is associated with about a 1-point increase in IQ on a 100-point scale? Is that significant? Probably not, especially when you consider all the other dietary and environmental factors that influence intelligence and educational attainment.

2) We don’t know whether this effect of vitamin D status during pregnancy on IQ will persist as the children grow up. It is more likely that socioeconomic and family factors during childhood will play a much larger role in educational attainment.

The Pros Of The Study:

  1. This study is superior to most previous studies on this topic because of its size and duration. It is also a well-designed study.

2) The authors pointed out a previous study has reported that for each decrease of one IQ point:

    • Lifetime income for men decreases by 1.93%.
    • Lifetime income for women decreases by 3.23%.

3) The effect of vitamin D status during pregnancy on IQ at age 4-6 plateaued at 40 ng/mL. That means the women in this study would obtain optimal benefit by increasing their 25-hydroxyvitamin D levels by 20 ng/mL. Since each 10 ng/mL increase in 25-hydroxyvitamin D during pregnancy increased IQ by 1.17, this would translate into:

  • A 4.5% increase in lifetime earnings for men.
  • A 7.6% increase in lifetime earnings for women.
  • When you look at it this way, the effect of vitamin D during pregnancy on IQ seems a bit more significant.

The Most Important Takeaway From This Study:

  • Of all the things you can do during pregnancy to give your kids an advantage in today’s competitive world, supplementation with vitamin D before and during pregnancy is probably the simplest, cheapest, and safest option available to you.
  • Even if optimizing 25-hydroxyvitamin D levels during pregnancy has no long-term effect on your child’s IQ, we know it has many other benefits for your health and your child’s health.
  • And, as long as you don’t exceed 50 ng/mL of 25-hydroxyvitamin D, it is perfectly safe.

The authors had this to say about supplementation with vitamin D before and during pregnancy: “Popular prenatal supplements, which typically contain 400-600 IU vitamin D, are likely insufficient to correct 25-hydroxyvitamin D deficiencies. Randomized controlled trials have suggested that daily supplementation of 800 to 1,000 may be needed during pregnancy, and that doses of 4,000 IU may be ideal in cases of severe deficiency.”

The Bottom Line

A recent study looked at 25-hydroxyvitamin D status during the second trimester of pregnancy and the IQ of the offspring at ages 4-6. The study found:

  • The average blood level of 25-hydroxyvitamin D at week 23 of pregnancy was 21.6 ng/mL.
    • 6% of the women were vitamin D deficient (<20 ng/mL 25-hydroxyvitamin D).
    • After adjusting for other variables known to affect IQ, every 10ng/mL increase in 25-hydroxyvitamin D status during pregnancy resulted in an increase of 1.17 points in overall IQ.
  • The effect of maternal vitamin D status on childhood IQ plateaued at around 40ng/mL, which is near the top of what is considered an adequate level of 25-hydroxyvitamin D.

The authors of the study concluded: “Gestational vitamin D concentrations were positively associated with IQ at age 4-6, suggesting that vitamin D plays an important role in programming neurocognitive development. Vitamin D status may be an important modifiable factor that can be optimized through appropriate nutritional recommendations and guidance…”

The authors went on to say: “Vitamin D supplementation may be indicated for women who have poor dietary intake of vitamin D and/or reduced cutaneous synthesis related to skin pigmentation…”

In terms of supplementation, the authors said: “Popular prenatal supplements, which typically contain 400-600 IU vitamin D, are likely insufficient to correct 25-hydroxyvitamin D deficiencies. Randomized controlled trials have suggested that daily supplementation of 800 to 1,000 may be needed during pregnancy, and that doses of 4,000 IU may be ideal in cases of severe deficiency.”

For more details and my perspective of the study, read the article above.

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

What Do The US Dietary Guidelines Say About Supplementation?

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What Do The US Dietary Guidelines Say About Your Diet?

Author: Dr. Stephen Chaney

US Dietary Guidelines 2020-2025Science is always changing, and nutritional science is no different. As we learn more, our concept of the “ideal diet” is constantly evolving. Because of that, the USDA and the US Department of Health & Human Services produce a new set of Dietary Guidelines for Americans every 5 years.

The 2020-2025 Dietary Guidelines for Americans have just been released. As usual, the process started with a panel of 20 internationally recognized scientists who produced a comprehensive report on the current state of nutritional science and made recommendations for updated dietary guidelines. After a period of public comment, the dietary guidelines were published.

There were two new features of the 2020-2025 Guidelines:

  • They provided dietary guidelines for every life stage from 6 months of life to adults over 60.
  • The guidelines also addressed personal preferences, cultural traditions, and budgetary concerns in so that each of us can develop a healthy diet that fits our lifestyle.

What Do The US Dietary Guidelines Say About Your Diet?

Here are the 2020-2025 Guidelines in a nutshell:healthy foods

  • Follow a healthy dietary pattern at every life stage.
  • Customize and enjoy nutrient-dense food and beverage choices to reflect personal preferences, cultural traditions, and budgetary considerations.
  • Focus on meeting food group needs with nutrient-dense foods and beverages and stay within calorie limits. They went on to say, “A healthy dietary pattern consists of nutrient-dense forms of foods and beverages across all food groups [emphasis mine], in recommended amounts, and within calorie limits.”

They said, “the core elements that make up a healthy dietary pattern include:”

    • Vegetables of all types – dark green, red, and orange vegetables; beans, peas, and lentils; starchy vegetables; and other vegetables.
    • Fruits – especially whole fruits.
    • Grains – at least half of which are whole.
    • Dairy – including fat-free or low-fat milk, yogurt, and cheese; lactose-free versions; and fortified soy beverages and soy yogurt as alternatives. [Other plant-based milk and yogurt foods were not recommended because they do not provide as much protein as dairy. So, they were not considered equivalent foods.]
    • Protein foods – including lean meats, poultry, and eggs; seafood; beans, peas, and lentils; and nuts, seeds, and soy products.
    • Oils – including vegetable oils and oils in food, such as seafood and nuts.
  • Limit foods and beverages higher in added sugars, saturated fat, and sodium; and limit No Fast Foodalcoholic beverages. Their specific recommendations are:
    • Added sugars – less than 10% of calories/day starting at age 2. Avoid foods and beverages with added sugars for those younger than 2.
    • Saturated fat – Less than 10% of calories starting at age 2.
    • Sodium – Less than 2,300 mg per day – even less for children younger than 14.
    • Alcoholic beverages – Adults of legal drinking age can choose not to drink, or to drink in moderation by limiting intake to 2 drinks or less in a day for men and 1 drink or less in a day for women, when alcohol is consumed. Drinking less is better for health than drinking more. There are some adults who should not drink alcohol, such as women who are pregnant.

For more details, read the 2020-2025 Dietary Guidelines for Americans.

The Dark Side Of The US Dietary Guidelines

Darth VaderThe US Dietary Guidelines point Americans in the right direction, but they are never as strong as most nutrition experts would like. The 2025 Dietary Guidelines are no exception. They have two major limitations:

#1: The food industry has watered down the guidelines. This happens every time a new set of guidelines are released. The food and beverage lobbies provide their input during the public comment period. And because they fund a significant portion of USDA research, their input carries a lot of weight. Here are the 3 places where they altered the recommendations of the scientific panel:

  • The scientific panel recommended that Americans decrease the intake of added sugar from 13% of daily calories to 6%. The final dietary guidelines recommended reducing sugar to 10% of daily calories.
  • The scientific panel recommended that both men and women limit alcoholic drinks to one a day. The final dietary guidelines recommended men limit alcoholic drinks to two a day.
  • The scientific panel included these statements in their report:
    • “Dietary patterns characterized by higher intake of red and processed meats, sugar-sweetened foods and beverages, and refined grains are…associated with detrimental health outcomes.”
    • “Replacing processed or high fat-meats…with seafood could help lower intake of saturated fat and sodium, nutrients that are often consumed in excess of recommended limits.”
    • “Replacing processed or high-fat meats with beans, peas, and lentils would have similar benefits.”

These statements are included in the final report, but they are buried in portions of the report that most people are unlikely to read. The summary that most people will read recommends shifts in protein consumption to “add variety” to the diet.

#2: The guidelines do not address sustainability and do not explicitly promote a shift to more Planetary Dietplant-based diets. Again, this was based on input from food lobby groups who argued that sustainability has nothing to do with nutrition.

If you are concerned about climate change and the degradation of our environment caused by our current farming practices, this is a significant omission.

I have covered this topic in a recent issue of “Health Tips From the Professor”. Here is a brief summary:

  • In 2019 a panel of international scientists was asked to conduct a comprehensive study on our diet and its effect on both our health and our environment.
  • The scientific panel carefully evaluated diet and food production methods and asked three questions:
    • Are they good for us?
    • Are they good for the planet?
    • Are they sustainable? Will they be able to meet the needs of the projected population of 10 billion people in 2050 without degrading our environment.
  • They developed dietary recommendations popularly known as the “Planetary Diet”. Here are the characteristics of the planetary diet.
    • It starts with a vegetarian diet. Vegetables, fruits, beans, nuts, soy foods, and whole grains are the foundation of the diet.
    • It allows the option of adding one serving of dairy a day.
    • It allows the option of adding one 3 oz serving of fish or poultry or one egg per day.
    • It allows the option of swapping seafood, poultry, or egg for a 3 oz serving of red meat no more than once a week. If you want a 12 oz steak, that would be no more than once a month.

Unless you are a vegan, this diet is much more restrictive than you are used to. However, if you, like so many Americans believe that climate change is an existential threat, I would draw your attention to one of the concluding statements from the panel’s report.

  • “Reaching the Paris Agreement of limiting global warming…is not possible by only decarbonizing the global energy systems. Transformation to healthy diets from sustainable food systems is essential to achieving the Paris Agreement.”

In other words, we can do everything else right, but if we fail to change our diet, we cannot avoid catastrophic global warming.

What Do The US Dietary Guidelines Say About Supplementation?

MultivitaminsThe authors of the 2020-2025 US Dietary Guidelines have relatively little to say about supplementation. However:

  • They list nutrients that are of “public health concern” for each age group. Nutrients of public health concern are nutrients that:
    • Are underconsumed in the American diet.
    • Are associated with health concerns when their intake is low.
  • They state that “dietary supplements may be useful in providing one or more nutrients that otherwise might be consumed in less than recommended amounts.”
  • They recommend specific supplements for several age groups.

Here are their nutrients of public health concern and recommended supplements for each age group:

#1: General population.

  • Nutrients of public health concern are calcium, dietary fiber, and vitamin D. They state that supplementation may be useful for meeting these needs.

#2: Breast Fed Infants.

  • Supplementation with 400 IU/day of vitamin D is recommended shortly after birth.

#3: Vegetarian Toddlers.

  • Iron and vitamin B12 are nutrients of concern.

#4: Children & Adolescents.

  • Calcium and vitamin D are nutrients of concern. Dairy and/or fortified soy alternatives are recommended to help meet these needs.
  • Iron, folate, vitamin B6, vitamin B12, and magnesium are also nutrients of concern for adolescent females.

#5: Adults (Ages 19-59).

  • 30% of men and 60% of women do not consume enough calcium and 90% of both men and women do not get enough vitamin D.

#6: Pregnant & Lactating Women:

  • Calcium, vitamin D, and fiber are nutrients of concern for all women in this age group.
  • In addition, women who are pregnant have special needs for folate/folic acid, iron, iodine, and vitamin D.
  • Women who are pregnant or thinking of becoming pregnant should take a daily prenatal vitamin and mineral supplement to meet folate/folic acid, iron, iodine, and vitamin D needs during pregnancy. They go on to say that many prenatal supplements do not contain iodine, so it is important to read the label.
  • All women who are planning or capable of pregnancy should take a daily supplement containing 400 to 800 mcg of folic acid.

#7: Older Adults (≥ 60).

  • Nutrients of concern for this age group include calcium, vitamin D, fiber, protein, and vitamin B12.
  • About 50% of women and 30% of men in this age group do not get enough protein in their diet.

My Perspective:

The US Dietary Guidelines use foods of public health concern as the only basis for recommending Supplementation Perspectivesupplementation. I prefer a more holistic approach that includes increased needs, genetic predisposition, and preexisting diseases as part of the equation (see the diagram on the right). I have discussed this concept in depth in a previous issue of “Health Tips From The Professor”.

I have also taken this concept and made supplement recommendations for various health goals in a free eBook called “Your Design For Healthy Living”.

Some people may feel I should have included more supplements in my recommendations. Others may feel I should have included fewer supplements in my recommendations. No list pf recommend supplements is perfect, but I have tried to include those supplements supported by good scientific evidence in my recommendations.

The Bottom Line 

The USDA and Department of Health & Human Services have just released the 2020-2025 US Dietary Guideline. In the article above I have summarized:

  • Their recommendations for a healthy diet.
  • Their recommendations for supplementation.
  • The dark side of the US Dietary Guidelines.

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.

Health Tips From The Professor