When I lived up north, February was the worst month of the winter – cold, gloomy, and while it’s only 28 days long, it seemed endless. If you’re in the cold weather, I hope you stay nice and warm, and that you also find some fun outdoor activities to help this month end quickly.
Here in Florida, this is one of our best months! No humidity, no rain, no bugs, and lots of sunshine. We love February!
February is also thought of as a month to show love for another (it should be every month, but we’ll leave that alone for now). Lovers go out to special dinners, sometimes buying expensive gifts or flowers. And many people send sweet cards to friends and family.
But the actual origination of Valentine’s Day isn’t such a loving story. The day is named after St. Valentine, a Christian martyr who was executed in ancient Rome on February 14th in the 3rd century A.D. There was also a pagan ritual that had to do with fertility, and where women put their names into an urn for bachelors to pick from. Somehow the two merged over the years and brought St. Valentine’s Day into the more romantic sphere.
In any case, it’s now a multi billion dollar business that has nothing to do with anything religious but can be fun for loving couples to celebrate.
A Letter From A Reader
This past week I received an email from a reader of this newsletter. I’ve asked people to send me a message if they have any aches or pains that they would like for me to discuss. This is a topic I’ve never discussed before, and since it’s causing this woman distress, I decided it’s the perfect discussion for the month.
Suzie was feeling pain across the front of her shoulder, and she had painful points along the bottom of her clavicle (collarbone). The subclavius muscle is a short muscle that originates on your 1st rib and inserts into the underside of your clavicle. You can look at it on Wikipedia (https://bit.ly/2KV7lT8) if you’d like to see how tiny it is and where to find it when you are self-treating for pain.
As shown in the graphic above, it is interesting to think that such a small muscle can cause so much pain in the front of your shoulder, and down your biceps to your inner elbow. Even more interesting is that most people aren’t aware of this muscle, so they search other places when they are feeling pain across the front of their shoulder. As a result, they don’t get relief, and they may even turn to pain medications.
A Novel Treatment For Shoulder Pain
If your pain starts in the front of your shoulder and radiates down your bicep, the pain may be caused by your subclavius muscle. If, you are in luck. The treatment for this muscle is so simple you can do it any place and at any time.
Simply press your fingertips as shown in this picture. If that exact point isn’t painful, move your fingertips a bit to one side or the other.
It will probably feel like a sharp pain, and you may even feel the tiny bump that is caused by the spasm.
Hold the pressure for a minute or so….
Release the pressure (but don’t move your finger off the point)…
Press deeply again and hold.
Do this several times until it doesn’t hurt to press on the point.
I have been working with people suffering from chronic pain and/or sports injuries since 1989. One thing I have found is that while I can find and successfully treat the muscles causing pain when people come into my office, it’s vital for them to continue their treatment at home.
A phenomenon called “muscle memory” will cause the muscle to begin to shorten as soon as we finish our therapy session. Left untreated the muscle will tighten again in as short as 2-3 days, and you’ll have pain again. However, if you self-treat the muscle you will continue to bring it back to its proper length, and ultimately it will stay, and the pain will be eliminated
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.
Many of you want to get vaccinated against COVID-19, but you are fearful. You have been sending me videos and posts about the risks of COVID vaccines. You have been asking, “Are the vaccines safe?” I don’t have time to respond to all of you personally, so I have decided to combine my responses into a single article in an effort to provide some scientific perspective on the controversies surrounding vaccination.
Let me start by reminding you that I am not someone who automatically endorses every vaccine. I believe every vaccine should be judged on its risk versus benefit. I have discussed this in a previous issue of “Health Tips From The Professor”. In my view, the main benefit of getting the flu shot is to protect others, especially the vulnerable with weak immune systems. Accordingly, the only time I have ever taken the flu shot was the year my granddaughter was born, and that was to protect her.
However, the original strain of COVID-19 is 3-5 times more infectious (the new variants are around 7 times more infectious) and 10 times deadlier than the flu. Even worse, many people never fully recover from COVID. This dramatically changes the risk, benefit equation.
I believe everyone has the right to decide whether they will be vaccinated. I also believe that everyone is entitled to their opinion. I am not writing this article to argue with people who believe vaccines are a bad idea. I am writing this article for those of you who want to get vaccinated but are fearful because of negative messages about vaccines on the internet or from your friends.
In addition, if too many people decline to get vaccinated, the consequences could be catastrophic. This is another powerful motivator for writing this article. I don’t want people refusing the vaccines for the wrong reasons. You deserve to know the pros and cons of vaccinations.
I apologize for the length of this post. There is a lot of negative information about vaccines on the internet. I wanted to respond to as much of it as possible. Here is what I will cover in today’s article:
The public health argument for vaccination.
The personal argument for vaccination.
The risks of vaccination – A perspective.
The claims about existing vaccines.
The good news nobody is talking about.
New vaccines on the horizon.
What questions remain?
What alternatives do we have to vaccination?
The truth about vaccination.
Now, back to the videos and posts. Some are utter nonsense. Others are videos posted by honorable people (some of whom are doctors) who have overstated the risks and understated the benefits of the vaccines. The best analogy I have heard recently is flying in an airplane. If we were to focus on all the horrible things that can happen when a plane crashes, we would never get on an airplane again. However, the risk of a plane crashing is 1 in 10 million, so most of us have no trouble getting on airplanes to take us where we want to go.
I will start by making a science-based comparison of the benefits and risks of the Pfizer and Moderna vaccines. Then I will touch briefly on some on the other vaccines that will soon be available.
To best understand the benefits of vaccination we need to envision what a world without effective COVID vaccines would look like. It drives me crazy when I hear people dismiss the risks of COVID by saying the death rate is only around 1% (1.5% to be exact). That vastly understates the risks of COVID.
The Public Health Argument For Vaccination
Let me start with the public health perspective:
For us to get the pandemic under control and have life to return to normal we need to reach herd immunity. What would that look like without vaccines?
Let’s start with deaths. The best current estimate of the US population is around 340 million. According to the CDC, there have been 26 million cases of COVID-19 in the US to date. That is around 7.7% of the US population. The original estimates were that 40-60% of the population would need to be immune to reach herd immunity. That means an additional 110-178 million Americans would need to be infected with COVID-19 before we achieved herd immunity. With a death rate of 1%, that would require that an additional 1-2 million Americans die before we reached heard immunity.
And this is just a minimum estimate. The % of the population required to reach herd immunity depends on the infectivity of the virus. With the new variants that are now spreading through the US population, 70-90% of the population may need to be infected before we could achieve herd immunity. In either case, are we willing to let millions of Americans die so that we can achieve herd immunity without the vaccine?
Now let’s talk about the 99% who don’t die. The best current estimates are that around 80% of people who were hospitalized with COVID and 20% of those with milder disease suffer from chronic fatigue and/or some degree of lung or heart damage after they have “recovered” from COVID. In some cases, this resolves in a few weeks, but for many it lasts for months, and for some it still has not resolved almost a year later. Are we willing to let millions of Americans suffer from chronic fatigue or worse when this could have been avoided with vaccination?
Obviously, these are worst case scenarios. We have already seen 20 million Americans be vaccinated. Many more are eagerly awaiting their turn to be vaccination. However, the concern of the public health community is that unfounded fears of vaccination will prevent us from reaching herd immunity through vaccinations. That would mean that many Americans would die needlessly from COVID. And many more would suffer needlessly from chronic fatigue or worse for months after “recovering” from COVID.
In summary, the public health argument for you getting vaccinated is clear. You are protecting your fellow Americans (and perhaps your vulnerable loved ones) from dying from COVID-19 or suffering long term health consequences from COVID-19. Whether you are protecting 10’s of thousands, 100’s of thousands, or millions of Americans depends on the percent of the population that gets vaccinated.
2) What about lockdowns? Here the data are clear. Lockdowns are effective at temporarily slowing the spread of the virus, so that hospitals are not overwhelmed. But they are not effective for much else. They don’t kill off the virus. And it surges again when the lockdown is lifted. We could lurch from lockdown to lockdown until we have achieved herd immunity, but I don’t think anyone wants that.
The Personal Argument For Vaccination
What about the benefits for you as an individual? Perhaps the best way of answering that question is to
white mask
address the recent announcement that you will still need to wear a mask after you have been vaccinated because you can still catch the virus and still spread it. I have seen some of you say, “If that’s true, why bother getting vaccinated?” I am as bummed as any of you that I will still need to wear a mask and socially distance after getting vaccinated but let me put that into perspective for you.
Let’s start with the science. While we often talk as if we have a single immune system, we actually have several semi-independent immune defense systems. For airborne viruses like COVID-19, our first line of defense is our upper respiratory tract. We have immune cells that line our nose, throat, and upper respiratory track that can slow or stop the viral infection. If the virus takes up residence in our upper respiratory tract, it can cause mild flu-like symptoms. Once the virus escapes the upper respiratory tract, it can invade the lower respiratory tract and our bloodstream. This is where all the bad things happen.
The Pfizer and Moderna vaccines are 60% effective at preventing COVID-19 from infecting our upper respiratory tract and 95% effective at preventing COVID-19 from infecting our lower respiratory tract and bloodstream.
This means after we have been vaccinated, we still have a 40% chance of being infected with COVID-19 and suffering mild flu-like symptoms. If we have been infected, we can still spread it to others. However, we have 95% protection against experiencing severe COVID-19 symptoms, being hospitalized, dying, and suffering from long term complications from COVID-19. This is the most compelling personal benefit of vaccination.
Finally, I should speak to the 40% risk of being infected. That is only a concern while the virus is widely circulating in the community. When we reach herd immunity and the virus levels are low, the probability of infection will also be low.
2) There is one other personal consideration. A recent study has confirmed what we already expected, namely that there is a considerable variation in immune response at every age. However, the surprising result was the study could not find any reliable predictor for the variation in immune response. In the words of one of the authors, “If you get infected with COVID-19, there is no way of telling whether it will be a mild cold or a trip to the ICU.” There have even been reports of young, healthy athletes dying from COVID-19. This does not happen often enough for it to affect the statistics. But if it were to happen to you or someone you loved, it would be important to you.
In summary, the personal argument for you getting vaccinated is that the Pfizer and Moderna vaccines give you 95% protection from severe disease, hospitalization, death, and long-term health consequences caused by COVID-19. This protection can be important even for people who are young and healthy.
The Risks Of Vaccinations
Now let’s turn to the risks of vaccination. The risks are real, but let’s put them into perspective.
The risks of vaccination need to be compared with the risks of attempting to reach herd immunity without vaccination that I have described above.
2) The risks of adverse events occurring after vaccination also need to be compared with the risk of those same adverse events occurring after infection with COVID-19, flu, or the common cold. This is something that has been completely ignored in most online discussions of vaccination risks. Every time something triggers our immune system, there is a small chance of it going haywire and triggering things like autoimmune responses and Bell’s palsy. It doesn’t matter if the trigger is a viral infection, a bacterial infection, or a vaccine. Simply put, you are equally likely to suffer from some of these adverse events if you get vaccinated or if you decline vaccination and become infected with COVID-19.
3) Some of the reports circulating on the internet are based on the Vaccine Adverse Effects Reporting Site (VAERS) despite the clear warning that these reports are unverified and may be inaccurate. Once the reports have been posted on VAERS, the CDC contacts the person reporting the event and obtains a complete medical history for the patient. If the patient died, the CDC obtains the death certificate and, if available, the autopsy report. They then use a sophisticated algorithm to determine whether the event was unexpected based on the patient’s age, health, and underlying diseases. Rather than using the unverified VAERS data, I have based my analysis on the CDC’s January 27 COVID-19 Safety Update which summarized the data collected from the first 20 million vaccinations.
The Claims About Existing Vaccines
Pinochio
Now, let’s turn to some of the claims you may have heard about the Pfizer and Moderna vaccines. There is a kernel of truth to each of the claims. However, the people sharing these claims are not sharing the full truth. As Paul Harvey used to say, they are not sharing “the rest of the story.”
I suppose I should start by addressing the oft-repeated statements that these vaccines are not FDA approved, but have received Emergency Use Authorization instead. They are experimental. There is no data on safety. They haven’t been studied in animals. We have never had an mRNA vaccine before.
In an ideal world clinical studies on the vaccines would have continued another year or two so they could have received full FDA approval. We would have found out things like how long immunity lasts and whether we could space the shots further apart. However, we don’t live in an ideal world. Thousands of Americans are dying every day. Fast action was needed. That is what Emergency Use Authorization was created for. Clinical studies are still ongoing to resolve questions like how long immunity lasts. Things like that are nice to know, but they are not essential for stopping the pandemic.
They have been studied in animals. I suspect this hasn’t been discussed publicly because many people oppose animal testing.
Safety was evaluated carefully in the vaccine clinical trials. No major safety issues were seen in the Pfizer and Moderna clinical trials with about 50,000 participants. With any drug or vaccine, you never know about rare side effects until millions of people have received the treatment. At this point, more than 20 million people have been vaccinated and very few unexpected side effects have been reported (more about that below). The safety of these vaccines is well established at this point.
mRNA vaccines are not an untested technology. They have been in development for at least 10 years. Personally, I prefer the mRNA vaccines because they are cleaner than earlier vaccines. They have fewer components and there are, therefore, fewer things that can go wrong.
2) Now, let me address the claim that large numbers of people get sick after receiving the vaccine, and are unable to go to work. That sounds scary but let me tell you “the rest of the story”.
Short term side effects of the Pfizer and Moderna vaccines include pain at the site of injection, fatigue, headache, generalized muscle pain, chills, fever, swelling, and joint pain, particularly after the second shot. These are common symptoms for almost any vaccine. Not everyone experiences these symptoms, and for some people the symptoms are mild. However, the symptoms are severe enough for some people that it keeps them out of work. This is the kernel of truth.
However, what people spreading this claim aren’t telling you is that the symptoms are temporary. They generally clear up within 24-48 hours. And people who do have severe symptoms usually miss only a day or two of work.
The bottom line is you may feel lousy for a day or two after the shot (especially the second shot). You may miss a day or two of work. But you will recover in a day or two. You will be fine, and the temporary discomfort will be worth it because you have achieved 95% protection from COVID-19.
3) Next, let me address the claim that some people have required medical attention and hospitalization after being vaccinated. That sounds even scarier, but here is “the rest of the story”.
What they are referring to are severe allergic reactions to the vaccine. In most cases, severe allergic reactions can be handled with an injection of epinephrine (Most people who are prone to severe allergic reactions carry an epi-pen with them at all times). However, severe allergic reactions can require medical attention and occasionally a brief visit to the hospital. Again, this is the kernel of truth, but here is “the rest of the story”.
The chance of a severe allergic reaction occurring is 1 in 100,000. That is about the same as your chance of being struck by lightning.
These are not random occurrences. 81% of the cases occur in people who have previously had severe allergic reactions to foods, medicines, vaccines, or insect bites, especially those people who have required medical attention or hospitalization in the past. In other words, most people know they are at risk ahead of time. If you have never had a severe allergic reaction to anything before, your chance of experiencing a severe allergic reaction to these vaccines is around 1 in a 100 thousand.
The bottom line is that if you have never experienced severe allergic response in the past, your chances of experiencing it following vaccination are slight. As a precaution vaccination sites ask you to wait for 15’ before leaving so you can be observed for allergic reactions.
If you have suffered from severe allergic reactions in the past, your chances of having a severe allergic reaction to the vaccine are greater. This could require medical attention or a brief hospitalization. My recommendation for you is to consult with your physician before signing up for the vaccine. If you and your physician decide vaccination is right for you, get your vaccination from a medical center or clinic where physicians are available should severe allergic responses arise.
The CDC has been following this side effect very carefully during the rollout of the Pfizer and Moderna vaccines. The good news is that most people fully recover within 24-48 hours. This is also a transient side effect.
4) Another claim is that the vaccine will, in effect, sterilize women taking it so that they cannot become pregnant.
Let’s start with the kernel of truth. Early last year, two scientists who had formerly worked for Pfizer released a sent a letter to vaccine experts across the world warning that the Pfizer vaccine could cause sterilization. That sounds super-scary, but here is the “rest of the story”.
That letter was part of what is called “the scientific method”. Scientists are continually challenging existing paradigms. This constant challenging and testing of ideas is the true strength of the scientific method.
Scientists understand this. When someone challenges an existing paradigm, we ask, “Is it true? What do the data show?” Here are the data.
The Pfizer study excluded pregnant women from the study. However, 23 women became pregnant and gave birth during the study. Twelve of them were in the vaccine group and eleven in the placebo group. This is a small number, but…
The mechanism proposed for the vaccine causing sterility also applies to infection with the live virus. At this point, more than 100 million people have had COVID worldwide and there has been no decrease in fertility.
The bottom line is that the hypothesis proposed by the former Pfizer scientists has been tested and disproved. There is no detectable risk of infertility associated with either COVID-19 exposure or the vaccines.
Unfortunately, most bloggers and many medical doctors don’t fully understand the scientific method. They don’t realize that things like the letter by the former Pfizer scientists are simply hypotheses and they don’t look at existing data to see whether the hypotheses are true or false.
5) Finally, there are claims that lots of people are dying after receiving the vaccine. This is based on misuse of the VAERS database. They are ignoring the warning that the data have not been verified. If you simply refer to the unverified VAERS database, 196 people have died following the first 20 million vaccinations. It sounds scary, but here is the rest of the story.
Every time one of these deaths is reported to the VAERS database, the CDC obtains the medical records and cause of death. Then they calculate whether the death was unexpected for someone with that medical condition. For example, 81% of the deaths have occurred in long term care facilities. When you read the medical records of these patients you find entries like “…in and out of hospice…” or “…has congestive heart failure and was in declining health…”
In the words of the CDC, the death of these patients was expected. They called these deaths “temporally-associated coincidental events.” I would word it a bit differently. These were patients on the brink of death. Anything could push them over the edge. It just happened to be the vaccination that did it.
When the CDC had completed their data analysis, they could only identify two unexpected deaths in healthy patients following vaccination. That is 1 out of 10 million – the same chance you have of dying in a crash the next time you get on a plane. When you compare that with a 1 in a hundred chance of dying and a 20% chance of having long term complications from COVID-19, the choice of getting vaccinated sounds a lot less scary.
6) I suppose I should close this section by addressing some of the videos you have shared with me of people claiming they have serious side effects from the Pfizer and Moderna vaccines. Unfortunately, these claims have not been submitted to the VAERS database, so they can be verified by the CDC. At this point they seem to be in the 1 in 10 million category, but I won’t know for sure until they have been submitted and verified. As a scientist, I deal with data, not speculation.
The Good News Nobody Is Talking About
The good news nobody is talking about is that the Pfizer and Moderna vaccines may trigger fewer autoimmune diseases than previous vaccines.
Whenever the immune system is triggered by either viral infection or vaccines, there is a small chance it will go haywire and trigger autoimmune responses, with Bell’s palsy and Guillain-Barre syndrome being the two most common. Typically, this occurs in at the rate of about 1 in a million vaccinations, with the exception of the swine flu vaccine a few years ago when it was 1 in 100,000.
At the 20 million mark with the Pfizer and Moderna vaccines there have been zero cases of Guillain-Barre syndrome and 4 cases of Bell’s palsy. The CDC considered the Bell’s palsy cases as coincidental given the medical history of the patients. However, even if the Bell’s palsy cases were caused by the vaccination, that would translate into a rate of 1 in 5 million vaccinations. This is about the same as your risk of developing Bell’s palsy after you have had the flu.
New Vaccines On The Horizon
Now, let me speak briefly about the Johnson & Johnson and AstraZeneca vaccines that are likely to be available in the US shortly.
Both vaccines utilize a weakened common cold virus with the gene for the COVID-19 spike protein spliced in. This is a vaccine delivery system that has been used for decades and has a well characterized safety profile.
The Johnson & Johnson vaccine is a single shot vaccine that is 66% effective against moderate to severe disease and 85% effective against hospitalization and death.
The AstraZeneca vaccine requires two shots for maximum effectiveness. Unlike the Pfizer and Moderna vaccines, clinical trials have determined the optimal time (3 months) between the first and second dose. The AstraZeneca vaccine is 76% effective after the first dose and 82% effective after the second dose.
In summary, both vaccines are slightly less effective than the Pfizer and Moderna vaccines. Their safety appears to be comparable to the Pfizer and Moderna vaccines, but we will know much more about their safety after the first 10 or 20 million doses have been administered in the US.
What Questions Remain?
What about the future? There are three big question marks at present.
Will the residual effects of COVID-19 (chronic fatigue, loss of heart and lung function) resolve or are they permanent? That is a scary thought, but we won’t really know the answer to this question for another year or two.
2) How long will vaccine protection last? You have been hearing that immune protection may only last a few months. If that were true, it would be very discouraging. I could understand you thinking, “Why bother?” However, once again we need to look at “the rest of the story”.
If we just look at levels of circulating antibodies, there is a great deal of individual variation. In some individuals, circulating antibodies disappear in a couple of months. For others, they last much longer. If circulating antibodies were the sole measure of our resistance to infection from COVID-19, it would appear the immune protection from vaccinations is short lived.
However, 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 that 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.
The CDC may recommend a booster shot a year from now. Hopefully, by then we will know if it is necessary.
3) Will the vaccines protect us from new variants of the virus? Preliminary data suggest that the existing vaccines are likely to offer significant (70-80%) protection against the new variants.
However, I know you are seeing doomsday predictions that new variants of COVID-19 will emerge that will be unaffected by the vaccines. If that were to happen, we would be back to square one. We would need to create a new vaccine. However, before you panic, you need to hear “the rest of the story”.
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-infective. 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. Again, we won’t know for sure until we have data on whether people who have been vaccinated are resistant to the new variants.
Once everyone has been vaccinated the first time around, the CDC may recommend a booster shot to protect against the new variants. Hopefully, by then we will know if it is necessary.
What Alternatives Do We Have To Vaccination?
Let me close by asking whether there are alternatives to vaccinations. Are there other things we could be doing to prevent COVID-19?
I should probably start with hydroxychloroquine. You have probably seen the video by a medical doctor saying that we should be using hydroxychloroquine rather than relying on the vaccines. She claims that hydroxychloroquine is safe and effective at preventing serious disease when given when someone is exposed or after the first symptoms of COVID appear. I am sympathetic to her viewpoint. If hydroxychloroquine had been proven to be safe and effective and it were readily available to the American public, I might feel differently about the importance of vaccination. But here is the “rest of the story” the doctor isn’t telling you.
This doctor who wants exhaustive clinical trials for the vaccines is willing to accept a couple of small, preliminary studies on the effectiveness of hydroxychloroquine. More importantly, the pushback was not about the general safety of hydroxychloroquine, as she states. It was based on published studies suggesting that hydroxychloroquine increases the risk of death when it is given late in COVID treatment to an old and sick population group. We don’t know whether hydroxychloroquine increased deaths because it was given late in the infection or because of certain underlying health conditions those patients had.
In a rational world the government would have funded a larger “Warp Speed” study to determine who benefits from hydroxychloroquine and who is endangered by hydroxychloroquine. But we don’t live in a rational world.
In a rational world a drug as cheap and readily available as hydroxychloraquine would be available to doctors who wanted to prescribe it for their COVID patients. We don’t live in a rational world.
2) Finally, there is my favorite topic, a healthy diet and supplementation. In previous issues of “Health Tips From the Professor” I have shared studies showing that adequate vitamin D status may reduce the risk of getting COVID. It also appears to reduce the risk of hospitalizations, ICU admissions, and deaths from COVID. I should emphasize that these studies suggest that adequate D status reduces the risk of getting COVID. None of the studies said it eliminated the risk of getting COVID.
I also have shared a major study that recommended supplementation to strengthen our immune systems and help protect us from respiratory diseases like COVID. Again, the authors said that supplementation reduced the risk of respiratory diseases. They did not say that supplementation eliminated the risk.
If you wish to strengthen your immune system with a healthy diet and supplementation and rely on that to protect you from COVID, I respect your decision. However, I caution you not to think of it as complete protection. It is partial protection. It won’t make you immune to COVID.
The Truth About Vaccination
COVID-19 is the deadliest disease we have seen in our lifetime. It attacks your lungs and every other organ in your body. It kills 1 out of every 100 people it infects. It even attacks and kills young healthy adults. Even worse, between 20% and 80% of its survivors may never fully recover. Their life may never be the same again.
The current vaccines offer 60% protection against mild disease and 95% protection against severe disease, hospitalization, death, and long-term complications from COVID-19 infection. The vaccines are not perfect. They do have some risks. There are still some unanswered questions. But the risks of vaccination are orders of magnitude less than the risks associated with COVID-19.
Good nutrition, mask wearing, social distancing, and hand washing also offer some protection against COVID-19. Here is my perspective.
COVID-19 is throwing everything it has at us. We need to respond with every resource at our disposal. Supplementation, vaccination, wearing masks, hand washing, and social distancing all provide partial protection. However, in combination they provide much more protection than they do individually. For example, good nutrition strengthens our immune system and makes vaccines more effective. Vaccines give our immune system the ammunition they need to fight COVID-19. Thus, vaccines make good nutrition more effective at protecting us.
I choose and recommend a holistic approach. COVID-19 is a deadly foe. I choose to arm myself with every defensive weapon I have at my disposal. I choose good nutrition, supplementation, vaccination, mask wearing, hand washing and social distancing.
The Bottom Line
COVID-19 is the deadliest disease we have seen in our lifetime. It attacks your lungs and every other organ in your body. It kills 1 out of every 100 people it infects. It even attacks and kills young healthy adults. Even worse, between 20% and 80% of its survivors may never fully recover. Their life may never be the same again.
The current vaccines offer 60% protection against mild disease and 95% protection against severe disease, hospitalization, death, and long-term complications from COVID-19 infection. The vaccines are not perfect. They do have some risks. There are still some unanswered questions. But the risks of vaccination are orders of magnitude less than the risks associated with COVID-19.
Good nutrition, mask wearing, social distancing, and hand washing also offer some protection against COVID-19. Here is my perspective.
COVID-19 is throwing everything it has at us. We need to respond with every resource at our disposal. Supplementation, vaccination, wearing masks, hand washing, and social distancing all provide partial protection. However, in combination they provide much more protection than they do individually.
For example, good nutrition strengthens our immune system and makes vaccines more effective. Vaccines give our immune system the ammunition they need to fight COVID-19. Thus, vaccines make good nutrition more effective at protecting us.
I choose and recommend a holistic approach. COVID-19 is a deadly foe. I choose to arm myself with every defensive weapon I have at my disposal. I choose good nutrition, supplementation, vaccination, mask wearing, hand washing and social distancing.
In the article above I have covered the following topics:
The public health argument for vaccination.
The personal argument for vaccination.
The risks of vaccination – A perspective.
The claims about existing vaccines.
The good news nobody is talking about.
New vaccines on the horizon.
What questions remain?
What alternatives do we have to vaccination?
The truth about vaccination.
For more information, 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.
Should You Avoid Supplement Use During Chemotherapy?
Since much of my research career was devoted to cancer research, specifically developing new chemotherapeutic drugs for treating cancer, many of you have asked me the question: “Do food supplements interfere with chemotherapy?”
My answer has always been that it is theoretically possible, but that we don’t really know the answer because the necessary studies have not been done.
However, I do know that most cancer drugs are retained in the body for a short period of time. So, my pragmatic advice has always been to avoid supplementation for a day or two before to a day or two after each round of chemotherapy. That is a strategy designed to minimize the possibility that supplementation would interfere with chemotherapy and maximize the possibility that supplementation might aid in recovery between rounds of chemotherapy.
That is why I was interested when I saw the recent headlines claiming certain supplements may interfere with chemotherapy for breast cancer. I wanted to find out if someone had finally done a definitive study on the effect of supplementation on chemotherapy.
This study was an offshoot of a much larger Phase III clinical trial designed to determine the best schedule for administering three drugs (doxorubicin, cyclophosphamide, and paclitaxel) to patients with high-risk early-stage breast cancer.
The 1,134 patients enrolled in this study were given questionnaires on their use of supplements when they registered for the study to determine supplement use prior to the study. They were also given questionnaires when they completed chemotherapy to determine supplement use during chemotherapy.
The questionnaires documented use of:
Multivitamins
The antioxidants vitamin C, vitamin A, vitamin E, carotenoids, and coenzyme Q10.
Vitamin D.
The B vitamins vitamin B6, vitamin B12, and folic acid.
The minerals iron and calcium.
Omega-3 fatty acids.
Glucosamine, melatonin, and acidophilus.
Recurrence of the breast cancer and death from breast cancer were measured 6 months after chemotherapy ended.
Do Supplements Interfere With Chemotherapy?
The study reported:
The number of patients using individual antioxidant supplements was too low to determine whether individual antioxidants had any effect on treatment outcomes.
When the patients using any antioxidant supplement were pooled into a single group, there was a nonsignificant association between antioxidant supplement use during chemotherapy and an increased risk of breast cancer recurrence and death from breast cancer.
Iron use during chemotherapy was significant associated with an increased risk of breast cancer recurrence.
Vitamin B12 use during chemotherapy was significantly associated with increased risk of breast cancer recurrence and death from breast cancer.
Multivitamin use was not associated with either recurrence or death from breast cancer.
The number of patients using the other supplements was too low to determine whether those supplements had any effect on treatment outcomes.
The authors concluded: “Associations between survival outcomes and use of antioxidant and other dietary supplements are consistent with recommendations for caution among patients when considering the use of supplements, other than a multivitamin, during chemotherapy.”
This is the conclusion that generated the headlines you may have seen.
However, in their discussion the authors conceded that a previous review concluded that, “…insufficient evidence existed with regard to the safety of dietary supplements [during chemotherapy] to make recommendations, and that still may be the case.”
I will discuss the reasons for their disclaimer below. However, I will point out that disclaimers like this never seem to make it into the headlines you read.
What Are The Strengths And Weaknesses Of This Study?
The only strength of this study is that it was performed in the context of an ongoing clinical trial, with surveys conducted before chemotherapy and during chemotherapy to assess supplement use.
However, the study had multiple weaknesses that limit the ability to draw any firm conclusions from the study.
#1: The number of people using supplements in this study was very small. For example:
Only 200 people took any antioxidants during chemotherapy.
Only 137 people took a vitamin B12 supplement during chemotherapy.
Only 109 people took an iron supplement during chemotherapy.
To put this into perspective, if a drug company were submitting a new drug for approval to the FDA, they would be required to submit data from ~50-100-fold more cancer patients to prove that the drug was effective.
With this small number of supplement users, even “statistically significant” observations are questionable.
In contrast, the number of people taking a multivitamin during chemotherapy was 497. Thus, those data were a little stronger than the data for individual supplements.
#2: They did not ask why people were taking supplements. It turns out that the patients who used supplements were older and sicker. They were more likely to be overweight and to have type 2 diabetes.
These are patients who are also more likely to have poor outcomes from chemotherapy. The authors tried to correct for that, but it is virtually impossible to make these corrections when the number of patients taking supplements is so low.
#3: They did not ask about the dose of supplements people were taking.
Multivitamins typically contain RDA levels of antioxidants and vitamin B12, so it would be safe to assume that RDA levels of antioxidants and vitamin B12 are safe during chemotherapy.
Approximately 50% of the women in the study were premenopausal, so it is likely that they were taking a multivitamin with iron. That suggests that RDA levels of iron are safe during chemotherapy for premenopausal women.
In short, the association between supplement use and poorer outcomes from chemotherapy is tenuous. If there is any association, it is likely with high dose individual supplements rather the lower levels of the same nutrients found in a multivitamin.
Is An Effect Of Supplement Use On Chemotherapy Plausible?
As a biochemist, the next question I ask is whether there is a plausible mechanism for an effect of any of these supplements on chemotherapy outcomes.
For two of the drugs in the regimen (paclitaxel and cyclophosphamide), free radical formation may contribute to their effectiveness, but it is not their main mechanism of action. Thus, it is plausible that high dose antioxidant supplements could make these drugs less effective, but the effect should be relatively small.
Tumors require high amounts of iron for proliferation, so it is plausible that excess iron could make tumors more resistant to chemotherapy. However, for premenopausal women, multivitamins with iron did not interfere with the drugs used in this study. Thus, it appears likely that RDA levels of iron, where appropriate, do not interfere with chemotherapy.
The authors said that the reason for the observed effects of vitamin B12 on chemotherapy in their study “remains to be understood”. However, the answer might be found in the dosage of vitamin B12. A previous study reported that doses of vitamin B12 that were greater than 20 times the RDA increased the risk of lung cancer.
If people in this study were taking doses of vitamin B12 in excess of 20 times the RDA, it would provide a plausible explanation for B12 interfering with chemotherapy. If not, there is no known explanation. In any case, I do not recommend taking such high doses of any supplement.
Should You Avoid Supplement Use During Chemotherapy?
Now, let’s get back to the original question: “Should you avoid supplement use during chemotherapy?” If you read the headlines saying, “Supplement Use During Chemotherapy May Be Risky”, you might think that the answer is an unqualified yes. That is also what your doctor is likely to think.
However, when you analyze the study behind the headlines you realize that the evidence supporting the headlines is very weak.
So, that puts us back to where we were before the study was published. Simply put:
It is theoretically possible that supplements interfere with chemotherapy, but we don’t know for sure.
A pragmatic approach is to avoid supplementation for a day or two before to a day or two after each round of chemotherapy. This is a strategy designed to minimize the possibility that supplementation would interfere with chemotherapy and maximize the possibility that supplementation might aid in recovery between rounds of chemotherapy.
Note: This is generic advice. I am not a medical doctor, so it would be unethical for me to provide individualized advice on how to minimize interactions between supplements and chemotherapy. What I recommend is that you ask your doctor whether my generic recommendations make sense for your cancer and your drug regimen.
If this study advanced our knowledge at all, it would be that:
The supplements most likely to interfere with chemotherapy appear to be high dose antioxidants, vitamin B12, and iron supplements.
Multivitamins, even multivitamins with iron when appropriate, are unlikely to interfere with chemotherapy.
The Bottom Line
Recent headlines have warned, “Supplement Use During Chemotherapy May Be Risky”. Is that true?
However, when you analyze the study behind the headlines you realize that the evidence supporting the headlines is very weak.
So, that puts us back to where we were before the study was published. Simply put:
It is theoretically possible that supplements interfere with chemotherapy, but we don’t know for sure.
A pragmatic approach is to avoid supplementation for a day or two before to a day or two after each round of chemotherapy. This is a strategy designed to minimize the possibility that supplementation would interfere with chemotherapy and maximize the possibility that supplementation might aid in recovery between rounds of chemotherapy.
Note: This is generic advice. I am not a medical doctor, so it would be unethical for me to provide individualized advice on how to minimize interactions between supplements and the chemotherapy drugs you are on. What I recommend is that you ask your doctor whether my generic recommendations make sense for your cancer and your drug regimen.
If this study advanced our knowledge at all, it would be that:
The supplements most likely to interfere with chemotherapy appear to be high dose antioxidants, vitamin B12, and iron supplements.
Multivitamins, even multivitamins with iron when appropriate, are unlikely to interfere with chemotherapy.
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.
Fructose is the villain of the day. It is #1 on everyone’s “No-No” list. Almost every website, blog, and diet book demonize it. Even authors I highly respect say we should absolutely avoid it.
We are told it causes obesity, diabetes, heart disease, and non-alcoholic fatty liver disease – a disease that was unheard of only a few decades ago. We are told to read labels and avoid any foods with fructose or high-fructose corn syrup listed on their label.
But wait. Isn’t fructose a natural sugar? The answer is, “Yes”. It is the main sugar in fruit and many other naturally sweet whole foods. In fact, there is the same amount of fructose in an 8-ounce soda and a medium apple.
Does that mean that fruits are also bad for us? What is the truth?
Is It The Fructose Or Is It The Food?
Let me put this into perspective for you. I have covered this in detail in a previous issue of Health Tips From The Professor. Here is a brief summary.
There are no sugar villains. There are no sugar heroes. Most of your favorite “natural” sugars are chemically and biologically indistinguishable from high-fructose corn syrup. Other natural sugars, like agave sugar, contain more fructose than high-fructose corn syrup.
All the studies showing the bad effects of fructose have been done with sodas and/or highly processed foods with added sugar. Let’s be clear. Those foods are bad for you.
Fruits, on the other hand, are good for you. You’ve heard the old adage, “An apple a day keeps the doctor away”. A recent study showed that isn’t just an “old wives’ tale”. It is true.
Why is that? Why is fructose in sodas and junk foods bad for us and fructose in fruits good for us?
Part of the answer is that fruits are high in fiber, which slows the release of fructose into the intestine as fruits are digested. In addition, the fructose in fruits is trapped in a cellular matrix, which also slows the release of fructose during digestion.
Sodas and highly processed foods, on the other hand, have nothing to slow the release of fructose. It is immediately available as soon as the food reaches the intestine.
A recent study sheds light on why the rate of fructose release in our intestine may be important. The study showed:
When fructose is released slowly our bodies know exactly what to do with it.
Most of it is metabolized by the cells that line our intestine, and the rest is metabolized by the liver.
In both cases fructose is converted to glucose and slowly released into the bloodstream.
This stabilizes blood sugar levels.
When fructose is released quickly our bodies are overwhelmed and bad things happen.
The intestine passes the excess on to the liver, and the liver converts it to fat rather than glucose.
The fat is stored in the liver.
This leads to insulin resistance, diabetes, heart disease, and fatty liver disease.
But could the fiber in fruits have other beneficial effects such as supporting populations of beneficial gut bacteria? The study ( J Beisner et al, Nutrients, 12: 3444, 2020) I will focus on today suggests the answer is yes.
How Was The Study Done?
Investigators from the University of Hohenheim, Germany recruited 12 healthy female volunteers, ages 20 – 40 (average age = 28).
Each of the subjects was given a series of diets to follow for one week each.
Week onewas a low fructose diet (10 g of fructose/day). For this diet phase subjects had to avoid sweets, highly processed foods, sodas, and fruits and vegetables containing more than 1 g of fructose per serving.
Week two was a high fructose fruit diet (100 g of fructose/day). This diet phase emphasized fructose-rich fruits and vegetables. Sweets, highly processed foods, and sodas had to be avoided.
Week three was a repeat of the low fructose diet (10 g of fructose/day).
Week four was a high-fructose corn syrup diet (100 g of fructose/day). For this diet phase subjects had to sweeten the food they were eating with a measured amount of high-fructose corn syrup. They also had to avoid fructose-rich fruits and vegetables.
The diets were designed to have around 2,000 calories/day and to have the same amounts of fat (30% of calories), protein (15% of calories), and carbohydrate (55% of calories). However, the fiber content of the diets was very different (around 17 g/day on the low fructose and high-fructose corn syrup diets and around 38 g/day on the high fructose fruit diet).
The subjects were given detailed instructions and training before starting on the 4-week program. They also kept a daily dietary record of everything they ate and drank so the investigators would know how closely they stuck to their dietary instructions.
This experimental design was based on previous studies showing that populations of gut bacteria change within 24-48 hours when you go on a new diet. Stool samples were collected at the end of each week and analyzed for gut bacteria.
Is Fructose Good For You Or Bad For You?
The study showed:
Consumption of a high-fructose, fruit-rich diet resulted in:
An increase in beneficial butyrate-producing bacteria (more about that below).
A decrease in bacteria associated with elevated total and LDL cholesterol.
Decreased blood levels of total and LDL cholesterol.
Consumption of a high-fructose corn syrup diet had the opposite effect. It resulted in:
A decrease in beneficial butyrate-producing bacteria.
An increase in bacteria associated with elevated total and LDL cholesterol.
Increased blood levels of total and LDL cholesterol.
The authors concluded: “We provide evidence that the high-fructose corn syrup diet induces an imbalanced microbiota [gut bacteria] profile characterized by a significantly reduced abundance of beneficial butyrate-producing bacteria and of bacteria known for anti-obesity effects…Despite the high fructose content, the fruit-rich diet shifts the intestinal microbiota composition in a protective manner…”
The authors said that there were probably two mechanisms for the different effects of fructose in high-fructose corn syrup and in fruits.
The fiber found in fruit supports the growth of beneficial bacteria in our intestine.
When high-fructose corn syrup is present in foods with low fiber content, it is released rapidly in the intestine. As I noted above, the cells that line our intestine become overwhelmed and pass some of that excess fructose on to our liver. However, the authors cited previous studies showing that some of that excess fructose remains in our intestine and supports the growth of unhealthy bacteria.
What Does Butyrate Do?
You are probably wondering what is special about butyrate-producing bacteria. Here is a brief synopsis.
Butyrate is a short chain fatty acid. As you might expect from its name, it was originally identified as a constituent of butter.
Some species of gut bacteria convert the fats in our diet to butyrate.
It is used as a preferred energy source for the cells that line our intestine. Consequently, butyrate production in our intestines has been linked to:
Reduced inflammation of the cells lining our intestine, which reduces the risk for diseases like inflammatory bowel disease (IBS) and Crohn’s Disease.
Reduced risk of “leaky gut syndrome”.
Reduced risk of colon cancer.
It is also absorbed into the bloodstream and appears to affect several metabolic pathways. For example, butyrate production in the intestine is associated with:
Decreased cholesterol levels.
Improved blood sugar control.
A healthy body weight.
What Does This Mean For You?
This was a small study. As the authors noted, larger studies of longer duration are needed to confirm that the effects of fructose on our gut bacteria depend on the food the fructose is in. However, several other studies have come to similar conclusions.
More importantly, this study merely shows that the effect of fructose-containing foods on our gut bacteria is a potential mechanism for explaining why the effect of fructose depends on the food it is in.
There is already overwhelming evidence that fructose in fruits is good for us, while high-fructose corn syrup in sodas and highly processed foods is bad for us.
Does that mean high-fructose corn syrup is villainous? Should we read labels and avoid any food containing high-fructose corn syrup?
I would remind you that the amount of fructose and the relative abundance of fructose and glucose are virtually identical in fruits and high-fructose corn syrup. It is not high-fructose corn syrup that is the problem, it is the foods it is found in.
We don’t need to become compulsive label readers. We just need to eat more foods without labels.
The Bottom Line
High-fructose corn syrup has been vilified in recent years. However, there is increasing evidence that it is not fructose that is the problem. It is the foods it is found in.
A recent study was designed to test that hypothesis. The investigators fed subjects high fructose diets in which the fructose came either from fruits or high-fructose corn syrup. The amount of fructose was identical in the two diets. The investigators then asked what effect the two diets had on gut bacteria. In short:
Consumption of the high-fruit diet increased healthy levels of beneficial gut bacteria and suppressed levels of unhealthy gut bacteria.
Consumption of the high-fructose corn syrup diet had the opposite effect. It increased unhealthy bacteria and suppressed beneficial bacteria.
The authors concluded: “We provide evidence that the high-fructose corn syrup diet induces an imbalanced microbiota [gut bacteria] profile characterized by a significantly reduced abundance of beneficial…bacteria and of bacteria known for anti-obesity effects…Despite the high fructose content, the fruit-rich diet shifts the intestinal microbiota composition in a protective manner…”
My take is as follows: This study shows that the effect of fructose-containing foods on our gut bacteria is a potential mechanism for explaining why the effect of fructose depends on the food it is in.
There is already overwhelming evidence that fructose in fruits is good for us, and high-fructose corn syrup in sodas and highly processed foods is bad for us.
Does that mean that high-fructose corn syrup is villainous? Should we read labels and avoid any food containing high-fructose corn syrup?
I would remind you that the amount of fructose and the relative abundance of fructose and glucose is virtually identical in fruits and high-fructose corn syrup. It is not high-fructose corn syrup that is the problem, it is the foods it is found in.
We don’t need to become compulsive label readers. We just need to eat more foods without labels.
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.
Author: Julie Donnelly, LMT –The Pain Relief Expert
Editor: Dr. Steve Chaney
Welcome To 2021
It seems like only a few weeks ago that we were getting ready to greet 2020. And in another way, it seems like it was an eternity ago because so much has happened during the past year. Personally, I am glad 2020 is over and I am visualizing a HEALTHY New Year for everyone!
But before we throw 2020 on the trash heap, let’s focus for a minute on the good things that happened in 2020. Yes, you heard me right – the good things!
Recently I was talking to a group of people, safely on Zoom, and someone asked us to discuss all the GOOD things that happened this year. What good things happened as a direct result of COVID-19?
For me, my therapy practice melted away and gave me many empty hours in my day. Like so many of us, the shift in income was scary. But, again, like so many of us, I decided to focus on what I could accomplish, and ignore the rest as best as I could.
If you come here to my office, you know that my therapy techniques are quite different than most of my colleagues in the massage world. I call my techniques “the Julstro Method of Osteopathic Muscular Therapy,” because early in my career I had the good fortune to be trained by a retired osteopathic physician. He taught me many osteopathic techniques that aren’t normally taught to massage therapists, and it has served me well. Even better, it has served my clients well, helping thousands of people who were at a loss for finding solutions to pain.
With my extra time, I asked myself how I could help even more people with my massage therapy techniques.
Lots Of Good Things Happened To Me In 2020
I have dabbled at training other massage therapists for several years, but COVID-19 put that training into hyperdrive! Suddenly I was creating instructional videos to teach others my techniques. A BIG shout out to Sherri Proctor for being the most talented, and patient, videographer in the world. Sherri is awesome and if you live here in the Sarasota vicinity and you need a videographer/photographer, I can’t recommend her highly enough.
I want to thank Barbara Shelby and Greg Hurst for being my models and making what could have been a difficult task become an easy one. I wanted videos (now in flash drive format and MP4 format) so people could easily follow how to do the Julstro self-treatments. Sherri did hours and hours of editing, again doing a fantastic job. She no sooner finished one project, and I was off to a new one.
Our next project was taking the videos I use when teaching massage therapists live, in a school setting. Sherri videoed me doing all the talking/teaching I do before and after each video. This was a monumental task, and Sherri did a great job.
My goal is to make these videos available to the world, so everyone can learn easy techniques that will help them achieve pain-free living. It is a big goal, but I hope to accomplish it this year. Check on my website (https://julstromethod.com) periodically to see when those videos become available.
This month I have spent a lot of time rehashing 2020 because I think it is important to look at the bright side of this unusual year. What good things have happened to you because of COVID? Write them down, I believe you will be amazed at how many things you have to be thankful for as 2020 draws to a close.
Let’s count our blessings!
A New Year’s Gift For You
Now that the holidays are over and 2021 is here, we all need to take a breath and relax. At least that is the goal. So, with that in mind, my New Year’s gift is meant for you to release tension from your body.
A little background on this New Year’s gift. About 30 years ago I was working as a massage therapist on a cruise ship. It was fantastic! The most consistent fun I ever had in my life.
On the ship we all had multiple jobs, and one of mine was to do a relaxing meditation the first morning of the cruise. That was the seeds of the MP3 that I am sending you this month. It worked so well that people started asking me to record it. It was funny how I managed to do that when you remember that I was on a cruise ship and it was before we had cell phones or fancy recording equipment. But I got it done well enough that people were able to leave with a cassette tape they could use at home.
Fast forward to my office in New York in the mid-late 1990’s. I would talk clients through the relaxation techniques, changing them as I went along so they would address each individual’s specific problems. Then a client offered to professionally record it for me. Wonderful!
I decided to make this recording beneficial for everyone, focusing on multiple problems that can cause people to suffer from painful, and in some cases, life-threatening conditions. I am happy to say that many people have been able to get relief and turn their health around by using the relaxing techniques in this MP3. The title is “Mental Massage – Relaxing into a Perfect Body ( https://we.tl/t-HVpMxtbBTB)”. I hope you will enjoy it!
Help Me Help You
I want this newsletter to help you live a Pain-Free Life. With that said, please send me an email (Julie@JulieDonnelly.com) and let me know what you would like me to discuss. Muscles cause pain all over the body and cause the same symptoms as arthritis, bursitis, carpal tunnel syndrome, headaches, and so much more. If you have a problem, please let me know and it will be the topic for one of these newsletters.
In the future I won’t be writing one of these articles every month, but I will respond to your questions and your needs. Please help me help you by sending in your questions.
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.
Is A Vegan Diet The Secret To Permanent Weight Control?
The new year is here, and you, like millions of other Americans, have decided this will be the year to get your weight under control. But how to do that is the question.
You have tried lots of diets over the years. You have given up sugar, then high-fructose corn syrup, then carbs in general. You have eliminated whole food groups from your diet. You have restricted your eating to between noon and 4 PM. You have eaten cabbage on Tuesdays and grapefruit on Thursdays (Just kidding about that one, but some fad diets are almost that bizarre).
You lost weight at first, but none of those diets were sustainable. You started adding back your favorite foods. Then the pounds you lost came back – and brought their friends with them.
At this point you may be desperate. You may be tempted to try one of those “magic” supplements that promises to rev up your metabolism and make those pounds melt away. Resist that temptation! Those supplements are either dangerous or worthless – sometimes both.
Or you may be tempted to sign up for one of those expensive diet programs that sends you low calorie versions of all your favorite junk foods. Don’t waste your money. You don’t really need more highly processed food in your diet. And you aren’t learning healthier food choices.
But what if…
…you could rev up your metabolism just by eating a healthy diet?
…you could lose weight naturally without counting calories or reducing portion sizes?
…you could keep most of the weight off permanently?
The study (H Kahleova et al, JAMA Network Open.2020; 3(11): e2025454) I will review today says there is diet that does all of these things. It is not the latest, greatest fad diet. In fact, it has been around for years. It is called the vegan diet.
How Was The Study Done?
This was a small, but very well-designed, study. It enrolled 244 obese (average BMI = 33), middle aged (average age = 54) subjects (87% female, 48% white). They were randomly assigned to a vegan diet or control diet and followed for 16 weeks.
The control group was told not to change their diet and exercise routine.
The vegan group was also told not to change their exercise routine. In addition, they were given printed materials and attended weekly classes that provided detailed instructions and cooking demonstrations to help them follow a vegan diet.
The vegan diet consisted of fruits, vegetables, whole grains, and legumes with no animal products or added fats. 75% of the calories came from carbohydrate, 15% from protein, and 10% from fat.
The diets of both groups were assessed by a 3-day dietary recall at the beginning of the study and 16 weeks later, at the end of the study. In addition, dietitians made unannounced telephone calls at random times during the week and weekends to assess the participant’s adherence to the diet.
In the vegan diet group, mean intake of carbohydrate and fiber increased, while intake of fat, protein, and cholesterol decreased. There was no significant change in intake in the control group.
The other parameters measured at the beginning of the study and week 16 were:
Body composition:
Weight and BMI (a measure of obesity).
Fat mass and lean muscle mass.
Belly fat.
Fat stores in liver and muscle (accumulation of fat stores in the liver and muscle is associated with insulin resistance).
Parameters of blood sugar control and insulin resistance:
Fasting blood glucose and hemoglobin A1c levels were measured.
Insulin secretion and blood glucose levels were measured during a 3-hour oral glucose tolerance test. Insulin secretion was used as a measure of insulin resistance, and blood glucose levels were used as a measure of insulin sensitivity (Note: This is a very simple explanation of complex calculations.)
Lipid Levels:
Total cholesterol.
HDL and LDL cholesterol.
A Vegan Diet And Weight Loss
The study results were impressive:
The vegan group lost 14 pounds, while the control group lost only 1 pound. There were two reasons for the greater weight loss in the vegan group:
The vegan group decreased their caloric intake by almost 500 calories per day. This was most likely due to the lower caloric density (calories per serving) of plant foods.
In other words, the vegan group consumed fewer calories without focusing on weight loss or portion size. They ate until they were full and consumed fewer calories in the process. Isn’t this what everyone wants from a weight loss diet?
The thermic effect (calories burned due to digestion) of the food they ate increased by 14% in the vegan group. This is because it requires more energy to digest foods when your digestive system has to break down the cellular matrix found in unprocessed plant foods.
In other words, the vegan group burned more calories every day just by eating healthy foods. No other diet can promise this.
2) Fat mass decreased by 10% (9 pounds) in the vegan group but was unchanged in the control group
3) Lean body mass (muscle mass) decreased by 1 pound in the control group and 4.6 pounds in the vegan group. There are two important observations here:
All the weight loss in the control group came from muscle.
33% of the weight loss in the vegan group came from muscle. This is the only negative outcome from this study and is likely due to the decreased protein intake in the vegan group. Previous studies suggest this loss of lean body mass could be prevented by increasing the protein content of the diet with a plant-based protein supplement.
4) Belly fat decreased by 15%, liver fat was decreased by 31%, and muscle fat was decreased by 19% in the vegan group. All three parameters were unchanged in the control group.
This is perhaps the most significant observation from these studies since these are the three deadliest forms of fat in our bodies. Any diet that significantly reduces these forms of fat is likely to dramatically improve our health.
These parameters have not been measured in most studies of other weight loss diets, so we have no idea whether other weight loss diets have this effect.
5) Fasting blood glucose decreased by 11%, insulin resistance decreased by 40%, and insulin sensitivity increased by 22%. These parameters were unchanged in the control group.
Note: While insulin resistance and insulin sensitivity are opposite ways of measuring the same phenomenon, they were measured in different ways in this study. That is why the percentage change was different for these two parameters. The important thing is that both parameters changed by a significant percentage in a direction that reduces the risk of type 2 diabetes.
These data show that just 16 weeks on a vegan diet is sufficient to significantly reduce the risk of developing type 2 diabetes. Previous studies have shown that a vegan diet can reverse type 2 diabetes for many people.
6) Total cholesterol decreased by 11% and LDL cholesterol decreased by 16%. Both parameters were unchanged in the control group.
Is A Vegan Diet The Secret To Permanent Weight Loss?
As I said, the results of this study are impressive. But you have probably heard similar claims for other diets like keto, paleo, etc. To put this into context for you I am going to discuss “The Truth (about weight loss diets) Nobody Talks About” and The Questions (about weight loss diets) Nobody Asks”.
The Truth Nobody Talks About: Why are there so many conflicting claims about weight loss diets? They can’t all work, or can they? Here is the truth nobody talks about.
If you just focus on short term weight loss and improvement in health parameters like cholesterol and blood sugar levels, the very low fat vegan diet and the very low carb keto diet give virtually identical results.
That statement is true for any restrictive diet, but I chose the vegan and keto diets because they are as different as any two diets can be. That means you can forget all the scientific-sounding mumbo-jumbo about why each diet is best and focus instead on what they have in common. Here is what they have in common.
They all compare themselves to the typical American diet. The American diet is high in saturated fat, high in sugar, high in refined carbs, and high in junk foods. Almost any diet is better than the typical American diet!
Unfortunately, none of these diets compare themselves to each other, so we don’t know which is best. We just know that all of them are better than the typical American diet.
All of them are whole food diets. Any diet that cuts out sodas, junk foods, and highly processed foods will result in weight loss and better health.
All of them are restrictive diets. Some restrict sugar. Others restrict fat. Some eliminate particular foods. Others eliminate food groups. Some restrict the time of day you can eat. When you do any of these things you are forced to focus on what you eat.
And when you focus on what you eat, you lose weight. That is why diets that force you to count calories, count carbs, or keep a food journal are successful.
Don’t misunderstand me. Although the vegan and low carb diets have not been directly compared in clinical trials, vegan diets may have some unique benefits that other diets do not. For example, this study shows that:
Because of the low caloric density of unprocessed plant foods, you can eat more food and consume fewer calories on a vegan diet. You don’t get this benefit from low carb diets. They are high in fat and have, therefore, a high caloric density.
Digestion of unprocessed plant foods increases your metabolic rate. This benefit also doesn’t exist for low carb diets. They contain less unprocessed plant foods than a vegan diet.
Belly fat, liver fat, and muscle fat are all decreased in just 16 weeks with a vegan diet. This may occur for other diets. But most studies of other diets have not looked at these parameters, so we don’t know if they have this benefit.
The Questions Nobody Is Asking: Since all these diets result in short-term weight loss, there are two questions we should be asking.
Which of these diets are healthy long term? Numerous studies have shown people who consume vegan diets and other primarily plant-based diets for 10, 20, or 30 years weigh less and have a lower incidence of heart disease, diabetes, and some cancers than people who consume the typical American diet.
Although the Atkins diet has been around for more than 50 years, there is still no evidence that the Atkins diet or other meat-based low carb diets are healthy long term. I have summarized these studies in my book, “Slaying The Food Myths”.
2) What happens when you get tired of the restrictions in these diets and start adding back a few of your favorite foods? If you start with a vegan diet and add a little dairy, eggs, and meat to it, you end up with a semi-vegetarian diet. People following a semi-vegetarian diet weigh less and are healthier than people consuming the typical American diet.
Keto diets are high in meat and saturated fat. If you add carbs, even healthy carbs, to that diet, you end up with the typical American diet, which is characterized by weight gain and poor health.
One Final Thought: Big Food has noticed that many Americans want to eat vegan but still crave the taste and convenience of their favorite foods. Big Food has been only too happy to oblige with a wide selection of highly processed “vegan” foods. Avoid these foods like the plague!
I have discussed the shortcomings of the “vegan” burgers found in your local supermarkets and fast food restaurants in a recent issue of “Health Tips From the Professor”.
The biggest problem with all these “vegan” food substitutes is that they are highly processed foods. The benefits of a vegan diet come from eating unprocessed plant foods. None of us need more highly processed foods in our diet.
Of course, it isn’t just vegan food substitutes. Any hope that the Atkins diet might have been healthy evaporated with the advent of “Atkins” processed foods. Now I am starting to see the same trend with “keto” and “paleo” foods.
The Bottom Line
The new year is here, and you, like millions of other Americans, have decided this will be the year to get your weight under control. But how to do that is the question.
You have tried lots of diets over the years. You have given up sugar, then high-fructose corn syrup, then carbs in general. You have eliminated whole food groups from your diet. You have restricted your eating to between noon and 4 PM. You have eaten cabbage on Tuesdays and grapefruit on Thursdays (Just kidding about that one, but some fad diets are almost that bizarre.
You lost weight at first, but none of these diets were sustainable. You started adding back your favorite foods. Then the pounds you lost came back – and brought their friends with them.
But what if…
…you could rev up your metabolism just by eating a healthy diet?
…you could lose weight naturally without counting calories or reducing portion sizes?
…you could keep most of the weight off permanently?
We know people who eat a vegan diet for 10, 20, or 30 years weigh less and are healthier than people consuming the typical American diet. Could the vegan diet be the diet you have been looking for?
The study I review this week was designed to answer this question. The investigators randomly assigned obese, middle-aged Americans, to follow either a vegan diet for 16 weeks or to continue eating their typical American diet.
The study results were impressive:
The vegan group lost 14 pounds, while the control group lost only 1 pound. There were two reasons for the greater weight loss in the vegan group:
The vegan group decreased their caloric intake by almost 500 calories per day. This was most likely due to the lower caloric density (calories per serving) of plant foods.
In other words, the vegan group consumed fewer calories without focusing on weight loss or portion size. They ate until they were full and consumed fewer calories in the process. Isn’t this what everyone wants from a weight loss diet?
The thermic effect (calories burned due to digestion) of the food they ate increased by 14% in the vegan group. This is because it requires more energy to digest foods when your digestive system has to break down the cellular matrix found in unprocessed plant foods.
In other words, the vegan group burned more calories every day just by eating healthy foods. No other diet can promise this.
Fat mass decreased by 10% (9 pounds) in the vegan group but was unchanged in the control group
Belly fat decreased by 15%, liver fat was decreased by 31%, and muscle fat was decreased by 19% in the vegan group. All three parameters were unchanged in the control group.
This is perhaps the most significant observation from these studies since these are the three deadliest forms of fat in our bodies. Any diet that significantly reduces these forms of fat is likely to dramatically improve our health.
These parameters have not been measured in most studies of other weight loss diets, so we have no idea whether other weight loss diets have this effect.
Fasting blood glucose decreased by 11%, insulin resistance decreased by 40%, and insulin sensitivity increased by 22%. These parameters were unchanged in the control group.
These data show that just 16 weeks on a vegan diet is sufficient to significantly reduce the risk of developing type 2 diabetes.
Total cholesterol decreased by 11% and LDL cholesterol decreased by 16%. Both parameters were unchanged in the control group.
For more details and a more in-depth comparison of the vegan diet with other popular 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.
Why Is Weight Loss More Difficult Than It Used to Be?
Author: Dr. Stephen Chaney
If you are one of the millions of Americans who set a New Year’s goal of losing weight and eating healthier, you are to be congratulated.
However, if you are like many Americans, you are probably asking yourself “Is losing weight getting harder, or is it just my imagination?”
If you are asking yourself “Is losing weight getting harder than the first time I went on a weight loss diet?”, the answer to that question is a clear yes. It has to do with the perils of yo-yo dieting.
But here is the question that most of you never thought to ask: “Is losing weight getting harder than it was for my parents and grandparents?”
The authors used data from The National Health and Nutrition Examination Study (NHANES), which is conducted by the CDC on an ongoing basis. For those not familiar with this program, here is a description of the NHANES program from the CDC website.
“The National Health and Nutrition Examination Survey (NHANES) is a program of studies designed to assess the health and nutritional status of adults and children in the United States.
The survey examines a nationally representative sample of about 5,000 people per round, with 2-year data sets available for analysis. These people are located in counties across the country.
The NHANES interview includes demographic, socioeconomic, dietary, and health-related questions. The examination component consists of medical, dental, and physiological measurements, as well as laboratory tests administered by highly trained medical personnel.
All participants visit the physician. Dietary interviews and body measurements are included for everyone. All but the very young have a blood sample taken and have a dental screening. Depending on the age of the participant, the rest of the examination includes tests to assess various aspects of health. In general, the older the individual, the more extensive the examination.
Health interviews are conducted in respondents’ homes. Health measurements are performed in specially-designed and equipped mobile centers, which travel to locations throughout the country. The study team consists of a physician, medical and health technicians, and dietary and health interviewers.”
In short, the NHANES dataset represents a valuable source of data for this kind of study in that it provides a 2-year snapshots of the health and nutritional status of the American population over many decades.
The authors of this study looked at the association between total caloric intake and diet composition with BMI (body mass index a measure of obesity) at 2-year intervals between 1971 and 2008. There were 36,377 US adults in this part of the study.
Because physical activity was only part of the NHANES dataset between 1988 and 2006, the correlation of physical activity with BMI was measured at 2-year intervals between 1988 and 2006. There were 14,419 adults in this part of the study.
Is Losing Weight Getting Harder?
The study showed:
Between 1971 and 2008 total caloric intake, carbohydrate intake, and BMI increased between 10% and 14%.
Nobody was surprised by this result. Americans are eating more calories and more carbs (primarily refined carbs and sugar) than we did 30 years ago. It’s no wonder we weigh more.
Between 1988 and 2006 physical activity increased a whopping 47-120%.
This result was a little surprising. It raises the question: “Why isn’t all this extra physical activity paying off in keeping our weight under control.
However, when the authors compared people who had the same diet (same caloric intake and same amount carbohydrate) and same physical activity with their BMI over the years they found a very surprising result.
When they compared people eating the same diets in 1971 and 2008, the group in 2008 weighed 10% more! And this wasn’t a single data point. There was a relatively linear increase in weight between 1971 and 2008 for people consuming exactly the same diet.
When they compared people with the same amount of physical activity in 1988 and 2006, the group in 2006 weighed 5% more! Once again, there was a relatively linear increase in weight between 1988 and 2006 for people performing exactly the same amount of exercise.
In other words, people weigh significantly more today than they did 20 or 30 years ago, even if they follow the exact same diet and exercise plans. Nobody saw this one coming.
That means it is harder to maintain a healthy weight today than it was just a few decades ago. You may have suspected this, but now you know for sure. Life isn’t fair!
The authors concluded: “Factors other than diet and physical activity may be contributing to the increase in BMI [in this country] over time. Further research is necessary to identify these factors and to determine the mechanisms through which they affect body weight.”
In other words, the real question is: “Why is weight loss more difficult than it used to be?”
Why Is Weight Loss More Difficult Than It Used To Be?
The short answer is, “Nobody knows for sure”. However, the authors raised several possibilities.
We are increasingly exposed to persistent organic pollutants (such as pesticides, flame retardants, and chemicals in food packaging) that accumulate in our bodies and may affect how our bodies process food and store fat.
The use of prescription drugs has risen dramatically since the 70’s and 80’s. Antidepressants, for example, are now one of the most commonly prescribed drugs in the US, and many antidepressants have been linked to weight gain. However, it’s not just antidepressants. Allergy medications, steroids, and pain medications can also cause weight gain.
Just looking at caloric intake and diet composition (% carbohydrate, fat, and protein) obscures other major changes in our diet over the last few decades. We are eating more meat, more highly processed foods, and more artificially sweetened foods. Highly processed foods and artificial sweeteners have both been linked to weight gain.
Our microbiome (gut bacteria) appears to be changing as well. Meat, highly processed foods, and artificial sweeteners have all been shown to influence which gut bacteria inhabit our intestines. We also know gut bacteria can influence our tendency to gain weight.
In short, a lot of things have changed over the past few decades. And these changes may be making it more difficult for us to lose weight. Some of these things, like diet and the influence of diet on our microbiome, we can control. Other things may be beyond our control.
The Bottom Line
A recent study has looked at the effect of diet and physical activity on BMI (a measure of obesity) over the past few decades.
When the authors compared people who had the same diet (same caloric intake and same amount carbohydrate) and same physical activity with their BMI over the years they found a very surprising result.
When they compared people eating the same diets in 1971 and 2008, the group in 2008 weighed 10% more!
When they compared people with the same amount of physical activity in 1988 and 2006, the group in 2006 weighed 5% more!
In other words, people weigh significantly more today than they did 20 or 30 years ago, even if they follow the exact same diet and exercise plans. Nobody saw this one coming.
That means it is harder to maintain a healthy weight today than it was just a few decades ago. You may have suspected this, but now you know for sure. Life isn’t fair!
For more details and to learn why it is harder to lose weight now than it was a few decades ago 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.
Diet season starts in just a few days! Like millions of Americans you will probably be setting a goal to lose weight. But which diet should you choose? Vegan, Paleo, Keto, 360, Intermittent Fasting, low-carb, low fat – the list is endless.
And then there are the commercial diets: Meal replacements, low calorie processed foods, prepared meals delivered to your door – just to name a few of the categories.
You can choose to count calories, focus on portion sizes, or keep a food journal.
And, if you really want to live dangerously, you can try the latest diet pills that claim to curb your appetite and rev up your metabolism.
The advertisements for all these diets sound so convincing. They give you scientific-sounding mumbo-jumbo to explain why they work. Then they talk about clinical studies they say prove their diet works.
If you are like most Americans, you have already tried several of these diets. They worked for a while, but the pounds came back – and brought their friends with them.
But, as the saying goes, “Hope springs eternal in the human breast. Surely some diet you haven’t tried yet will work for you.
There is such a diet. But it will require a change of mindset. It will also require effort. There is no magic wand that will chase the extra pounds away forever.
If you are searching for the perfect diet to start the new year, let me be your guide. Here are:
4 tips on what to avoid and…
6 tips on what to look for…
…when you are choosing the perfect diet.
Tips For Choosing A Diet That Works
Things To Avoid:
1) Endorsements
Endorsements by your favorite athlete or public person are paid for. They don’t necessarily represent their opinion. Nor do they assure you that they follow that diet or use that diet supplement.
Endorsements by Dr. Strangelove and his buddies can be equally misleading. They usually tell you that the medical establishment has been lying to you, and they have discovered the “secret” to permanent weight loss and the “Fountain of Youth”.
Recommendations of the medical and scientific communities usually represent a consensus statement by the top experts in their field. I would choose their advice over Dr. Strangelove’s opinion any day.
2) Testimonials
Most of the testimonials you see on TV or in print are either paid for or are fake
Testimonials by your friends can be equally misleading. We are all different. What works for your friend or your trainer may not work for you.
For example, some of us do better on low-carb diets, and others do better on low fat diets.
[Note: Some DNA testing companies claim they can sequence your DNA and tell you which diet is best. However, as I reported in a recent article in “Health Tips From The Professor”, independent studies show that DNA testing is of no use in predicting whether low-carb or low-fat diets are better for you.]
3) Diets Based on “Magic” Or “Forbidden” Foods or Food Groups.
I have often said we have 5 food groups for a reason. Each food group provides a unique blend of nutrients and phytonutrients. And each plant food group provides a unique blend of fibers that support the growth of different types of friendly gut bacteria.
The bottom line is that each of us does better with some foods than others, but there are no “magic” or “forbidden” foods that apply to everyone.
4) “Magic” Diets.
I have written perhaps the first diet book, “Slaying The Food Myths”, that doesn’t feature a “magic” diet that is going to make the pounds melt away and allow you to live to 100. Instead I recommend a variety of healthy diets and suggest you choose the one that fits you best.
However, I understand the allure of “magic” diets. Dr. Strangelove claims the diet will be effortless. He gives you some scientific-sounding mumbo-jumbo to convince you the diet is scientifically sound. Then he cites some clinical studies showing the diet will cause you to lose weight and will improve your health parameters (things like cholesterol, triglycerides, blood sugar, and blood pressure). It sounds so convincing.
Before you fall for Dr. Strangelove’s latest “magic” diet, let me share two things that may blow your mind:
The studies are all short-term (usually 3 months or less).
When you rely on short-term studies, the very low-fat Vegan diet and very low-carb Keto diet give you virtually identical weight loss and improvement in health parameters!
Those two diets are as different as any two diets could be. That means we can forget all the scientific-sounding mumbo-jumbo as to why each of those diets work. Instead, we should ask what these two diets have in common.
The answer is simple:
#1: The clinical studies are comparing “magic” diets to the typical American diet. Anything is better than the typical American diet! It is high in sugar, refined carbohydrates, saturated fat, and highly processed foods. No wonder the “magic” diets look so good.
#2: The diets are whole food diets. Anytime you eliminate sodas, fast foods, and highly processed foods, you will lose weight.
#3: The diets eliminate one or more food groups. Whenever you eliminate some of your favorite foods from your diet, you tend to lose weight without thinking about it. I call this the cream cheese and bagels phenomenon.
If you are following a low-fat diet, it sounds great to say you can eat all the bagels you want. But without cream cheese to go with the bagels, you tend to eat fewer bagels.
If you are following a low-carb diet, it sounds great to say you can eat as much cream cheese as you want, but without bagels to go with your cream cheese, you tend to eat less cream cheese.
#4: Because they eliminate many of your favorite foods, “magic” diets make you focus on what you eat. Whenever you focus on what you eat, you tend to lose weight. That is why food journals and calorie counters are effective.
#5: Finally, whenever you lose weight, your health parameters (cholesterol, triglycerides, blood sugar, and blood pressure) improve.
Things To Look For In Choosing A Healthy Diet For The New Year
1) Choose whole food diets. Avoid sodas, fast foods, and highly processed foods.
2) Choose primarily plant-based diets. These can range from Vegan through semi-vegetarian, Mediterranean, DASH, and Nordic. All are healthy diets. I have discussed the evidence for this recommendation in my book “Slaying The Food Myths”. Here is a brief summary.
When we look at long term (10-20 year) studies:
Vegetarians weigh less and are healthier than people consuming the typical American diet.
People consuming semi-vegetarian, Mediterranean, and DASH diets are healthier than people consuming the typical American diet.
If you look at low-carb diets:
People consuming plant-based low-carb diets weigh less and are healthier than people consuming the typical American diet.
People consuming meat-based low-carb diets are just as fat and unhealthy as people consuming the typical American diet.
The Atkins diet low-carb diet has been around for more than 50 years, and there is no evidence it is healthy long-term
3) Choose diets that include a variety of foods from all 5 food groups. I have discussed the rationale for that recommendation above.
4) Choose diets that consider meat as a garnish, not a main course.
5) Choose diets that feature healthy carbs and healthy fats rather than low-carb or low-fat diets.
6) Think lifestyle, not diet. If you choose a restrictive diet so you can achieve quick weight loss, you will probably be just as fat and unhealthy next December 31st as you are this year. Instead, choose diets that teach healthy eating and lifestyle changes that you can make a permanent part of your life.
Tips For Keeping The Weight Off
You know the brutal truth. Around 95% of dieters regain everything they lost and then some within a few years. You have probably gone through one or more cycles of weight loss and regain yourself – something called “yo-yo dieting”. You may even be asking yourself if it is worth bothering to try to lose weight this year.
Rather focusing on the negative statistics of weight loss, let’s look at the good news. There are people who lose the weight and keep it off. What do they do?
There is an organization called the National Weight Control Registry that has enrolled more than 10,000 people who have lost weight and kept it off. The people in this group lost weight on almost every diet imaginable. However, here is the important statistic: On average people in this group have lost 66 pounds and kept it off for 5 years.
The National Weight Control Registry has kept track of what they have done to keep the weight off. Here is what they do that you may not be doing:
They consume a reduced calorie, low fat diet.
They get lots of exercise (around 1 hour/day).
They have internalized their eating patterns. In short, this is no longer a diet. It has become a permanent part of their lifestyle. This is the way they eat without even thinking about it.
They monitor their weight regularly. When they gain a few pounds, they modify their diet until they are back at their target weight.
They eat breakfast on a regular basis.
They watch less than 10 hours of TV/week.
They are consistent (no planned cheat days).
Which Weight Loss Diet Is Best For You?
I have covered a lot of ground in this article. Let me summarize it for you.
If you are thinking about popular diets:
Primarily plant-based diets ranging from Vegan to Mediterranean and Dash are associated with a healthier weight and better health long term.
If want to lose weight quickly, you may want to start with the more restrictive plant-based diets, like Vegan, Ornish, Pritikin or semi-vegetarian.
If you do better with a low-carb diet, my recommendation is the low-carb version of the Mediterranean diet.
If your primary goal is rapid weight loss, you could also start with one of the healthier of the restrictive low-carb diets, like the Paleo or the 360 diet. I do not recommend the Keto diet.
No matter what diet you start with, plan to transition to the primarily plant-based diet that best fits your lifestyle and food preferences. This is the diet you will want to stick with to maintain your weight loss and achieve better health long term.
Plan on permanent lifestyle change rather than a short-term diet. Otherwise, you are just wasting your time.
Eat whole foods. Big Food keeps up with America’s favorite diets and is only too happy to sell you highly processed foods that match your favorite diet. Avoid those like the plague.
If you are thinking about commercial diets featuring meal replacement products:
Look for meal replacement products that:
Do not contain artificial sweeteners, flavors, or preservatives.
Use non-GMO protein. A non-GMO certification for the other ingredients is not necessary. For a more detailed explanation of when non-GMO certification is important and when it is unnecessary, see my article in “Health Tips From the Professor”.
Have stringent quality controls in place to assure purity. “Organic” and/or “non-GMO” on the label do not assure purity.
Look for programs that can provide clinical studies showing their diet plan is effective for weight loss and for keeping the weight off. Many programs have short-term clinical studies showing they are effective for weight loss, but very few have longer-term studies showing the weight stays off.
Finally, look for programs that teach permanent lifestyle change. This should include guidance on exercise and healthy eating.
I do not recommend most commercial diets that feature prepared low-calorie foods “shipped right to your door” as a major part of their program. The foods are highly processed. Plus, they include all your favorite unhealthy foods as part of the program. Even if they include lifestyle change as part of their program, they are undermining their message with the foods they are providing you.
I would be remiss if I didn’t mention that Weight Watchers is highly recommended by most experts in the field. Weight Watchers emphasizes journaling and counting calories, which is a plus because it makes you focus on what you are eating. They also have a good lifestyle program and support that can help you transition to permanent lifestyle change if you are willing to put in the effort. However, I don’t recommend their prepared low-calorie foods. They are no better than foods provided by the other commercial diet programs.
The Bottom Line
Weight loss season is upon us. If you plan to lose weight and/or adopt a healthier diet in the coming year, you are probably trying to decide which diet to try this year. In this issue of “Health Tips From The Professor” I give you:
4 tips on what to avoid when selecting your diet.
6 tips on how to choose your perfect diet.
7 tips on how to keep the weight off.
Then I put all this information together to help you choose the best diet, the best meal replacement product, and/or the best commercial diet program.
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.
I love the Christmas season. The colors, the smells, the sounds of music. I’m a vegan so turkey isn’t happening for me, but the array of deliciously prepared vegetables, and the variety of desserts always make me excited for this month to get underway!
We give so much to others, especially during this season, that I want to remind you to take care of yourself too. Like they say on the airplane, ”Put on your own oxygen mask first!” One of the best gifts you can give to those you love, is a healthy and happy you!
Eliminate the aches and pains that can make you feel grumpy, and if you have someone who could benefit from eliminating pain, please feel free to send them my way. That includes people who don’t live near me. Contact me (https://julstromethod.com/product/pain-relief-training-zoom-us/) and we can meet on Zoom and work together to find and stop your pain. I’ll be happy to help you.
I hope you have a wonderful, blessed Christmas!
Muscles Can Cause Bunion & Big Toe Pain
Your foot and toes are all moved by muscles in your lower leg. When these muscles are tight you may have plantar fasciitis (arch pain), and other foot pains, including pain in your big toe. You may even have throbbing pain in the bunion area of your big toe.
This is a bit too complicated to explain here in this newsletter, but basically the muscles are pulling the long bone (tarsal) of the big toe, so it starts to move out. Other muscles are pulling on your toes, causing your big toe to move in toward the other toes. The bone hurts, especially when you are wearing closed shoes that put pressure on the bone.
In other newsletters I’ve discussed the muscles of your lower leg, and this would be a good time to work on each of these muscles. After you have released any tension in your lower leg muscles, you can treat your big toe directly.
Relief From Big Toe Pain
This takes a bit of explaining, but I think if you do the treatment as I’m explaining it, you’ll be able to get it done. I’m going to demonstrate on your left foot, reverse the directions if your pain is in your right foot.
Press your left thumb into your arch muscle just below your bunion bone (actually, the head of the first tarsal bone).
Put your right pointer finger between your big toe and second toe. Pull your big toe toward you (away from the other toes)
Push your right thumb directly into the bunion bone and press in deeply.
Basically, you are trying to move the bones back into alignment.
You can also buy a toe-spreader that will hold your big toe straight. I suggest you wear it while you are sleeping.
You probably won’t get it to go completely straight, but having taught this to many people after figuring it out on my own sore left bunion, I can tell you that it works.
This is a simple self-treatment, but it can really give you a great deal of relief!
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.
Nagging Pain?
Have you “tried everything” to stop nagging pain? Did you know that chronic pain can be caused by tight muscles knotting up and pulling your joints out of alignment? Do you do the same movements over and over, causing a strain on your joints and repetitive strain injury? Would you like to discover how to release tight muscles that cause chronic pain?
Julie Donnelly, LMT, has been specializing in the treatment of chronic pain and sports injuries since 1989. She has successfully worked with thousands of clients, both in her office and virtually on Zoom. Based on the techniques she has created and demonstrates in her books including Treat Yourself to Pain-Free Living, Julie will show you how to find and self-treat the muscle knots that keep you in pain.
It’s almost like visiting with Julie at her office, but without all the time and expense of traveling! And, it’s as simple as 1-2-3.
1 – Send Julie an email (Julie@JulieDonnelly.com) explaining your area of pain
2 – Julie will come up with a treatment plan for your specific problem(s)
3 – Meet with Julie on Zoom and she’ll show you how to do each of the techniques that will release the tight muscles that are causing you pain!
AND…..as a special bonus, Julie will send you a booklet that includes pictures of what she has just shown you during your private session.
If you are a weightlifter or bodybuilder, chances are you are taking an L-carnitine supplement or a protein shake fortified with L-carnitine. That is because L-carnitine has been promoted for increasing muscle mass and physical performance for so long that most people have come to believe it must be true. Is it true, or is it just another food myth?
If you visit Dr. Strangelove’s website, you may also be told that carnitine supplementation is beneficial for weight loss, migraines, baldness, ADHD and autism, chronic fatigue syndrome, and/or low energy, muscle loss, and cognitive decline in older adults. Are these claims fact or fiction?
On the flip side, recent studies have suggested that the carnitine in red meat might be bad for your heart. Could the same be true for carnitine supplements? Could they also be bad for your heart?
A recent systematic review (AG Sawicka et al, Journal of the International Society of Sports Nutrition, 17: 49, 2020) of L-carnitine supplementation answers these important questions. The authors called their study “The bright and dark sides of L-carnitine supplementation” because they set out to systematically investigate the benefits and potential risks of L-carnitine supplementation.
But before I share the results of this study, I need to give you a little background on L-carnitine. It is time for another Biochemistry 101 segment.
Biochemistry 101: What You Need To Know About Carnitine
Carnitine plays an essential role in human metabolism. It is required for transport of fatty acids into our mitochondria so they can be used to generate energy. Without carnitine we would be unable to utilize most of the fats in our diet as an energy source.
As you might expect, carnitine is essential for any tissues that have mitochondria, but it is particularly important for high energy tissues like skeletal and heart muscle.
For most of us, our liver and kidneys make all the carnitine we need. So, we don’t really need carnitine from food or supplements.
However, we do get significant amounts of carnitine from red meat, much smaller amounts of carnitine from other animal foods, and almost no carnitine from plant foods. Adults consuming diets with red meat and other animal foods get about 60-180 mg of carnitine a day from their diet, whereas vegans only get around 10-12 mg/day.
Uptake of carnitine from the blood into muscle tissues requires insulin. Thus, carnitine uptake into muscle is significantly less on a low-carbohydrate or keto diet than it is on a mixed diet containing carbohydrates.
Finally, our kidneys do an excellent job of regulating blood carnitine levels, with excess carnitine being excreted into the urine. Thus, total body carnitine levels are virtually the same with high-carnitine and low-carnitine diets.
This raises the question: “Are L-carnitine supplements good for you?”
Now, let’s talk about the dark side of carnitine. I have discussed this in a previous issue of “Health Tips From the Professor”. Here is a brief summary:
People who eat a lot of red meat harbor a species of bacteria in their intestine that converts carnitine to trimethylamine (TMA). We don’t know whether this species of gut bacteria is favored by the presence of red meat in the diet or the absence of certain fruits, whole grains, and legumes from the diet of meat eaters.
The TMA is reabsorbed into the bloodstream, and the liver converts TMA to TMAO (trimethylamine N-oxide).
TMAO is associated with an increased risk of heart attack, stroke, and heart failure.
When you think about it, this is a perfect example of double jeopardy. Red meat is high in carnitine, and red meat eaters have gut bacteria that result in carnitine being converted to a compound that may increase the risk of heart disease.
This raises the question: “Are L-carnitine supplements bad for you?”
Let’s look at these two questions. First, I will discuss the recent review. Then I will put the conclusions of that review into perspective by looking at what other health experts say.
Are Carnitine Supplements Good For You Or Bad For You?
Most previous studies of carnitine supplementation have lasted only two or three weeks, which may not be long enough to measure an effect of carnitine supplementation on performance. So, the authors of this review paper selected studies that lasted 11 weeks or more for their review.
The review included 11 studies. They lasted either 12 or 24 weeks. Participants received doses ranging from 1 gm to 4.5 gm of L-carnitine per day. Here are the conclusions of the review:
Participants receiving L-carnitine alone had no increase in muscle carnitine content.
Participants receiving L-carnitine + 80 grams of carbohydrate had around a 10% increase in muscle carnitine content. [To put that into perspective, 80 grams of carbohydrate is roughly equivalent to 2 cups of white rice or two medium potatoes.]
One study compared male vegetarians with male omnivores. The omnivores had no increase in muscle carnitine content, but the vegetarians did. [The study did not analyze the diets of the omnivores and vegetarians, but it is probably safe to assume that the carbohydrate content was higher on the vegetarian diet.]
There was no significant effect of L-carnitine on muscle mass or physical performance. [This is logical, given the minimal effect of L-carnitine supplementation on muscle carnitine levels.
Thus, this review found little evidence that L-carnitine supplementation was good for you. It resulted in little or no increase in muscle carnitine levels or in physical performance.
Two of the 11 studies measured plasma TMAO levels. These studies found that L-carnitine supplementation resulted in a significant increase in plasma TMAO levels.
Thus, this review found some evidence that L-carnitine supplementation might be bad for you.
What Is The Truth About Carnitine And TMAO?
Is carnitine good for you? With respect to this question, the conclusions of this review are similar to the conclusions of other health experts. For example, in their Fact Sheet On CarnitineFor Health Professionals the NIH states “Some athletes take carnitine to improve performance. However, twenty years of research finds no consistent evidence that carnitine supplements can improve exercise or physical performance in healthy subjects—at doses ranging from 2–6 grams/day administered for 1 to 28 days. For example, carnitine supplements do not appear to increase the body’s use of oxygen or improve metabolic status when exercising, nor do they necessarily increase the amount of carnitine in muscle.”
The NIH fact sheet goes on to list some diseases causing muscle loss or muscle weakness, for which L-carnitine supplementation is appropriate. However, in these cases, the carnitine supplementation should be recommended by health professionals.
Is carnitine bad for you? The TMAO story is a bit more complicated. As I mentioned above, there is an association between red meat consumption and blood TMAO levels and an association between blood TMAO levels and heart disease.
Is it TMAO that increases the risk of heart disease or is it some other component (saturated fat, for example) of red meat that increases the risk of heart disease? Nobody knows. More research is needed.
There is also a “red herring” that complicates the TMAO story. It turns out that TMAO helps fish survive the high pressures they encounter in the deep ocean. Thus, many fish are high in TMAO, and fish consumption also increases blood TMAO levels.
Are the bad effects of TMAO in fish outweighed by the heart healthy components in fish (omega-3s, for example)? Nobody knows. More research is needed.
To summarize:
There is no reason to take L-carnitine supplements unless directed by your health professional. There is little evidence they will help your physical performance. There is also no good evidence to support the other benefits of L-carnitine you find listed on Dr. Strangelove’s blog or the website of your favorite supplement company.
L-carnitine supplements may be bad for your heart, but much more research will be needed to be sure. [Note: Based on what we know about the role of gut bacteria in TMAO production, vegans could probably take l-carnitine supplements without causing an increase in TMAO levels. However, that is probably a moot point. There is no evidence that L-carnitine is more effective for vegans than it is for omnivores.]
The Bottom Line
If you are a weightlifter or bodybuilder, chances are you are taking an L-carnitine supplement or a protein shake fortified with L-carnitine. That is because L-carnitine has been promoted for increasing muscle mass and physical performance for so long that most people have come to believe it must be true. Is it true, or is it just another food myth?
On the flip side, recent studies have suggested that the carnitine in red meat might be bad for your heart. Could the same be true for L-carnitine supplements? Could they also be bad for your heart?
A recent review looked at these questions. Here are the conclusions of the review:
Participants receiving L-carnitine alone had no increase in muscle carnitine content.
Participants receiving L-carnitine + 80 grams of carbohydrate had around a 10% increase in muscle carnitine content. [To put that into perspective, 80 grams of carbohydrate is roughly equivalent to 2 cups of white rice or two medium potatoes.]
There was no significant effect of L-carnitine on muscle mass or physical performance. [This is logical, given the minimal effect of L-carnitine supplementation on muscle carnitine levels.
Thus, this review found little evidence that L-carnitine supplementation was beneficial. It resulted in little or no increase in muscle carnitine levels or in physical performance.
This review also found that L-carnitine supplementation resulted in a significant increase in plasma TMAO, a compound that has been associated with an increased risk of heart disease.
Thus, this review found some evidence that L-carnitine supplementation might be bad for you.
The NIH has also issued a fact sheet for health professionals summarizing research on L-carnitine over the past 20 years. The conclusions from their fact sheet can be best summarized as:
There is no reason to take L-carnitine supplements unless directed by your health professional. There is little evidence they will help your physical performance. There is also no good evidence to support the other benefits of L-carnitine you find listed on Dr. Strangelove’s blog or the website of your favorite supplement company.
L-carnitine supplements may be bad for your heart, but much more research will be needed to be sure.
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.
When I lived up north, February was the worst month of the winter – cold, gloomy, and while it’s only 28 days long, it seemed endless. If you’re in the cold weather, I hope you stay nice and warm, and that you also find some fun outdoor activities to help this month end quickly.
This past week I received an email from a reader of this newsletter. I’ve asked people to send me a message if they have any aches or pains that they would like for me to discuss. This is a topic I’ve never discussed before, and since it’s causing this woman distress, I decided it’s the perfect discussion for the month.
