Dr. Steve Chaney, Author at Health Tips From The Professor

Hip Pain Causes

October 15, 2019 by Dr. Steve Chaney

Does Dehydration Make The Pain Worse?

Author: Julie Donnelly, LMT –The Pain Relief Expert

Editor: Dr. Steve Chaney

Let’s talk about something really serious – hydration! Since our body is mostly water, averaging 50-65% of our body weight, hydration is vital for life. The balance between water and electrolytes plays a key in how our systems function, including every cell, organs (heart, liver, etc.), nerves, and muscles. Even our bones are made up of about 30% water, and our brain is approximately 60% water.

Dehydration has disastrous results! You may experience headaches that become migraines, or even a feeling of brain fog. Your brain tells the other organs when and how to function, so dehydration in the brain will affect your entire body. Insufficient water may cause your eyes to get heavy, and you may become constipated. The effects on your heart, lungs, liver, and other vital organs is even worse.

Yet something as simple as sipping water throughout the day can prevent all of this from happening. It is suggested that men drink 8 glasses of water a day, and women drink 7.5 glasses a day. Of course, searching the internet will bring up experts who vary widely on the amount of water that is required for good health.

Since I am a muscular therapist, my major concern is how dehydration affects the muscles and our pain levels. Studies have shown that when there is insufficient water in the body, pain is felt more acutely, including muscle pain, arthritic pain, and joint pains.

What is the Best Water To Drink?

Designer water has become popular in the USA, but are they necessary? I saw a recent post saying: “If you are paying $3 a bottle for Smart Water, it isn’t working.”

As for specialized water products, Steve Chaney, PhD, the author of Slaying the Food Myths and Slaying the Supplement Myths, has stated that products such as ionized water and alkaline water “win the Flying Pig award” from a complicated chemical point of view. It’s way beyond the scope of this newsletter to explain his rationalization, but if you’re interested you can find his books on Amazon and read the full explanation (and a whole lot more!).

The bottom line, according to Dr. Chaney, is to just drink pure water, preferably water that doesn’t have chemicals added for various reasons.

William W. Li, MD, the author of Eat to Beat Disease, also recommends avoiding water that is stored in plastic bottles, even bottles without BPA plastic. Plastic particles called microplastics will shed into the water. One study (https://orbmedia.org/sites/default/files/FinalBottledWaterReport.pdf) found as many as 2,400 pieces of microplastic in eight fluid ounces of bottled water.

To protect yourself from this problem, I suggest you get a stainless-steel water bottle, and if you like to use a straw you can get stainless steel straws on Amazon. That solves the problem and also helps the ocean since so many bottles end up floating in rivers, streams, and the ocean.

Hip Pain Causes

I’ve spoken about hip pain and the muscles that cause it several times in the past. Basically, the muscles that insert into your hip bone (pelvis) and into your thigh bone (Rectus Femoris, Gluteus Maximus/Medius/Minimus, and Tensor Fascia Lata) get tight and pull up on your leg. This upsets the alignment of your hip, and you have pain.

Recently I discovered yet another reason, one I’d never considered before, yet I’ve now seen it in several clients. It’s a bit complicated so I’ll go slow so you can visualize what I’m describing.

A client of mine had LEFT hip pain. When he would come in, I would work on his left hip and he would have temporary relief. I’m not used to people only having “temporary” relief, so I was going over and over in my mind what could be happening. Then he gave me a clue that really made sense.

He said as he walked down the beach and his left leg was up the slope, with his right leg closer to the water, his left hip was really hurting. But when he turned around and now his right leg is up the slope and his left leg was down, closer to the water, his hip pain went away.

This picture above is an exaggeration but look at how the walker’s right leg is up the slope and left leg is down the slope. You can imagine that his hips are also tilted with the left being lower, but he’s trying to be level (or his body would be tilted to the side – LOL).

Back to my client….remember that his LEFT hip is hurting as he’s walking down the beach with his right leg lower than his left leg. Then he turns around and with left leg now lower than his right leg, he is out of pain. I contemplated that situation, and suddenly it came to me! His RIGHT leg was actually the leg that is shorter!

My conclusion was, as he was walking with his left leg on the high side of the sand, it was jamming his left leg up into his hip, but when he turned around and was walking with his left leg on the low side of the sand, and his right leg on the high side, it made his hips be level, and he didn’t have pain.

So, I asked him to lie on the massage table with his feet off the end so I could see if one leg was shorter than the other, and sure enough, his right heel was about ¼” higher than his left heel.

That means the muscles that insert into his right leg were tight and pulling up on his thigh bone.

Treating The Hip Pain

I worked on all the muscles that impact his right hip for most of the session, and for a bit of the time I worked on his left hip muscles. I have posted all these treatments in prior newsletters, so I won’t repeat them here.

When I was finished, I did another picture, and I was so pleased to see the difference in his leg length. His two heels were now level.

I tested that theory out with other clients this week, and most of the time the shorter leg is the hip that is hurting, but with two other clients, it was the longer leg that was feeling the hip pain. Both times I worked on the hip muscles of the shorter leg, and it worked!

It amazes me that after 31 years of specializing in the treatment of chronic pain, I’m still figuring out new solutions!

Do you stretch? Most of the time stretching feels good, but sometimes it hurts more after stretching than it did before. The reason is the muscles are tied up in knots.

Think of what would happen if you had a 12” length of rope, tied a big knot in it so it’s now only 10” long, and then tried to stretch it back to 12”. Even if you get it back to the 12” you did it by making the knot tighter and overstretching the fibers on either side of the knot.

That’s what happens in your body when the muscles are shortened by spasms (knots) and you try to stretch the muscle without first releasing the knots in the fibers.

There is a solution!

Introducing a safe-stretching kit that has changed names to reflect what it’s doing to help you have more flexibility and mobility.

Originally called Trigger Point Yoga, and now called Focused Flexibility Training (https://www.mcssl.com/SecureCart/ViewCart.aspx?mid=35DED97F-0CB9-4B06-BAD3-16CDDEDAED40&sctoken=291595251fc14977a18eefe24a2bf69e&bhjs=1&bhqs=1), by any name this is the best product available for safe stretching.

For only $67.00 you can have all the tools you need to stretch safely and stop pain FAST!

Three DVD’s (and now it’s also an MP4) that give you step-by-step direction.
- One DVD shows me teaching an athlete how to do every self-treatment taught in Treat Yourself to Pain-Free Living.
- Two DVD’s where you work with an amazing yoga instructor named Ana. You’ll do 15 minutes of self-treating the muscles you’ll be stretching, and then 30 minutes of beautifully filmed, guided yoga stretching.
A Perfect Ball, which is truly perfect because it is solid in the center and soft on the outside, enabling you to work deeply without bruising your bones.
A bamboo stick (while supplies last) or a TotalTX pipe to work on your thigh muscles.

Wishing you well,

Julie Donnelly

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

About The Author

Julie Donnelly is a Deep Muscle Massage Therapist with 20 years of experience specializing in the treatment of chronic joint pain and sports injuries. She has worked extensively with elite athletes and patients who have been unsuccessful at finding relief through the more conventional therapies.

She has been widely published, both on – and off – line, in magazines, newsletters, and newspapers around the country. She is also often chosen to speak at national conventions, medical schools, and health facilities nationwide.

What’s Worse Saturated Fat or Sugar?

October 8, 2019 by Dr. Steve Chaney

What Causes Fatty Liver Disease?

Author: Dr. Stephen Chaney

The great American food fight continues. The low fat enthusiasts tell you saturated fat is going to kill you. The low carb enthusiasts tell you saturated fat is fine. It’s sugar that’s going to kill you.

You can find studies that support either viewpoint. And the story keeps changing. One day the headlines proclaim: “The latest study shows…” A few weeks later you see a headline saying: “Wait. That’s wrong. Science now shows…” It’s no wonder you are confused and perhaps a bit cynical.

So, what’s worse saturated fat or sugar?

Perhaps we should step back and ask how we got to this point.

Why Is the Saturated Fats and Sugar Dilemma So Confusing?

To understand why the literature around saturated fats and sugar is so confusing, we need to go back to the 1950s. The first studies implicating saturated fats as a risk factor for heart disease replaced saturated fats with unsaturated fats. Everything else in the diet was kept the same. When you do that, the answer is clear-cut. Saturated fats increase heart disease risk and unsaturated fats decrease heart disease risk.

When the American Heart Association first recommended a low-fat diet, they had in mind replacing saturated fats with fresh fruits, vegetables, whole grains, and beans. The remaining fat would be mostly unsaturated. Today, we would call that a Mediterranean diet, which, by the way, has been shown to reduce both diabetes and heart disease risk.

Big Food Inc. took one look at that and panicked. They make their money from processed foods, not from fresh fruits and vegetables. If the American people made the changes the American Heart Association recommended, Big Food Inc. would go bankrupt.

They sprang into action. They had their laboratories whip up processed foods that replaced fat with sugar, white flour, and a witch’s brew of chemicals. Then they told the American people: “Never fear. You don’t have to give up your favorite foods. We have created low fat versions of the foods you love.”

That became the diet that most Americans adopted. Even worse, most Americans continued eating foods high in saturated fats. We ended up with the worst of all possible worlds – a diet high in saturated fat and high in sugar. This became the Standard American Diet (SAD).

This shift has corrupted most of the recent research studies on saturated fat and sugar. Most of the studies on saturated fat or sugar have compared them with the Standard American Diet, not with a healthy diet. When you do that, your results are going to be skewed. Almost anything is better that the Standard American Diet.

Why Was This Study Done?

When we think of obesity, we think of the excess fat we can see. But what we have learned in recent years is that the fat you can’t see is far more damaging to our health. I am talking about fat stores in the liver, something called fatty liver disease.

Fatty liver disease has serious consequences. It causes insulin resistance and inflammation, and that increases the risk of diabetes and heart disease. Even worse, it can lead to cirrhosis and liver failure.

Excess sugar is converted to saturated fat in the liver. Therefore, the popular literature attributes the epidemic of fatty liver disease to increased intake of simple sugars. But is it true? Saturated fats require no conversion. They can simply be deposited in the liver as is. Shouldn’t they be at least as damaging to the liver as sugar?

It turns out that no studies have actually compared the effect of excess calories in the form of saturated fat, unsaturated fat, and simple sugars on fat accumulation in the liver. This study (PK Luukkonen et al, Diabetes Care, 41: 1732-1739, 2018) was designed to fill that gap.

How Was The Study Done?

The authors enrolled 38 middle aged (average age = 48), overweight (average BMI = 31) adults for the study. The participants were divided into three groups and were fed an extra 1,000 calories per day of saturated fat (SAT group), unsaturated fat (UNSAT group), or sugar (SUGAR group) for 3 weeks. The composition of those extra 1,000 calories was as follows:

The SAT group ate an extra 30 g coconut oil, 40 g butter, and 100 g blue cheese
- Macronutrient composition = 1% carbohydrate, 86% fat, 13% protein, 0% simple sugars.
- Fat composition = 76% saturated fats, 21% monounsaturated fats, 3% polyunsaturated fats
The UNSAT group ate an extra 36 g olive oil, 26 g pesto, 54 g pecans, and 20 g butter
- Macronutrient composition = 2% carbohydrate, 91% fat, 7% protein, 0% simple sugars.
- Fat composition = 21% saturated fats, 57% monounsaturated fats, 22% polyunsaturated fats
The SUGAR group ate an extra 9.5 ounces of orange juice, 16 ounces of sugar-sweetened beverages, and 200 g of candy.
- Macronutrient composition = 100% simple sugars.

Compliance to these dietary additions was confirmed by measuring the fat composition of serum triglycerides. As expected, the triglycerides were primarily composed of saturated fat in the SAT and SUGAR groups and unsaturated fats in the UNSAT group.

None of the participants had diabetes or other diseases, pre-existing liver disease, excessive consumption of alcohol (which can also lead to fatty liver disease). They were also not taking any drugs that could influence glucose or lipid metabolism.

Upon entry into the study, the three groups were comparable with respect to age, sex, BMI (a measure of obesity), amount and type of fat stores in the liver, and insulin sensitivity.

The baseline diet to which the extra calories were added was also comparable between the three groups and did not change during the study. That meant that the only difference between groups was the composition of the extra calories they consumed.

What Causes Fatty Liver Disease?

At the end of three weeks:

All 3 groups gained weight, but the weight gain was slightly larger (0.6 pounds) for the SAT and SUGAR groups than for the UNSAT group (0.4 pounds).
Fat stores in the liver increased by 55% in the SAT group, 33% in the SUGAR group, and 15% in the UNSAT group.
The fat stores were primarily saturated fat in the SAT and SUGAR groups and primarily unsaturated fat in the UNSAT group.
Insulin resistance was increased in the SAT group, but not in the SUGAR and UNSAT groups.

Previous studies have suggested that the effect of liver fat stores on insulin resistance might be mediated by fat metabolites called ceramides. Therefore, they also measured plasma ceramide levels.

Plasma ceramides were increased in the SAT group, but not in the SUGAR and UNSAT groups.

Previous studies have also suggested that the effect of saturated fat on insulin resistance might be mediated by a change in gut bacteria that produce endotoxins which end up in the bloodstream.

A change in gut bacteria and an increase in plasma endotoxins was observed in the SAT group, but not in the SUGAR and UNSAT groups.

What is Worse Saturated Fat Or Sugar?

The authors of this study concluded: “Saturated fat induced the greatest increase in fat stores in the liver, insulin resistance, and harmful ceramides. Decreased intakes of saturated fat could be beneficial in reducing fat stores in the liver and the associated risk of diabetes.”

Is that statement true? This study was well designed. However, this is a very small study. It needs to be replicated by larger studies. In the meantime, we can ask if the findings are consistent with previous studies.

You may have noticed, the authors included three variables in their study (saturated fats, unsaturated fats, and simple sugars), but I focused only on the comparison between saturated fats and simple sugars in this article. That is because the damage caused by saturated fats versus simple sugars is controversial in the popular literature. In contrast, most (but not all) experts agree that saturated fats are worse for you than unsaturated fats.

Let’s start with the relatively non-controversial comparison (saturated fats versus unsaturated fats) before turning to the comparison between saturated fats and simple sugars. When comparing saturated fats and unsaturated fats, the author’s conclusion that saturated fats are worse for you is probably true.

In this study saturated fats caused greater fat accumulation in the liver than unsaturated fats, and these differences were statistically significant.
The fat stores in the liver mirrored the fat composition of the diet. Saturated fat caused saturated fat stores. Unsaturated fat caused unsaturated fat stores.
Saturated fats increased insulin resistance while unsaturated fats did not.
This is consistent with several previous studies that have shown:
Saturated fats cause greater fat accumulation in the liver than polyunsaturated fats in younger, normal weight individuals.
High saturated fat intake is associated with fatty liver disease and insulin resistance.
Saturated fat increases heart disease risk, while unsaturated fat decreases heart disease risk.

However, the differences between saturated fats and sugar were less clear.

In this study saturated fats caused greater fat accumulation in the liver and more insulin resistance than simple sugars.
The conclusion that saturated fats are worse for you than simple sugars was strengthened by the following:
Saturated fat caused insulin resistance, while simple sugars did not.
Saturated fat caused a change to gut bacteria which resulted in increased endotoxin levels in the bloodstream, while simple sugars did not.
The conclusion that saturated fats are worse for you than simple sugars was weakened by the following:
The difference in fat accumulation in the liver was not statistically significant. A larger study may have provided a more definitive answer.
Previous studies have suggested that saturated fats and simple sugars may be equally bad for you. They both increase the risk of diabetes and heart disease.

Clearly, this study does not end the debate about whether saturated fats or simple sugars are worse for you. However, it does provide a new perspective.

Previous studies have not compared the effects of saturated fat and sugar on fatty liver disease when all other aspects of the diet were identical. If the observations of this study are confirmed in subsequent studies, it could influence how we evaluate the relative risks of saturated fats and sugars in the future.

What Does This Study Mean For You?

When you strip away all the noise, there are three obvious conclusions from this and most previous studies:

Excess calories in any form are bad for us. We don’t just store fat in the liver, and fat stores in other parts of our body have bad effects on our health as well.
Unsaturated fats are better for us than saturated fats. They reduce the risk of heart disease. This study suggests they also reduce the risk of fatty liver disease, insulin resistance, and possibly diabetes.
The jury is still out on the health consequences of saturated fats versus simple sugars. This study suggests that simple sugars may be less likely to cause fatty liver disease. While fatty liver disease can lead to diabetes and heart disease, so can fat stores anywhere else in the body. Other studies suggest that excess calories as saturated fats and simple sugars are equally likely to lead to obesity, diabetes and heart disease.

My recommendation is to avoid both saturated fats and simple sugars. Don’t focus on low fat diets or low carb diets. Instead focus on whole food diets with healthy fats and healthy carbs.

The Bottom Line

A recent study compared the effect of diets high in saturated fats (SAT group), unsaturated fats (UNSAT group), or simple sugars (SUGAR group) on fat accumulation in the liver. The results were:

Fat stores in the liver increased by 55% in the SAT group, 33% in the SUGAR group, and 15% in the UNSAT group.
The fat stores were primarily saturated fat in the SAT and SUGAR groups and primarily unsaturated fat in the UNSAT group.
Insulin resistance was increased in the SAT group, but not in the SUGAR and UNSAT groups.

The authors of this study concluded: “Saturated fat induced the greatest increase in fat stores in the liver and insulin resistance. Decreased intakes of saturated fat could be beneficial in reducing fat stores in the liver and the associated risk of diabetes.”

My recommendation is to avoid both saturated fats and simple sugars. Don’t focus on low fat diets or low carb diets. Instead focus on whole food diets with healthy fats and healthy carbs.

For more details on the study and what it means for you, read the article above.

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

Omega-3s During Pregnancy Are Healthy

October 2, 2019October 1, 2019 by Dr. Steve Chaney

It’s Definite: Omega-3s Reduce Preterm Births

Author: Dr. Stephen Chaney

The role of omega-3s on a healthy pregnancy has been in the news for some time. Claims have been made that omega-3s reduce preterm births, postnatal depression, and improve cognition, IQ, vision, mental focus, language and behavior in the newborn as they grow.

The problem is that almost all these claims have been called into question by other studies. If you are pregnant or thinking of becoming pregnant, you don’t know what to believe.

Should you eat more fish?
Should you take omega-3 supplements?
Or should you just ignore the claims about omega-3s and a healthy pregnancy?

Omega-3s during pregnancy is healthy or not? These are not trivial questions. Let’s consider preterm births as an example. The medical profession has made enormous advances in keeping premature babies alive. However, premature babies are still at higher risk of several health conditions including:

Visual impairment.
Developmental Delay.
Learning difficulties.

Plus, it is expensive to keep premature babies alive. One recent study estimated that increasing omega-3 intake during pregnancy could reduce health care costs by around $6 billion in the United Stated alone.

Unfortunately, it’s not just omega-3s and pregnancy. The same is true for almost all nutritional health claims. One day a study comes out claiming that nutrient “X” cures some disease or has some miraculous benefit. The bloggers and news media hype that study. Suddenly you see that health claim everywhere. It becomes so omnipresent that you are tempted to believe it must be true.

But, wait. A few months later another study comes to an opposite conclusion. Now the media is telling you that health claim is false. The months come and go, and new studies keep coming out. Some support the health claim. Others refute it.

Pretty soon the nutrition headlines just become “noise.” You don’t know what to believe. If you want the truth, “Who ya gonna call?”

Who Ya Gonna Call?

It’s not Ghostbusters. It not Dr. Strangelove’s health blog. It’s a group called the Cochrane Collaboration.

The Cochrane Collaboration consists of 30,000 volunteer scientific experts from across the globe whose sole mission is to analyze the scientific literature and publish reviews of health claims so that health professionals, patients, and policy makers can make evidence-based choices about health interventions.

The Cochrane Collaboration reviews all the relevant studies on a topic, exclude those that are biased or weak, and make their recommendations based on only the strongest studies. Their reviews are considered the gold standard of evidence-based medicine.

If you are of a certain age, you may remember that TV commercial “When EF Hutton talks, people listen.” It is the same with the Cochrane Collaboration. When they talk, health professionals listen.

This week we will examine the Cochrane Collaboration’s review titled “Omega-3 Fatty Acid Addition During Pregnancy.”

How Was The Study Done?

For this analysis the Cochrane Collaboration reviewed 70 randomized controlled trials which compared the effect of added omega-3s on pregnancy outcomes with the effect of either a placebo or no omega-3s. These trials included almost 19,927 pregnant women.

In one sense, Cochrane reviews are what is called a “meta-analysis”, in which data from numerous studies are grouped together so that a statistically significant conclusion can be reached. However, Cochrane Collaboration reviews differ from most meta-analyses found in the scientific literature in a very significant way.

Many published meta-analyses simply report “statistically significant” conclusions. However, statistics can be misleading. As Mark Twain said: “There are lies. There are damn lies. And then there are statistics.”

The problem is that the authors of most meta-analyses group studies together without giving sufficient consideration to the quality of studies included in their analysis. This creates a “Garbage In – Garbage Out” effect. If the quality of individual studies is low, the quality of the meta-analysis will also be low. Simply put, the conclusions from some published meta-analyses are not worth the paper they are written on.

The Cochrane Collaboration also reports statistically significant conclusions from their meta-analyses. However, they also carefully consider the quality of each individual study in their analysis. They look at possible sources of bias. They look at the design and size of the studies. Finally, they ask whether the conclusions are consistent from one study to the next. They clearly define the quality of evidence that backs up each of their conclusions as follows:

High-quality evidence. Further research is unlikely to change their conclusion. This is generally reserved for conclusions backed by multiple high-quality studies that have all come to the same conclusion. These are the recommendations that are most often adopted into medical practice.
Moderate-quality evidence. This conclusion is likely to be true, but further research could have an impact on it.
Low-quality evidence. Further research is needed and could alter the conclusion. They are not judging whether the conclusion is true or false. They are simply saying more research is needed to reach a definite conclusion.

It’s Definite: Omega-3s During Pregnancy is Healthy

Here are the conclusions that the Cochrane Collaboration said were supported by high-quality evidence:

Omega-3s reduce the risk of preterm births.
Omega-3s reduce the risk of low birth weight infants.

The authors concluded: “Omega-3 supplementation during pregnancy is an effective strategy for reducing the risk of preterm birth…More studies comparing [the effect of] omega-3s and placebo [on preterm births] are not needed at this point.”

In other words, they are saying this conclusion is definite. Omega-3 supplementation should become part of the standard of medical care for pregnant women.

However, they did say that further studies were needed “…to establish if, and how, outcomes vary by different types of omega-3s, timing [stage of pregnancy], doses [of omega-3s], or by characteristics of women.”

That’s because these variables were not analyzed in this study. The study included clinical trials:

Of women at low, moderate, and high risk of poor pregnancy outcomes.
With DHA alone, with EPA alone, and with a mixture of both.
Omega-3 doses that were low (˂ 500 mg/day), moderate (500-1,000 mg/day), and high (> 1,000 mg/day).

Do Omega-3s Make For A Healthy Pregnancy?

What about the effect of omega-3s on other pregnancy outcomes?

The conclusions the Cochrane Collaboration said were supported by moderate quality evidence included reductions in:

Perinatal death.
Admissions to the neonatal intensive care unit.

There was not enough high or moderate quality data to determine the effect of omega-3s on other pregnancy outcomes such as postnatal depression. More research is still needed in those areas. However, if they do occur, you can just consider them as side benefits.

What Does This Report Mean For You?

The proven effect of omega-3 supplementation on preterm births is significant because preterm births increase the risk of:

Visual impairment.
Developmental Delay.
Learning difficulties.

The likely effect of omega-3s on admission to neonatal intensive care units is significant because those units are very expensive.

One recent study concluded that omega-3 supplementation during pregnancy might save the US health care system $6 billion per year.

This study did not determine whether omega-3 supplementation was equally important for women at low, moderate, and high likelihood of poor pregnancy outcomes.

Therefore, omega-3 supplementation should be considered for all pregnant women.

This study did not determine whether omega-3 supplementation was equally important during the first, second, or third trimester.

Therefore, omega-3 supplementation should be considered by all women of childbearing age who might become pregnant.

This study did not determine whether DHA, EPA, or a mixture of the two was most effective.

Therefore, your omega-3 supplement should probably contain both DHA and EPA. A group of experts recently recommended that adults consume at least 650 mg/day of omega-3s with 220 mg of that coming from DHA and 220 mg/day coming from EPA.

This study did not determine the minimum effective dose of omega-3s to reduce preterm births.

Most health organizations recommend that pregnant women consume between 200-500 mg/day of omega-3s.
For example, one group of experts recently recommended pregnant women consume at least 300 mg/day of DHA and 220 mg/day of EPA.
The American College of Obstetrics and Gynecology recommends supplementation with 200 mg/day of DHA. However, that recommendation assumes that the increase will come from fish and was influenced by concerns that omega-3-rich fish are highly contaminated with heavy metals and PCBs.
Since most pregnant women in this country consume around 89 mg/day of DHA + EPA, some degree of omega-3 supplementation in the 200-500 mg/day range is warranted.

The Bottom Line

The effect of omega-3s on pregnancy outcomes have been confusing. Some studies conclude that omega-3s during pregnancy is healthy. Other studies suggest they are ineffective. What are you to believe?

Fortunately, a group called the Cochrane Collaboration recently conducted a comprehensive review of this topic. This is significant because Cochrane Reviews are internationally recognized as the highest standard in evidence-based health care. They influence the treatment protocols recommended by the medical community.

This Cochrane Review concluded that omega-3 supplementation during pregnancy:

Reduces preterm births and low birth weight infants.
Likely reduces perinatal death and admissions to the neonatal intensive care unit.

The authors of the review said: “Omega-3 supplementation during pregnancy is an effective strategy for reducing the risk of preterm birth…More studies comparing [the effect of] omega-3s and placebo [on preterm births] are not needed at this point.”

In other words, they are saying this conclusion is definite. Omega-3 supplementation should become part of the standard of medical care for pregnant women.

This study did not determine the minimum effective dose of omega-3s to reduce preterm births.

Most health organizations recommend that pregnant women consume between 200-500 mg/day of omega-3s.
Since most pregnant women in this country consume around 89 mg/day of DHA + EPA, some degree of omega-3 supplementation is warranted.

For more details on the study and what it means for you, read the article above.

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

Will A Healthy Lifestyle Help Prevent Alzheimer’s Disease?

September 24, 2019 by Dr. Steve Chaney

Can Lifestyle Overcome Genetics?

Author: Dr. Stephen Chaney

Will a healthy diet help prevent Alzheimer’s disease?

Alzheimer’s disease and other forms of dementia are among the most feared diseases of aging. What use is it to have a healthy body, a loving family, and a successful career if you can’t remember any of it? You should be able to enjoy your Golden years, not see them slip through your fingers.

If you have a family history of dementia or have sent your DNA off for testing and learned you are genetically predisposed to dementia, you are probably worried. You are not alone.

According to the World Health Organization:

50 million people worldwide have dementia.
Alzheimer’s Disease accounts for 60-70% of all dementia cases.

According to the Alzheimer’s Association:

8 million Americans are currently living with Alzheimer’s Disease.
1 in 3 seniors will die from Alzheimer’s or another form of dementia.
The number of Americans with Alzheimer’s Disease is expected to increase to 14 million by 2050.

Perhaps the scariest thing about Alzheimer’s is that the medical community has no answers. There are no drugs to prevent or cure Alzheimer’s and brain transplants are out of the question. Some medical professionals will tell you nothing can be done, but is that true?

Studies have suggested that a healthy lifestyle can help reduce your risk of developing Alzheimer’s and other forms of dementia. But what about genetics? Will a healthy lifestyle only reduce your risk of dementia if your genetic risk is low or will it be equally effective when your genetic risk is high? Can lifestyle overcome genetics?

This study (I Lourida et al, JAMA, 322: 430-437, 2019 ) was designed to answer that important question.

How Was The Study Done?

This study used data collected from the UK Biobank study, which was designed to assess the effect of genetics and lifestyle on health outcomes. The UK Biobank study enrolled more than 500,000 participants between 2006 and 2010.

At the time of enrollment, UK Biobank participants were given a physical exam. Blood samples were taken and preserved for subsequent genetic analysis. They also completed an online questionnaire and were interviewed about lifestyle, medical history, and nutritional habits.

This study used a subset of the UK Biobank data, consisting of 196,383 people who were 60 years or older and free of cognitive impairment or dementia at the time of enrollment. They were followed for an average of 8 years.

The authors created the following scoring system to assess the effect of genetics and lifestyle on Alzheimer’s disease and dementia:

The Genetic Risk Score represents the combined effect of all genetic variants known to increase the risk of Alzheimer’s disease and dementia. [Note: There is no single gene that determines whether you will develop Alzheimer’s and other forms of dementia. There are multiple gene variations that affect your risk.]

The Healthy Lifestyle Score was based on 4 well-established dementia risk factors (smoking status, physical activity, diet, and alcohol consumption). The risk factors were defined as follows:

Smoking status was categorized as current or no current smoking.
Regular physical activity was defined as meeting the American Heart Association of:
≥ 150 minutes of moderate exercise per week – OR –
≥ 75 minutes of vigorous activity per week.

A healthy diet was defined as meeting at least 4 of these 7 criteria.

≥ 3 servings/day of fruit.
≥ 3 servings/day of vegetables.
≥ 2 servings/week of fish.
≥ 3 servings/day of whole grains.
≤ 1 serving/week of processed meats.
≤ 1.5 servings/week of red meat.
≤ 1.5 servings/day of refined grains.

Moderate alcohol consumption was defined as:

Up to one drink a day for women.
Up to two drinks a day for men.

Finally, the diagnosis of Alzheimer’s Disease or dementia was obtained from the centralized databank of the UK National Health Service.

Will A Healthy Lifestyle Help Prevent Alzheimer’s Disease?

Here are the results from the study:

People at high genetic risk were almost twice as likely to develop dementia as those at low genetic risk.

In other words, genetics matter. If you have “bad” genes, your risk of developing dementia is increased significantly.

A healthy lifestyle decreased the risk of developing dementia by about 40% for both people at high genetic risk and for people at low genetic risk.

In other words, lifestyle also matters. You can significantly decrease your risk of developing dementia, no matter what your genetic risk.

People at high genetic risk and an unhealthy lifestyle were almost three times more likely to develop dementia than people at low genetic risk and a healthy lifestyle.

In other words, the combination of a high genetic risk and an unhealthy lifestyle is the worst of all possible worlds.

People at low genetic risk and an unhealthy lifestyle were just as likely to develop dementia as people at high genetic risk and a healthy lifestyle.

In other words, bad genetics does not doom you to Alzheimer’s and dementia. A healthy lifestyle can cut your risk almost in half. Conversely, good genetics is not a “Get Out of Jail Free” card. You can squander the advantage of good genetics with an unhealthy lifestyle.

Simply put, both genetics and lifestyle influence the risk of developing Alzheimer’s Disease and dementia. However, the take-home lesson from this study is that:

A healthy lifestyle can partially offset the effect of bad genetics.
A healthy lifestyle can enhance the effect of good genetics.
An unhealthy lifestyle can negate the benefit of good genetics.

Can Lifestyle Overcome Genetics?

This study clearly suggests that a healthy lifestyle can significantly reduce the effect of “bad” genetics on your risk of developing Alzheimer’s and other forms of dementia as you age. Considering that the medical profession has no other answer for preventing or treating Alzheimer’s Disease, this is really good news.

In the words of Dr. John Haaga of the U.S. National Institute on Aging: “No one can guarantee you’ll escape this awful disease, but you can tip the odds in your favor with clean living.”

The main strength of this study is its very large size. It is also supported by many smaller studies that have come to similar conclusions.

Moreover, a recent intervention study has been performed in Scandinavia in which one group was enrolled in a healthy lifestyle program while the other group continued with their previous health habits. That study also concluded that healthy habits could help prevent mental decline. The Alzheimer’s Association also has a similar intervention study in the United States. We should have more definitive information on this important subject very soon.

Finally, Alzheimer’s Disease may not be unique. Another recent study found that a healthy lifestyle can partially overcome a high genetic risk for developing heart disease.

The Bottom Line

A recent study looked at the effect of genetics and lifestyle on developing Alzheimer’s Disease and other forms of dementia. Here are the results from the study:

People at high genetic risk were almost twice as likely to develop dementia as those at low genetic risk.

In other words, genetics matter. If you have “bad” genes, your risk of developing dementia is increased significantly.

A healthy lifestyle decreased the risk of developing dementia by about 40% for both people at high genetic risk and for people at low genetic risk.

In other words, lifestyle also matters. You can significant decrease your risk of developing dementia, no matter what your genetic risk.

People at high genetic risk and an unhealthy lifestyle were almost three times more likely to develop dementia than people at low genetic risk and a healthy lifestyle.

In other words, the combination of a high genetic risk and an unhealthy lifestyle is the worst of all possible worlds.

People at low genetic risk and an unhealthy lifestyle were just as likely to develop dementia as people at high genetic risk and a healthy lifestyle.

In the words of Dr. John Haaga of the U.S. National Institute on Aging: “No one can guarantee you’ll escape this awful disease, but you can tip the odds in your favor with clean living.”

For more details on the study and how a healthy lifestyle was defined in this study, read the article above.

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

Can Plant-based Diets Be Unhealthy?

September 10, 2019 by Dr. Steve Chaney

Do Plant-Based Diets Reduce Heart Disease Deaths?

Author: Dr. Stephen Chaney

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

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

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

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

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

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

How Was The Study Done?

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

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

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

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

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

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

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

Do Plant-Based Diets Reduce Heart Disease Deaths?

The participants in this study were followed for an average of 25 years.

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

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

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

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

What Else Did The Study Show?

The investigators made a couple of other interesting observations:

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

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

Can Plant-Based Diets Be Unhealthy?

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

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

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

The main message from this study is clear.

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

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

For example:

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

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

The Bottom Line

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

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

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

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

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

The main message from this study is clear.

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

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

For more details on the study, read the article above.

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

Can Eating Fish Make Kids Smarter?

September 3, 2019 by Dr. Steve Chaney

Will Omega-3s Turn Your Kid Into A Genius?

Author: Dr. Stephen Chaney

You have probably heard the old saying that fish is brain food. Is it true? Could eating fish make your kid(s) smarter?

It is certainly a plausible hypothesis. Many fish are good sources of long chain omega-3s (omega-3 fatty acids). Long chain omega-3s, particularly DHA, are an important part of the myelin sheath that coats our neurons.

We can think of the myelin sheath as analogous to the plastic coating on electrical wiring. The coating on electrical wires assures that the electrical signal gets from the beginning of the wire to the end without shorting out somewhere in the middle. The myelin sheath plays a similar role for our neurons.

A number of clinical studies suggest that adequate intake of fish and/or fish oil during pregnancy and the early stages of childhood is important for brain development. Other studies suggest that omega-3 supplementation may improve mental focus and reading skills in school-age children.

The current clinical study (J Liu et al, Scientific Reports, 7: 17961, 2017) looked at the effect of fish consumption in Chinese children aged 9-11 on their IQ score measured at age 12.

How Was The Study Done?

This study included 541 Chinese school children who were part of an ongoing prospective longitudinal study. [That is scientific jargon meaning that one variable (diet) was measured at the beginning of the study and correlated with a second variable (IQ) measured several years later.]

The children were asked to fill out a food frequency questionnaire at ages 9-11. Fish intake frequency was measured by asking the children: “How often do you consume fish in a typical month?” The children were required to choose from:

seldom (less than 2 times per month),
sometimes (2-3 times per month), and
often (at least once a week).

It was assumed that the children might not have known what kind of fish their mothers prepared, so they were not asked to identify the kind of fish they ate.

At the time the children were enrolled in the program the investigators collected data on 13 other variables which might influence IQ. These variables included:

Gender
Parent’s education.
Parent’s occupation.
Parent’s marital status.
Whether the child was breastfed or not.
Duration of breastfeeding.
Home location.
Siblings.
Breakfast consumption (previous research has suggested breakfast intake may influence cognition).

At age 12 the IQ of the children was assessed using the Chinese version of a standard IQ test. The IQ tests were administered independently by two trained investigators to minimize investigator bias.

Verbal IQ was assessed based on:
- Information Recall.
- Comprehension
- Arithmetic
- Vocabulary
- Recognition of Similarities.

Performance IQ was assessed based on:
- Picture Arrangement.
- Picture Completion.
- Object Assembly.
- Block Design.
- Coding
- Mazes
The Total IQ score was based on a combination of the Verbal and Performance scores.

The study measured the impact of fish consumption at ages 9-11 on IQ at age 12 and included statistical correction for other variables that might have influenced IQ.

Can Eating Fish Make Your Kids Smarter?

When the children who frequently consumed fish (≥once a week) were compared to children who seldom consumed fish (˂2 times a month), their IQ scores were:

75 points higher in verbal IQ.
79 points higher in performance IQ.
80 points higher in total IQ.

When the children who sometimes consumed fish (2-3 times a month) were compared to children who seldom consumed fish, their IQ scores were:

92 points higher in verbal IQ.
52 points higher in performance IQ.
31 points higher in total IQ.

These data are consistent with previous studies showing that both dietary fish and omega-3 intake are associated with improved cognitive and academic performance in school age children.

[Note: This study also suggested that fish consumption may improve sleep quality, and the improved sleep quality may influence IQ. This is a complex subject. As such, it is best discussed in a future issue of “Health Tips From the Professor”.]

What Are the Strengths And Weaknesses Of This Study?

Strengths: The strengths of the study were:

It was a relatively large study.
Fish consumption was measured 1-3 years earlier than IQ.
The association between fish consumption and IQ remained significant after adjusting for 13 other variables known to influence IQ.
There was a clear dose-response relationship between the three levels of fish consumption.
It is consistent with a number of other studies showing that fish/omega-3 intake improves cognitive performance in children.

Thus, the authors concluded: “We believe the findings cannot be easily attributed to chance and that, instead, they reflect a reliable relationship between early, frequent fish consumption and later, improved cognitive performance.”

Weaknesses: The weaknesses of the study were:

It did not ask what kinds of fish the children were eating. Some fish are much better sources of omega-3s than others, so it is not entirely accurate to attribute the higher IQ to omega-3 intake.
It did not assess the effect of “diet context” on the results. The Chinese diet is a primarily plant-based, low-fat diet. It is unclear whether eating fish once a week would have the same effect on IQ in the context of a typical American diet.
It is an “association study.” It simply measured the association between fish consumption and IQ. It does not prove cause and effect.

Finally, this is the first study to measure the correlation between fish consumption and IQ in this age group. Clearly, more experiments are needed to confirm these findings.

Will Omega-3s Turn Your Kid Into A Genius?

Who wouldn’t want their children or grandchildren to have higher IQs?

However, I wouldn’t read too much into a study like this.

Let me share some perspective by way of a personal story. When I was in grade school, every child was given an IQ test and an aptitude test (I scored very low on anything mechanical in the aptitude test, which my wife can attest to.)

We children, as might be expected, shared our IQ scores. However, the scores didn’t prove to be as meaningful as we initially expected.

There were some kids in my class who had much higher IQ scores. In fact, they ranked in the genius category. However, many of them did mediocre in school and had undistinguished careers. In contrast, some of the kids who scored lower on their IQ tests had spectacular careers in their chosen fields.

The moral of this story is, of course, that there is a lot more than IQ that goes into success in school and success in life. With IQ, like many other things, it is important to have enough, but more is not necessarily better.

However, this study is consistent with many other studies suggesting that omega-3s, especially DHA, are important for brain development, mental focus, and cognitive skills in children. Consequently, if you have a child or grandchild, you want to make sure that they are getting enough omega-3s in their diet.

How much is enough, you might ask? Recommendations range from 70 mg/day EPA+DHA for children ages 1-3 to 100-150 mg/day EPA+DHA for older children, with about 2/3 of that coming from DHA.

While that may not sound like much, a recent study of 10, 942 American children ages 1-11 found that only around 25% of them were getting the recommended amount of EPA+DHA from their diet. In fact, most American children only get around 20-40 mg of EPA+DHA from their diet.

Fish are the preferred source of EPA+DHA because they also provide a healthy protein source, something else your child may not be getting enough of. The best fish sources of omega-3s are mackerel, salmon, sea bass, and sardines.

Of course, if your child is one of the many children who are not fond of omega-3-rich fish, you may want to consider an omega-3 supplement, especially one rich in DHA.

The Bottom Line

A recent study analyzed the correlation between fish consumption and IQ in school aged children. The study found:

When the children who frequently consumed fish (≥once a week) were compared to children who seldom consumed fish (˂2 times a month), their IQ scores were:

75 points higher in verbal IQ.
79 points higher in performance IQ.
80 points higher in total IQ.

When the children who sometimes consumed fish (2-3 times a month) were compared to children who seldom consumed fish, their IQ scores were:

92 points higher in verbal IQ.
52 points higher in performance IQ.
31 points higher in total IQ.

These data are consistent with previous studies showing that both dietary fish and omega-3 intake are associated with improved cognitive and academic performance in school age children.

For more details on the study and perspective on what the study means for you, read the article above.

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

Do Older Adults Eat Enough Protein?

August 27, 2019 by Dr. Steve Chaney

The Impact Of Inadequate Protein Intake On Healthy Aging

Author: Dr. Stephen Chaney

Do older adults eat enough protein?

Most Americans lose lean muscle mass as they age, a physiological process called sarcopenia. There are three factors that influence the rate at which we lose muscle mass as we age:

Our physiology changes. Our bodies break down our protein stores more rapidly and we have a harder time utilizing the protein in our diet to replenish those protein stores.
We become less active. In some cases this reflects physical disabilities, but all too often it is because we are not giving weight-bearing exercises the proper priority in our busy lives.
Our diets become inadequate. The major driver of this phenomenon is loss of appetite which results in decreased caloric intake. However, physical disability, isolation, and insufficient income also contribute.

Sarcopenia in turn results in:

Loss of muscle strength. Even the simple act of picking up a grandchild or a bag of groceries can become problematic.
Increased risk of falls and fractures.
Lower quality of life.

Obviously, sarcopenia is a major health issue for those of us in our golden years. If you are younger, it is a concern for your parents or grandparents. Sarcopenia is a health issue that affects everyone.

But what can be done to prevent sarcopenia? We can’t change our physiology, but we can change our activity level and our diet. Weight-bearing exercise tugs on our muscle fibers. That stimulates those fibers to incorporate protein into new muscle cells. It is no wonder that weight-bearing exercise is recommended for preventing sarcopenia.

What about diet? Are older adults getting enough protein in their diet? The conventional wisdom is that protein intake is not a problem. We’ve been told that Americans get enough protein in our diet. In fact, we’ve been told that most of us get more protein than we need.

Is that true for older Americans? In fact, very few studies have specifically looked at protein intake in older Americans. This study (JL Krok-Schoen et al, The Journal of Nutrition, Health & Aging, 23: 338-347, 2019 ) was designed to fill that void.

How Was The Study Done?

This study used data on 11,680 Americans who participated in NHANES surveys between 2005 and 2014. (NHANES or National Health and Nutrition Examination Surveys is a program run by the CDC that is designed to assess the health and nutritional status of adults and children living in the United States).

Participants in the study were grouped into three groups: 51-60 years (4,016 participants), 61-70 years (3,854 participants), and 71 years and older (3,810 participants).

Protein intake and diet quality were based on the average of two 24-hour dietary recall interviews. Trained dietary interviewers collected detailed information on all foods and beverages consumed during the past 24 hours.

Participants also filled out a questionnaire designed to assess health outcomes that might be affected by loss of muscle mass.

Note: The NHANES database is used for many studies on the association between diet and health outcomes. However, it is important to remember that a 24-hour diet recall is a single snapshot in time. This is a weakness of this and all similar studies. For example, in this study a participant’s average protein intake may be more or may be less than the amount reflected in the 24-hour diet recall.

Are Older Adults Eat Enough Protein?

To determine whether American older adults eat enough protein in their diet, the investigators compared protein intake in each age group with the DRI (Dietary Reference Intake) for protein of 0.8 grams of protein per kilogram of body weight (0.36 grams per pound). This is the standard set by the Food & Nutrition Board of the National Academy of Sciences for all adults over the age of 19.

The results were:

Up to 46% of older adults were not getting the recommended 0.8 g/kg/day of protein. When broken down by age groups, the percentages were:
- 38% of the 51-60 age group.
- 42% of the 61-70 age group.
- 46% of those over 70.
Women were more likely to be consuming inadequate protein than men.
Blacks were more likely to be consuming inadequate protein than other demographic groups.

When the investigators looked at the correlation between diet quality and protein intake, those consuming inadequate protein:

Had significantly lower calorie intake.
Skipped meals more frequently.
Had lower HEI (Healthy Eating Index) scores. Specifically:
They scored low on intake of greens, beans, dairy, total protein foods, seafood protein foods, and plant protein foods.
They scored high on intake of refined grains and added sugars.
Had inadequate intakes of fiber, zinc, selenium, vitamin C, vitamin E, and vitamin D.

The Impact Of Inadequate Protein Intake On Healthy Aging

When the investigators compared older adults with inadequate protein intake to adults in the same age groups with adequate protein intake, those with inadequate protein intake:

Had a higher prevalence of physical, mental, and social limitations.
Were more likely to be limited when stooping, crouching, or kneeling, standing or sitting for long periods, walking up 10 steps, preparing meals, and walking for a quarter mile.
They had trouble lifting more than 10 or 15 pounds.

Limitations on everyday activities like these have a significant impact on the quality of life experienced by these individuals.

What Does This Study Mean For You?

If you are over 50 or have a family member over 50, this study should serve as a wake-up call. You or your loved ones may not be getting enough protein.

In the words of the authors: “A considerable portion of older adults (31%-50%) did not meet their protein recommendation (0.8 g/kg/d)…This contradicts the common perception that Americans are usually meeting or exceeding the 0.8 g/kg/d protein recommendation.”

The situation may be even worse than this study indicates. This study used the DRI standard for adequate protein intake of 0.8 g/kg/d. Many recent studies suggest that significantly higher protein intakes (1-1.2 g/kg/d) are needed for older adults to prevent loss of muscle mass (sarcopenia). If so, the likelihood that you or your loved ones are not getting enough protein is even higher.

In the words of the authors: “There is a general consensus recommending dietary protein intakes of 1-1.2 g/kg/d…for older adults…If over one third of older adults are not meeting the recommendation of 0.8 g/kg/d, these data suggest that far fewer older adults would be meeting the proposed higher levels (1-1.2 g/kg/d) needed to meet the demands to promote healthy aging.”

The consequences of inadequate protein intake in the older adults may have a significant effect on their quality of life.

In the words of the authors: “This analysis found a positive association between achieving the recommended protein intake and self-reported physical functioning. The functional limitations associated with not meeting the protein requirement were all related to activities of daily living…”

Because of decreased appetite in many older adults, it is difficult to meet protein intakes of 1-1.2 g/kg/d with food alone. Protein supplementation can play a valuable role.

In the words of the authors: “When food alone is insufficient to meet a patient’s needs, oral nutritional supplementation may provide a means to meet protein intake recommendations.

“To some extent, sarcopenia can be managed with protein supplementation, considering all the factors that are working to reduce food intake in aging.” [The authors used the phrase “To some extent” because weight-bearing exercise is also required to manage sarcopenia].

While this study focused on protein intake, weight-bearing exercise is also essential to prevent sarcopenia. Exercise and adequate protein intake work together to build and maintain lean muscle mass.
Finally, we should not ignore the fact that those adults who were not getting enough protein were also getting insufficient levels of many micronutrients that affect the aging process. A good diet and supplementation are also important for healthy aging.

Specifically, the authors noted:

“Dietary fiber is associated with many benefits, especially in reducing the risk of heart disease.”
“Vitamin D inadequacy is associated with reduced mobility and an increase in risk for falls and fracture.”
“Zinc deficiencies…may cause dysfunctions in immunity and reduced healing time.”

The Bottom Line

A recent study analyzed protein intake in older American adults. The conclusions of the study were:

If you are over 50 or have a family member over 50, this study should serve as a wake-up call. You or your loved ones may not be getting enough protein.
The situation may be even worse than this study indicates. This study used the DRI standard for adequate protein intake of 0.8 g/kg/d. Many recent studies suggest that significantly higher protein intakes are needed for older adults to prevent loss of muscle mass (sarcopenia). If so, the likelihood that you or your loved ones are not getting enough protein is even higher.
The consequences of inadequate protein intake in the older adults may have a significant effect on their quality of life.
Because of decreased appetite in many older adults, it is difficult to meet protein intakes of 1-1.2 g/kg/d with food alone. Protein supplementation can play a valuable role.
While this study focused on protein intake, weight-bearing exercise is also essential to prevent sarcopenia. Exercise and adequate protein intake work together to build and maintain lean muscle mass.
Finally, we should not ignore the fact that those adults who were not getting enough protein were also getting insufficient levels of many micronutrients that affect the aging process. A good diet and supplementation are also important for healthy aging.

For more details on the study, read the article above.

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

Eye Pain Relief

August 20, 2019 by Dr. Steve Chaney

A Simple Treatment To Make Your Eye Pain Disappear

Author: Julie Donnelly, LMT –The Pain Relief Expert

Editor: Dr. Steve Chaney

As the song goes: ”…Summertime and the living is e-a-s-y….” Here in Florida we know that the living is easy because it’s so hot who wants to be doing anything except either sitting in the shade, or inside in the air conditioning. Personally, I don’t think this summer was so bad, especially the evenings, but then, I really hate the cold so maybe my opinion is biased.

To stay in alignment with “living is easy,” I’m taking the advice of a few experts who teach easy ways to stay calm, motivated, and happy. I’m taking a 30-day break from the news. It’s so much in my face lately that it’s really affecting me in a very negative way. So far, I’m two days into my 30 days.

I’ve decided that I want to take away some of the stress that seems to be normal for everyone. To that end I was listening to a speaker who was talking about the dangers of stress and what it does to the body. Really frightening! He was saying that negative news sells and, for example, in the 1990’s in one city of the USA, homicides had gone down 42%, but the local TV station increased its coverage of homicides by 700%. It’s only gotten worse in 2019. It’s making us think we live in a dangerous country, and it sure isn’t helping our blood pressure.

To solve that problem, this speaker recommended going on a “news fast” for 30 days. Absolutely no negative news of any kind for a full month. I’m surrounded by news all day so it’s a challenge, but I’ve found a great substitute: www.GoodNewsNetwork.org. Their mission is to be an antidote to the barrage of negativity experienced in the mainstream media.

So, I want to share this with you, and if you have any other good news stations/websites you love, please feel free to share it with me.

I think I’m off to the beach with a big umbrella and a thermos of ice-cold tea! Living the e-a-s-y life!

Have a relaxing month!

Eye Strain And Eye Pain

This week I had a client come to the office with a situation that is pretty rare. He described his pain as on his eyeball, which then referred to the entire top half of his skull. It was like drawing a line that went under his eyes, through his ears, and around his head. It was definitely a headache but concentrated on his eyes. He was in desperate need of eye pain relief.

This client works in an industry that has the computer screen changing frequently and he’s needing to locate information on the new screen quickly. He has experienced eye strain before, but other times just having the weekend off has resolved the problem. This time the pain didn’t go away.

We don’t ever think about the muscles that move our eyes, but they can get repetitively strained just like any other muscle in the body. This especially happens if you are watching something that has your eye moving back and forth rapidly, like a game on your computer or phone.

The muscles that are most prone to a repetitive strain injury are the ones on the top of the eye and on the outside of the eye. I’m not an eye doctor so I can’t explain why these two muscles cause more problems than the others, but my experience has shown this to be the truth.

Eye Pain Relief

The treatment is simple, but you need to do it cautiously. If you wear contacts, you’ll need to remove them. The pressure is VERY light.

Put your fingertip directly onto your eyeball and press down GENTLY.

Slide your finger from the top of your eyeball to the outside of your eyeball.

If you find a point where it is tender, that’s the spasm that is putting a strain on your eyeball. Just leave your fingertip on that point for 30 seconds.

You may even get a light show while doing this, with different shapes and colors.

You’ll find that this simple treatment will soothe tired eyes at the end of the day. But remember, the pressure needs to be light and gentle.

Why stay in pain when it’s so easy to find the muscular source of the problem and eliminate it?

Treat Yourself to Pain-Free Living (https://julstromethod.com/product/treat-yourself-to-pain-free-living-hardcopy/) is filled with over 100 pictures and descriptions proven to show you how to find and self-treat muscle spasms from head to foot!

Join the 1000’s of people worldwide who have discovered that tight muscles were the true source of pains they thought were from arthritis, fibromyalgia, and other serious conditions. You have nothing to lose, and everything to gain by releasing tight muscles.

Treat Yourself to Pain-Free Living is your step-by-step guide to pain 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.

About The Author

Are Pregnant Women and Children Dangerously Deficient in Omega-3s?

August 13, 2019 by Dr. Steve Chaney

What Is The Omega-3 Status Of The American Population?

Author: Dr. Stephen Chaney

It is no secret that the American population is deficient in omega-3s. Numerous studies have documented that fact. There are many reasons for Americans’ low intake of omega-3s:

The high price of omega-3-rich fish.
Concerns about sustainability, heavy metal contamination, and/or PCB contamination of omega-3 rich fish.
Misleading headlines claiming that omega-3 supplements are worthless and may even do you harm.

Of course, the questions you are asking are probably?

How deficient are we?
Does it matter?

The latest study (M Thompson et al, Nutrients, 2019, 11: 177, doi: 10.3390/nu11010177) goes a long way towards answering those important questions.

How Was The Study Done?

This study used data on 45,347 Americans who participated in NHANES surveys between 2003 and 2014. (NHANES or National Health and Nutrition Examination Surveys is a program run by the CDC that is designed to assess the health and nutritional status of adults and children living in the United States).

EPA and DHA intake from foods was based on the average of two 24-hour dietary recall interviews. Trained dietary interviewers collected detailed information on all foods and beverages consumed during the past 24 hours.

To assess EPA and DHA intake from supplements study participants were asked what supplements they had taken in the past 30 days, how many days out of 30 they had taken it, and the amount that was taken on those days.

What Is The Omega-3 Status Of The American Population?

The results of the NHANES surveys were shocking.

In terms of total EPA+DHA intake:

EPA+DHA intake across all age groups was lower than recommended.
Toddlers (ages 1-5), children (ages 6-11), and adolescents (ages 12-19) had lower EPA+DHA intakes than adults (ages 20-55) and seniors (ages > 55).
Women had lower EPA+DHA intakes than men.
Pregnant women and women of childbearing age did not differ in their EPA+DHA.
Pregnant women consumed less fish than women of childbearing age (perhaps because of concerns about heavy metal contamination).
Pregnant women consumed more omega-3 supplements.

In terms of EPA+DHA from supplements:

Less than 1% of the American population reported using omega-3 supplements.
The one exception was pregnant women. 7.3% of pregnant women reported taking an omega-3 supplement.
People taking omega-3 supplements had significantly higher EPA+DHA intake than people not taking omega-3 supplements.
This was also true for pregnant women. Those taking omega-3 supplements had higher EPA+DHA intake.

Of course, like any clinical study, it has strengths and weaknesses.

The biggest weakness of this study is that omega-3 intake is based on the participants recall of what they ate. The strengths of the study are its size (45,347 participants) and the fact that its estimate of omega-3 intake is consistent with several smaller studies.

Are Americans Deficient In Omega-3s?

Now we are ready to answer the questions I posed at the beginning of this article. Let’s start with the first one: “How deficient are we?”

You would think the answer to that question would be easy. It is not. This study provides a precise estimate of American’s omega-3 intake. The problem is there is no consensus as to how much omega-3s we need. There is no RDA for omega-3s.

There are, in fact, three sets of guidelines for how much omega-3s we need, and they disagree.

The World Health Organization (WHO) recommendations for EPA+DHA intake range from 100-150 mg/day at ages 2-4 years to 200-500 mg/day for adults.
The US National Institute of Medicine (IOM) recommendations for EPA+DHA intake range from 70 mg/day for ages 1-3 to 110 mg/day for adult females and 160 mg/day for adult males.
As if that weren’t confusing enough, an international group of experts recently convened for a “Workshop on the Essentiality of and Recommended Dietary Intakes for Omega-6 and Omega-3 Fatty Acids” (Workshop). This group recommended an EPA+DHA intake of 440 mg/day for adults and 520 mg/day for pregnant and lactating women.

Using these recommendations as guidelines, this study reported that:

EPA+DHA intake for children 1-5 years old was ~25% of the WHO recommendations and ~40% of IOM recommendations.
EPA+DHA intake for children 6-11 years old was ~27% of WHO recommendations and ~40% of IOM recommendations.
EPA+DHA intake for adolescents 12-19 years old was ~50% of IOM recommendations (The WHO did not have a separate category for adolescents.
EPA+DHA intake for adults 20-55 years old was ~30% of WHO recommendations, and ~65% of IOM recommendations.
EPA+DHA intake for seniors >55 years old was 38% of WHO recommendations and 82% of IOM recommendations.
EPA+DHA intake for pregnant women was ~20% of Workshop recommendations (The WHO and IOM did not have a separate category for pregnant women).

While the percentage deficiency varied according to the EPA+DHA guidelines used, it is clear from these results that Americans of all age groups are not getting enough omega-3s from their diet.

The authors concluded: “We found omega-3 intakes across all age groups was lower than recommended amounts.”

Are Pregnant Women and Young Children Dangerously Deficient In Omega-3s?

While the authors concluded that all age groups were deficient in omega-3s, they were particularly concerned about the omega-3 deficiencies in pregnant women and young children.

The authors said: “Taken together, these findings demonstrate that low omega-3 fatty acid intake is consistent among the US population and could increase the risk for adverse health outcomes, particularly in vulnerable populations (e.g., young children and pregnant women).”

In part, the focus on young children and pregnant women was based on their very low omega-3 intake. With intakes at 20-27% of recommended levels, I would consider these groups to be dangerously deficient in omega-3s.

However, the focus on young children and pregnant women was also based on the seriousness of the adverse health outcomes associated with low omega-3 intake in these population groups. This answers the second question I posed at the beginning of this article: “Does it matter?”

According to the authors low intake of EPA and DHA during pregnancy and early childhood is associated with maternal depression, pre-term births, low birth-weight babies, increased risk of allergies and asthma, problems with learning and cognition, and other neurocognitive outcomes.

None of these associations between low omega-3 intake and adverse health outcomes have been proven beyond a shadow of a doubt, but the evidence is strong enough that we should be alarmed by the very low omega-3 intake in pregnant women and young children.

There is, however, a simple solution. The authors of this study concluded: “Individuals taking EPA/DHA containing supplements had significantly elevated intake compared to individuals not taking omega-3 fatty acid-containing supplements or not reporting any supplement use.”

They went on to say: “As supplement use is associated with increased omega-3 intake, supplementation could be an important source of EPA/DHA, particularly for pregnant women given their lower fish consumption compared to non-pregnant women of childbearing age.”

I agree. Given the low omega-3 intake in these population group and current guidelines for omega-3 intake. I recommend:

Pregnant & lactating women (and women of childbearing age who might become pregnant) take an omega-3 supplement providing around 520 mg of EPA+DHA/day.
Young children (ages 1-5) take an omega-3 supplement providing around 100 mg of DHA/day.

Of course, this study also confirmed that Americans of all age groups are not getting enough omega-3s from their diet, and low omega-3 intake may increase the risk of heart disease. Furthermore, recent studies have shown that high purity omega-3 supplements may reduce heart disease risk.

You will find my recommendations for omega-3 supplementation for adults in a previous issue of “Health Tips From the Professor.”

The Bottom Line

The largest study to date (45,347 participants) measured omega-3 intake for Americans of all ages and compared that to current recommendations for omega-3 intake.

The authors of the study concluded:

“We found omega-3 intakes across all age groups was lower than recommended amounts.”
“Low omega-3 fatty acid intake … could increase the risk for adverse health outcomes, particularly in vulnerable populations (e.g., young children and pregnant women.”

However, the focus on young children and pregnant women was also based on the seriousness of the adverse health outcomes associated with low omega-3 intake in these population groups.

According to the authors low intake of EPA and DHA during pregnancy and early childhood is associated with maternal depression, pre-term births, low birth-weight babies, increased risk of allergies and asthma, problems with learning and cognition, and other neurocognitive outcomes.

There is, however, a simple solution. The authors of this study also concluded:

“Individuals taking EPA/DHA containing supplements had significantly elevated intake compared to individuals not taking omega-3 fatty acid-containing supplements or not reporting any supplement use.”
“As supplement use is associated with increased omega-3 intake, supplementation could be an important source of EPA/DHA, particularly for pregnant women given their lower fish consumption compared to non-pregnant women of childbearing age.”

For more details on the study and my recommendations for omega-3 supplementation, read the article above.

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

What is Nutrigenomics

August 6, 2019 by Dr. Steve Chaney

What Is The Truth About Personalized Nutrition Testing? – Part 2

Author: Dr. Stephen Chaney

When the human genome was sequenced in 2003, many of us in the scientific community thought we were on the verge of a revolution in human health and longevity. We would soon be able to tell individuals their risk of developing various diseases.

Even better, we would be able to tell them the kind of diet and supplementation they needed to avoid those diseases. We would be able to personalize our nutritional recommendation for every individual based on their genome – something called nutrigenomics.

How naive we were! It has turned out to be much more complicated to design personalized nutrition recommendations based on someone’s genome than we ever imagined.

What Is Nutrigenomics?

As a Professor at the University of North Carolina I specialized in cancer drug development for over 30 years. Over the last decade of my career a ﬁeld called pharmacogenomics became widely accepted in the ﬁeld of cancer drug development. In simple terms, pharmacogenomics looks at how an individual’s genes influence the effectiveness and side effects of drugs.

Because of pharmacogenomics, drugs today are being approved to target cancers for people whose cancer cells have a particular genetic makeup. These drugs would not have been approved a decade ago because if you test them on cancer in the general population, they have little or no eﬀectiveness. They only work on a subset of people who have a form of cancer with a specific genetic makeup.

In principle, nutrigenomics is the same principle. You’ve heard for years that we all have unique nutritional needs. Now we are starting to learn why. It’s because we all have unique variations in our genetic makeup. These genetic mutations increase our risk of certain diseases, and they increase our needs for certain nutrients.

For example, mutations in the MTHFR gene increase the risk of certain birth defects, and supplementation with folic acid is particularly important for reducing birth defects in that population group.

Similarly, mutations in the vitamin D receptor, the VDR gene, interfere with vitamin D absorption from foods and are associated with a condition known as “vitamin D-resistant rickets.” Babies born with this genetic defect require mega doses of vitamin D for normal bone formation.

These are the best-established examples of gene mutations that affect nutritional needs. Many more gene-nutrient interactions have been proposed, but they have not been validated by follow-up experiments.

The situation is similar when we look at gene mutations associated with metabolic responses such as fat and carbohydrate metabolism, obesity, insulin resistance and type 2 diabetes. There are a few gene mutations that have strong associations with obesity and diabetes. Many more gene-metabolism interactions have been proposed, but the data are weak and inconsistent.

The Promise Of Nutrigenomics

Now that you understand what nutrigenomics is and have some background information about it, let’s look at the promise of nutrigenomics. One promise of nutrigenomics is personalized supplement programs.

We all have different nutritional needs. Wouldn’t it be wonderful if someone could analyze your genome and provide you with a personalized supplement program that precisely fits your genetically determined nutritional requirements?

There are companies that offer such personalized supplement programs. Are they providing you with something of value or is their testing bogus? Are their supplements worthless?

Another promise of nutrigenomics is personalized diet advice. Some people seem to do better on low-fat diets. Other people do best on low-carb diets. Saturated fats and red meats may be more problematic for some individuals than for others. Wouldn’t it be wonderful if someone could analyze your genome and provide you with a personalized diet program – one that allows you to lose weight easily and gain vibrant health.

There are companies that will analyze your genome and tell you whether you are more likely to lose weight and be healthier on a low-fat or low-carbohydrate diet. Is their testing accurate or is it bogus? Are they providing you with useful information, or is their diet advice worthless?

The Problem With Nutrigenomics

The short answer to the questions I posed in the previous section is that personalized supplement and diet programs are on the horizon, but we are not there yet. Companies promising you personalized nutrition programs based on DNA tests are misleading you. They quote a few studies supporting the tests they run and ignore the many studies showing their tests are worthless.

In case you think that is just my opinion, let me quote from some recent reviews on the current status of nutrigenomics.

For example, a review (C Murgia and MM Adamski, Nutrients, 366, 2017) published in 2017 concluded: “The potential applications to nutrition of this invaluable tool were apparent since the genome was mapped. The first articles discussing nutrigenomics and nutrigenetics were published less than a year after the first draft of the human DNA sequence was made available…However, fifteen years and hundreds of publications later, the gap between the experimental and epidemiologic evidence and health practice is not yet closed.”

“The [complexity] of the genotype information is not the only factor that complicates this translation into practice. The discovery of other levels of control, including epigenetics [modifications of DNA that affect gene expression] and the intestinal microbiome, are other complicating factors. While the science of nutritional genomics continues to demonstrate potential individual responses to nutrition, the complex nature of gene, nutrition and health interactions continues to provide a challenge for healthcare professionals to analyze, interpret and apply to patient recommendations.”

Another review (M Gaussch-Ferre et al, Advances in Nutrition, 9: 128-135, 2018 ) published in 2018 concluded: “Overall, the scientific evidence supporting the dissemination of genomic information for nutrigenomic purposes remains sparse. Therefore, additional knowledge needs to be generated…”

In short, the experts are saying we still don’t know enough to predict the best diets or the best supplements based on genetic information alone. Why is that? Why is it so complicated? In part, it can be explained by a term called penetrance. Penetrance simply means that the same gene mutation can have different effects in different people. In some people, its effects may be barely noticeable. In other people its effects may be debilitating.

What Is The Truth About Personalized Nutrition Testing?

Penetrance is not just a word. It’s a concept. What causes differences in genetic penetrance? Here are the most likely explanations.

Human genetics is very complex. There are some gene mutations, such as those causing cystic fibrosis and sickle cell anemia, that can cause a disease by themselves. Most gene mutations, however, simply predispose to a disease or metabolic disturbance and are highly influenced by the activity of other genes. That’s because the products of gene expression form intricate regulatory and metabolic networks. When a single gene is mutated, it interacts with many other genes in the network. And, that network is different for each of us.
Many common diseases are polygenic. That includes disease like heart disease, diabetes, and most cancers. Simply put, that means that they are not caused by a single gene mutation. They are caused by the cumulative effect of many mutations, each of which has a small effect on disease risk. The same appears to be true for mutations that influence carbohydrate and fat metabolism and affect nutrient requirements.
The outcome of gene mutations is strongly influenced by our diet, lifestyle, and environment. For example, a common mutation in a gene called FTO predisposes to obesity. However, the effect of this mutation on obesity is strongest when it is coupled with inactivity and foods of high caloric density (translation: junk foods and fast foods instead of fresh fruits and vegetables). Simply put, that means most of us are genetically predisposed to obesity if we follow the American lifestyle, but obesity is not inevitable.
Epigenetics has an important influence on gene expression. When I was a graduate student, we believed our genetic destiny was solely determined by our DNA sequence. That was still the prevailing viewpoint when the human genome project was initiated. We thought that once we had our complete DNA sequence, we would know everything we needed to know about our genetic destiny.

How short sighted we were! It turns out that our DNA can be modified in multiple ways. These modifications do not change the DNA sequence, but they can have major effects on gene expression. They can turn genes on or turn them off. More importantly, we have come to learn that these DNA modifications can be influenced by our diet, lifestyle, and exposure to environmental pollutants.

This is the science we call epigenetics. We have gone from believing we have a genome (DNA sequence) that is invariant and controls our genetic destiny to understanding that we also have an “epigenome” (modifications to our DNA) that is strongly influenced by our diet, lifestyle, and environment and can change day-to-day.

Our microbiome has an important influence on our health and nutritional status. Simply put, the term microbiome refers to our intestinal microbes. Our intestinal bacteria are incredibly diverse. Each of us has about 1,000 distinct species of bacteria in our intestines.

Current evidence suggests these intestinal bacteria influence our immune system, inflammation and auto-immune diseases, brain function and mood, and our predisposition to weight gain – and this may just be the tip of the iceberg.

More importantly, our microbiome is influenced by our diet. For example, vegetarians and meat eaters have entirely different microbiomes. Furthermore, the effect of diet on our microbiome is transitory. If you change your diet, the species of bacteria in your microbiome will completely change in a few weeks.

Finally, our microbiome also influences our nutritional requirements. For example, some species of intestinal bacteria are the major source of biotin and vitamin K2 for all of us and the major source of vitamin B12 for vegans. Intestinal bacteria may also contribute to our supply of folic acid and thiamine. Other intestinal bacteria inactivate and/or remove some vitamins from the intestine for their own use. Thus, the species of bacteria that populate our intestines can influence our nutritional requirements.

Now that you know the complexity of gene interactions you understand why we are not ready to rely on DNA tests yet. We don’t yet know enough to design a simple DNA test to predict our unique nutritional needs. That science is at least 10-20 years in the future. Companies that tell you otherwise are lying to you.

My Recommendations for Supplements and Foods

Here are my recommendations for how to decide which foods or supplements you should eat:

Think of DNA testing as only the first step in the process of learning which foods and supplements are best for you. Since DNA testing is not definitive by itself, I wouldn’t recommend spending thousands of dollars on a DNA test.
Next, start with diets that we know are healthy long-term. As I discussed in my book, “Slaying The Food Myths,” any primarily plant-based diet ranging from vegan to Mediterranean and DASH diets is likely to be healthy long-term. If you find you need a low carb diet, I recommend the low-carb version of the Mediterranean diet.
Don’t eliminate plant food groups like fruits, whole grains, or legumes from your diet unless you have an objective reason to do so (more about that below).
Learn to listen to your body. Keep track of the foods and/or supplements you eat and how they make you feel.
In terms of listening to your body, start with your digestive system. I have vegan friends who experience constant gas and bloating and think of it as a badge of honor. I have keto friends who experience constant constipation and think of it as a badge of honor. Neither is correct. That is just their body telling them the diet they are eating is not right for them. Here is the process I recommend:
Start by trying the various plant-based diets for 4 to 6 weeks until you find the one that works best for you. For example, when I tried that approach it became clear that a vegan diet was not for me. I discovered I do much better on a semi-vegetarian diet.
If you are still experiencing digestive issues, start paying more attention to the foods you are eating. If you keep a log of the foods you eat and when you experience digestive issues for a few weeks, you will likely be able to identify foods that are problematic for you. Once you have done that, eliminate them from your diet for a few weeks and then go back and do a food challenge test where you add that food back to your diet to confirm that it is a problem for you.
If all this fails, I recommend an elimination diet or FODMAP diet to identify foods to avoid (You can find instructions for both on the internet). [Note: Skin tests are notoriously unreliable, but they may give you some clues about foods to avoid that you could confirm with a food challenge.]
Finally, if digestive issues persist, you should make an appointment with your doctor.
Also, pay attention to blood sugar control following the same approach I outlined for digestive issues.
Symptoms of high blood sugar are fatigue, thirst, headache, trouble concentrating, and frequent urination.
Symptoms of low blood sugar are hunger, shakiness, anxiety, irritability, feeling lightheaded, and sleepiness.
Biomarkers of disease, like LDL cholesterol, HDL cholesterol, triglycerides, c-reactive protein (a measure of inflammation), and HbA1c (a measure of blood sugar control), can be useful indicators of whether a diet or supplement is right for you. However, you should interpret improvements in disease biomarkers with caution because they can be misleading when you have been following a diet or supplement program for a short time.

Any diet that results in rapid weight loss will improve disease biomarkers in the short term. Similarly, some supplement programs give a transitory improvement in disease biomarkers. It is only when a diet or supplement program has been followed for 5, 10, or 20 years that disease biomarkers become truly reliable indicators of the success or failure of that diet or supplement program.

Finally, feelings of well-being, energy, mood, and clarity of thinking are subjective and highly susceptible to the placebo effect. They are the least reliable indicators of the success or failure of a food or supplement program.

The Bottom Line

Nutrigenomics is defined as the interaction between our genetic makeup and our diet. How far have we advanced in the science of nutrigenomics? Can a simple DNA test provide us with useful information?

For example, we all have different nutritional needs. Wouldn’t it be wonderful if someone could analyze your genome and provide you with a personalized supplement program that precisely fits your genetically determined nutritional requirements?

There are companies that offer such personalized supplement programs. Are they providing you with something of value or is their testing bogus? Are their supplements worthless?

Two recent reviews have surveyed the nutrigenomic literature (all published clinical studies) and have concluded that we still don’t know enough to predict the best diets or the best supplements based on genetic information alone. Why is that? It is because:

Human genetics is very complex.
Many common diseases are polygenic (caused by the cumulative effect of many mutations).
The effect of gene mutations on our health and wellbeing is strongly influenced by our diet, lifestyle, and environment.
Epigenetics has an important influence on gene expression.
Our microbiome has an important influence on our health and nutritional status.

For more details and my personal recommendations on how to determine the best diet and supplement program for you, read the article above.

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