Dr. Steve Chaney

Do Older Adults Eat Enough Protein?

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The Impact Of Inadequate Protein Intake On Healthy Aging

Author: Dr. Stephen Chaney

 

Do older adults eat enough protein?

older adults signMost 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?

older adults eat enough protein studyThis 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?

older adults eat enough protein puzzleTo 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

crying iconWhen 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?

  • older adults eat enough protein questionIf 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.”

  • supplement shakeThe 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

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A Simple Treatment To Make Your Eye Pain Disappear

Author: Julie Donnelly, LMT –The Pain Relief Expert

Editor: Dr. Steve Chaney

 

good newsAs 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

 

eye pain reliefThis 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

 

eye pain relief massageThe 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 pain free living bookand 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

julie donnellyJulie 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.

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

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

Author: Dr. Stephen Chaney

 

pregnant women omega 3 deficient fishIt 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?

scientific studyThis 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?

 

omega 3 statusThe 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?

 

pregnant women omega 3 deficient questionsNow 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?

 

danger symbolWhile 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.

pregnant women omega 3 deficient pregnancyHowever, 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.”

omega 3 supplementsThey 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.”

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.

  • 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

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

Author: Dr. Stephen Chaney

 

nutrigenomicsWhen 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?

what is nutrigenomicsAs 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

 

promise of nutrigenomicsNow 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 truth signThe 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.”

thumbs down symbol“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.

nutrigenomics microbiomeHow 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:

  • steve chaneyThink 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?

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?

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.

Personalized Nutrition Tests Help Gain Control Of Your Blood Sugar

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What Is The Truth About Personalized Nutrition Testing?  – Part 1

Author: Dr. Stephen Chaney

 

companies promote personalized nutritional testsPersonalized nutrition testing is all the rage. Should you limit carbs or should you limit fats? Should you avoid sugar? Should you eat more protein or less protein? What supplements should you take?

Companies promise you that their version of personalized nutrition testing will tell you all that and more. Are they being truthful or are their claims false? Are the personalized nutrition tests they offer valuable or are they a waste of money?

In particular, recent headlines have proclaimed that a new personalized testing system can help you do a better job of controlling your blood sugar levels. Is this claim true?

Let me answer that question in 3 steps:

  • First, I will discuss why that kind of test could be valuable and describe how the study was done.
  • Next, I will evaluate the strengths and weaknesses of the study.
  • Finally, I will discuss why personalized nutrition testing is so difficult. I will also give you guidance on how you can gain better control of your blood sugar fluctuations without expensive tests.

 

Why Is Predicting How To Control Blood Sugar Important?

 

gluclose measurementWhy is it important to devise a personalized nutrition test to measure an individual’s blood sugar response to various foods? The answers to this are twofold:

  • The combination of the obesity epidemic and the American diet have created the perfect storm. Millions of Americans have high blood sugar levels. Elevated blood sugar levels are associated with heart disease, diabetes, cancer, inflammatory diseases and much more. This is a public health crisis.
  • Keeping track of carbohydrates in the foods you eat is not a particularly effective way to control your blood sugar levels. This approach is based on average responses, and none of us are average. I have discussed individual variation in blood sugar responses to common foods in a previous issue of “Health Tips From The Professor.”

How Was The Study Done?

coffee and phoneThe study (H Mendes-Soares et al, American Journal of Clinical Nutrition, 110: 63-75, 2019) enrolled 327 participants, primarily from two counties in Minnesota. The characteristics of the participants was as follows:

  • 77% female.
  • Average age 45.
  • 64% overweight and 27% obese which, unfortunately, is average for the American population.
  • HbA1c (a measure of long-term blood glucose control) averaged 5.2, with 8.4% of the population having elevated HbA1c (indicative of chronic high blood sugar levels and consistent with pre-diabetes).

The study lasted one week and was rigorously controlled.

  • The subjects provided a stool sample 2 days prior to the study. The stool sample was used to characterize the populations of gut bacteria (microbiome) for every subject.
  • Prior to the study, the subjects were also asked to fill out a questionnaire asking about their health, lifestyle, activities, and diet preferences. Height, weight, blood pressure, and HbA1c levels were also measured.
  • Subjects were given phone apps to record their food (meal content, duration, and time) and activity (intensity, duration, and time) throughout the week. They were also asked to record medications and sleep.
  • Subjects were outfitted with a glucose monitor that measured blood glucose levels continuously throughout the week. The subjects were also instructed to use a manual blood glucose monitor 4 times a day. This served as a check on the accuracy of the continuous blood glucose monitor.
  • On 4 days the subjects were given a standardized breakfast consisting of a bagel with cream cheese. This allowed estimation of variation in blood sugar response between subjects and day to day variations in blood sugar response for individual subjects.
  • Finally, the subjects were told to maintain their normal eating habits with no significant deviations during the week.

All this information was used to develop a personalized model to predict the blood sugar response of each subject to various foods. However, this was no ordinary model. It was not just using the subject’s genome or microbiome to predict their blood sugar response to foods. The model included:

  • Microbiome: Population of gut bacteria. This information came from the stool test.
  • Meal information: carbohydrate, fat, protein, sugar, fiber, calories, sodium, alcohol, & water. This information came from the food app on their phones that the subjects used to log everything they ate for a week.
  • Meal context: Time of day, total carbohydrate consumed over past 3 hours and 6 hours, total calories consumed over past 2 hours, 3 hours, and 6 hours, total fiber consumed over past 12 hours. This information also came from their food app.
  • HbA1c: A measure of long-term blood sugar control. This was measured at the beginning of the study.
  • Personal information: Physical activity duration and frequency, sleep quality, stress, and hunger levels throughout the day. This information came from their exercise phone app. BMI (a measure of obesity), age, gender, and regularity of defecation. This came from the questionnaire they filled out when they entered the study.
  • Continuous blood sugar responses before, during, and after each meal. This came from the glucose monitor the subjects wore for a week.

I went into detail in describing the modeling approach so you can understand how comprehensive the model was. This in not just some personalized testing protocol where you can just send off a stool sample for microbiome testing, a cheek swab for DNA testing, and/or fill out a diet and lifestyle questionnaire. This is the kind of personalized testing that could only be done in a medical center and would likely cost well over a thousand dollars.

 

Can Personalized Tests Help You Gain Better Control Of Your Blood Sugar?

 

Here are the key findings from the study.

  • thumbs upThe accuracy of this model for predicting the blood sugar response of individual subjects was around 60% compared to around 40% when the investigators just took into consideration the carbohydrate content of the meals.
  • Every component of the model contributed to the accuracy of predicting individual blood glucose response.

These findings led the authors to conclude that their model “…is a promising means for designing effective nutritional interventions to control glycemic [blood sugar] responses to foods.” This conclusion is what generated the headlines you may have seen.

What Are The Weaknesses Of The Study?

thumbs downIn many ways this was a very well-designed study, but it had two major weaknesses.

  • The day to day reproducibility of blood glucose predictions for the standardized bagel and cream cheese meal was only around 66%. That is disappointing for a very expensive test that can only be performed in a medical center.
  • The authors did not calculate the predictive value of glycemic index, which they could have easily done from their data. Since glycemic index is a better predictor of blood sugar response than carbohydrate content, this is a major weakness of the study. One is left wondering if this extensive and expensive test approach is significantly better at predicting blood sugar responses than simply using glycemic index as a predictor.

 

What Is The Truth About Personalized Nutrition Testing?

 

Here are the takeaways from this study:

  • truth signRestricting carbohydrates is not a particularly effective way to control your blood sugar levels. Unless you completely eliminate carbohydrates, your chances of controlling blood sugar levels are only around 40%. And, if you do eliminate carbohydrates, your diet is deficient in nutrients, phytonutrients, fiber, and friendly gut bacteria. In short, it is a very unhealthy diet.
  • If the personalized nutrition testing protocol described in this study were commercially available, you could increase your ability to control blood sugar levels to 60%. That is an improvement, but…
  • You would need to continuously monitor diet, exercise, and blood sugar levels for a week as part of the testing protocol as described above.
  • The test would likely cost thousands of dollars and require that you travel to a major medical center with the capabilities to administer such a program.
  • We don’t know whether this testing protocol is significantly better at predicting your blood sugar response to various foods than simply relying on the glycemic index of those foods.
  • If you significantly changed your diet and/or lifestyle, this program would likely become worthless at predicting your blood sugar response. That is because the predictive ability of this program depends on the interaction of every component of your diet and lifestyle.

In short, this personalized nutrition program requires a lot of effort and expense for a slight increase in your ability to predict which foods cause your blood sugar levels to increase.

 

My Recommendations

If you want to keep your blood sugar under control, here are my recommendations:

  • steve chaneyAvoid “personalized nutrition tests.” The ones that offer any benefit are expensive and time-consuming. The slight advantage they offer is not worth your time and effort.
  • Start by eliminating sodas, sugary junk foods, and highly processed foods from your diet. That includes white flour and other refined grains. This one change will make a bigger improvement in your blood sugar control than anything else you can do.
  • Don’t eliminate whole food groups in an effort to restrict the carbohydrates in your diet. This is particularly true for fruits, legumes, and whole grains. They provide nutrients, phytonutrients, fiber, and support the growth of healthy gut bacteria that are essential for your good health.
  • If you have trouble controlling your blood sugar levels, choose carbohydrate foods with a low glycemic index.
  • Think in terms of meals rather than individual foods. A piece of chocolate cake will have much less effect on your blood sugar level when consumed as part of a meal containing protein, fiber, and healthy fats than when consumed as a snack.
  • We are all different. Learn to listen to your body. This is more important than personalized nutrition testing or anything else I have mentioned. Pay attention to the foods you eat.

If you consistently experience symptoms of hyperglycemia (high blood sugar) shortly after you eat a particular food, and/or symptoms of hypoglycemia (low blood sugar) a short time later, that food is not your friend.

It doesn’t matter that a personalized nutrition test said you could eat it. It doesn’t matter that the food has a low glycemic index. You should minimize that food in your diet.

  • Symptoms of high blood sugar: fatigue, thirst, headache, trouble concentrating, and frequent urination.
  • Symptoms of low blood sugar: hunger, shakiness, anxiety, irritability, feeling lightheaded, and sleepiness.

The Bottom Line

 

A recent study reported that a personalized testing program was 60% accurate in predicting an individual’s blood sugar response to various foods. That was slightly better than the 40% accuracy when the investigators just considered the carbohydrate content of the foods.

However:

  • The day to day reproducibility of blood glucose predictions for a standardized meal was only around 66%. That is disappointing for a very expensive test that can only be performed in a medical center.
  • The authors did not calculate the predictive value of glycemic index, which they could have easily done from their data. Since glycemic index is a better predictor of blood sugar response than carbohydrate content, this is a major weakness of the study. One is left wondering if this extensive and expensive test approach is significantly better at predicting blood sugar responses than simply using glycemic index as a predictor.

For more details and my personal recommendations on how to best control your blood sugar levels, 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.

TMJ Pain Treatment: Your Masseter Muscle 

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Your Masseter Muscle Can Cause TMJ Pain

Author: Julie Donnelly, LMT –The Pain Relief Expert

Editor: Dr. Steve Chaney

 

tmj pain treatment musclesDo you chew gum? Do you habitually clench your teeth? Do you grind your teeth while you’re sleeping? If you do, then this article is especially relevant to you! You’ll want to pay attention to learn about TMJ pain treatment.

Your masseter muscle (circled on graphic) originates on your cheekbone and inserts into your jawbone. When this short but very powerful muscle contracts, it draws your back teeth together so you can chew your food or clench your teeth.

When all is well and the muscle is functioning properly, the muscle lengthens while you put food into your mouth, and then contracts to enable you to chew the food.  However, if you chew gum or clench your teeth, you are shortening the muscle without the balancing stretch of the fibers.  This is a key cause of TMJ disorder, a painful condition that causes jaw pain and causes your jaw to shift to one side when you open your mouth.

[In case you were wondering, TMJ stands for temporomandibular joint. You have one on either side of your jaw connecting your jawbone to your skull. Your TMJs act as sliding hinges, allowing you to open and close your mouth and move your jaw from side to side.]

It’s Not Just a Minor Problem – It Can Be a Very Major Situation

Too often people think this is just a painful, but minor condition.  However, it can become serious, especially if you chew gum or clench your teeth.

tmj painSeveral years ago, a medical doctor asked me to see a young patient who was in his office to get medical clearance before having her masseter muscle severed.  Her jaw was locked tight and the oral surgeon was concerned that if she got sick and regurgitated that she would choke to death.  As a result, he was planning on severing the muscle the following day.

If this happened, the young woman would lose the ability to shut her mouth, and she would be drooling for the rest of her life!  This was a terrible situation!  The doctor felt her masseter muscle and it felt like she had nuts packed in both of her cheeks.  He told her he wouldn’t sign the clearance papers until she saw me to release these tight muscle spasms.

The following treatment took only 15 minutes to accomplish the task of releasing the muscles. I spent most of the time teaching her how to do this self-treatment, and when she was told to open her mouth slowly, she did it. She was so relieved that she burst out crying.  Surgery was prevented and the young woman was able to open and close her mouth easily.

Just 15 minutes of this TMJ pain treatment saved her from spending the rest of her life with her mouth open and drooling.  Amazing!

 

Why the Masseter Muscle Can Cause Arthritis in Your Jaw

 

It’s all about wearing down the bone.  For example, if your masseter on your right side is very tight, each time you open your mouth wide enough to put food into your mouth the muscle won’t release.  As a result, your left jaw is open normally, but your right jaw isn’t. As a result, your jaw gets pulled toward the right, rubbing across the jaw bones.

Eventually, just as water will wear down a rock, your jaw constantly rubbing across the joint will wear down the bone.  This will cause arthritis and other pains.

 

TMJ Pain Treatment for Your Masseter Muscle

 

tmj pain treatment reliefPut your fingers across your masseter muscle as shown in the picture to the left.

If you clench your teeth, you’ll feel the muscle bulge under your fingertips.

To make this easier to understand, we’ll start with your right fingers. Begin treatment by pressing your right fingers deeply on the right side only, just resting your left fingertips on the left masseter muscle. Hold the pressure for 15 seconds and gently release.

Next, press your left fingers deeply into your left masseter muscle and hold for 15 seconds.

Continue going back and forth and when you don’t feel pain anymore, then search the muscle for other painful points (they will feel like small peas) and repeat.  You may, or may not, find multiple spasms; treat each one individually.

Continue doing this until both muscles are pain-free.  Then press deeply into both sides at the same time. Slowly open your mouth as wide as you can – you are now stretching the masseter muscle.

Muscle memory is probably happening with these muscles, so I suggest you do this several times a day until you can’t find any more spasms. At that point, your masseter muscles are released and the TMJ pain treatment has been successful.

 

Final Thought

If you are under a stressful situation, it’s worthwhile to spend a bit of time treating these muscles, even if you aren’t feeling pain.  It’s common for a person under stress to be clenching their teeth, and “an ounce of prevention is worth a pound of cure.”

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 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

julie donnellyJulie 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.

Omega-3 Benefits: Lower High Blood Pressure

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What Does the FDA Say About Omega-3 Benefit Claims?

Author: Dr. Stephen Chaney

 

 

Among omega-3 benefits is lower high blood pressure.  That claim can be made according to the FDA. 

lower high blood pressureHeart Disease is still the number 1 cause of death in this country. And, while deaths from heart disease have been declining in recent years, deaths due to high blood pressure have been increasing.  That is concerning because:

High blood pressure is a killer! It can kill you by causing heart attacks, strokes, congestive heart failure, kidney failure and much more.

High blood pressure is a serial killer. It doesn’t just kill a few people. It kills lots of people. The American Heart Association estimates that high blood pressure directly or indirectly caused 410,000 deaths in 2014. That is almost 1 person every second and represents a 41% increase from 2000. It’s because high blood pressure is not a rare disease.

  • 32% of Americans have high blood pressure, also called hypertension, (defined as a systolic blood pressure of 140 mm Hg or more or a diastolic blood pressure of 90 mm Hg or more).
  • Another 33% of Americans have prehypertension (systolic blood pressure of 120-139 mm Hg or diastolic blood pressure of 80-89 mm Hg).

That’s over 65% of Americans with abnormal blood pressure!

High blood pressure is a silent killer. That’s because it is a very insidious disease that sneaks up on you when you least expect it. Systolic blood pressure increases 0.6 mm Hg/year for most adults over 50. By age 75 or above 76-80% of American adults will have high blood pressure.  Even worse, many people with high blood pressure have no symptoms, so they don’t even know that their blood pressure is elevated. For them the first symptom of high blood pressure is often sudden death.

Blood pressure medications can harm your quality of life. Blood pressure medications save lives. However, like most drugs, blood pressure medications have a plethora of side effects – including weakness, dizziness, fainting, shortness of breath, chest pain, nausea, diarrhea or constipation, heartburn, depression, heart palpitations, and even memory loss. The many side effects associated with blood pressure medications lead to poor compliance, which is probably why only 46% of patients with high blood pressure are adequately controlled.

You do have natural options. By now you are probably wondering whether there are natural approaches for controlling your blood pressure that are both effective and lack side effects. The answer is a resounding YES! I’ll outline a holistic natural approach for keeping your blood pressure under control in a minute but let me start with the FDAs recent approval of what they call “qualified claims” that omega-3s lower blood pressure.

 

What Does the FDA Say About Omega-3 Benefits?

omega-3 benefitsIn my book “Slaying The Supplement Myths” I talk about the “dark side” of the supplement industry. There are far too many companies who try to dupe the public by making outrageous and unsubstantiated claims about their products.

Only the FDA stands between us and those unscrupulous companies, and they take their role very seriously. That is why it is big news whenever the FDA allows companies to make health claims about their products.

Even then, the FDA is very cautious. They allow what they call “qualified” health claims. Basically, that means they are saying there is enough evidence that the health claim is probably true, but not enough evidence to say it is proven.

Of course, if you understand the scientific method, you realize there will always be some studies on both sides of every issue. That is why the only health claims the FDA allows are qualified health claims.

With that background in mind, let’s look at the qualified health claims the FDA allows for omega-3 benefits.

  • Since 2004 the FDA has allowed the qualified claim “Supportive but not conclusive research shows that consumption of EPA and DHA omega-3 fatty acids may reduce the risk of coronary heart disease.”
  • A few weeks ago, they added five qualified health claims about omega-3s and blood pressure. The 5 claims are very similar, so I will only list two below for the sake of brevity.
  • “Consuming EPA and DHA combined may reduce blood pressure and reduce the risk of hypertension, a risk factor for CHD (coronary heart disease).”
  • Consuming EPA and DHA combined may reduce the risk of CHD (coronary heart disease) by lowering blood pressure.
  • Of course, they add the usual wording about the evidence being inconsistent and inconclusive.

 

Omega-3 Benefits?

measure omega-3 benefits levelWe’ve known for some time that omega-3 fatty acids help lower blood pressure, but two recent studies were instrumental in convincing the FDA to allow these qualified health claims. These studies have highlighted just how strong the effect of omega-3s on lowering blood pressure is.

The first study was a meta-analysis of 70 randomized, placebo-controlled clinical trials of long chain omega-3 (EPA + DHA) supplementation and blood pressure (Miller et al, American Journal of Hypertension, 27: 885-896, 2014 ).

This study showed:

  • In the group with normal blood pressure at the beginning of the study EPA + DHA supplementation decreased systolic blood pressure by 1.25 mm Hg.
  • Given that systolic blood pressure rises an average of 0.6 mm Hg/year in adults over 50, the authors estimated that omega-3 supplementation alone would delay the onset of age-related high blood pressure by 2 years.
  • In the group with elevated blood pressure not taking medication at the beginning of the study, EPA + DHA supplementation decreased systolic blood pressure by an impressive 4.51 mm Hg and diastolic blood pressure by 3.05 mm Hg.
  • The authors noted that this decrease in systolic blood pressure could “prevent an individual from requiring medication [with all its side effects] to control their hypertension” or decrease the amount of medication required.

However, the doses of omega-3s used in these studies ranged from 1 to over 4 grams/day (mean dose = 3.8 grams/day). That sparked a second study (Minihane et al, Journal of Nutrition, 146: 516-523, 2016) to see whether lower levels of omega-3s might be equally effective. This study was an 8-week double-blind, placebo-controlled study comparing the effects of 0.7 or 1.8 grams of EPA + DHA per day (versus an 8:2 ratio of palm and soybean oil as a placebo) on blood pressure.

This study showed:

  • In the group with normal blood pressure at the beginning of the study, EPA + DHA supplementation caused no significant decrease in blood pressure. This could be due to the smaller number of subjects or the lower doses of EPA + DHA used in this study.
  • In the group with elevated blood pressure not taking medication at the beginning of the study, EPA + DHA supplementation decreased systolic blood pressure by 5 mm Hg and, the effect was essentially identical at 0.7 grams/day and 1.8 grams/day.
  • The authors concluded “Our data suggest that increased EPA + DHA intakes of only 0.7 grams/day may be an effective strategy for blood pressure control.”

 

A Holistic Approach to Lower High Blood Pressure

holistic approach to lower high blood pressureThe FDA’s allowed claims about omega-3s are good news indeed, but that’s not the only natural approach that lowers blood pressure. You have lots of other arrows in your quiver. For example:

  • The DASH diet (A diet that has lots of fresh fruits and vegetables; includes whole grains, low fat dairy, poultry, fish, beans, nuts and oils; and is low in sugar and red meats) reduces systolic blood pressure by 5-6 mm Hg. [Low fat, low carb and Mediterranean diets also lower blood pressure, but not by as much as the DASH diet].
  • Reducing sodium by about 1,150 mg/day reduces systolic blood pressure by 3-4 mm Hg.
  • Reducing excess weight by 5% reduces systolic blood pressure by 3 points.
  • Doing at least 40 minutes of aerobic exercise 3-4 times/week reduces systolic blood pressure by 2-5 mm Hg.
  • Nitrates, whether derived from fresh fruits and vegetables or from supplements probably also reduce blood pressure, but we don’t yet know by how much.

If you’ve been keeping track, you’ve probably figured out that a holistic lifestyle that included at least 0.7 grams/day of long chain omega-3s (EPA + DHA) plus the other omega-3 benefits in the list above could reduce your systolic blood pressure by a whopping 18-22 mm Hg.  What

That’s significant because, the CDC estimates that reducing high systolic blood pressure by only 12-13 mm Hg could reduce your risk of:

  • Stroke by 37%.
  • Coronary heart disease by 21%.
  • Death from cardiovascular disease by 25%.
  • Death from all causes by 13%.

 

A Word of Caution

While holistic approaches have the potential to keep your blood pressure under control without the side effects of medications, it is important not to blindly rely on holistic approaches alone. There are also genetic and environmental risk factors involved in determining blood pressure. You could be doing everything right and still have high blood pressure. Plus, you need to remember that high blood pressure is a silent killer that often doesn’t have any detectable symptoms prior to that first heart attack or stroke.

My recommendations are:

  • Monitor your blood pressure on a regular basis.
  • If your blood pressure starts to become elevated, consult with your doctor about starting with natural approaches to bring your blood pressure back under control. Doctors are fully aware of the side effects of blood pressure medications, and most doctors are happy to encourage you to try natural approaches first.
  • Continue to monitor blood pressure as directed by your doctor. If natural approaches are insufficient to bring your blood pressure under control, they will prescribe the lowest dose of blood pressure medication possible to get your blood pressure where it needs to be.
  • Don’t stop making holistic lifestyle choices to reduce blood pressure just because you are on medication. The more you do to keep your blood pressure under control with a healthy diet and lifestyle, the less medication your doctor will need to use (That means fewer side effects).

 

The Bottom Line

Heart Disease is still the number 1 cause of death in this country. And, while deaths from heart disease have been declining in recent years, deaths due to high blood pressure have been increasing. That is why anything we can do lower blood pressure naturally is important. What does the FDA say about omega-3s and blood pressure?

  • Since 2004 the FDA has allowed the qualified claim “Supportive but not conclusive research shows that consumption of EPA and DHA omega-3 fatty acids may reduce the risk of coronary heart disease.”
  • A few weeks ago, they added qualified health claims about omega-3s and blood pressure. For example, they now allow the following claims.
  • “Consuming EPA and DHA combined may reduce blood pressure and reduce the risk of hypertension, a risk factor for CHD (coronary heart disease).”
  • Consuming EPA and DHA combined may reduce the risk of CHD (coronary heart disease) by lowering blood pressure.

For more information on the studies that convinced the FDA to allow claims about omega-3s and blood pressure and for a discussion of holistic natural approaches for lowering blood pressure, 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.

Best Diet For Heart Disease Prevention

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Are The American Heart Association’s Recommendations Correct?

Author: Dr. Stephen Chaney

 

What is the best diet for heart disease prevention? 

diet for heart disease preventionHeart disease is a killer. It continues to be the leading cause of death – both worldwide and in industrialized countries like the United States and the European Union. When we look at heart disease trends, it is a good news – bad news situation.

  • The good news is that heart disease deaths are continuing to decline in adults over 70.
  • The decline among senior citizens is attributed to improved treatment of heart disease and more seniors following heart-healthy diets.
  • The bad news is that heart disease deaths are starting to increase in younger adults, something I reported in an earlier issue, Heart Attacks Increasing in Young Women of “Health Tips From the Professor.”
  • The reason for the rise in heart disease deaths in young people is less clear. However, the obesity epidemic, junk and convenience foods, and the popularity of fad diets all likely play a role.

Everyone has a magic diet for reducing heart disease risk. The American Heart Association tells us to avoid fats, especially saturated fats. Vegans tell us to avoid animal protein. Paleo and keto enthusiasts tell us carbs are the problem. Who is correct?

Of course, we don’t eat fats, carbohydrates, or proteins. We eat foods. That is why a recent study (T Meier et al, European Journal of Epidemiology, 34: 37-45, 2019) is so important. It reported which foods increase and which decrease the risk of premature heart disease deaths.

How Was The Study Done?

diet for heart disease prevention studyThe authors of the current study analyzed data from the “Global Burden of Diseases (GBD) Study”, a major world-wide effort designed to estimate the portions of deaths caused by various risk factors.

The current study focused on the impact of 12 dietary risk factors on heart disease deaths between 1990 and 2016 for 51 countries in four regions (Western Europe, Central Europe, Eastern Europe, and Central Asia).

The dietary risk factors were:

  • Diets low in fiber, fruits, vegetables, legumes, nuts and seeds, polyunsaturated fatty acids, omega-3 fatty acids, and whole grains.
  • Diets high in sodium, processed meats, sugar-sweetened beverages, and trans fatty acids.

Saturated fat and meat were not explicitly included in the GBS Study data. However, diets low in polyunsaturated fats and omega-3 fats are likely high in saturated fats. Similarly, diets low in fruits, vegetables, whole grains, and legumes are likely higher in meats. The study also did not include dairy, and some recent studies suggest that some dairy foods may decrease heart disease risk.

For simplicity I will only consider the findings from Western Europe because their diet and heart disease death trends are similar to those in the United States.

 

Best Diet for Heart Disease Prevention?

plant-based diet bestThe study found that in 2016 (the last year for which data were available):

  • Dietary risk factors were responsible for 49.2% of heart disease deaths.
  • 6% of all diet-related heart disease deaths occurred in adults younger than 70, and that percentage has been increasing in recent years.

When they looked at the contribution of individual foods to diet related heart disease deaths, the percentages were:

  • Diets low in whole grains = 20.4%
  • Diets low in nuts and seeds = 16.2%
  • Diets low in fruits = 12.5%
  • Diets high in sodium = 12.0%
  • Diets low in omega-3s = 10.8%
  • strong heartDiets low in vegetables = 9.0%
  • Diets low in legumes = 7.0%
  • Diets low in fiber = 5.7%
  • Diets low in polyunsaturated fats = 3.7%
  • Diets high in processed meats = 1.6%
  • Diets high in trans fatty acids = 0.8%
  • Diets high in sugar-sweetened beverages = 0.1%

So, what is the best diet for heart disease prevention?

In short, this study concluded:

  • A primarily plant-based diet is the best protection against premature death due to heart disease.
  • All plant-based food groups (whole grains, nuts and seeds, fruits, vegetables, and legumes) play an important role in reducing heart disease deaths.
  • Meat was not included in the analysis, but it is likely that most people’s diets in this region of the world contained some meat. The most likely take-away is that meat does not affect heart disease risk in the context of a primarily plant-based diet.
  • Dairy was not included in the analysis either, but some studies suggest dairy, particularly fermented dairy foods, reduce heart disease risk.
  • Finally, the study concluded: “Compared to other…modifiable risk factors (physical inactivity, drug and alcohol abuse, tobacco smoking, obesity, etc.), an altered diet is the most effective means of preventing premature deaths from cardiovascular disease in Western Europe.”

While every study has its weaknesses, this study is consistent with multiple previous studies showing that primarily plant-based diets are best for reducing heart disease risk. You will find a more complete discussion of these studies in my book “Slaying The Food Myths.”

 

Are the American Heart Association’s Recommendations Correct?

With this study’s results in mind we can now ask whether the recommendations of the American Heart Association and other popular diets are correct. Are they likely to reduce heart disease deaths?

  • The American Heart Association Recommends a dietary pattern that emphasizes a variety of fruits and vegetables, whole grains, nuts and legumes, skinless poultry and fish, and low-fat dairy products. This study supports those recommendations.
  • This study also supports the heart-health benefits of the Mediterranean and DASH diets.
  • Meat and dairy were not explicitly considered in this study. Thus, the results of this study are also consistent with vegan and semi-vegetarian diets.
  • However, low carb diets like Paleo and keto eliminate some of the key food groups (whole grains, fruits, and legumes) that appear to be essential for reducing heart disease risk. 40% of the heart-health benefits in this study came from those 3 food groups. Thus, this study does not support claims that those two diets are heart-healthy long term.

 

The Bottom Line

 

Everyone has a magic diet for reducing heart disease risk. The American Heart Association tells us to avoid fats, especially saturated fats. Vegans tell us to avoid animal protein. Paleo and keto enthusiasts tell us carbs are the problem. Who is correct?

A recent study provides some important clues. It looked at dietary patterns associated with reduced risk of premature death from heart disease in Western Europe. The study concluded:

  • A primarily plant-based diet is the best protection against premature death due to heart disease.
  • All plant-based food groups (whole grains, nuts and seeds, fruits, vegetables, and legumes) play an important role in reducing heart disease deaths.
  • Meat did not appear to affect heart disease risk in the context of a primarily plant-based diet.
  • Dairy was not included in the analysis, but some studies suggest dairy, particularly fermented dairy foods, reduce heart disease risk.
  • Finally, the study concluded: “Compared to other…modifiable risk factors (physical inactivity, drug and alcohol abuse, tobacco smoking, obesity, etc.), an altered diet is the most effective means of preventing premature deaths from cardiovascular disease.”

While every study has its weaknesses, this study is consistent with multiple previous studies showing that primarily plant-based diets are best for reducing heart disease risk. You will find a more complete discussion of these studies in my book “Slaying The Food Myths.”

With this study’s results in mind we can now ask whether the recommendations of the American Heart Association and other popular diets are correct. Are they likely to reduce heart disease deaths?

  • The American Heart Association Recommends a dietary pattern that emphasizes a variety of fruits and vegetables, whole grains, nuts and legumes, skinless poultry and fish, and low-fat dairy products. This study supports those recommendations.
  • This study also supports the heart-health benefits of the Mediterranean and DASH diets.
  • Meat and dairy were not explicitly considered in this study. Thus, the results of this study are also consistent with vegan and semi-vegetarian diets.
  • However, low carb diets like Paleo and keto eliminate some of the key food groups (whole grains, fruits, and legumes) that appear to be essential for reducing heart disease risk. 40% of the heart-health benefits in this study came from those 3 food groups. Thus, this study does not support claims that those two diets are heart-healthy long term.

For more details read the article above.

 

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

Are Attention-Deficit/Hyperactivity Disorder Symptoms Affected By Diet?

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What Can You Do To Reduce ADHD Symptoms In Your Child?

Author: Dr. Stephen Chaney

 

attention deficit hyperactivity disorderAttention-Deficit/Hyperactivity Disorder rates for American children are skyrocketing. One study reported that the percentage of children diagnosed with ADHD has increased by 43% between 2003 and 2011. Another study reported an increase of 67% between 1997 and 2015. Currently, 10-12% of American schoolchildren are diagnosed with ADHD. That amounts to around 6 million children with Attention-Deficit/Hyperactivity Disorder.

The reason for the rapid increase in ADHD symptoms is controversial.

  • Some experts claim the increase simply reflects more accurate diagnostic protocols.
  • Others say the increase is driven by aggressive marketing of ADHD drugs by pharmaceutical companies.
  • Others feel the cause is environmental, with the worsening American diet and increased exposure to toxins in everyday consumer products being named as the most likely culprits.

Attention-Deficit/Hyperactivity Disorder Side Effects

 

62% of children diagnosed with Attention-Deficit/Hyperactivity Disorder are taking ADHD medications. These medicines reduce, but do not eliminate, ADHD symptoms. But the improvements come at a high price. Side effects include:

  • Sleeping problems.
  • Reduced taste perception.
  • Loss of appetite.
  • Anxiety, moodiness, and irritability.
  • Headaches and stomachaches.

Because of the side effects of ADHD medicines, parents often look for more natural solutions. Many of them report that improving their child’s diet reduces their child’s ADHD symptoms as well or better than ADHD medications. Are their opinions accurate, or do the child’s ADHD symptoms improve just because their parents are paying more attention to them?

The latest headlines proclaim that improving a child’s diet does not reduce their ADHD symptoms. Are those headlines correct, or do parents know something that the scientists missed?

To answer those questions, we should start by looking at the study (https://doi.org/10.1093/jn/nxy273) behind the headlines.

 

How Was The Study Done?

 

attention deficit hyperactivity disorder studyThe authors of this study analyzed data from 3680 children who were involved in the Generation R Study in Rotterdam, Netherlands. This study measured the association between Attention-Deficit/Hyperactivity Disorder symptoms and diet quality.

However, this was not a simple association study. It was something called a prospective cohort study. That means rather than measuring the association at a single time like most studies, this study measured ADHD symptoms at age 6 and 10 and diet quality at age 8.

Attention-Deficit/Hyperactivity Disorder symptoms were assessed by using parent-reported questionnaires. Dietary intake was assessed by using a validated food frequency questionnaire filled out by the parents. Diet quality was based on comparing a child’s dietary intake to the Dutch dietary recommendations for children (Which are not significantly different from the US dietary recommendations).

 

Are Attention-Deficit/Hyperactivity Disorder Symptoms Affected By Diet?

 

The results of the study were confusing:

  • ADHD symptoms at age 6 were associated with poorer diet quality at age 8.
  • However, there was no association between diet quality at age 8 and ADHD symptoms at age 10.

The author’s conclusions, which generated the headlines you may have seen, were even more confusing.

Based on the first finding (Attention-Deficit/Hyperactivity Disorder symptoms at age 6 associated with poorer diet quality at age 8), they concluded “…children with more ADHD symptoms may be at a higher risk of an unhealthy diet.” They hypothesized:

  • ADHD symptoms may cause “…impulsive eating of highly palatable foods or no patience to eat vegetables…”
  • “…parents try to soothe difficult behavior of their children by offering meals, snacks, and beverages children prefer instead of healthy choices.”

Based on the second finding (diet quality at age 8 having no relationship with ADHD symptoms at age 10), they concluded “…overall diet quality does not affect ADHD risk.”

In short, they concluded that Attention-Deficit/Hyperactivity Disorder caused poor diets, but poor diets did not cause ADHD.

 

Are The Conclusions Of This Study Accurate?

attention deficit hyperactivity disorder thumbs downThe authors identified several important limitations of their study. For example, they acknowledged:

  • They relied on parent reporting of both ADHD symptoms and dietary intake.
    • Parents may have found it difficult to assess ADHD behavior in their children.
    • Parents may not have known what their children consumed at school or during after-school care.
  • Both dietary intake and ADHD symptoms may change over time.
    • ADHD symptoms are different at age 6 and 10, so two different ADHD assessment questionnaires were used.
    • Parents have less control (and knowledge) of their child’s diet at age 10 than at age 8. The dietary assessment at age 8 might not have been valid for the children two years later.

However, to me the two biggest weakness of the study were:

  • All the children in the study had ADHD symptoms at both ages 6 and 10. These were the same children! That makes the fact that ADHD symptoms correlated with diet quality at age 6, but not at age 10 highly suspect.
  • ADHD symptoms and diet quality were measured at different times. This is a bizarre experimental design. The study would have been much stronger if the authors had measured both diet quality and ADHD symptoms at each age.

In short, this study is fatally flawed. The conclusions of the study are inaccurate. You should ignore the headlines.

 

What Can You Do To Reduce Attention-Deficit/Hyperactivity Disorder Symptoms In Your Child?

 

attention deficit hyperactivity disorder questionThe recent study does illustrate the difficulty in proving diet-ADHD interactions. The truth is ADHD is a complex condition. It is affected by genetics, environment, family interactions, and food. This is best illustrated by a review written by two pediatricians specializing in ADHD that I featured in ADHD Diet vs Medication of “Health Tips From The Professor.”

The authors of the review described multiple nutritional approaches that reduce ADHD symptoms. The catch was each nutritional intervention only worked for some children. Parents needed to be willing to find what works best for their child by trial and error. Let me give some examples.

  • Eliminating Food Additives: The idea that food additives cause ADHD symptoms originated with the Feingold diet which was popularized in the 1970s. The Feingold diet eliminated food additives, foods with salicylates (luncheon meats, sausage, hot dogs), drinks containing artificial colors and flavors, and chemical preservatives (e.g. BHA and BHT). After clinical studies showed that only 6% percentage of children benefitted from this diet, it fell out of favor.

However, the experts who pooh-poohed the diet missed a key point. Yes, 6% is a very small percentage of the general population. However, if you are one of those parents whose child is in the 6%, this approach works wonders. A recent study showed that when children with suspected sensitivity to food additives were challenged with food colors, 65-89% of them displayed ADHD sensitivities.

My recommendation: Food additives are not one of the five essential food groups. There is no reason not to eliminate food additives from your child’s diet, and it might make a world of difference for their ADHD symptoms.

  • Adding Omega-3 Fatty Acids: The authors of the review reported that several studies have shown children with ADHD tend to have low levels of omega-3 fatty acids. They also cited several studies which showed significant improvement in reading skills and reductions in ADHD symptoms when children with ADHD were give omega-3 supplements. It was usually the children with the lowest omega-3 status who showed the biggest improvement in ADHD symptoms.

attention deficit hyperactivity disorder symptomsThe pediatricians who wrote the review routinely use doses of 300-600 mg of omega-3s with their ADHD patients. They find that this intervention reduces ADHD symptoms in many children but does not completely eliminate the need for medications.

My recommendation: Whether adding omega-3s will help your child is anyone’s guess. However, it is a natural approach with no side effects. It is definitely worth trying.

  • Adding Iron and Zinc: Some studies have suggested that iron and zinc deficiencies may be associated with ADHD symptoms.

My recommendation: A good children’s multivitamin should be sufficient to eliminate these deficiencies.

  • Eliminating Sugar: This recommendation is controversial, but the authors of the review said it helps some of the children they treat reduce their ADHD symptoms.

My recommendation: Reducing intake of refined sugars in your child’s diet makes sense for many reasons, especially considering the role of sugar intake in obesity. If it also reduces ADHD symptoms, that is an added benefit.

  • Eating A Healthy Diet: Several studies have shown that children eating “Healthy” diets (fish, chicken, vegetables, fresh fruit, whole grains & low fat dairy products) have fewer ADHD symptoms than children eating “Western” diets (Fast foods, red meat, processed meats, processed snacks, high fat dairy products & soft drinks).

My recommendation: Again, this is an approach that makes sense for many reasons. If you and your family were to follow a “Healthy” diet instead of a “Western” diet, it would likely have numerous health benefits. Plus, you would automatically remove ADHD triggers such as food additives and sugar from your child’s diet.

  • Eliminating Food Sensitivities: If you have tried everything and your child’s ADHD symptoms are as bad as ever, your child may have a sensitivity to a perfectly healthy food. Even natural foods can be a problem for children with food sensitivities, and it appears that there may be a large percentage of hyperactive children with food sensitivities. The authors of the review reported that elimination diets (diets that eliminate all foods which could cause food sensitivity) improve behavior in 76-82% of hyperactive children.

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

My recommendation: I view this as something to be tried after all other natural approaches have failed. However, if there is a particular food that causes hyperactivity in your child, identifying it and eliminating it from their diet could be something that would benefit them for the rest of their life.

 

The Bottom Line

 

You may have seen recent headlines suggesting that healthy diets do not reduce ADHD symptoms. In fact, the study behind the headlines concluded that ADHD may cause poor diets, but poor diets do not cause ADHD.

My mission in writing “Health Tips From the Professor” is to analyze the studies behind the headlines and tell you whether you can believe the headlines or not.

In this case my analysis is clear-cut.

  • The study is fatally flawed.
  • Its conclusions are inaccurate.
  • You can forget the headlines.

However, the study does illustrate the difficulty in proving diet-ADHD interactions. The truth is ADHD is a complex condition. It is affected by genetics, environment, family interactions, and food.

There are multiple nutritional approaches that reduce ADHD symptoms. The catch is each nutritional intervention only works for some children. Parents need to be willing to find what works best for their child by trial and error. Here are some of the nutritional approaches that have merit:

  • Eliminate food additives.
  • Add omega-3s.
  • Add a children’s multivitamin.
  • Eliminate added sugars.
  • Eat a healthy diet.
  • Eliminate food sensitivities.

For more details read the article above.

 

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

Do Ultra-Processed Foods Make You Fat?

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What Is The Secret For Weight Loss?

Author: Dr. Stephen Chaney

 

Do ultra-processed foods make it harder to loose weight?

ultra-processed foods questionsIt is so confusing. It seems like everyone has a magical weight loss diet. You just follow their diet and the pounds will melt away. The problem is that everyone’s recommendations are different. What is the average consumer to think? Is the best diet low fat, low carb, low sugar, Paleo, Keto, or vegan? Or is intermittent fasting the secret to successful weight loss?

What if the secret to weight loss was none of the diets mentioned above, yet was something common to all of them?

The one common feature of every popular diet is they cut out sodas and processed foods and replace them with whole unprocessed foods. What if cutting out highly processed foods was the secret to successful weight loss, and none of the other restrictions of the various diets really mattered?

There are lots of studies suggesting that ultra-processed foods might be the problem. [Note: In the scientific community the term highly processed foods has been replaced with ultra-processed foods. There are subtle differences between the two terms, but for our purposes we will consider them identical]. Consumption of ultra-processed foods has been shown to be associated with overeating, obesity, poor health outcomes, and premature death.

For example, consumption of ultra-processed foods and obesity have increased in parallel. Today ultra-processed foods constitute the majority of calories consumed in America, and 40% of Americans are now obese.

However, associations don’t prove cause and effect. In the words of the authors of the latest study: “There has never been a randomized controlled trial demonstrating any beneficial effects of reducing ultra-processed foods or deleterious effects of increasing ultra-processed foods in the diet.”

The latest study (KD Hall et al, Cell Metabolism, 30: 1-11, 2019 ) was the first randomized controlled trial designed to test the hypothesis that consumption of ultra-processed foods leads to obesity.

 

How Was The Study Done?

ultra-processed foods studyTwenty overweight subjects (10 men and 10 women) volunteered for the study. Their average age was 31 and their average BMI was 27, which means they were overweight, but not obese. All were weight-stable in the months preceding the study.

They were admitted to the metabolic ward at the NIH where every aspect of what they ate and the exercise they got was controlled. The subjects were randomly assigned to consume an ultra-processed or an unprocessed diet for two weeks followed by the alternative diet for the final two weeks.

During the study the subjects were given three meals a day that provided twice the calories they were accustomed to eating plus unlimited snacks. They were instructed to eat as much or as little as they desired. The calories consumed were calculated based on how much food they left on their plates.

The ultra-processed diet and unprocessed diets were matched with respect to:

  • Total calories in the food portions given to the subjects.
  • Caloric density (calories per serving size).
  • Macronutrients (carbohydrate, fat, & protein).
  • Sugars, fiber, and sodium.

The ultra-processed and unprocessed diets were neither low fat, low carb, or high protein. The caloric composition was around 48% carbohydrate, 35% fat, and 17% protein.

However, because of the differences between ultra-processed and unprocessed foods, it was impossible to match all parameters. For example, the ultra-processed and unprocessed diets differed significantly in:

  • Added sugar: 54% of the sugar in the ultra-processed diet was added sugar versus only 1% added sugar in the unprocessed diet.
  • Insoluble fiber: 16% of the fiber in the ultra-processed diet was insoluble fiber versus 77% in the unprocessed diet.
  • Saturated fat: 34% of the fat in the ultra-processed diet was saturated versus 19% in the unprocessed diet.
  • Omega-6 to omega-3 ratio: The ratio was 11:1 in the ultra-processed diet versus 5:1 in the unprocessed diet.

To give you an example of what the two diets looked like, dinner one night for the unprocessed diet group consisted of beef tender roast with barley and spinach and a parfait made of fresh berries and nonfat, unflavored Greek yogurt while the ultra-processed diet group got processed turkey and cheese sandwiches (on white bread) with baked chips, canned peaches and nonfat vanilla Greek yogurt. For breakfast one morning the unprocessed diet group got omelets made from fresh eggs while the ultra-processed diet group got omelets made from Fresh Start liquid.

 

Do Ultra-Processed Foods Make You Fat?

ultra-processed foods make you fatThe results of the study were quite interesting:

  • Subjects ate an additional 508 calories per day when on the ultra-processed diet.
  • Those extra calories came from both carbohydrate and fat, not from protein.
  • Subjects gained 2 pounds in just two weeks on the ultra-processed diet and lost 2 pounds in two weeks on the unprocessed diet.
  • Subjects ate their food more quickly on the ultra-processed diet (50 calories/minute) than on the unprocessed diet (32 calories/minute).

The authors of the study asked the participants several subjective questions about the two diets to better understand why they consumed more calories on the ultra-processed diet. However, those questions did not provide any useful insights. For example, the subjects rated the two diets equally with respect to:

  • Palatability and familiarity of the foods in the diet.
  • Hunger prior to eating and both fullness and satisfaction when they were finished eating.

These findings surprised the authors. The authors had assumed their subjects would eat more ultra-processed foods because they liked them better.

With respect to the overall study results, the authors concluded: “Limiting consumption of ultra-processed foods may be an effective strategy for obesity prevention and treatment.”

In short, their study confirms what many experts have long suspected, but does not provide a mechanistic explanation of why ultra-processed foods lead to overconsumption and obesity.

 

What Is The Secret For Weight Loss?

 

ultra-processed foods secretThe arguments over which diet is best for weight loss never end. Everyone claims they have the secret, and everyone quotes studies showing their diet works.

Yet the diets are as different as night and day. They shouldn’t all work, but they do. For example, weight loss is virtually identical on a very low-fat vegan diet and a very low carb keto diet. That tells us that the secret can’t be either low-fat or low carb.

The secret must be something all these diets have in common. When you ask what they have in common, the answer is simple. All the popular diets start by eliminating sodas and ultra-processed foods and replacing them with unprocessed foods.

Could it be that something as simple as eliminating sodas and ultra-processed foods and replacing them with unprocessed foods is the secret to successful weight loss? Many experts have hypothesized that ultra-processed foods were the cause of the obesity epidemic, but this is the first randomized controlled clinical trial to prove that hypothesis.

Like any individual study, this study needs to be confirmed by additional randomized controlled studies. One might hope for longer duration studies with more subjects, but it would be very difficult to duplicate the precision of this study. Asking volunteers to enter a metabolic ward where every aspect of their life is controlled for multiple weeks is both expensive and a huge commitment by the volunteers.

My recommendation is simple. You don’t have to choose radical diets that eliminate whole food groups to lose weight successfully. They are hard to follow and may not be healthy long-term. Just ditch the sodas, junk foods, and highly processed foods. Rediscover the pleasures of whole unprocessed foods. You will lose weight gradually and safely. You will be healthier.

Of course, it is not quite that simple.

  • Portion control is essential. You can eat too much unprocessed food.
  • Caloric density (calories per serving) is important. This is one reason why primarily plant-based diets are generally more successful for long-term weight control.
  • Practice mindful eating. Savor your food and eat it slowly. You will be less likely to overeat.
  • And, of course, don’t neglect the exercise component.

For a more detailed analysis of the pros and cons of popular diets, read my book, “Slaying The Food Myths.”

 

The Bottom Line

 

It seems like everyone has a magical weight loss diet. You just follow their diet and the pounds will melt away. The problem is that everyone’s recommendations are different. What is the average consumer to think? Is the best diet low fat, low carb, low sugar, Paleo, Keto, or vegan? Or is intermittent fasting the secret to successful weight loss?

What if the secret to weight loss was none of the diets mentioned above, yet was something common to all of them? The one common feature of every popular diet is they cut out sodas and processed foods and replace them with whole unprocessed foods.

For years experts have claimed that the consumption of highly processed foods is responsible for the obesity epidemic and replacing  ultra-processed foods with unprocessed foods was the secret to successful weight loss. However, those claims are based on associations, and association studies do not prove cause and effect.

Finally, the first randomized controlled trial to test this hypothesis has been published. The study showed:

  • Subjects ate an additional 508 calories per day when on the ultra-processed diet.
  • Subjects gained 2 pounds in just two weeks on the ultra-processed diet and lost 2 pounds in two weeks on the unprocessed diet.

My recommendation is simple. Just ditch the sodas, junk foods, and highly processed foods. Rediscover the pleasures of whole unprocessed foods. You will lose weight gradually and safely. You will be healthier.

Of course, it’s not quite that simple. I discuss other aspects of successful weight loss in the article above.

For a more detailed analysis of the pros and cons of popular diets, read my book, “Slaying The Food Myths.”

For more details read the article above.

 

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

Health Tips From The Professor