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

Can You Believe Clinical Studies

February 19, 2019 by Dr. Steve Chaney

The “Secret” About Clinical Studies Nobody Is Telling You

Author: Dr. Stephen Chaney

It is so confusing. You get lots of advice in today’s world.

Your friend shares a new diet they read about and tells you how well it worked for her.
Your trainer puts you on a diet his sports guru recommended.
You read Dr. Strangelove’s health blog and decide you need to throw out all the foods in your refrigerator.
Your doctor tells you what you should eat and whether you should take supplements.
You decide to follow the recommendations of the American Heart Association or American Diabetes Association because they are the experts.

The problem is you are told all this advice is based on clinical studies – AND – most of the advice is conflicting. You don’t know who to believe, and, even worse, you are starting to wonder whether you can believe clinical studies.

I have covered the source of much of this confusion in my two books “Slaying The Food Myths” and “Slaying The Supplement Myths.” The Cliff Notes summary from these books is:

The placebo effect approaches 50% for things like feeling good, energy and mood.
Reputable scientists ignore testimonials and look for clinical proof.
What works for your friend or trainer may not work for you.
Any extreme diet that eliminates foods and food groups from your diet will cause short-term weight loss and improvements in health parameters like cholesterol, blood sugar, and blood pressure.
Reputable scientists look for studies documenting the long-term health outcomes of those diets. Some diets that look healthy short-term are unhealthy long-term.
Advocates of these fad diets emphasize short-term successes of their favorite diet and don’t even look for studies on long-term health outcomes.

Every clinical study has its flaws.

Reputable scientists recognize this and don’t base their recommendations on individual studies. Instead, they base their recommendation on the preponderance of evidence from multiple studies.
Strangelove and other bloggers don’t understand that. They select studies that support their viewpoint and ignore the rest.
Some clinical studies are better than others. In fact, some really bad clinical studies get published.
Reputable scientists know how to distinguish between good studies and bad studies. They ignore bad studies and base their recommendations on good studies.
Strangelove, other bloggers, and the news media aren’t scientists. They don’t know how to distinguish between good and bad studies. They simply report the studies that support their viewpoint.
Strangelove, other bloggers, and the new media prefer audience over accuracy. They measure success by the number of readers rather than the accuracy of their articles.
“Man bites dog” stories gather the most readers. Dr. Strangelove and the media focus on studies that challenge the advice you have been getting from the health and nutrition establishment. The studies may not be accurate, but they attract a lot of readers.
Responsible scientists will give you the boring truth, even if it doesn’t attract many readers.

In my books I help you navigate through the world of conflicting clinical studies, so you can base your decisions on the very best clinical studies. However, there is one more “secret” you need to know. It is one that every scientist knows, but the public almost never hears about.

However, before I tell you the secret, let me set up this discussion by talking about glycemic index and use one food, the lowly banana, as an example.

Glycemic Index – How Sweet It Is

If you are a diabetic or are following one of the many low-carb diets, you probably know all about glycemic index. You probably have a glycemic index list in your kitchen or on your phone. You probably consult that list often to determine which foods you can eat and which you can’t. (If you aren’t familiar with the term, it is simply a measure of how big a blood sugar increase each food causes).

What if I were to tell you the glycemic index list you are relying on may not apply to you?

Then there is the lowly banana. You have probably heard from your trainer or favorite nutrition blog that you should avoid bananas because they are too high in sugar. However, if you were to consult a nutrition expert, they would tell you that bananas are a great choice. Bananas are nutrient powerhouses. In addition, a ripe banana has a glycemic index of 51 and anything under 55 is considered low-glycemic.

What if I were to tell you that the advice about bananas that both your trainer and nutrition experts give you is correct for some people? You just need to find out which advice applies to you.

The Secret About Clinical Studies Nobody Is Telling You

Now, you are ready to learn the secret. It is this: Clinical studies are based on averages, and none of us are average. Because of that, even the very best clinical study results may not apply to you.

In a way, this reminds me of “The Wizard Of Oz.” You remember the story. If you were sitting in front of the curtain, the wizard was impressive. He was all powerful. He was making learned pronouncements about the way things should be. But, behind the curtain, the reality was quite different.

The authors of most clinical studies and most nutrition gurus make learned pronouncements about the life changes you should make based on the results of their study. They seldom let you peak behind the curtain to see how much the results vary from one individual to the next.

One exception is a recent study that reported individual variation in blood sugar responses to various foods. There are lots of examples from that study I could share with you, but I will use bananas versus sugar cookies as an example.

When they reported average values, bananas had a glycemic index of 51 and sugar cookies had a glycemic index of around 59. Both of those values are very close to what you find in most glycemic index lists.

The glycemic index of a banana is only 13% less than the glycemic index of sugar cookies. However, since the cut-off between high and low glycemic indices is 55, bananas are classified as low-glycemic and sugar cookies are classified as high-glycemic. According to conventional wisdom, bananas are good for you and sugar cookies are bad for you. But, what about individual variation? Does that wisdom really apply to you?

Based on the range of blood-sugar responses reported in the paper, I have created the scatter plot on the left to help you visualize the range of individual responses. The horizontal line represents the average glycemic index for sugar cookies and bananas. The dots represent the glycemic response of individuals in the study. For some people in the study the glycemic response to bananas was greater than the average glycemic response to sugar cookies. For other individuals the glycemic response to sugar cookies was less than the average glycemic response to bananas.

You can see the extent of individual variability even more clearly in the figure on the right, which was reproduced from one of the figures in the paper. The authors reported that for some individuals, bananas caused no increase in blood sugar while sugar cookies caused a big spike in blood sugar (the response most people would expect). However, for other individuals, sugar cookies caused no increase in blood sugar while bananas caused a big spike in blood sugar.

Now you understand why I told you the glycemic list you are relying on may not apply to you. You also understand why I said the advice you have been given about bananas might not apply to you.

Lest you think this just applies to bananas, the same study reported that individual blood sugar responses varied by:

4-fold for sugar-sweetened soft drinks, grapes, and apples.
5-fold for rice.
6-fold for bread and potatoes.
7-fold for ice cream and dates.

Can You Believe Clinical Studies?

I used glycemic index as an example. The same principle is true for almost any clinical study.

Let’s consider clinical studies looking at the effect of diet on health outcomes such as heart disease.

The headlines may say that a particular diet significantly decreases your risk of heart disease.
When you read the paper behind the headlines, you discover that the diet decreases heart disease by 15%. That result may be statistically significant, but it is hardly life changing.
If you could peak behind the curtain you might discover that the diet cut heart disease risk in half for some individuals and had no effect on heart disease risk for others.

Clinical studies looking at weight loss are another example.

You might be told “Clinical studies show people who follow diet X lose 12 pounds in 6 weeks”.
That’s an average value. If you could peak behind the curtain, you would discover that nobody lost exactly 12 pounds. Some lost more. Some lost less. Some may have actually gained weight.

I am not saying that well-designed clinical studies are useless. They are a good foundation for general nutrition guidelines. What I am saying is that not every nutritional guideline applies to you.

What Does This Study Mean For You?

Some of you may be saying: “What does this mean for me?” When you carry the concept of individual variability through to its ultimate conclusion, the bottom line message is:

Conclusions from clinical trial results are based on averages – none of us are average.
Daily Values (DV) are based on averages – none of us are average.
Nutritional recommendations for optimal health are based on averages – none of us are average.
The identiﬁed risk factors for developing diseases are based on averages – none of us are average.
Glycemic index lists are based on averages. None of us are average.

That means lots of the advice you may be getting about your risk of developing disease X, the best diet to prevent disease X, the best foods to keep your blood sugar under control, or the role of supplementation in preventing disease X may be generally true – but it might not be true for you.

So, my advice is not to blindly accept the advice of others about what is right for your body. Just because some health guru recommends it, doesn’t mean it is right for you. Just because it worked for your buddy, doesn’t mean it will work for you. Learn to listen to your body. Learn what foods work best for you. Learn what exercises just feel right for you. Learn what supplementation does for you.

Don’t ignore your doctor’s recommendations, but don’t be afraid to take on some of the responsibility for your own health. You are a unique individual, and nobody else knows what it is like to be you.

Final Thought: Glycemic Index Versus Glycemic Load

Since I used glycemic index as an example in this discussion, I feel obligated to discuss the difference between glycemic index and glycemic load. Glycemic index is based on the blood sugar response to 50 gm of carbohydrate in various foods. Glycemic load is based on the blood sugar response to a serving of that food. In some cases, that’s a big difference.

Glycemic index can sometimes be deceiving. Let me give you two examples. Carrots and watermelon are often found on lists of high glycemic foods. If that sounds a bit weird to you, it is.

One serving (one medium carrot) of carrots has 6 grams of carbohydrate (of which, only 2.9 grams is sugar). To get 50 grams of carbohydrate, you would need to eat 8 carrots. Watermelon is, not surprisingly, mostly water. One serving (a 1-inch thick sliced wedge or one cup) of watermelon contains 11 grams of carbohydrate (of which, 9 grams of sugar). To get 50 grams of sugar, you would need to eat 4.5 cups of watermelon. For both carrots and watermelon, their glycemic load is a more accurate measure of their effect on your blood sugar than is their glycemic index.

Leaving individual variation out of consideration, here is a simple guide for choosing low-glycemic foods if you are trying to control your blood sugar levels.

Foods with a low glycemic index are generally a good choice.
Many foods with a high glycemic index also have a high glycemic load.
If you are uncertain about some foods on the high glycemic index list, also check their glycemic load.

The Bottom Line

Clinical studies are the bedrock on which we build recommendations for diet, exercise, and supplementation. In the article above I discuss how to distinguish between good and bad clinical studies. I also discuss how individual variability influences the interpretation of clinical studies.

For more details read the article above.

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

Does Magnesium Optimize Vitamin D Levels?

February 12, 2019 by Dr. Steve Chaney

The Case For Holistic Supplementation

Author: Dr. Stephen Chaney

Does magnesium optimize vitamin D levels?

One of the great mysteries about vitamin D is the lack of correlation between vitamin D intake and blood levels of its active metabolite, 25-hydroxyvitamin D. Many people who consume RDA levels of vitamin D from foods and/or supplements end up with low blood levels of 25-hydroxyvitamin D. The reason(s) for this discrepancy between intake of vitamin D and blood levels of its active metabolite are not currently understood.

Another great mystery is why it has been so difficult to demonstrate benefits of vitamin D supplementation. Association studies show a strong correlation between optimal 25-hydroxyvitamin D levels and reduced risk of heart disease, cancer, and other diseases. However, placebo-controlled clinical trials of vitamin D supplementation have often come up empty. Until recently, many of those studies did not measure 25-hydroxyvitamin D levels. Could it be that optimal levels of 25-hydroxyvitamin D were not achieved?

The authors of the current study hypothesized that optimal magnesium status might be required for vitamin D conversion to its active form. You are probably wondering why magnesium would influence vitamin D metabolism. I had the same question.

The authors pointed out that:

Magnesium status affects the activities of enzymes involved in both the synthesis and degradation of 25-hydroxyvitamin D.
Some clinical studies have suggested that magnesium intake interacts with vitamin D intake in affecting health outcomes.
If the author’s hypothesis is correct, it is a concern because magnesium deficiency is prevalent in this country. In their “Fact Sheet For Health Professionals,” the NIH states that “…a majority of Americans of all ages ingest less magnesium from food than their respective EARs [Estimated Average Requirement]; adult men aged 71 years and older and adolescent females are most likely to have low intakes.” Other sources have indicated that magnesium deficiency may approach 70-80% for adults over 70.

If the author’s hypothesis that magnesium is required for vitamin D activation is correct and most Americans are deficient in magnesium, this raises some troubling questions.

Most vitamin D supplements do not contain magnesium. If people aren’t getting supplemental magnesium from another source, they may not be optimally utilizing the vitamin D in the supplements.
Most clinical studies involving vitamin D do not also include magnesium. If most of the study participants are deficient in magnesium, it might explain why it has been so difficult to show benefits from vitamin D supplementation.

Thus the authors devised a study (Q Dai et al, American Journal of Clinical Nutrition, 108: 1249-1258, 2018 ) to directly test their hypothesis.

How Was The Study Designed?

The authors recruited 180 volunteers, aged 40-85, from an ongoing study on the prevention of colon cancer being conducted at Vanderbilt University. The duration of the study was 12 weeks. Blood was drawn at the beginning of the study to measure baseline 25-hydroxyvitamin D levels. Three additional blood draws to determine 25-hydroxyvitamin D levels were performed at weeks 1, 6, and 12.

Because high blood calcium levels increase excretion of magnesium, the authors individualized magnesium intake based on “optimizing” the calcium to magnesium ratio in the diet rather than giving everyone the same amount of magnesium. The dietary calcium to magnesium ratio for most Americans is 2.6 to 1 or higher. Based on their previous work, they considered an “ideal” calcium to magnesium ratio to be 2.3 to 1. The mean daily dose of magnesium supplementation in this study was 205 mg, with a range from 77 to 390 mg to achieve the “ideal” calcium to magnesium ratio. The placebo was an identical gel capsule containing microcrystalline cellulose.

Two 24-hour dietary recalls were conducted at baseline to determine baseline dietary intake of calcium and magnesium. Four additional 24-hour dietary recalls were performed during the 12-week study to assure that calcium intake was unchanged and the calcium to magnesium ratio of 2.3 to 1 was achieved.

In short this was a small study, but it was very well designed to test the author’s hypothesis.

Does Magnesium Optimize Vitamin D Levels?

This was a very complex study, so I am simplifying it for this discussion. For full details, I refer you to the journal article (Q Dai et al, American Journal of Clinical Nutrition, 108: 1249-1258, 2018).

The most significant finding was that magnesium supplementation did affect blood levels of 25-hydroxyvitamin D. However, the effect of magnesium supplementation varied depending on the baseline 25-hydroxyvitamin D level at the beginning of the study.

When the baseline 25-hydroxyvitamin D was 20 ng/ml or less (which the NIH considers inadequate), magnesium supplementation had no effect on 25-hydroxyvitamin D levels.
When the baseline 25-hydroxyvitamin D was 20-30 ng/ml (which the NIH considers the lower end of the adequate range), magnesium supplementation increased 25-hydroxyvitamin D levels.
When the baseline 25-hydroxyvitamin D level approached 50 ng/ml (which the NIH says may be “associated with adverse effects”), magnesium supplementation lowered 25-hydroxyvitamin D levels.

The simplest interpretation of these results is:

When vitamin D intake is inadequate, magnesium cannot magically create 25-hydroxyvitamin D from thin air.
When vitamin D intake is adequate, magnesium can enhance the conversion of vitamin D to 25-hydroxyvitamin D.
When vitamin D intake is too high, magnesium can help protect you by lowering 25-hydroxyvitamin D levels.

The authors concluded: “Our findings suggest that optimal magnesium status may be important for optimizing 25-hydroxyvitamin D status. Further dosing studies are warranted…”

What Does This Study Mean For You?

This was a groundbreaking study that has provided novel and interesting results.

It provides the first evidence that optimal magnesium status may be required for optimizing the conversion of vitamin D to 25-hydroxyvitamin D.
It suggests that optimal magnesium status can help normalize 25-hydroxyvitamin D levels by increasing low levels and decreasing high levels.

However, this was a small study and, like any groundbreaking study, has significant limitations. For a complete discussion of the limitations and strengths of this study I refer you to the editorial (S Lin and Q Liu, American Journal of Clinical Nutrition, 108: 1159-1161, 2018) that accompanied the study.

In summary, this study needs to be replicated by larger clinical studies with a more diverse study population. In order to provide meaningful results, those studies would need to carefully control and monitor calcium, magnesium, and vitamin D intake. There is also a need for mechanistic studies to better understand how magnesium can both increase low 25-hydroxyvitamin D levels and decrease high 25-hydroxyvitamin D levels.

However, assuming the conclusions of this study to be true, it has some interesting implications:

If you are taking a vitamin D supplement, you should probably make sure that you are also getting the DV (400 mg) of magnesium from diet plus supplementation.
If you are taking a calcium supplement, you should check that it also provides a significant amount of magnesium. If not, change supplements or make sure that you get the DV for magnesium elsewhere.
I am suggesting that you shoot for the DV (400 mg) of magnesium rather than reading every label and calculating the calcium to magnesium ratio. The “ideal” ratio of 2.3 to 1 is hypothetical at this point. A supplement providing the DV of both calcium and magnesium would have a calcium to magnesium ratio of 2.5, and I would not fault any manufacturer for providing you with the DV of both nutrients.
If you are taking high amounts of calcium, I would recommend a supplement that has a calcium to magnesium ratio of 2.5 or less.
If you are considering a magnesium supplement to optimize your magnesium status, you should be aware that magnesium can cause gas, bloating, and diarrhea. I would recommend a sustained release magnesium supplement.
Finally, whole grains and legumes are among your best dietary sources of magnesium. Forget those diets that tell you to eliminate whole food groups. They are likely to leave you magnesium-deficient.

Even if the conclusions of this study are not confirmed by subsequent studies, we need to remember that magnesium is an essential nutrient with many health benefits and that most Americans do not get enough magnesium in their diet. The recommendations I have made for optimizing magnesium status are common-sense recommendations that apply to all of us.

The Case For Holistic Supplementation

This study is one of many examples showing that a holistic approach to supplementation is superior to a “magic bullet” approach where you take individual nutrients to solve individual problems. For example, in the case of magnesium and vitamin D:

If you asked most nutrition experts and supplement manufacturers whether it is important to provide magnesium along with vitamin D, their answer would likely be “No”. Even if they are focused on bone health, they would be more likely to recommend calcium along with vitamin D than magnesium along with vitamin D.
If your doctor has tested your 25-hydroxyvitamin D levels and recommended a vitamin D supplement, chances are they didn’t also recommend that you optimize your magnesium status.
Clinical studies investigating the benefits of vitamin D supplementation never ask whether magnesium intake is optimal.

That’s because most doctors and nutrition experts still think of nutrients as “magic bullets.” I cover holistic supplementation in detail in my book “Slaying The Supplement Myths.” Other examples that make a case for holistic supplementation that I cover in my book include:

A study showing that omega-3 fatty acids and B vitamins may work together to prevent cognitive decline. Unfortunately, most studies looking at the effect of B vitamins on cognitive decline have not considered omega-3 status and vice versa. No wonder those studies have produced inconsistent results.
Studies looking at the effect of calcium supplementation on loss of bone density in the elderly have often failed to include vitamin D, magnesium, and other nutrients that are needed for building healthy bone. They have also failed to include exercise, which is essential for building healthy bone. No wonder some of those studies have failed to find an effect of calcium supplementation on bone density.
A study reported that selenium and vitamin E by themselves might increase prostate cancer risk. Those were the headlines you might have seen. The same study showed Vitamin E and selenium together did not increase prostate cancer risk. Somehow that part of the study was never mentioned.
A study reported that high levels of individual B vitamins increased mortality slightly. Those were the headlines you might have seen. The same study showed that when the same B vitamins were combined in a B complex supplement, mortality decreased. Somehow that observation never made the headlines.
A 20-year study reported that a holistic approach to supplementation produced significantly better health outcomes.

In summary, vitamins and minerals interact with each other to produce health benefits in our bodies. Some of those interactions we know about. Others we are still learning about. When we take high doses of individual vitamins and minerals, we create potential problems.

We may not get the full benefit of the vitamin or mineral we are taking because some other important nutrient(s) may be missing from our diet.
Even worse, high doses of one vitamin or mineral may interfere with the absorption or enhance the excretion of another vitamin or mineral. That can create deficiencies.

The same principles apply to our diet. I mentioned earlier that whole grains and legumes are among the best dietary sources of magnesium. Eliminating those two foods from the diet increases our risk of becoming magnesium deficient. And, that’s just the tip of the iceberg. Any time you eliminate foods or food groups from the diet, you run the risk of creating deficiencies of nutrients, phytonutrients, specific types of fiber, and the healthy gut bacteria that use that fiber as their preferred food source.

The Bottom Line

A recent study suggests that optimal magnesium status may be important for optimizing 25-hydroxyvitamin D status. This is one of many examples showing that a holistic approach to supplementation is superior to a “magic bullet” approach where you take individual nutrients to solve individual problems. For example, in the case of magnesium and vitamin D:

If you asked most nutrition experts and supplement manufacturers whether it is important to provide magnesium along with vitamin D, their answer would likely be “No.” Even if they are focused on bone health, they would be more likely to recommend calcium along with vitamin D than magnesium along with vitamin D.
If your doctor has tested your 25-hydroxyvitamin D levels and recommended a vitamin D supplement, chances are he or she did not also recommend that you optimize your magnesium status.
Clinical studies investigating the benefits of vitamin D supplementation never ask whether magnesium intake is optimal. That may be why so many of those studies have failed to find any benefit of vitamin D supplementation.

I cover holistic supplementation in detail in my book “Slaying The Supplement Myths” and provide several other examples where a holistic approach to supplementation is superior to taking individual supplements.

In summary, vitamins and minerals interact with each other to produce health benefits in our bodies. Some of those interactions we know about. Others we are still learning about. Whenever we take high doses of individual vitamins and minerals, we create potential problems.

We may not get the full benefit of the vitamin or mineral we are taking because some other important nutrient(s) may be missing from our diet.
Even worse, high doses of one vitamin or mineral may interfere with the absorption or enhance the excretion of another vitamin or mineral. That can create deficiencies.

The same principles apply to what we eat. For example, whole grains and legumes are among the best dietary sources of magnesium. Eliminating those two foods from the diet increases our risk of becoming magnesium deficient. And, that’s just the tip of the iceberg. Any time you eliminate foods or food groups from the diet, you run the risk of creating deficiencies.

For more details about the current study and what it means to 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.

Soy And Breast Cancer Survivors

February 5, 2019 by Dr. Steve Chaney

Do Soy & Cruciferous Vegetables Reduce Breast Cancer Treatment-Related Symptoms?

Author: Dr. Stephen Chaney

The topic of soy and breast cancer has been a controversial subject for years. If you read Dr. Strangelove’s nutrition blogs, you would be led to believe that soy causes breast cancer and shortens the lifespan of breast cancer survivors.

This is one of the many myths I have debunked in my book “Slaying The Supplement Myths.” Multiple clinical studies have proven that soy reduces the likelihood of developing breast cancer. Several clinical studies have shown it also decreases recurrence of breast cancer and enhances survival following breast cancer treatment. Other clinical studies have found no effect of soy on recurrence or longevity in breast cancer survivors. Zero studies have found any detrimental effects of soy in breast cancer survivors.

So, is there a true relationship between soy and breast cancer survivors? These studies have all shown that soy is part of a healthy diet and should not be feared by women who have survived breast cancer.

Breast cancer survivors suffer from several treatment-related side effects. These include menopausal symptoms, fatigue, joint problems, hair thinning, and memory loss.

The most recent headlines claim that soy and cruciferous vegetables (broccoli, cauliflower, cabbage, Brussels sprouts, kale and related vegetables) decrease menopause and other treatment-related symptoms in breast cancer survivors. If you have seen those headlines, you are probably wondering:

Are they true?
Should I increase soy consumption following breast cancer treatment?

How Was The Study Designed?

This study (SJO Nomura et al, Breast Cancer Research and Treatment, 168: 467-479) enrolled 192 Chinese-American and 173 non-Hispanic White women in the San Francisco Bay area between 2006 and 2012. The average age of the women was 57. They were all breast cancer survivors who had been treated 1-5 years previously. Most had been treated at least 2 years previously.

The participants were recruited by mail and filled out questionnaires which provided demographic data, health information, and information on treatment-related symptoms. They also filled out a food frequency questionnaire designed to estimate intake of soy foods and cruciferous vegetables.

In terms of food consumption, the range was:

0 to 24 gram/day for soy.
<33 grams/day to >71 grams/day for cruciferous vegetables. For reference, one serving (1/2 cup) of cooked broccoli weighs 78 grams.

Soy And Breast Cancer Survivors?

In looking at the effect of soy and cruciferous vegetables on treatment-related symptoms, it is important to understand that the two groups of women had different baseline characteristics.

The Chinese-American women had a higher average intake of both soy and cruciferous vegetables.
The Non-Hispanic White women were more likely to experience treatment-related worsening of menopausal symptoms.
The Chinese-American women were more likely to experience fatigue, joint problems, hair thinning, and memory loss.

With that in mind, here are the results of the study:

Soy intake:

When all women in the study were grouped together, high (>24 grams/day) versus low (0 grams/day) soy intake was associated with a 57% reduction in fatigue.
For Non-Hispanic White women high versus low soy intake was associated with a 71% reduction in menopause symptoms and a 75% reduction in fatigue.
The effect of soy on treatment-related symptoms was non-significant for Chinese-American women, perhaps because the baseline intake of soy was greater for this group.

Cruciferous vegetable intake:

When all women in the study were grouped together, high (>71 grams/day) versus low (<33 grams/day) cruciferous vegetable intake was associated with a 50% reduction in menopause symptoms.
For Chinese-American women, high versus low intake of cruciferous vegetables was associated with a 39% reduction in memory loss.
The effect of cruciferous vegetables on treatment-related symptoms was non-significant for Non-Hispanic White women.

The authors concluded: “In this population of breast cancer survivors, higher soy and cruciferous vegetable intake was associated with less treatment-related menopausal symptoms and fatigue. To confirm study findings, additional research is needed that explores the relationship between diet and breast cancer treatment-related symptoms…in a larger, diverse study population.”

What Does This Study Mean For You?

This is a small, preliminary study that needs to be repeated before any definitive recommendations can be made. Here are my take-home points from this study.

Soy is an excellent source of high-quality plant protein. We already know there is no reason to avoid soy following breast cancer treatment. This study provides another reason to include soy as part of a healthy, plant-based diet following treatment. This study also provides a rationale for including cruciferous vegetables as part of a healthy, plant-based diet following treatment.
However, 24 grams of soy represents a single serving of many soy foods. This study does not provide a rationale to increase soy consumption beyond a single serving.
The danger after studies like this are publicized is that breast cancer survivors will just focus on soy and cruciferous vegetables in their diet. This study looked at the effects of soy and cruciferous vegetables based on their potential effects on menopausal symptoms. However, they are just two components of a healthy, plant-based diet, and we know that primarily plant-based diets are associated with a decreased risk of breast cancer.

In my opinion, we need to focus less on “magic bullet” approaches (single nutrients and single foods) and focus more on holistic approaches. We should be asking how holistic, healthy diets influence recovery from breast cancer and reduction of treatment-related symptoms. We should be encouraging breast cancer survivors to focus on all aspects of a healthy diet, not just soy and cruciferous vegetables.

The Bottom Line

This is one of the many myths I have debunked in my book “Slaying The Supplement Myths.” Multiple clinical studies have shown that soy is part of a healthy diet and should not be feared by women who have survived breast cancer.

The most recent headlines claim that soy and cruciferous vegetables (broccoli, cauliflower, cabbage, Brussels sprouts, kale and related vegetables) decrease menopause symptoms and fatigue in breast cancer survivors.

These headlines are based on a small, preliminary study that needs to be repeated before any definitive recommendations can be made. Here are my take-home points from this study.

Soy is an excellent source of high-quality plant protein. We already know there is no reason to avoid soy following breast cancer treatment. This study provides another reason to include soy as part of a healthy, plant-based diet following treatment. This study also provides a rationale for including cruciferous vegetables as part of a healthy, plant-based diet following treatment.
However, 24 grams of soy represents a single serving of many soy foods. This study does not provide a rationale for increasing soy consumption beyond a single serving.
This study focused on soy and cruciferous vegetables based on their potential effects on menopausal symptoms. However, they are just two components of a healthy, plant-based diet, and we know that primarily plant-based diets are associated with a decreased risk of breast cancer. In my opinion, we need to focus less on “magic bullet” approaches (single nutrients and single foods) and focus more on holistic approaches. We should be asking how healthy diets influence recovery from breast cancer and reduction of treatment-related symptoms.

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.

Dairy Products and Heart Disease

January 29, 2019 by Dr. Steve Chaney

Will Eating Cheese Help You Live Longer?

Author: Dr. Stephen Chaney

A recent study is generating lots of headlines. Here are some examples:

Eating Dairy Foods Can Help Reduce Heart Disease Risk.
Fermented Dairy-Products May Protect Against Heart Attack.
Full-Fat Dairy May Actually Benefit Heart Health.
Eating Cheese Might Help You Live Longer.
Eating Cheese and Butter Every Day Linked To Living Longer.

My favorite headlines were the ones about cheese and longevity. For example, one headline read: “New Study Finds People That Eat Cheese Live Longer.” The article opened by saying “Sprinkle on another handful of mozzarella on your pizza, add an extra slice of American cheese on your burger, or grab a bite of sharp cheddar with your crackers. A new study published in The Lancet claims that eating cheese reduces your risk of stroke and cardiovascular disease. Now that’s something we like to hear.”

A lot of people must like to hear good news about cheese. The headlines about cheese making you live longer outnumbered all the other headlines by about 3 to 1.

In summary, the claims ranged from dairy foods in general to milk & fermented dairy foods, full-fat dairy foods, cheese, and cheese & butter. Let’s look at the study behind the claims to see which of these claims about dairy products and heart disease are true and which are wishful thinking.

How Was The Study Designed?

The study behind the headlines (M. Dehghan et al. The Lancet, 392: 2288-2297, 2018 ) was a very ambitious study called PURE (Prospective Urban Rural Epidemiology study). It was a large multinational study of 136,384 individuals aged 35-70 from 21 countries in five continents.

At the beginning of the study participants filled out a country-specific food frequency questionnaire. The data from this survey were broken down into total dairy foods, milk, yogurt, cheese, and butter. The data were also subdivided into low-fat and full-fat dairy foods.

The participants were followed for an average of 9.1 years. The outcomes measured at the end of the study were overall mortality, cardiovascular mortality, cardiovascular disease, heart attack, stroke and heart failure. The way these outcomes were measured was also country specific because the way these data are collected varies from country to country. [Note: There were some other outcomes measured, but for the sake of simplicity I have not included them in the discussion. Their omission does not change the discussion.]

Finally, in case you were wondering, this research was not funded by money from the dairy industry.

Dairy Products and Heart Disease Risk?

The results were interesting:

Higher intake of total dairy foods (>2 servings/day compared with no intake) was associated with a lower risk of overall mortality (17% less), cardiovascular mortality (23% less), cardiovascular disease (22% less) and stroke (34% less). No association of dairy consumption with heart attack or heart failure was seen.
Higher intake of milk (>1 serving per day compared with <0.5 servings/day) was associated with a lower risk cardiovascular disease (18% less).
Higher intake of yogurt (>1 serving/day compared with <0.5 servings/day) was associated with a lower risk of overall mortality (17% less) and cardiovascular disease (10% less).
No significant effect of cheese was observed for any of the outcomes measured.
Butter intake was low and was not associated with any of the outcomes measured.

The authors concluded: “We observed that higher dairy consumption was associated with lower risks of mortality and cardiovascular disease, particularly stroke. Our study suggests that consumption of dairy products should not be discouraged and perhaps should even be encouraged in low-income and middle-income countries where dairy consumption is less.”

Will Eating Cheese Help You Live Longer?

The claims you have been seeing about consumption of dairy foods in general, milk, and yoghurt reducing heart attack risk are supported by this study and several other recent studies.
I hate to disappoint you, but the claims about cheese and butter consumption reducing cardiovascular disease and extending lifespan are clearly wishful thinking. They are not supported by this study.

The discussion of full-fat versus low-fat dairy products is more complicated. You are undoubtedly aware that most current dietary guidelines recommend avoiding full-fat dairy foods in favor of low-fat alternatives. Studies like this have led some to question whether these dietary guidelines should be changed.

Interestingly, the authors of the PURE study did not make any claims about the benefits of full-fat dairy foods in their discussion of the results. These claims have all come from internet blogs and articles. Why were the authors of the study reluctant to make that claim? To answer that question I turned to reviews of the study published in the Science Media Center by experts in that field of study. Here were some of their comments:

Because dietary guidelines recommending the consumption of low-fat dairy foods exist primarily in western countries (specifically, the US, Canada & Europe) the distribution of low-fat dairy and full-fat dairy was not evenly divided between counties. Most of the low-fat dairy consumption occurred in western countries. In contrast, most of the full-fat dairy consumption occurred in developing countries. That introduces a couple of confounding variables that are unique to this study. For example:
- In developing countries, diets are often primarily plant-based and tend to be low in sugar and highly processed foods, while in western countries, diets are often primarily meat-based and are high in sugar and highly processed foods. The addition of full-fat dairy to a plant-based diet may not have the same effect as adding it to a pizza or hamburger.
In developing countries, people with higher incomes, a healthier lifestyle, and better access to health care are often the ones who consume more dairy products. In other words, the PURE study can’t tell us whether consumption of full-fat dairy lead to better health outcomes in those countries or whether wealthier and healthier people in those countries had the means to consume more dairy.
In many developing countries, a large segment of the population is lactose intolerant. Increased full-fat dairy consumption by these people would be largely yogurt and other fermented dairy foods which have health benefits of their own.

In short, confounding variables unique to this study make it difficult to say with confidence that full-fat dairy foods were just as beneficial as low-fat dairy foods.

In western countries the results of previous studies are mixed. Some suggest that full-fat dairy foods are just as effective as low-fat dairy foods at reducing heart disease risk. Others report that the primary heart-health benefits come from low-fat dairy foods.

Dairy Products and Heart Disease: Diet Context Matters

Why so much confusion? Some recent studies suggest that diet context matters. Simply put, that means the effect of the overall diet is more important than single food groups (dairy). To illustrate this point, let’s look at two other studies.

The first study (M Chen et al, The American Journal of Clinical Nutrition 104: 1209-1217, 2016 ) was published two years ago by investigators at the Harvard Chan School of Public Health. That study included data from 43,000 men in the Health Professionals Follow-Up Study, 87,000 women in the Nurses’ Health Study, and 90,000 women in the Nurses’ Healthy Study II. All these study participants were from the United States. This study put dairy fat consumption into the context of the overall diet. The main findings were:

Full-fat dairy foods did not increase heart disease risk compared to a diet that contains high amounts of refined carbohydrates and sugar (the typical American diet).
However, when dairy fat was replaced with the same number of calories from:
- vegetable fat, the risk of heart disease decreased by 10%.
- polyunsaturated fat, the risk of heart disease decreased by 24%.
- healthy carbohydrates (fruits, vegetables, and whole grains), the risk of heart disease decreased by 28%.

In other words, the effect of dairy fat on heart disease depends on the overall diet. If you add dairy fat to an already bad, heart-unhealthy diet, it does not further increase heart disease risk. (This finding may explain why several recent studies of western populations have found no difference between full-fat and low-fat dairy consumption.) However, this study also shows that addition of full-fat dairy to a heart-healthy diet is likely to increase heart disease risk.

The lead author of that study was quoted as saying: “These results suggest that dairy fat is not an optimal type of fat in our diets. Although one can enjoy moderate amounts of full-fat dairy such as cheese, a healthy diet pattern tends to be low in saturated fat. These results strongly support existing recommendations to choose mainly unsaturated fats from vegetable oils, nuts, seeds, avocados, and some oily fish for a heart-healthy diet.”

The second major study is the 7^th-Day Adventist study, which I have described in detail in my book “Slaying The Food Myths.” This study showed that a lacto-ovo vegetarian diet was less heart healthy than a vegan diet but is far heart-healthier than the typical American diet.

What Does This Study Mean For You?

Dairy foods are good for you: Increased consumption of dairy foods, milk, and yogurt are associated with decreased risk of heart disease. As I have said before, we have 5 food groups for a reason. Dairy foods are an essential part of a healthy diet.

If you are lactose-intolerant I have good news for you. Yogurt and other fermented dairy foods are probably even better for you than non-fermented dairy foods.
If you are avoiding dairy for other reasons, be sure to get your calcium, magnesium, and vitamin D from other sources. There may be other important nutrients in dairy that are heart-healthy, but these are the ones we are sure of.

The jury is still out on full-fat dairy products: It is best to follow current dietary guidelines and consume primarily low-fat dairy products.

If you are a cheese lover, it is probably OK to consume moderate amounts of cheese or other full-fat dairy foods on occasion as part of a heart-healthy, primarily plant-based diet. In short, it is probably better to add a little cheese to a green salad than it is to add it to pizza or a hamburger. It is probably better to pair your cheddar with an apple than with crackers.

Hopefully, this gives you a better understanding of the relationship between dairy products and heart disease.

The Bottom Line

A recent study looked at the consumption of dairy products and heart disease risk, and overall mortality risk in a study with 134,000 participants from 21 countries on five continents. The media response to this study has been overwhelming. Some of the recent headlines are:

Eating Dairy Foods Can Help Reduce Heart Disease Risk.
Fermented Dairy-Products May Protect Against Heart Attack.
Full-Fat Dairy May Actually Benefit Heart Health.
Eating Cheese Might Help You Live Longer.
Eating Cheese and Butter Every Day Linked To Living Longer.

The first two claims were supported by the study results. The claims about cheese and butter were wishful thinking. They were not supported by the study results. The claim about full-fat dairy was supported by the data, but the authors of the study did not make that claim because of study limitations.

Another recent study of 220,000 participants in the United States provides a better estimate of the effect of full-fat dairy foods on heart health. The main findings of this study were:

Full-fat dairy foods did not increase heart disease risk compared to a diet that contains high amounts of refined carbohydrates and sugar (the typical American diet).
However, when dairy fat was replaced with the same number of calories from:
- vegetable fat, the risk of heart disease decreased by 10%.
- polyunsaturated fat, the risk of heart disease decreased by 24%.
- healthy carbohydrates (fruits, vegetables, and whole grains), the risk of heart disease decreased by 28%.

In other words, the effect of dairy fat on heart disease depends on the overall diet. If you add full-fat dairy to an already bad heart-unhealthy diet, it does not further increase heart disease risk. However, if you add full-fat dairy to a heart-healthy diet, it is likely to increase heart disease risk.

For more details and a thorough discussion of the full-fat versus low-fat controversy read the article above.

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

Why You May Be Sore After A Massage

January 22, 2019 by Dr. Steve Chaney

Why You Sometimes Feel Worse Before You Feel Better

Author: Julie Donnelly, LMT –The Pain Relief Expert

Editor: Dr. Steve Chaney

Do you ever hurt after you’ve been to a massage therapist? Or maybe you’ve gone to the gym, or done yoga, after a long time away and you feel horrible the next day. You may decide that the massage therapist did something wrong, or that you’re better off not exercising or stretching. I’d like to explain what is happening when you have a negative effect after what you think should be helpful. You’ll begin to understand why you may be sore after a massage.

I’ve been a licensed massage therapist since 1989 and I’ve worked on thousands of people during these 30 years. Most people feel great after their session and continue to feel good for weeks afterward, but about 5% of people have what starts out as a negative result.

This negative situation has bothered me a great deal for all these years, and while I knew they would be okay, I didn’t know what to say to them while they were hurting. That is, I didn’t know until now! I’ve done a lot of research, and I spoke to a lot of professionals who specialize in treating pain symptoms. Everyone always gave me the same answer…”They’ll hurt for a bit and then feel wonderful.” That was encouraging, but it wasn’t enough to make me happy when I spoke to my clients.

I finally found an answer that explains the entire problem…it’s called “the Healing Crisis.”

What Is A Healing Crisis?

So, thanks to Google I found a website that is so well written that I’m going to share it with you. I want to give credit where it is due. The author of this information is Cindy Murdoch who is a staff writer for Underground Health. I tried to contact her for permission to share this info, but the website wasn’t responding, and I couldn’t find her by doing a Google search. So, I’ll just say, “Thank you Cindy” and share this with you.

I’ll synopsize the information here, but if you’re interested you can read the entire thing by going to https://www.alkawayusa.com/post/what-is-a-healing-crisis. Everything below that I copied from the website is in italics.

Sore After A Massage? Explanation

Healing Crisis: It’s Logical When You Read What Is Going On

Definition: A healing crisis, or healing reaction, is a temporary worsening of symptoms that occurs when the body is going through the process of healing itself through the elimination of toxins.

Even though the crisis is uncomfortable and sometimes alarming in nature, it is a good sign that the body is working to heal itself.

A healing crisis usually lasts two to three days, but can extend for much longer periods of time, even weeks. More than one healing crisis may be necessary for a complete cure to take place.

The Answer I Have Been Searching For Since 1989!

I am so happy to have found this website, and this article. This is exactly what I’ve always known in my heart, but I didn’t have the research to prove it. The article continues….

The stage is set for a healing crisis when the body is overloaded with toxins that have been trapped within its tissues for a long period of time – sometimes for many decades. As a general rule, the more toxic the body is, the more intense the healing crisis will be. As healing begins, many systems in the body work together to eliminate waste products and toxins and can become overwhelmed by the process. Remember, these symptoms are temporary, and once they pass, the body is healthier and stronger.

A healing crisis can also be produced by a treatment or therapy that causes yeast, viruses, bacteria, cancer cells, etc. to have massive die-offs. The dead cells can overwhelm the elimination processes as they are expelled from the body.

There are also ways to assist the body during a healing reaction. These can include: drinking plenty of fluids, especially water, to help carry off the toxins and getting plenty of rest – mentally, physically and emotionally.

In Summary

Healing crises are good even though they make you feel bad. They are a sign that the healing process chosen is working by eliminating the body of toxins, impurities and imbalances in the body.

The healing crisis lets you know that you are on the right path to renewed health and vigor. “No pain, no gain” is truly applicable when talking about a healing crisis.

Wishing you well,

Julie Donnelly

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

About The Author

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

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

A Low Carb Diet and Weight Loss

January 15, 2019 by Dr. Steve Chaney

Do Low-Carb Diets Help Maintain Weight Loss?

Author: Dr. Stephen Chaney

Traditional diets have been based on counting calories, but are all calories equal? Low-carb enthusiasts have long claimed that diets high in sugar and refined carbs cause obesity. Their hypothesis is based on the fact that high blood sugar levels cause a spike in insulin levels, and insulin promotes fat storage.

The problem is that there has been scant evidence to support that hypothesis. In fact, a recent meta-analysis of 32 published clinical studies (KD Hall and J Guo, Gastroenterology, 152: 1718-1727, 2017 ) concluded that low-fat diets resulted in a higher metabolic rate and greater fat loss than isocaloric low-carbohydrate diets.

However, low-carb enthusiasts persisted. They argued that the studies included in the meta-analysis were too short to adequately measure the metabolic effects of a low-carb diet. Recently, a study has been published in the British Medical Journal (CB Ebbeling et al, BMJ 2018, 363:k4583 ) that appears to vindicate their position.

Are low carb diets best for long term weight loss?

Low-carb enthusiasts claim the study conclusively shows that low-carb diets are best for losing weight and for keeping it off once you have lost it. They are saying that it is time to shift away from counting calories and from promoting low-fat diets and focus on low-carb diets instead if we wish to solve the obesity epidemic. In this article I will focus on three issues:

How good was the study?
What were its limitations?
Are the claims justified?

How Was The Study Designed?

The investigators started with 234 overweight adults (30% male, 78% white, average age 40, BMI 32) recruited from the campus of Framingham State University in Massachusetts. All participants were put on a diet that restricted calories to 60% of estimated needs for 10 weeks. The diet consisted of 45% of calories from carbohydrate, 30% from fat, and 25% from protein. [So much for the claim that the study showed low-carb diets were more effective for weight loss. The diet used for the weight loss portion of the diet was not low-carb.]

During the initial phase of the study 161 of the participants achieved 10% weight loss. These participants were randomly divided into 3 groups for the weight maintenance phase of the study.

The diet composition of the high-carb group was 60% carbohydrate, 20% fat, and 20% protein.
The diet composition of the moderate-carb group was 40% carbohydrate, 40% fat, and 20% protein.
The diet composition of the low-carb group was 20% carbohydrate, 60% fat, and 20% protein.

Other important characteristics of the study were:

The weight maintenance portion of the study lasted 5 months – much longer than any previous study.
All meals were designed by dietitians and prepared by a commercial food service. The meals were either served in a cafeteria or packaged to be taken home by the participants.
The caloric content of the meals was individually adjusted on a weekly basis so that weight was kept within a ± 4-pound range during the 5-month maintenance phase.
Sugar, saturated fat, and sodium were limited and kept relatively constant among the 3 diets.

120 participants made it through the 5-month maintenance phase.

Do Low-Carb Diets Help Maintain Weight Loss?

The results were striking:

The low-carb group burned an additional 278 calories/day compared to the high-carb group and 131 calories/day more than the moderate-carbohydrate group.
These differences were even higher for those individuals with higher insulin secretion at the beginning of the maintenance phase of the study.
These differences lead the authors to hypothesize that low-carb diets might be more effective for weight maintenance than other diets.

What Are The Pros And Cons Of This Study?

This was a very well-done study. In fact, it is the most ambitious and well-controlled study of its kind. However, like any other clinical study, it has its limitations. It also needs to be repeated.

The pros of the study are obvious. It was a long study and the dietary intake of the participants was tightly controlled.

As for cons, here are the three limitations of the study listed by the authors:

#1: Potential Measurement Error: This section of the paper was a highly technical consideration of the method used to measure energy expenditure. Suffice it to say that the method they used to measure calories burned per day may overestimate calories burned in the low-carb group. That, of course, would invalidate the major findings of the study. It is unlikely, but it is why the study needs to be repeated using a different measure of energy expenditure.

#2: Compliance: Although the participants were provided with all their meals, there was no way of being sure they ate them. There was also no way of knowing whether they may have eaten other foods in addition to the food they were provided. Again, this is unlikely, but cannot be eliminated from consideration.

#3: Generalizability: This is simply an acknowledgement that the greatest strength of this study is also its greatest weakness. The authors acknowledged that their study was conducted in such a tightly controlled manner it is difficult to translate their findings to the real world. For example:

Sugar and saturated fat were restricted and were at very similar levels in all 3 diets. In the real world, people consuming a high-carb diet are likely to consume more sugar than people in the other diet groups. Similarly, people consuming the low-carb diet are likely to consume more saturated fat than people in the other diet groups.
Weight was kept constant in the weight maintenance phase by constantly adjusting caloric intake. Unfortunately, this seldom happens in the real world. Most people gain weight once they go off their diet – and this is just as true with low-carb diets as with other diets.
The participants had access to dietitian-designed prepared meals 3 times a day for 5 months. This almost never happens in the real world. The authors said “…these results [their data] must be reconciled with the long-term weight loss trials relying on nutrition education and behavioral counseling that find only a small advantage for low carbohydrate compared with low fat diets according to several recent meta-analyses.” [I would add that in the real world, people do not even have access to nutritional education and behavioral modification.]

What Does This Study Mean For You?

This study shows that under very tightly controlled conditions (dietitian-prepared meals, sugar and saturated fat limited to healthy levels, calories continually adjusted so that weight remains constant) a low-carb diet burns more calories per day than a moderate-carb or high-carb diet. These findings show that it is theoretically possible to increase your metabolic weight and successfully maintain a healthy weight on a low-carb diet. These are the headlines you probably saw. However, a careful reading of the study provides a much more nuanced viewpoint. For example, the fact that the study conditions were so tightly controlled makes it difficult to translate these findings to the real world.
In fact, the authors of the study acknowledged that multiple clinical studies show this almost never happens in the real world. These studies show that most people regain the weight they have lost on low-carb diets. More importantly, the rate of weight regain is virtually identical on low-carb and low-fat diets. Consequently, the authors of the current study concluded “…translation [of their results to the real world] requires exploration in future mechanistic oriented research.” Simply put, the authors are saying that more research is needed to provide a mechanistic explanation for this discrepancy before one can make recommendations that are relevant to weight loss and weight maintenance in the real world.
The authors also discussed the results of their study in light of a recent, well-designed 12-month study (CD Gardener et al, JAMA, 319: 667-669, 2018 ) that showed no difference in weight change between a healthy low-fat versus a healthy low-carbohydrate diet. That study also reported that the results were unaffected by insulin secretion at baseline. The authors of the current study noted that “…[in the previous study] participants were instructed to minimize or eliminate refined grains and added sugars and maximize intake of vegetables. Probably for this reason, the reported glycemic load [effect of the diet on blood sugar levels] of the low-fat diet was very low…and similar to [the low-carb diet].” In short, the authors of the current study were acknowledging that diets which focus on healthy, plant-based carbohydrates and eliminate sugar, refined grains, and processed foods may be as effective as low-carb diets for helping maintain a healthy weight.
This would also be consistent with previous studies showing that primarily plant-based, low-carb diets are more effective at maintaining a healthy weight and better health outcomes long-term than the typical American version of the low-fat diet, which is high in sugar and refined grains. In contrast, meat-based, low-carb diets are no more effective than the American version of the low-fat diet at preventing weight gain and poor health outcomes. I have covered these studies in detail in my book “Slaying The Food Myths.”

Consequently, the lead author of the most recent study has said: “The findings [of this study] do not impugn whole fruits, beans and other unprocessed carbohydrates. Rather, the study suggests that reducing foods with added sugar, flour, and other refined carbohydrates could help people maintain weight loss….” This is something we all can agree on, but strangely this is not reflected in the headlines you may have seen in the media.

The Bottom Line

A recent study compared the calories burned per day on a low-carb, moderate-carb, and high-carb diet. The study concluded that the low-carb diet burned significantly more calories per day than the other two diets and might be suitable for long-term weight control. If confirmed by subsequent studies, this would be the first real evidence that low-carb diets are superior for maintaining a healthy weight.
However, the study has some major limitations. For example, it used a methodology that may overestimate the benefits of a low-carb diet, and it was performed under tightly controlled conditions that can never be duplicated in the real world. As acknowledged by the authors, this study is also contradicted by multiple previous studies. Further studies will be required to confirm the results of this study and show how it can be applied in the real world.
In addition, the kind of carbohydrate in the diet is every bit as important as the amount of carbohydrate. The authors acknowledge that the differences seen in their study apply mainly to carbohydrates from sugar, refined grains, and processed foods. They advocate diets with low glycemic load (small effects on blood sugar and insulin levels) and acknowledge this can also be achieved by incorporating low-glycemic load, plant-based carbohydrates into your diet. This is something we all can agree on, but strangely this is not reflected in the headlines you may have seen in the media.
Finally, clinical studies report averages, but none of us are average. When you examine the data from the current study, it is evident that some participants burned more calories per hour on the high-carb diet than other participants did on the low carb diet. That reinforces the observation that some people lose weight more effectively on low-carb diets while others lose weight more effectively on low-fat diets. If you are someone who does better on a low-carb diet, the best available evidence suggests you will have better long-term health outcomes on a primarily plant-based, low-carb diet such as the low-carb version of the Mediterranean diet.

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.

What Are Intermittent Fasting Benefits?

January 8, 2019 by Dr. Steve Chaney

Will Intermittent Fasting Make You Leaner & Healthier?

Author: Dr. Stephen Chaney

Intermittent fasting is all the rage. If you believe the hype, intermittent fasting will make you leaner and healthier. Some of its proponents claim you don’t even need to give up your favorite foods. You don’t need to give up your Big Macs for fruits and vegetables. You don’t need to restrict what you eat. You just need to restrict when you eat.

If you read the blogs about intermittent fasting, you will come across all sorts of metabolic mumbo-jumbo about ketone bodies, adiponectin, leptin, IGF-1, and blood glucose levels. It sounds so convincing. Don’t get sucked in by these pseudo-scientific explanations. At this point they are mostly speculation.

What are intermittent fasting benefits?

Instead, ask “What is the evidence that intermittent fasting works?” More importantly, ask “What is the evidence it works in human?” Most of the studies have been done in animal model systems. Claims based on animal models may not apply to humans.

This week I will discuss a review on caloric restriction and various forms of fasting that recently appeared in Science, one of the most highly respected scientific journals (Di Francesco et al, Science, 362: 770-775, 2018 ).

This article was a comprehensive review of three closely-related dietary approaches:

Caloric restriction in which daily caloric intake is restricted by 15-40%.
Time-restricted fasting which limits daily intake of food to a 4-12 hour period.
Intermittent fasting in which there is a day or more of fasting or decreased food intake between periods of unrestricted eating.

Note:

What the review calls time-restricted fasting is referred to in the mass media as intermittent fasting. What the review calls intermittent fasting is referred to in the mass media as alternate day fasting. To avoid confusion, I will use the mass media definitions.
I will focus on what the mass media refers to as intermittent fasting and just briefly summarize the other two approaches.

Will Caloric Restriction Allow You To Live Longer?

The concept of caloric restriction has been around for a long time and is the best studied of the dietary approaches covered in this review. In brief:

Caloric restriction has been studied in animal model systems ranging from mice to primates. In every animal model studied, caloric restriction reduced the incidence of age-related degenerative diseases and increased either life span or health span or both.
In both animal model systems and humans, caloric restriction lowers cholesterol, lowers blood pressure, improves blood sugar control, reduces inflammation, and reduces oxidative damage.
Populations that eat a healthy diet and practice voluntary caloric restriction appear to enjoy remarkable longevity.
The effects of caloric restriction appear to operate via the sirtuin anti-aging pathway. Most of the other effects are downstream of this pathway.
The effects of caloric restriction (including activation of the sirtuin pathway) are mimicked by resveratrol and related polyphenols.

In short:

Caloric restriction and some naturally occurring compounds such as resveratrol are clearly effective in animal model systems and are likely to be effective in humans.
However, we live too long to allow definitive studies of the effect of caloric restriction on human life span and health span.
This dietary approach has never gained popularity because very few people want to starve themselves just so they can live a longer, healthier life.

Intermittent Fasting Benefits: Leaner & Healthier?

There are many variations to intermittent fasting. As the review stated, intermittent fasting can mean that food consumption is restricted to anywhere from 4 to 12 hours. However, the most popular version of intermittent fasting at present restricts food consumption to 8 hours followed by a 16-hour period of fasting. Here is what you need to know about intermittent fasting:

Once again, most of the studies have been done in rodents. Those studies appear to show that intermittent fasting results in weight loss, improved blood sugar control, lower cholesterol and triglyceride levels and reduced inflammation even when caloric intake remains unchanged. These findings have generated the claims you see in the media. However, you need to remember that what works in rodents does not necessarily work in humans.
Unlike caloric restriction, the benefits of intermittent fasting are dependent on circadian rhythm. [Note: If you are unfamiliar with the concept of circadian rhythm, it is a master control that is genetically hardwired into almost every organism on the planet, including humans. In general, circadian rhythm is synchronized with the light-dark cycle.] The effect of circadian rhythm that is relevant to this discussion is that metabolic rate and many of the enzymes involved in food metabolism in humans are more active during the day than at night. Not surprising, animal studies suggest that intermittent fasting is most effective when the feed-fast cycle is synchronized with their circadian rhythm.
The timing of the feeding portion of the intermittent fasting cycle also appears to be important for humans. According to the review by Di Francesco et al, the few clinical studies that have been performed on humans show:
Limiting food intake to the middle of the day decreased glucose levels, cholesterol & triglyceride levels, and inflammation.
Eating a larger breakfast and smaller dinner improved metabolic markers better than when participants ate a smaller breakfast and larger dinner.
Type 2 diabetics attained better blood sugar control when most of their calories were consumed in the first half of the day. In contrast, restricting their calories to late afternoon or evening resulted in either no blood sugar improvement or a worsening of blood sugar controls.
Finally, subjects lost more weight on a reduced calorie diet when most of the food was consumed in the morning rather than in the evening.
If you read the very popular “Obesity Code” book by Dr. Fung you will discover he is recommending a diet that consists of fruits & vegetables, fiber-rich foods, healthy protein & healthy fats, and avoids sugar, refined grains, and processed foods. He also recommends avoiding snacking. That is exactly the kind of diet I recommend in my book, “Slaying The Food Myths.” If the average American adopted that diet and did nothing else, they would be leaner and healthier. So much for the claim that you can eat all your favorite junk foods and become leaner and healthier by intermittent fasting.
Finally, most of the human clinical studies have carefully controlled caloric intake. From these studies it is apparent that many of the metabolic benefits of intermittent fasting come from synchronizing your food intake with your circadian rhythm. However, in those studies that focused on time of eating and did not control calories, food intake was reduced by intermittent fasting. This is the unacknowledged benefit of intermittent fasting. When you restrict the time period for eating and restrict snacking you generally end up eating less. Thus, the weight loss associated with intermittent fasting may be caused by reduced caloric intake rather than fasting.

What Does This Mean For You? Here are the take-home lessons from this review:

Most of the studies on intermittent fasting have been done with animals, not with humans.
Both animal and human studies suggest that the benefits of intermittent fasting result from synchronizing your food intake with your circadian rhythm. The old adage of “Eat breakfast like a king, lunch like a prince, and dinner like a pauper” may be true for most of us. [Note: Circadian rhythms vary slightly from person to person. Some people will do better by their fast at mid-day rather than at breakfast. However, they will probably still benefit by eating a bigger meal mid-day and a smaller meal in the evening.]
Although there is no conscious effort to control calories, intermittent fasting appears to result in an inadvertent reduction in food intake by restricting the time allowed for eating and by eliminating late night snacking. This reduction in caloric intake is likely responsible for much of the weight loss associated with intermittent fasting.
In summary, intermittent fasting appears to work, but it is not clear whether you need to follow a rigid schedule of eating and fasting. The available clinical studies suggest that if you eat a healthy, primarily plant-based diet, eat most of your calories early in the day, don’t snack between meals, and don’t eat anything after dinner, you will obtain most, if not all, of the benefits attributed to intermittent fasting.

If you define intermittent fasting that way, the professor has been doing intermittent fasting for years. He just didn’t know that was what he was doing.

Does Alternate Day Fasting Make You Healthier?

Fasting regimens promoted for weight loss typically involve one or several days in which no or few calories are consumed followed by a period of unrestricted eating.

At present, the two most popular regimens are the alternate day fast and the alternate day modified fast. The alternate day fast involves a 24-hour water fast followed by a normal feeding period of 24-hours. The alternate day modified fast reduces caloric intake to 25% of normal on fasting days. Here is a brief summary of what we know about alternate day fasting:

Once again, most of the studies have been done in animals.
Since neither animals nor humans generally consume double their normal caloric intake during the 24-hour feeding period, alternate day fasting results in an overall reduction in caloric intake. Not surprisingly, the benefits of alternate day fasting in animal studies are similar to the benefits observed with caloric restriction.
Short-term human clinical trials suggest that alternate day fasting results in weight loss. The weight loss causes an improvement in blood sugar control, lower blood pressure, and lower cholesterol & triglyceride levels. Based on these studies, alternative day fasting is likely to be an effective strategy for short-term weight loss and has some short-term health benefits.
However, there are no long-term studies on the effectiveness of this approach. It is highly unlikely that most people would be able to follow this regimented a diet plan long term. Thus, it is also unlikely that the weight loss and health benefits can be maintained long term.
Finally, fasting is not for everyone. It is generally not recommended for people who are hypoglycemic, the elderly, pregnant women, and people with eating disorders.

The Bottom Line

In this article I discussed a recent review of intermittent fasting and other approaches that involved fasting or long-term caloric restriction. Here are the take-home lessons on intermittent fasting:

Most of the studies on intermittent fasting have been done with animals, not with humans. Many of the claims you hear about on the benefits of intermittent fasting are based on the animal studies. They may not apply to humans.
Both animal and human studies suggest that the benefits of intermittent fasting result from synchronizing your food intake with your circadian rhythm. The old adage of “Eat breakfast like a king, lunch like a prince, and dinner like a pauper” may be true for most of us. [Note: Circadian rhythms vary slightly from person to person. Some people will do better by breaking their fast at mid-day rather than at breakfast. However, they will probably still benefit by eating a bigger meal mid-day and a smaller meal in the evening.]
Although there is no conscious effort to reduce calories, intermittent fasting appears to result in an inadvertent reduction in food intake by restricting the time allowed for eating and by eliminating late night snacking. This reduction in caloric intake is likely responsible for much of the weight loss associated with intermittent fasting.
In summary, intermittent fasting appears to be beneficial, but it is not clear whether you need to follow a rigid schedule of eating and fasting. The available clinical studies suggest that if you eat a healthy, primarily plant-based diet, eat most of your calories early in the day, don’t snack between meals, and don’t eat anything after dinner, you will obtain most, if not all, of the benefits attributed to intermittent fasting. If you define intermittent fasting that way, the professor has been doing intermittent fasting for years. He just didn’t know that was what he was doing.

For more details on intermittent fasting and for a discussion of long-term caloric restriction and alternate day fasting 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.

300th Issue Celebration: The Latest Developments in Health, Nutrition & Fitness

January 2, 2019 by Dr. Steve Chaney

Nutrition Breakthroughs Over The Last Two Years

Author: Dr. Stephen Chaney

In the six years that I have been publishing “Health Tips From The Professor,” I have tried to go behind the headlines to provide you with accurate, unbiased health information that you can trust and apply to your everyday life. The 300^th issue of any publication is a major cause for celebration and reflection, especially when its publication coincides with the first day of a brand-new year – and “Health Tips From The Professor” is no different.

I am dedicating this issue to reviewing some of the major stories I have covered in the past 100 issues. There are lots of topics I could have covered, but I have chosen to focus on three types of articles:

Articles that have debunked long-standing myths about nutrition and health.
Articles that have corrected some of the misinformation that seems to show up on the internet on an almost daily basis.
Articles about the issues that most directly affect your health.

What Diets Are Best For Weight Loss?

Since this review is being written in January, let’s start with some of the articles about diets and weight loss. I have covered the effectiveness of the Paleo, Keto, Mediterranean, DASH, vegetarian, and Vegan diets for both short and long-term weight loss in my book “Slaying The Food Myths,” so I won’t repeat that information here. Instead, I will cover the popular Whole 30 Diet. I will also address the value of DNA tests in predicting which diet is best for you when it comes to weight loss.

I reviewed the Whole 30 Diet this past January. There is a lot to like about this diet, but some things to dislike as well. Here is a brief summary: Because it is a very rigid diet, it is excellent for short-term weight loss. What is less clear is whether it is good for weight maintenance or is even healthy over the long term. For more details, check out my article The Whole 30 Diet.

As for DNA testing, my recent article, Can Genetics Predict Which Diet is Best for You, in Health Tips From The Professor reviewed a study that looked at the value of DNA tests at predicting whether a low carb or low fat diet would be better at helping you lose weight. The article made some interesting observations about the relative value of low-carb and low-fat diets for weight loss. However, the most important conclusion of the study was that DNA testing was of no value at predicting whether a low-carb or low-fat diet would be the best weight loss strategy for you.

Can Diet Influence Long-Term Health Outcomes?

This topic was a major focus of “Slaying The Food Myths.”

Let me start with a quiz:

Which diet decreases heart disease risk by 50% (Mediterranean Diet for Heart Health)?
Which diet decreases both heart disease and diabetes risk by 50% (Diet, Type 2 Diabetes and Heart Disease)?
Which diet decreases the risk of premature death by 31% (Premature Death Risk)?

Hint: The answer is slightly different in each case, but these are all whole-food, primarily plant-based diets. If you have forgotten the details, you may wish to check these articles out.

Here are some articles that didn’t make it into the book:

Can diet reduce ADHD symptoms (Diet for Children with ADHD)?
Can diet reduce Alzheimer’s risk (Can Diet Reduce Alzheimer’s Risk)?
Can diet reduce prostate cancer risk (Best Diet to Prevent Cancer)?
Can diet reduce colon cancer risk (Colon Cancer Prevention)?

The answer to each of these questions appears to be yes. If any of these are a concern for you, you’ll want to read the corresponding article.

Food Controversies And Your Health

I discussed a lot of food controversies in “Slaying The Food Myths,” but here are a few that didn’t make it into the book.

“Are High Fat Dairy Foods Good For You?”
“Are Eggs Good For Your Heart?”
Is meat bad for your heart? There are two recent studies that came to opposite conclusions on this important topic. To evaluate the evidence, you need to look at both studies.
- “Is Meat Heart Healthy?”
- “Does Meat Protein Increase Heart Disease Risk?”

“The Truth About Low-Carb Diets.” What do the latest studies show?

Junk Foods And Your Health

I discussed sugar myths and pointed out that artificially sweetened foods were no better for you in “Slaying The Food Myths.” Here are some other topics that may be of interest.

“Does Sucralose Make You Hungry?”
“When Is Fructose Bad For You (and when is it good for you)?”
“Do Processed Foods Increase Your Risk of Cancer?”
“Are Fast Foods Killing Our Kids?”

Myths That Supplements Are Worthless

In my book “Slaying The Supplement Myths” I showed that many of the claims that supplements were either worthless or dangerous were simply myths kept alive by the pharmaceutical/medical industry and “Dr. Strangelove’s” nutrition blogs. For example, in my book I listed clinical studies that have disproved claims that:

Soy causes breast cancer
Methylfolate is required for everyone with MTHFR deficiency
Folic acid causes colon cancer.
Vitamin E and selenium cause prostate cancer.
B6 and B12 cause lung cancer in men.
Calcium supplements cause heart disease.

Just to name a few. However, new studies suggesting that supplements may be ineffective keep emerging, and each study is ballyhooed by the pharmaceutical/medical industry and the media. Let me update you with my reviews of studies that have been published since my book was written.

However, before I do that, let me put the controversies into perspective by looking at the strengths and weaknesses of the clinical studies behind the headline. I have written two articles on that topic in the past two years.

In “Are Clinical Studies Misleading?” I discuss the reasons why the same kind of clinical studies that work well for determining the efficacy of drugs are ill suited for determining the efficacy of supplements.
In “None Of Us Are Perfect” I point out that clinical studies are based on averages, and none of us are average. What worked for most participants in the study, might not work for you. Conversely, even if a supplement did not work for the average participant in a study, it might work for you.

With that in mind, lets look at some recent studies that have made the headlines.

Omega-3s And Heart Disease Risk

I covered this topic in detail in my book. However, four recent studies have been published since the book was written. One of the studies declared that omega-3s were worthless at reducing heart disease risk. The other three studies were much more positive, although you wouldn’t know that from some of the headlines in the media.

You will find my analysis of the negative study in “Do Omega-3s Reduce Heart Disease Risk?”
You will find my analysis of the three positive studies in:
- “Omega-3s And Heart Disease Risk.”
- “Are Omega-3 Supplements Good For You?”

The bottom line is that evidence for a beneficial effect of omega-3 supplements on reducing heart disease risk is becoming much stronger, although you probably won’t hear that from your doctor or the media. If you want to know how much and what kind of omega-3s are optimal, you will want to read my articles.

Vitamin D: Myths Versus Truth

Two recent studies have been published questioning the importance of vitamin D supplementation. The first study claimed that vitamin D supplementation was ineffective for maintaining healthy bones in the elderly. If you believed the headlines, the second study showed that vitamin D was ineffective at reducing both heart disease and cancer. If you read the paper, you discovered that the authors did show benefits of vitamin D at preventing cancer deaths in the general population and reducing cancer risk in high risk groups. However, both studies suffered from some serious flaws that limited the ability of the studies to clearly demonstrate the benefits of vitamin D supplementation.

You will find my analysis of the vitamin D and bone health study in “Are Vitamin D Supplements Worthless?”
You will find my analysis of the vitamin D, heart health, and cancer study in “The Truth About Vitamin D.”
In “Does Vitamin D Reduce Cancer Risk?” you will find my review of another major clinical study that concluded vitamin D does reduce cancer risk. That study also shows why it has been so difficult for other studies to demonstrate a clear benefit of vitamin D at reducing cancer risk.

The “Dark Side” Of The Food Supplement Industry

I covered the dark side of the supplement industry in great detail in my book “Slaying The Supplement Myths.” Here are a few more examples that have crossed my desk since the book was written:

In “Is The Jellyfish Memory Supplement A Hoax?” I give another example of what the FTC describes as junk science and misleading advertising.
In “Are Curcumin (Turmeric) Benefits Bogus?” I give another example of why it is so important to base supplement claims on clinical studies rather than cell culture and animal studies.
In “Exposing The Dark Side Of The Supplement Industry” I give examples of adulteration (substitution of cheaper ingredients for the ingredient claimed on the label), supplements that are dangerous, and misleading product claims.

What Does The Future Hold?

I have just touched on a few of my most popular articles in the list I gave you above. You may want to scroll through that list to find articles of interest to you that you might have missed. If you don’t see what you are looking for, just go to https://www.chaneyhealth.com/healthtips and type the appropriate term in the search box.

In the coming year, you can look for more articles debunking myths, exposing lies and providing balance to the debate about the health topics that affect you directly. As always, I pledge to provide you with scientifically accurate, balanced information that you can trust. I will continue to do my best to present this information in a clear and concise manner so that you can understand it and apply it to your life.

If you have other topics that you would like me to cover, please click on the link below to enter your suggestions in the comment box.

Final Comment: You may wish to share the valuable resources in this article with others. If you do, then copy the link at the top and bottom of this page into your email. If you just forward this email and the recipient unsubscribes, it will unsubscribe you as well.

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.

Merry Christmas

December 25, 2018 by Dr. Steve Chaney

Merry Christmas 2018

Author: Dr. Stephen Chaney

The Christmas season is a wonderful time of year. It is a time when we get together with family and reconnect with friends. It’s a time of year when we remember the joy of giving and the joy of making the world a better place.

For those of us who are Christians, it is a time to remember that God gave us his only son. But, no matter what our religion, it is a time of year when we can focus on the common beliefs we share and the true purpose of our lives here on earth. It is a time to share the Christmas spirit of peace on earth and good will to all.

The Professor and his family wish you a blessed Christmas and happy, healthy & prosperous New Year.

Enjoy A Stress-Free Holiday Season

December 18, 2018 by Dr. Steve Chaney

Stay Pain Free

Author: Julie Donnelly, LMT –The Pain Relief Expert

Editor: Dr. Steve Chaney

Welcome To December – It’s The Most Wonderful Time Of Year

This is such a beautiful season with lots of special events filling up our time. There are holiday gatherings and good food, in fact, even the TV commercials are more fun to watch than normal. But, how do we still enjoy a stress-free holiday?

This time of year is a mixed blessing for many people. The fun of getting together with friends and family can be tempered with the stress of trying to do too much in a limited time, and the additional stress of the extra financial outlay. It’s easy to forget to take care of ourselves when we’re focusing on a long “to-do” list.

Enjoy A Stress-Free Holiday Season

Here’s a quick 3-minute relaxation technique that will help bring peace and release stress:

Sit in a comfortable chair. Have your hands relaxed at your side, and your feet flat on the floor.
Take 2-3 slow, deep breaths…breathing out tension and mentally sinking down into the chair.
Visualize tension melting like ice cream, starting at your forehead and slowly going all the way down your body until it is flowing out through your fingertips and toes. Enjoy the feeling as the tension is draining away.
Next, visualize pure, positive energy in the form of diamond-dust showering you, moving down from your head and flowing out through your hands and feet. “See” it sparkling…pink, blue, yellow…shining crystals that bring calmness to your body.

Enjoy the feeling for as long as possible before slowly coming back to reality. Once you have done this a few times you’ll be able to sit quietly and fast-forward the entire process to less than a minute.

You Are Your Own Best Therapist

YOU are your own Best Therapist! Visit www.JulstroMethod.com and www.FlexibleAthlete.com to discover logical answers to questions about chronic pain and repetitive strain injuries.

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.

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