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

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.

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.

The Truth About Vitamin D

December 11, 2018 by Dr. Steve Chaney

Does Vitamin D Reduce Risk Of Heart Disease & Cancer?

Author: Dr. Stephen Chaney

You have every right to be confused. One day you are told that vitamin D reduces your risk of heart disease and cancer. The next day you are told vitamin D makes has no effect on those diseases. You are told vitamin D is a waste of money. What should you believe? What is the truth about vitamin D?

In mid-November a major clinical study called VITAL was published. It examined the effect of vitamin D and omega-3s on heart disease and cancer risk. Last week I wrote about the omega-3 portion of the study. This week I will cover the vitamin D portion of the study.

Once again, if you rely on the media for your information on supplementation, you are probably confused. Headlines ranged from “Vitamin D Is Ineffective For Preventing Cancer And Heart Disease to “Vitamin D Lowers Odds Of Cancer Death.” What is the truth?

The problem is that reporters aren’t scientists. They don’t know how to interpret clinical studies. What they report is filtered through their personal biases. That is why I take the time to carefully evaluate the clinical studies, so I can provide you with accurate information. Let me sort through the dueling headlines and give you the truth about vitamin D, cancer, and heart disease.

How Was The Study Designed?

The VITAL study (JE Manson et al, New England Journal of Medicine, DOI: 10.1056/NEJMoa1811403) enrolled 25,871 healthy adults (average age = 67) in the United States. The study participants were 50% female, 50% male, and 20% African American. None of the participants had preexisting cancer or heart disease. The characteristics of the study group were typical of the American population at that age, namely:

The average BMI was 28, which means that most of the participants were significantly overweight.
7% of them had diabetes.

Study participants were given questionnaires on enrollment to assess clinical and lifestyle factors including dietary intake. Blood samples were taken from about 65% of the participants to determine 25-hydroxyvitamin D levels (a measure of vitamin D status) at baseline and at the end of the first year. The participants were given either 2,000 IU of vitamin D/day or a placebo and followed for an average of 5.3 years.

There were two important characteristics of the participants in this study that may have influenced the outcome.

The average 25-hydroxyvitamin D level of participants at the beginning of the study was 31 ng/ml (78 nmol/L). The NIH considers 20-50 ng/ml (50-125 nmol/L) to be the optimal level of 25-hydroxyvitamin D for most physiological functions. This means that study participants started in the middle of the optimal range with respect to vitamin D status.

[Note: The NIH defines the 20-50 ng/ml range as “adequate.” However, I know many of my readers like to aim beyond adequate to reach what they consider to be “optimal.” In the case of vitamin D, that might not be a good idea. The NIH considers anything above 50 ng/ml as associated “with potentially adverse effects.” For that reason, I will refer to the 20-50 ng/ml range as optimal for this article. I wouldn’t want to encourage my readers to be aiming for above 50 ng/ml.]

Only 12.7% of participants had 25-hydroxyvitamin D levels below 20 ng/ml, which the NIH considers to be inadequate. The results with this group were not statistically different from the study participants with optimal vitamin D status, but it is not clear that there were enough people in this subgroup for a statistically valid comparison with participants starting with an optimal vitamin D status.
At the end of the first year, 25-hydroxyvitamin D levels in the treatment group increased to 42 ng/ml (105 nmol/L), which is near the upper end of the optimal range. Thus, for most of the participants, the study was evaluating whether there was a benefit of increasing vitamin D status from the middle to the upper end of the optimal range.
The study allowed subjects to continue taking supplements that contained up to 800 IU of vitamin D. While the authors tried to correct for this statistically, it is a confounding variable.

Does Vitamin D Reduce The Risk Of Cancer?

You may remember from last week that omega-3s were more effective for reducing heart disease risk than for reducing cancer risk. What is the truth about vitamin D and cancer risk? The results are reversed for vitamin D, so I will discuss cancer first.

The study reported that vitamin D supplementation did not reduce a diagnosis of invasive cancer of any type, breast cancer, prostate cancer, or colon cancer during the 5.3-year time-period of this study. This was the result that was reported in the abstract and was what lazy journalists, who never read past the abstract, reported.

However, the rest of the study was more positive. For example, occurrence of invasive cancer of any type was reduced by:

23% in African-Americans.
24% in patients with a healthy body weight.

Several previous studies have suggested that vitamin D may be more effective at preventing cancer in people with a healthy body weight, but the mechanism of this effect is currently unknown.

Most previous studies have not included enough African-Americans to determine whether they respond more favorably to vitamin D supplementation. However, African-Americans have a higher risk of cancer, so this finding deserves follow-up.

In addition, when the study looked at deaths from cancer, the results were very positive. For example:

Cancer deaths during the 5.3-year study period were reduced by 17%.
The longer vitamin D supplementation was continued the more effective it became at reducing cancer deaths. For example,
When the authors excluded cancer deaths occurring during the first year of supplementation, vitamin D reduced cancer deaths by 21%.
When the authors excluded cancer deaths occurring during the first two years of supplementation, vitamin D reduced cancer deaths by 25%.

Finally, no side effects were noted in the vitamin D group.

Does Vitamin D Reduce The Risk Of Heart Disease?

The VITAL study also looked at the effect of vitamin D on heart disease risk. What is the truth about vitamin D and heart disease? The results from this study were uniformly negative. There was no effect of vitamin D supplementation on all major cardiovascular events combined, heart attack, stroke, or death from heart disease. Does that mean vitamin D has no role in reducing heart disease risk? That’s not clear.

The authors had a thought-provoking explanation for why the results were negative for heart disease, but positive for cancer. Remember that the participants in this trial started with a 25-hydroxyvitamin D level of 31 ng/ml and increased it to at least 42 ng/ml with vitamin D supplementation.

The authors stated that previous studies have suggested the 25-hydroxyvitamin D level associated with the lowest risk for heart disease is between 20 and 25 ng/ml. If that is true, most of the participants in this trial were already in the lowest possible risk for heart disease with respect to vitamin D status before the study even started. There would be no reason to expect additional vitamin D to further reduce their risk of heart disease.

In contrast, the authors said that previous studies suggest the 25-hydroxyvitamin D level associated with the lowest risk of cancer deaths is above 30 ng/ml. If that is true, it would explain why vitamin D supplementation in this study was effective at reducing cancer deaths.

However, previous placebo-controlled clinical studies have also been inconclusive with respect to vitamin D and heart disease. My recommendation would be to think of adequate vitamin D status as part of a holistic approach to reducing heart disease – one that includes a heart-healthy diet and a heart-healthy lifestyle – rather than a “magic bullet” that decreases heart disease risk by itself.

As for heart-healthy diets, I discuss the pros and cons of various diets in my book, “Slaying The Food Myths.” As I discuss in my book, the weight of scientific evidence supports primarily plant-based diets that include omega-3s as heart healthy. As an example, the Mediterranean diet is primarily plant-based and is rich in healthy oils like olive oil and omega-3s. It is associated with reduced risk of both heart disease and cancer.

What Is The Truth About Vitamin D?

There is a lot of confusion around the question of whether vitamin D reduces the risk of cancer. This study strengthened previous observation suggesting that vitamin D supplementation decreases cancer deaths. However, it is also consistent with previous studies that have failed to find an effect of vitamin D on cancer development. How can we understand this apparent discrepancy? The authors provided a logical explanation. They pointed out that:

Cancer development takes 20-30 years while this clinical study lasted only 5.3 years. That means that vitamin D supplementation only occurred at the tail end of the cancer development process. In fact, the cancer was already there in most of the patients in the study who developed cancer. It just had not been diagnosed yet. In the words of the authors: “Given the long latency for cancer development, extended follow-up is necessary to fully ascertain potential effects [of vitamin D supplementation].”
In contrast, none of the patients had been diagnosed with cancer when they entered the trial. That means that the patients were diagnosed with cancer during the 5.3-year study period. They were receiving extra vitamin D during the entire period of cancer treatment. Thus, the effect of vitamin D on reducing cancer deaths was easier to detect.

What Does This Study Mean For You?

Vitamin D Is Likely To Decrease Your Risk Of Dying From Cancer: When you combine the results of this study with what we already know about vitamin D and cancer, the results are clear. Vitamin D appears to reduce your risk of dying from cancer. More importantly, the longer you have been supplementing with vitamin D, the greater your risk reduction is likely to be.

Vitamin D May Decrease Your Risk Of Developing Cancer: Association studies suggest that optimal vitamin D status is associated with decreased cancer risk, especially colon cancer risk. However, the long time for cancer development means that we may never be able to prove this effect through double-blind, placebo-controlled clinical trials.

Holistic Is Best: When you combine the VITAL study results with what we already know about vitamin D and heart disease, it appears that supplementing with vitamin D is unlikely to reduce your risk of developing heart disease unless you are vitamin D deficient. However, a holistic approach that starts with a healthy, primarily plant-based diet and makes sure your vitamin D status is adequate is likely to be effective.

The same is likely true for cancer. While the latest study suggests that vitamin D supplementation reduces your risk of dying from cancer, those vitamin D supplements are likely to be even more effective if you also adopt a healthy diet and lifestyle.

How Much Vitamin D Do You Need? The optimal dose of vitamin D is likely to be different for each of us. One of the things we have learned in recent years is that there are significant differences in the efficiency with which we convert vitamin D from diet and/or sun exposure into the active form of vitamin D in our cells. Fortunately, the blood test for 25-hydroxyvitamin D is readily available and is widely considered to be an excellent measure of our vitamin D status.

I recommend that you have your blood level of 25-hydroxyvitamin D tested on an annual basis. Based on the best currently available data, I recommend you aim for >20 ng/ml (50 nmol/L) if you wish to minimize your risk of heart disease and >30 ng/ml (75 nmol/L) if you wish to minimize your risk of cancer. If you can achieve those levels through diet and a multivitamin supplement, that is great. If not, I would recommend adding a vitamin D supplement until those levels are achieved.

Finally, you shouldn’t think of vitamin D as a magic bullet. If you are a couch potato and eat sodas and junk food, don’t expect vitamin D to protect you from cancer and heart disease. You should think of maintaining adequate 25-hydroxyvitamin D levels as just one component of a holistic approach to healthy, disease-free living.

The Bottom Line

There is a lot of confusion around the question of whether vitamin D reduces the risk of cancer and heart disease. A major clinical study has just been published that sheds light on these important questions. It reported:

Vitamin D did not decrease the risk of developing cancer during the 5.3-year study duration. The authors pointed out that cancer takes 20-30 years to develop, which means their study was probably too short to detect an effect of vitamin D on the risk of developing cancer.
Vitamin D did decrease the risk of dying from cancer, and the longer people were supplementing with vitamin D the bigger the protective effect of vitamin D was.
Vitamin D did not decrease the risk of heart disease. However, most study participants had a level of 25-hydroxyvitamin D that was optimal for reducing the risk of heart disease at the beginning of the study. There was no reason to expect that extra vitamin D would provide additional benefit.
With respect to both cancer and heart disease the best advice is to:
- Get your 25-hydroxyvitamin D levels tested on an annual basis and supplement, if necessary, to keep your 25-hydroxyvitamin D levels in what the NIH considers to be an adequate range (20-50 ng/ml).
- We do not have good dose response data for the beneficial effects of vitamin D on heart disease and cancer. However, according to this article, previous studies suggest you may want to am for 25-hydroxyvitamin D levels above 20 ng/ml to reduce the risk of heart disease and above 30 ng/ml to reduce your risk of cancer.
- Consider vitamin D as just one component of a holistic approach to healthy, disease-free living.

For more details about the interpretation of these studies and what they mean for you, read the article above.

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

Are Omega-3 Supplements Good For You?

December 4, 2018 by Dr. Steve Chaney

Do Omega-3s Reduce Risk Of Heart Disease & Cancer?

Author: Dr. Stephen Chaney

Are omega-3 supplements good for you?

You have every right to be confused. In the late 1990s and early 2000s several major clinical studies showed that omega-3 supplements reduced the risk of heart attacks and stroke. In contrast, a few months ago a major study called ASCEND was published that failed to find any benefit of omega-3s at reducing heart disease risk. The headlines said “Omega-3 Supplements Don’t Protect Against Heart Disease”. You were told that omega-3 supplements were worthless. I pointed out the weakness of that study in a previous issue of “Health Tips From the Professor”.

In mid-November two more major clinical studies were published. However, if you rely on the media for your information on supplementation, you are probably still confused. Headlines ranged from “Omega-3 Supplements Do Not Prevent Cancer Or Heart Disease” to “Eating More Fish Or Taking Omega-3 Fish Oil Supplements Can Cut Heart Attack Risk.” What is the truth?

Note: One of the clinical studies looked at the effect of omega-3s on both cancer and heart disease risk. I will discuss the cancer results briefly, but most of my focus will be on the heart disease findings.

How Were The Studies Designed?

The VITAL STUDY (JE Manson et al, New England Journal of Medicine, DOI: 10.1056/NEJMoa1811403 )in the United States. The study participants were 50% female, 50% male, and 20% African American. None of the participants had pre-existing heart disease. The characteristics of the study group were typical of the American population at that age, namely:

The average BMI was 28, which means that most of the participants were significantly overweight.
7% of them had diabetes.
38% were on cholesterol-lowering medications.
50% had high blood pressure treated by medication.

Study participants were given questionnaires on enrollment to assess clinical and lifestyle factors including dietary intake. Blood samples were taken from about 50% of the participants to determine omega-3 index at baseline and at the end of the first year. The participants were given a high purity omega-3 supplement (1 gram capsules containing 840 mg of total omega-3s, 460 mg of EPA, and 380 mg of DHA as the ethyl esters) or a placebo and followed for an average of 5.3 years.

There were two important characteristics of this study that distinguished it from the negative ASCEND study.

This study specifically excluded cardiovascular drugs other than statins and blood pressure medications because many of those drugs provide the same benefits as omega-3s. Patients in the ASCEND study were on 3-5 heart medications
The omega-3 status of participants at the beginning of this study was very low. The omega-3 status of participants in the ASCEND study was near optimal at the beginning of the study.

The REDUCE-IT study (DL Bhatt et al, New England Journal Of Medicine, DOI:10.1056/NEJMoa1812792 ): This study enrolled 8,179 participants (average age = 64) from several countries. The study participants were 70% male and 90% white. The average BMI was 31, which is considered obese. This study differed from the VITAL study in that all the patients were at high risk of heart disease.

70% of them had preexisting heart disease.
The remaining 30% had diabetes plus at least one additional risk factor for heart disease.
In addition, all of them had elevated triglycerides, which is an independent risk factor for heart disease.

The participants were given a high purity EPA supplement (4 grams of EPA as the ethyl ester) or a placebo and followed for an average of 4.9 years.

Do Omega-3s Reduce The Risk Of Heart Disease?

The VITAL Study: The primary end point for this study was something called “major cardiovascular events”, which was a composite every cardiovascular end point measured in the study. For this end point the results were negative. Omega-3 supplementation did not cause a significant decrease in major cardiovascular events compared to the placebo.

This was the result that was reported in the abstract and was what lazy journalists, who never read past the abstract, reported.

However, the rest of the study was very positive. For example, major cardiovascular events were reduced by:

26% in African-Americans.
26% in patients with diabetes.
17% in patients with a family history of heart disease.
19% in patients with two or more risk factors for heart disease.
19% in patients with low fish intake.

In other words, omega-3 supplementation caused a significant decrease in heart disease risk for high risk patients and for patients with a poor diet (low intake of omega-3s).

In addition, several individual cardiovascular events were significantly reduced by omega-3 supplementation. For example:

Heart attacks were reduced by 28% in the general population and by 70% for African-Americans.
Death from heart attacks was reduced by 50%.
Total coronary heart disease was reduced by 17%.
Death from coronary heart disease was reduced by 24%.

In short, headlines saying that omega-3 supplementation can decrease heart attack risk appear to be accurate. Saying that eating more fish can reduce heart attack risk is stretching it a bit. The study was not done with fish, and you would need to eat 2-4 servings of omega-3-rich fish a week to get an equivalent amount of omega-3s. That’s a lot of fish.

The authors attributed the positive results obtained in this study compared to the negative results obtained in several recent studies to four factors:

Many of the previous studies had fewer participants, used lower doses of omega-3s, and were shorter. There may not have been enough statistical power to demonstrate a benefit of omega-3s in those studies.
Participants in many of the previous studies were on multiple medications that mimicked the beneficial effects of omega-3s, making it more difficult to show a positive effect of omega-3 supplementation.
Most of the previous studies either did not measure the omega-3 status of participants or had a study population that started the study with near optimal omega-3 status. The VITAL study showed that omega-3s had a stronger beneficial effect for people who seldom ate fish.
African-Americans were underrepresented in most previous studies. The VITAL study showed that omega-3s were more beneficial for African-Americans than for other ethnic groups.

As for side effects, there was no increased risk of bleeding or any other serious side effect from omega-3 supplementation.

The REDUCE-IT Study: This study of high-risk patients was even more positive than the VITAL study.

The composite of all cardiovascular end points was reduced by 25%.
The risk reduction was greatest for men, non-whites, and people over 65.
The risk reduction was also greatest for people with pre-existing heart disease, very high triglyceride levels, and people who required high-dose statin therapy to keep their cholesterol under control.

In other words, everyone benefited from omega-3 supplementation in this study because they were all at high risk, but those at the highest risk benefitted the most.

When they looked at individual cardiovascular events:

Fatal and non-fatal heart attacks were reduced by 31%.
Cardiovascular death was reduced by 20% and death from any cause was reduced by 23%.
Fatal and non-fatal stroke was reduced by 28%.
Hospitalization for unstable angina was reduce by 32%.

However, this very high dose of EPA was not completely without risk:

1% of patients in the EPA group were hospitalized for atrial fibrillation versus 2.1% in the placebo group.
7% of patients in the EPA group experienced a serious bleeding event compared to 2.1% in the placebo group.

Do Omega-3s Reduce The Risk Of Cancer?

The VITAL Study: The VITAL study also looked at the effect of omega-3s on cancer risk. The results from this study were uniformly negative. There was no effect of omega-3 supplementation on invasive cancer of any type, breast cancer, prostate cancer, colon cancer, or death from cancer. Does that mean omega-3s have no role in reducing cancer risk? That’s not clear.

If we look at previous animal studies and human association studies, reduced cancer risk is seen when omega-3s replaced saturated fats, trans fats, and/or omega-6 fats in the diet. The subjects in the VITAL study ate a typical American diet, and the study made no effort to change what they were eating. It just added an omega-3 supplement. There is relatively little evidence that you can eat burgers and fries and expect omega-3s to reduce cancer risk.

The VITAL study merely confirms what previous studies have suggested. You can’t continue to eat a typical American diet and expect omega-3s to make cancer go away. Omega-3s should be thought of as part of a holistic approach to reducing cancer risk. If they have any role in reducing cancer risk, it is likely to be as part of a primarily plant-based diet that substitutes omega-3s for the bad fats in the American diet.

For example, the Mediterranean diet is primarily plant-based and is rich in healthy oils like olive oil and omega-3s. It is associated with reduced risk of several cancers, especially cancers of the breast and colon.

Are Omega-3 Supplements Good For You?

There is a lot of confusion around the question of whether omega-3s are good for the heart. Some studies say yes. Others say no. If you average all the studies together, as some recent meta-analyses have done, it is easy to throw up your hands and conclude there is no definitive evidence that omega-3s reduce heart disease risk. However, if you look at why the studies differ a clear pattern emerges.

If the study subjects are on multiple heart medications that duplicate the beneficial effects of omega-3s, the studies tend to be negative. If the subjects are only on one or two medications, the studies tend to be positive. Since most people I know would prefer to minimize the number of medications they are on, the negative studies with multiple medications are simply not relevant to them.
If the study subjects are at low risk of heart disease, the studies tend to be negative. If the subjects are at high risk, the studies tend to be positive. This does not mean that omega-3s are of no benefit if you are at low risk of heart disease. It simply reflects the fact it is easier to show a beneficial effect of any intervention when you have a pool of high-risk patients who are likely to experience some sort of cardiovascular event during the time-period of the study.

For example, as discussed in my recent book, “Slaying The Supplement Myths,” this the same pattern you see with statin clinical studies. If patients are at high risk, statin drugs clearly save lives. If they are at low risk, it is almost impossible to show any benefit of statin drugs. Cardiologists extrapolate from the high-risk studies and prescribe statins to low-risk patients. I think it is time to take a similar approach with omega-3s.

If the subjects have a good omega-3 status at the beginning of the study, additional omega-3 supplementation usually has no benefit. If their omega-3 status is poor at the beginning of the study, the results of omega-3 supplementation tend to be positive. This is just common sense. Supplementation is meant to fill gaps in the diet – not to provide a surplus of nutrients. Of course, the reality is many Americans do not get enough omega-3s in their diet.

What Do These Studies Mean For You?

Omega-3s Are Good For Your Heart: When you combine the latest studies with what we already know about omega-3s and heart disease, the results are clear-cut.

If you are at high risk of heart disease, don’t eat many omega-3-rich fish, and/or don’t want to be on a handful of heart medications, the evidence is strong that omega-3s reduce your risk of heart disease.
On the other hand, if you are at low risk of heart disease, eat 2-4 servings of omega-3-rich fish a week, and/or are happy taking multiple heart medications with all their side effects, it is difficult to prove that omega-3s have any benefits. That doesn’t mean that omega-3s don’t have benefits. It just means we can’t prove they do.

If you are still having trouble making up your mind whether omega-3 supplements are the right choice for you, I might remind you:

If you are like millions of Americans, the first sign you are at risk of heart disease might be sudden death.
If you are like most Americans, you are probably not getting enough omega-3s in your diet.
If you prefer taking drugs, you are probably not interested in supplements anyway.

Holistic Is Best: When you combine the VITAL study results with what we already know about omega-3s and cancer, it appears that adding omega-3s to a bad diet is unlikely to reduce your risk of cancer. However, a holistic approach that starts with a healthy, primarily plant-based diet and substitutes omega-3s for the bad fats in the American diet is likely to substantially reduce your cancer risk. The Mediterranean diet might be considered an example of that approach.

The same is likely true for heart health. While the latest two studies suggest that adding omega-3 supplements to your regular diet reduces your heart disease risk, those omega-3 supplements are likely to be even more effective if you also adopt a heart-healthy diet and lifestyle.

Omega-3 Supplements vs Omega-3 Drugs: The Omega-3 preparations used in this study are pharmaceutical-grade omega-3 preparations and are marketed as drugs. Thus, it is likely that many doctors will recommend them rather than less expensive omega-3 supplements. Which choice is best for you?

The preparation used in the VITAL study is similar in composition to many commercially available omega-3 supplements. The main difference is that it is high purity and is subject to the quality control standards required for pharmaceutical drugs. Many omega-3 supplements do not meet these standards, but some do. If you wish to use an omega-3 supplement, do your research. Inquire about their quality control standards and only buy high purity supplements.

The preparation used in the REDUCE-IT study used ultra-pure EPA only. That preparation did not contain any other omega-3s, so a commercially available omega-3 supplement would not be comparable. However, I do not recommend an EPA-only supplement for three reasons.

The results for high risk patients in the REDUCE-IT study were similar to those for high risk patients in the VITAL study. This suggests that removing DHA and other omega-3s may not provide additional protection against heart disease. A head to head comparison of the two supplements would be required to prove the superiority of an EPA-only supplement.
I have the same concern for this high-dose EPA supplement as I have for any high-dose single nutrient supplement. DHA and other omega-3s provide benefits such as cognitive health that EPA does not. Very high dose EPA is likely to interfere with the uptake and utilization of the other omega-3s.
The EPA only supplement used in the REDUCE-IT study had side effects that were not seen with the mixed omega-3 supplement used in the VITAL study. It is not clear whether those side effects were due to differences in dose or differences in formulation.

Omega-3 Ethyl Esters vs Omega-3 Triglycerides: There has been a lot of hype about the superiority of omega-3 triglyceride preparations recently. These studies were both done with omega-3 ethyl esters and proved to be very effective. Until someone shows that omega-3 triglyceride preparations provide better results at reducing heart disease risk than omega-3 ethyl esters, I would leave omega-3 triglyceride supplements on the shelf.

How Much Omega-3s Do You Need? We have too few dose-response studies to reliably predict how much omega-3s are optimal for reducing heart disease risk. The 1 gram/day dose used in the VITAL study gave good results, so that is an excellent starting point. The 4 gram/day dose used in the REDUCE-IT study seemed to provide little additional benefit.

Of course, the optimal dose is likely to be different for each of us. Once the omega-3 index blood test becomes more widely available I would recommend getting your omega-3 index determined on an annual basis and aiming for an omega-3 index of 8 or above, since that is the level associated with a low risk of heart disease.

The Bottom Line

However, two recent studies support the effectiveness of omega-3s for reducing heart disease risk. When you combine the latest studies with what we already know about omega-3s and heart disease, the results are clear-cut.

If you are at high risk of heart disease, don’t eat many omega-3-rich fish, and/or don’t want to be on a handful of heart medications, the evidence is strong that omega-3s reduce your risk of heart disease.
On the other hand, if you are at low risk of heart disease, eat 2-4 servings of omega-3-rich fish a week, and/or are happy taking multiple heart medications with all their side effects, it is difficult to prove that omega-3s have any benefits. That doesn’t mean that omega-3s don’t have benefits. It just means we can’t prove they do.

If you are still having trouble making up your mind whether omega-3 supplements are the right choice for you, I might remind you:

If you are like millions of Americans, the first sign you are at risk of heart disease might be sudden death.
If you are like most Americans, you are probably not getting enough omega-3s in your diet.
If you prefer taking drugs, you are probably not interested in supplements anyway.

In addition, one of the studies confirmed what we already know about omega-3s and cancer. Adding omega-3s to a bad diet is unlikely to reduce your risk of cancer. However, a holistic approach that starts with a healthy, primarily plant-based diet and substitutes omega-3s for the bad fats in the American diet is likely to substantially reduce your cancer risk. The Mediterranean diet might be considered an example of that approach.

For more details read the article above. In addition, the article covers topics like omega-3 supplements versus omega-3 drugs, omega-3 ethyl esters versus omega-3 triglycerides, and how much omega-3s we need. It also discusses why several recent studies have failed to find a benefit of omega-3s for reducing heart disease risk.

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

Do Organic Foods Decrease Cancer Risk?

November 27, 2018 by Dr. Steve Chaney

Is Eating Organic Worth The Cost?

Author: Dr. Stephen Chaney

Millions of Americans choose organic foods whenever possible. However, organic foods are expensive, and some experts claim they are a waste of money. That is why recent headlines claiming that eating organic foods decrease cancer risk have created such a stir. I will look at the study behind the headlines below, but first let me summarize what we do know about organic foods.

I discussed a study comparing organic and conventionally-grown produce in a recent issue, Organic Foods Healthier, of “Health Tips From the Professor”. It was a major study that combined the results from 343 of the best-designed previous studies. The study found that pesticide and herbicide residues were 4-fold lower in organically-raised produce than in conventionally-raised produce. It also found that the polyphenol content of organically-raised produce was slightly higher than in conventionally-raised produce.

Neither of these findings automatically mean that eating organic produce will improve your health. However, there is increasing evidence that pesticide exposure is linked to increased risk of cancer. Thus, it seems logical that eating organic might decrease cancer risk. It is that hypothesis that the current study (J Baudry et al, JAMA Internal Medicine, doi: 10.1001/jamainternmed.2018.4357 ) was designed to test.

How Was The Study Designed?

This study is part of a major French study called NutriNet-Santé that was launched in 2009. The NutriNet-Santé study is web-based study designed to investigate associations between nutrition and health.Volunteers with access to the internet were recruited from the general population. After agreeing to participate in the study, the volunteers were asked to complete a battery of online assessment forms.

The baseline data for the NutriNet-Santé study included age, sex, occupational status, education level, marital status, income, number of children, smoking status, physical activity, and diet. Dietary intake was assessed using three 24-hour dietary recalls collected over a 2-week period. Two of the 24-hour dietary recalls were on weekdays and one was on a weekend.

The dietary recalls were used to create a “score” of diet quality. Without going into detail, diets that favored animal protein, animal fats, sweets, and highly processed foods were considered “poor quality diets.” Diets that favored plant proteins, vegetable oils & and omega-3 fats, fruits, vegetables, and whole grains were considered “good quality diets.”

This portion of the NutriNet-Santé was designed to measure the correlation between organic food consumption and cancer risk. Two months after enrollment in the study, the participants were asked to provide information on the frequency with which they chose the organic version of 16 different types of food. From this information each participant was assigned an “organic food score” ranging from 0 to 32 points.

The participants in this study were also asked to complete a yearly health status questionnaire online. If they reported a cancer diagnosis, they were asked to provide their medical records, and the study physicians contacted the patient’s physician to confirm details of the diagnosis.

A total of 68,946 French adults completed the study (78% female, mean age 44.2 years). They were followed for an average of 4.56 years. During this time period there were 1340 new cancer diagnoses in this population.

Do Organic Foods Decrease Cancer Risk?

The participants were divided into four groups based on their organic food score. When participants with the highest organic food score were compared to those with the lowest organic food score there was a:

25% reduction in total cancer risk.
86% reduction in non-Hodgkin lymphoma risk. This is not a novel finding. A previous study has also suggested eating organic might reduce the risk of non-Hodgkin lymphoma.
76% reduction in all lymphoma risk.
34% reduction in postmenopausal breast cancer risk.

The authors concluded “A higher frequency of organic food consumption was associated with a reduced risk of cancer. Although the study findings need to be confirmed, promoting organic food consumption in the general population could be a promising preventive strategy against cancer.”

These are the results and conclusions that made the headlines. However, the scientists who designed the study were aware of previous data showing that people who eat organic are also more likely to eat a healthy diet and follow a healthy lifestyle. Thus, their statistical analysis of the data considered all factors that might influence cancer risk. This analysis provided a much more nuanced interpretation of the data. They found that the association between increased organic food consumption and decreased cancer risk:

Was significant for women, older adults, individuals with a family history of cancer, individuals who had a poor diet, and former smokers.
Was seen for people of all weights but was greatest for individuals who were obese.
Was non-significant for men, younger adults, individuals with no family history of cancer, individuals who had a good diet, never-smokers, and current smokers.
Was non-significant for other types of cancer.

You are probably wondering “Does this mean organic foods are beneficial for some people, but not for others?” A superficial interpretation of these data might lead to that conclusion, but let’s dig a little deeper.

What Does This Study Mean For You?

In interpreting a study of this type, it is important to ask whether enough people will develop cancer during the study for the results to be statistically significant. That depends on 3 factors:

The number of people enrolled in the study.
The duration of the study.
The probability that participants will develop cancer during the duration of the study.

When you look at the whole study population, all three criteria have been met. There were 68,949 participants who were followed for 4.56 years. During that time 1340 of them developed cancer, of which 459 were breast cancer, 47 were non-Hodgkin lymphomas, and 15 were other lymphomas. A higher frequency of organic food consumption was associated with a decreased in the risk of all these cancers, and that decreased risk was statistically significant. This is the main take-home lesson of the study.

However, when you start to break the study down into subgroups, the number of people in each subgroup and the duration of the study become limiting factors. For example:

We don’t really know whether eating organic foods are unimportant for men or whether there were too few men in the study for any benefit to be statistically significant.
Colon cancer and many other cancers develop gradually over a 10 to 20-year period. We don’t know whether choosing organic foods is unimportant for these cancers or whether 4.56 years is too short a time to show a significant benefit.
The same is true for several of the other variables in this study. For example, if you are an older adult, have a family history of cancer, have a bad diet, and/or have smoked in the recent past, your probability of developing cancer over a 4.56-year time period is relatively high. On the other hand, if you are younger, have no family history of cancer, have a good diet, and have never smoked, your probability of developing cancer during that same time period is very low.

So, how do we interpret the data with these subgroups? We could conclude that eating organic foods in unimportant for people who are young, have no family history of cancer, have a good diet, and have never smoked. A more likely interpretation, however, is that people in these groups have such a low risk of cancer that 4.56 years is too short to demonstrate a benefit of organic foods. It might require a 10, 20, or 30-year study to show benefit of organic foods for these people.

Let me close with three important observations:

People often say too me: “I can’t afford organic fruits and vegetables, but I am concerned about pesticide exposure. Does that mean I should avoid fruits and vegetables?” The data from this study provide a clear answer. Eating lots of fruits and vegetables is beneficial even if you can’t afford organic.

[I also let them know about “The Dirty Dozen” ( Rank Produce Items By Pesticide Level ). This is a list of the fruits and vegetables most likely to be contaminated with pesticides. If your budget for organic foods is limited, these are the most important fruits and vegetables to spend it on.]

I find it ironic that people who consume a poor diet are the ones most likely to experience an immediate benefit from choosing organic foods. This is, of course, the group that is least likely to eat organic.
If you smoke, eating organic probably isn’t going to help you much. Your best bet is to stop smoking.

The Bottom Line

A recent study looked at the association between organic food consumption and cancer risk. When participants who consumed organic foods frequently were compared to those who almost never consumed organic foods there was a:

25% reduction in total cancer risk.
86% reduction in non-Hodgkin lymphoma risk. This is not novel. A previous study has also suggested eating organic might reduce the risk of non-Hodgkin lymphoma.
76% reduction in all lymphoma risk.
34% reduction in postmenopausal breast cancer risk.

These are the results and conclusions that you have seen in the headlines. However, the scientists who designed the study were aware of previous data showing that people who eat organic are also more likely to eat a healthy diet and follow a healthy lifestyle. Thus, their statistical analysis of the data considered all factors that might influence cancer risk. This analysis provided a much more nuanced interpretation of the data, which I have discussed in the article above.

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.

Warm Up Before Stretching

November 20, 2018 by Dr. Steve Chaney

Avoid Muscle Pain Before It Starts

Author: Julie Donnelly, LMT –The Pain Relief Expert

Editor: Dr. Steve Chaney

Happy Thanksgiving!

November is the month that reminds us to be grateful for all the blessings we enjoy because we are Americans. Of course, we should be grateful every day for the freedoms we have in this beautiful country! Have you thought about the freedom you enjoy the most? For me it’s the freedom to worship however I choose because we don’t have a particular religion forced on us. I also love the fact that I can own my business and move it anywhere I like in the entire country.

I hope you’ll give some thought to what you are grateful for as this happy holiday draws near.

Should we warm up before stretching?

Avoid Muscle Pain Before It Starts

Now that the weather has turned cooler in all parts of the USA, more people are exercising outdoors. Are you? Be sure to warm up your muscles before you go running or cycling. One good way to gently and effectively warm up your joints is to bring them into their full range-of-motion. This is also a great morning routine when you first get up.

You have been told to stretch before you exercise. However, stretching while a muscle is tied up with spasms that shorten its fibers may cause the muscle fibers to get micro-tears. You could be creating muscle pain rather than avoiding muscle pain.

As an analogy, think about what happens if you tie a rope in knots and then try to stretch it to its original length without first untying the knots. That is exactly what happens when you try to stretch a muscle that is tight or has spasms. Release the spasms by warming up first, and then stretch. It works great and will assure that you don’t hurt worse after stretching than you did before you stretched.

Warm Up Before Stretching

The key here is not attempting to stretch your muscles, but to just gently move your joints. Here is a whole-body warm-up procedure I recommend.

First, bring your arm all the way across the front of your body, then slowly help the movement by linking your opposite arm across your elbow and pull your arm toward your chest. Repeat this with your opposite arm, loosening the back of your shoulders. Only go to the point of “feels so good,” never to a point of pain.

Then bring both arms as far back as you can, releasing the front of your shoulders. While you’re there, move your head and neck down toward your chest and around to the side, moving the top of your shoulders and neck.

Next, with your arms still out to the side, rotate your arms forward several times, and then backwards several times. Your intention is to move your shoulder joint in as many directions as possible, always doing the movement gently and slowly.

Warm up your waist and lower back by keeping your hips still and rotating your upper body as far to the left as you comfortably can, and then as far to the right. The goal here is to gently move all the joints from your mid-back to your hips.

To loosen your hip joint, you’ll want to easily swing your leg back and forth. If you are standing with your foot on the floor, you’ll need to hold your foot up, so it clears the floor.

When possible, it’s good to be standing on a step or some books so the foot on your swinging leg will be relaxed. Below I am demonstrating by standing on two packs of copy paper.

Stand with your right leg on a step, and then slowly and gently swing your left leg back and forth. Let your leg drop, giving an easy stretch to your hip joint. Then reverse so you can do the same to your right leg & hip. Then hold on to something and swing your leg in front of you, going from side-to-side.

This entire program will take from 5-10 minutes of your time, and its goal is to just get your joints moving. It should always feel good, like you are waking up your joints to prepare for the day. There are many good morning routines to loosen up joints that stiffen while sleeping.

After you have released the knots in your muscles, you can stretch safely. Now you are ready to start your day!

How to Untie the Spasms that are Knotting Up Your Muscles

If your muscles have painful knots, this gentle warm-up procedure is not always enough. I also teach people how to untie the knots (spasms) that form in muscles. Those knots shorten the fibers and put a strain on the joints. I always recommend that you apply direct pressure on the knots, holding the pressure for 30 seconds to press toxins out of the fibers and draw blood into the muscle.

If you have been to see me at my office, you know that I always teach how to do two or three of the Julstro Method self-treatments that will help you stop pain. I’ve been doing this for years, and it works.

Back in 2001 I wrote my first self-treatment book titled The Pain-Free Triathlete. At the time most of my clients were either serious athletes or Ironman triathletes. That ultimately expanded to become a book for the general public and in 2010 I wrote Treat Yourself to Pain-Free Living. Thanks to print-on-demand that book was constantly updated and revised, with the latest version being done in 2018. Then I wrote the updated book for athletes titled: The Pain-Free Athlete.

I also have a DVD stretching program that combines all the self-treatments with a safe Yoga stretching routine. That DVD program is titled Focused Flexibility Training, although it started out as Trigger Point Yoga (only the name was changed).

The 15 Minute Back Pain Solution was another book added to the collection. This book focuses on the muscles that specifically cause low back pain, and hip/groin/knee pain, as well as sciatica. Originally it was only available as a Kindle book, but it is now being printed and will be ready soon.

It’s not difficult to release the tight muscle spasms that are causing you pain, it just takes a bit of direction to know how to find the point and how to treat it. Each of these books and DVD programs show you how to do that quickly and easily.

You can look at each of these books and programs by going to www.JulstroMethod.com/shop

Wishing you well,

Julie Donnelly

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

About The Author

Are High Fat Dairy Foods Good For You?

November 13, 2018 by Dr. Steve Chaney

Can You Have Your Cream And Eat It Too?

Author: Dr. Stephen Chaney

Dairy foods can play an important role in helping us get enough calcium in our diet and may provide some other benefits (discussed below). However, many dairy foods contain a lot of saturated fat. Thus, we have been told to select low-fat dairy foods. So, what should we make of the recent headlines and blogs telling us that high-fat dairy foods are good for us?

Are high fat dairy foods good for us?

To answer that question, I picked a recent article (F. Imamura et al, PLOS Medicine, doi: 10.1371/journal.pmed.1002670 ) claiming that dairy fats lower the risk of type 2 diabetes and did an in-depth analysis of the data behind the headlines.

Fat Chemistry 101

Before I get started, let me cover what I call “Fat Chemistry 101”. Sorry, professors never fully retire.

Fat Nomenclature: Let me briefly describe some of the nomenclature that chemists and biochemists use when they describe fats. Fats, or triglycerides, are generally defined as three fatty acids attached to a molecule of glycerol. The chemical nomenclature for fatty acids consists of a “C” followed by the number of carbons in that fatty acid. That, in turn, is followed by a colon (:) and the number of doubles bonds (0 for a saturated fatty acid, 1 for a monounsaturated fatty acid, and 2 or more for a polyunsaturated fatty acid). Let me give some examples, specifically the examples I will refer to in this article.

Saturated fatty acids:

C15:0 (pentadecanoic acid)
C16:0 (palmitic acid)
C17:0 (heptadecanoic acid)
C18:0 (stearic acid)

Monounsaturated fatty acids:

C18:1 (oleic acid)

C16:0, and C18:0 are referred to as even-chain fatty acids (They have an even number of carbon atoms). C15:0 and C17:0 are referred to as odd-chain fatty acids (They have an odd number of carbon atoms).

C16:0 (palmitic acid) is the most abundant saturated fatty acid in meats and dairy food. C18:0 (stearic acid) is the second most abundant saturated fatty acid in these foods. The odd-chain fatty acids C15:0 and C17:0 are primarily found in dairy fat although small amounts can also be found in meat and fish.

All saturated fats raise LDL cholesterol. However, the effect is not equally strong for all saturated fats. The effect on LDL cholesterol is strongest for palmitic acid (C16:0). It is weaker for stearic acid, possibly because stearic acid (C18:0) can be metabolized to oleic acid (C18:1), which has no effect on LDL cholesterol.

Foods Are A Complex Mixture Of Fats: We generally think of saturated fats coming from meat and dairy, monounsaturated fats coming from olive oil and avocados, and polyunsaturated fats as coming from vegetable oils, seeds, and nuts. However, that is an oversimplification. Meats also contain monounsaturated and polyunsaturated fats. Olive oil contains some saturated and polyunsaturated fats. Vegetable oils also contain monounsaturated and saturated fats.

Why do I even mention this? It is important because we tend to label a food “good” or “bad” based on its most abundant fat. Perhaps we would be better served if we considered all the major fats in that food before deciding whether it is good or bad for us.

How Was The Study Designed?

With that background in mind, let us turn our attention to the current study. The authors wished to test the hypothesis that high-fat dairy foods might decrease the risk of type 2 diabetes. The results of previous studies had been mixed, but the authors hypothesized that might have been due to the limitations of using dietary recalls to assess intake of high-fat dairy foods. Specifically, they theorized that dietary recalls tend to underestimate the less apparent sources of dairy fats such as creams, sauces, cheeses, and butter used as part of meal preparation or in prepared foods.

They postulated that blood and tissue concentrations of the odd-chain fatty acids (C15:0 and C17:0) would be a much better biomarker of dairy fat consumption than dietary recalls. They performed a meta-analysis of all studies that measured blood or tissue levels of odd-chain fatty acids and looked at type 2 diabetes as an outcome.

Their meta-analysis included 16 studies from 12 countries with a total of 63,682 participants (age range: 49 to 76 years). The participants were slightly overweight, but none of them had type 2 diabetes at the beginning of the studies. The participants were followed for an average of 9 years. By the end of the studies 15,180 (24%) had developed type 2 diabetes.

Are High Fat Dairy Foods Good For You?

When the authors compared the highest versus the lowest levels of odd-chain fatty acids in the subjects, the results of the study were as follows:

The highest level of C15:0 fatty acids was associated with a 20% lower incidence of type 2 diabetes.
The highest level of C17:0 fatty acids was associated with a 35% lower incidence of type 2 diabetes. This is consistent with several previous studies that have suggested C17:0 fatty acids are a better predictor of type 2 diabetes than C15:0 fatty acids.
When these data were combined the overall effect was a 29% lower incidence of type 2 diabetes.

The authors concluded: “These novel findings support the need for additional clinical and molecular research to elucidate the potential effects of [odd-chain] fatty acids on glucose-insulin metabolism and the potential role of selected [high-fat] dairy products for the prevention of type 2 diabetes.”

What Does This Study Mean For You?

On the surface, this looks like a very strong study. It is, after all, a meta-analysis with over 68,000 subjects. It also used biomarkers for dairy fat consumption rather than relying on less accurate dietary recalls. Finally, it is consistent with several earlier studies suggesting that high-fat dairy foods decrease the risk of type 2 diabetes and heart disease. What could go wrong?

The answer is “Plenty.”

Studies looking at the effect of high-fat dairy foods on the risk of heart disease and type 2 diabetes have been inconsistent. Some have shown benefit, but others have come up empty. Despite the inconsistent results, the idea that high-fat dairy foods might be good for us has gotten a lot of media attention. I suspect that is because this is the kind of news we really want to be true. After all, wouldn’t it be great news if we could eat all the cheese, cream, and butter we wanted?
Some studies have concluded that high-fat and low-fat dairy products were equally effective at decreasing the risk of heart disease and type-2 diabetes. If these studies are correct, they would suggest something else in dairy foods is protective, not the kind of fat.
The odd-chain saturated fatty acids are very minor constituents of dairy fat. Together, they represent 1.3% of the fatty acids in dairy fat. In contrast, even-chain saturated fatty acids make up 68% of the fatty acids in dairy fat. Palmitic acid (C16:0) makes up 30% or 23 times the concentration of odd-chain fatty acids. Stearic acid (C18:0) makes up 12% or 9 times the concentration of odd-chain fatty acids.
This study, and most previous studies, have just looked at the association between odd-chain fatty acids and type 2 diabetes. They do not prove cause and effect.
No mechanism has been proposed that would account for the proposed beneficial effects of odd-chain saturated fatty acids, especially in the presence of much higher concentrations of even-chain saturated fatty acids.
A study published last year (BJ Jenkins et al, Scientific Reports, 7:44845, doi: 10.1038/srep44845 ) reported that blood levels of C15:0 were dependent on intake of dairy foods, but that blood levels of C17:0 were independent of dairy intake. These authors presented evidence showing C17:0 in the human body resulted from metabolism of C18:0 (stearic acid) in our diet rather than coming from dairy fats.

In other words, the odd-chain fatty acid (C15:0) that comes from dairy foods is the one that has only a weak association with the risk of developing type 2 diabetes. The odd-chain fatty acid with a strong association with diabetes risk is synthesized in our bodies from stearic acid (C18:0), a fatty acid that is also found at high levels in meat.

So, are high fat dairy foods good for you? More studies are needed.

The Bottom Line

A recent study has reported that high-fat dairy products may reduce the risk of type 2 diabetes. This is consistent with a few other studies that have suggested high-fat dairy products may reduce the risk of diabetes and heart disease.

The idea that high-fat dairy foods might be good for us has gotten a lot of media attention. I suspect that is because this is the kind of news we really want to be true. After all, wouldn’t it be great news if we could eat all the cheese, cream, and butter we wanted?

However, the clinical results have been inconsistent. Some have shown benefit, but others have come up empty. Most of the studies also had significant limitations. I have discussed the limitations of the current study in the article above.

We can remain hopeful that high-fat dairy foods will eventually be shown to be good for us, but until we have stronger evidence for the proposed benefits of dairy fats, my recommendation is to consume high-fat dairy products sparingly.

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.

Is Our Microbiome Affected By Exercise?

November 6, 2018 by Dr. Steve Chaney

Microbiome Mysteries

Author: Dr. Stephen Chaney

In a recent post, What is Your Microbiome and Why is it Important, of “Health Tips From The Professor” I outlined how our microbiome, especially the bacteria that reside in our intestine, influences our health. That influence can be either good or bad depending on which species of bacteria populate our gut. I also discussed how the species of bacteria that populate our gut are influenced by what we eat and, in turn, influence how the foods we eat are metabolized.

I shared that there is an association between obesity and the species of bacteria that inhabit our gut. At present, this is a “chicken and egg” conundrum. We don’t know whether obesity influences the species of bacteria that inhabit our gut, or whether certain species of gut bacteria cause us to become obese.

Previous studies have shown that there is also an association between exercise and the species of bacteria that inhabit our gut. In particular, exercise is associated with an increase in bacteria that metabolize fiber in our diets to short chain fatty acids such as butyrate. That is potentially important because butyrate is a primary food source for intestinal mucosal cells (the cells that line the intestine). Butyrate helps those cells maintain the integrity of the gut barrier (which helps prevent things like leaky gut syndrome). It also has an anti-inflammatory effect on the immune cells that reside in the gut.

However, associations don’t prove cause and effect. We don’t know whether the differences in gut bacteria were caused by differences in diet or leanness in populations who exercised regularly and those who did not. This is what the present study (JM Allen et al, Medicine & Science In Sports & Exercise, 50: 747-757, 2018 ) was designed to clarify. Is our microbiome affected by exercise?

How Was The Study Designed?

This study was performed at the University of Illinois. Thirty-two previously sedentary subjects (average age = 28) were recruited for the study. Twenty of them were women and 12 were men. Prior to starting the study, the participants filled out a 7-day dietary record. They were asked to follow the same diet throughout the 12-week study. In addition, a dietitian designed a 3-day food menu based on their 7-day recall for the participants to follow prior to each fecal collection to determine species of gut bacteria.

The study included a two-week baseline when their baseline gut bacteria population was measured, and participants were tested for fitness. This was followed by a 6-week exercise intervention consisting of three supervised 30 to 60-minute moderate to vigorous exercise sessions per week. The exercise was adapted to the participant’s initial fitness level, and both the intensity and duration of exercise increased over the 6-week exercise intervention. Following the exercise intervention, all participants were instructed to maintain their diet and refrain from exercise for another 6 weeks. This was referred to as the “washout period.”

VO_2max (a measure of fitness) was determined at baseline and at the end of the exercise intervention. Stool samples for determination of gut bacteria and concentrations of short-chain fatty acids were taken at baseline, at the end of the exercise intervention, and again after the washout period.

In short, this study divided participants into lean and obese categories and held diet constant. The only variable was the exercise component.

Is Our Microbiome Affected By Exercise?

The results of the study were as follows:

Fitness, as assessed by VO_2max, increased for all the participants, and the increase in fitness was comparable for both lean and obese subjects.
Exercise induced a change in the population of gut bacteria, and the change was comparable in lean and obese subjects.
Exercise increased fecal concentrations of butyrate and other short-chain fatty acids in the lean subjects, but not in obese subjects.
The exercise-induced changes in gut bacteria and short-chain fatty acid production were largely reversed once exercise training ceased.

The authors concluded: “These findings suggest that exercise training induces compositional and functional changes in the human gut microbiota that are dependent on obesity status, independent of diet, and contingent on the sustainment of exercise.” [Note: To be clear, the exercise-induced changes in both gut bacteria and short-chain fatty acid production were independent of diet and contingent on the sustainment of exercise. However, only the production of short-chain fatty acids was dependent on obesity status.]

What Does This Study Mean For You?

There are two important take home lessons from this study.

With respect to our gut bacteria, I have consistently told you that microbiome research is an emerging science. This is a small study, so you should regard it as the beginning of our understanding of the effect of exercise on our microbiome rather than conclusive by itself. It is consistent with previous studies showing an association between exercise and a potentially beneficial shift in the population of gut bacteria.

The strength of the study is that it shows that exercise-induced changes in beneficial gut bacteria are probably independent of diet. However, it is the first study to look at the interaction between obesity, exercise and gut bacteria, so I would interpret those results with caution until they have been replicated in subsequent studies.

With respect to exercise, this may be yet another reason to add regular physical activity to your healthy lifestyle program. We already know that exercise is important for cardiovascular health. We also know that exercise increases lean muscle mass which increases metabolic rate and helps prevent obesity. There is also excellent evidence that exercise improves mood and helps prevent cognitive decline as we age.

Exercise is also associated with decreased risk of colon cancer and irritable bowel disease. This effect of exercise has not received much attention because the mechanism of this effect is unclear. This study shows that exercise increases the fecal concentrations of butyrate and other short-chain fatty acids. Perhaps, this provides the mechanism for the interaction between exercise and intestinal health.

The Bottom Line

A recent study has reported that:

Exercise induces a change in the population of gut bacteria, and the change was comparable in lean and obese subjects.
Exercise causes an increase in the number of gut bacteria that produce butyrate and other short-chain fatty acids that are beneficial for gut health.
These effects are independent of diet, but do not appear to be independent of obesity because they were seen in lean subjects but not in obese subjects.
The exercise-induced changes in gut bacteria and short-chain fatty acid production are largely reversed once exercise training ceases.

For more details and my interpretation of the data, read the article above.

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

Are Vitamin D Supplements Worthless?

October 30, 2018 by Dr. Steve Chaney

Are We Asking The Right Question?

Author: Dr. Stephen Chaney

We have been told that vitamin D is a miraculous “must have” vitamin. We have been told it’s not just important for healthy bones. It’s also important for a strong immune system, heart health, protection from cancer, and many other health benefits. We have been told that we should get our 25-hydroxy vitamin D levels tested and supplement with extra vitamin D if they are low.

Now, the latest headlines are saying all of that is wrong. They are telling us vitamin D supplements do not improve bone density or protect against falls and bone fractures. They are telling us to forget all the other claimed benefits of vitamin D. Those claims have been disproved. Forget about the 25-hydroxy vitamin D tests. They are a waste of money.

What is the truth? Why is it so confusing? Are vitamin D supplements worthless? Let me guide you through the claims and counterclaims so you can discover the truth for yourself.

How Did Vitamin D Become So Popular?

Let’s start with a brief history of vitamin D. It all started with the industrial revolution in Northern Europe. Suddenly, children and adults in the large cities were spending the bulk of their waking hours in dark factories rather than outdoors on the farm. They were already living in northern latitudes where sunlight was weak during the winter months. To make matters worse pollution from the factories was creating a haze that blocked the sunlight.

That lead directly to the discovery that sunlight was crucial to our body’s ability to synthesize vitamin D and that vitamin D was essential for building strong bones. The solution to the public health crisis of rickets and osteomalacia was to fortify dairy products with vitamin D. The almost universal adaptation of vitamin D fortification virtually eliminated rickets and osteomalacia except in association with certain rare diseases. The two important lessons learned from this experience were:

Vitamin D is essential for healthy bone formation.
Vitamin D supplementation improves bone health for individuals who are deficient in vitamin D

As we discuss the latest findings, we need to keep in mind that these fundamental principles have not changed.

In the late 20^th century our understanding of vitamin D took another leap with the discovery that vitamin D receptors were not restricted to bone cells. Almost every cell in our body contained vitamin D receptors. That lead to studies showing that people with low vitamin D intakes were more likely to experience heart disease, cancer, some autoimmune diseases, and infectious diseases such as flu than people with high vitamin D intakes.

The final leap in our understanding of vitamin D took place when the medical profession started routinely testing blood levels of 25-hydroxy vitamin D. That is when we discovered that some people who appeared to have adequate intake of vitamin D and/or adequate exposure to sunlight had low blood levels of 25-hydroxy vitamin D. Furthermore, follow-up studies showed that low 25-hydroxyvitamin D levels correlated with an increased risk of heart disease, cancer, and infectious disease. The important lessons learned from these experiments were:

Vitamin D deficiency is associated with increased risk of multiple diseases.
25-hydroxy vitamin D tests are the best way to measure vitamin D deficiency.

Once again, these fundamental principles have not changed.

What Did The Study Show?

The study (MJ Bolland et al, Lancet Diabetes Endocrinology 2018) behind the headlines was a meta-analysis of 81 randomized, placebo-controlled studies with a total of 53,537 subjects that looked at the effect of vitamin D supplementation in elderly populations on bone mineral density, bone fractures, and falls.

The meta-analysis only included studies in which vitamin D intake was the sole variable. In many cases the subjects were not taking a calcium supplement. If they were taking a calcium supplement, both the vitamin D group and placebo group were taking the same amount of calcium.

The results were unequivocal. In this study vitamin D supplementation had no effect on bone mineral density, bone fractures, or falls in elderly populations. The authors concluded “There is little justification to use vitamin D supplements to maintain or improve musculoskeletal health.”

Is this conclusion justified? Let’s put the findings of this study into a broader perspective.

Are We Asking The Right Questions?

Before throwing out our vitamin D supplements let’s ask whether this study is asking the right question. I have covered this topic in detail in my new book “Slaying The Supplement Myths” (https://slayingthesupplementmyths.com) with respect to similar studies that had called into question the value of calcium supplements for bone health. Let me cover the highlights here.

In my book I created the graphic on the right to put the question of who benefits from supplementation into perspective. For the purposes of this discussion, I will just focus on poor diet (or, in the case of vitamin D, poor exposure to sunlight). As I discussed above, science shows that people who are not getting enough vitamin D from diet and sunlight benefit from vitamin D supplementation. Unfortunately, vitamin D enthusiasts and some supplement companies have muddied the waters by going beyond what good science shows and suggesting or implying that everyone will benefit from vitamin D supplementation.

This is part of the problem. Once you have created a paradigm that everyone will benefit from vitamin D supplementation, that paradigm is easy to disprove. If someone already has adequate, or nearly adequate, levels of 25-hydroxy vitamin D, would we expect additional vitamin D to make a difference? Of course not, but that is exactly the question the most recent study was asking.

In discussing the limitations of their study, the authors said: “It is possible that trials of populations with low baseline 25-hydroxy vitamin D might produce different results because only 4 trials, involving 831 participants (1.6% of all participants), reported mean baseline 25-hydroxy vitamin D levels lower than 25 nmol/L (the level indicating vitamin D deficiency).

In other words, the study did not measure the effect of vitamin D supplementation for people who were vitamin D deficient. The only take-home lesson from this study is that people with adequate, or near adequate, vitamin D status do not benefit from vitamin D supplementation. That is a “no-brainer.”

Vitamin D And A Bone Healthy Lifestyle

The other glaring deficiency of this study is that it was only measuring the effect of vitamin D on bone health. They purposely excluded any other factor that might influence bone health. That was a fatal flaw because healthy bone requires a holistic approach, not individual nutrients. In my book Slaying the Supplement Myths I refer to this as a “bone healthy lifestyle.”

The most important feature of a “bone healthy lifestyle” is this:

Calcium, vitamin D, and resistance (weight bearing) exercise are all essential for healthy bones.
However, none of them is sufficient by itself. You need all three. You need a holistic approach if you wish to build strong bones.

Simply put, that means unless you include adequate calcium and exercise there is no reason to expect vitamin D supplementation to help build strong bones. Unfortunately, none of the studies included in the recent meta-analysis took a holistic approach to bone health. Some included calcium, but many didn’t. Resistance exercise was never considered. The studies were doomed to failure.

When you include flawed studies in your meta-analysis, you have what computer programmers call “Garbage in. Garbage out.” A meta-analysis can never be stronger than the individual studies it includes.

Other features of a “bone healthy lifestyle” include:

We need more than calcium and vitamin D for strong bones. We need magnesium, zinc, copper, manganese, vitamin C and vitamin K. If we are deficient in any of these, calcium will not be utilized as efficiently.
The foods we eat are also important. Our bones serve as a buffer system to keep our bodies slightly alkaline. Every time we eat acid-forming foods a little bit of bone is dissolved to neutralize the acid. For optimal bone health we need to minimize acid-forming foods and eat more alkaline-forming foods. That means we need to avoid sodas, sweets and refined grains. We also need to minimize meats, eggs, and dairy. Instead, we should focus on fruits, vegetables, peas, beans, lentils, seeds, and nuts.
Beware of drugs. The list of common medications that dissolve bones is a long one. Some of the worst offenders are anti-inflammatory steroids such as cortisone and prednisone, drugs to treat depression, drugs to treat acid reflux, and excess thyroid hormone. I am not suggesting that you should avoid properly prescribed medications. I would suggest you ask your doctor or pharmacist whether the drugs you are taking adversely affect bone density. If they do, you should pay a lot more attention to the other aspects of a “bone healthy lifestyle.”

Are Vitamin D Supplements Worthless?

Now we can come back to the question “Are vitamin D supplements worthless?” as the recent headlines have suggested. If you phrase the question as “Does everyone benefit from vitamin D supplementation?” or “Is vitamin D supplementation alone sufficient to build strong bones?” the answer is a clear no.

However, those are the wrong questions. If you ask: “Does vitamin D supplementation benefit people who are vitamin D-deficient?” the answer is a clear yes. If you ask: “Does a holistic approach that includes resistance exercise, adequate calcium, and adequate vitamin D improve bone health?” the answer is likely to be yes as well.

What about the headlines claiming that vitamin D is also worthless for strengthening the immune system and reducing the risk of heart disease, cancer, and auto-immune diseases? The studies on which these claims are based suffer from the same flaws. They are asking the same wrong questions.

My recommendations:

Have your blood levels of 25-hydroxy vitamin D tested on a regular basis. I have them tested each year when I get my physical.
If your blood levels of 25-hydroxy vitamin D are below 25 nmol/L (which the NIH considers deficient), you are likely to benefit from vitamin D supplementation. If they are above 50 nmol/L (which the NIH considers sufficient), vitamin D supplementation is unlikely to provide additional benefit. However, that level of vitamin D doesn’t guarantee that you will have strong bones. You also need sufficient calcium and resistance exercise.
If your blood levels are in the insufficient range (between 25 nmol/L and 50 nmol/L), the situation is more complicated. If you are close to 50 nmol/L, you may benefit slightly from adding a vitamin D supplement, but the benefit will be too small to show up in a clinical study such as the one that resulted in the recent headlines. My advice is to look at your diet and medication use. If they put you at risk for low bone density, my recommendation would be to add a vitamin D supplement – along with adequate calcium and resistance exercise, of course. If you are closer to 25 nmol/L, you will likely benefit from a vitamin D supplement along with adequate calcium and exercise.
Don’t think of vitamin D supplementation as a “magic bullet” that will solve all your ills. Instead, think of it as just one component of a holistic approach to a bone healthy lifestyle.

The Bottom Line

A recent meta-analysis concluded that vitamin D supplementation did not improve bone mineral density, reduce bone fractures, or reduce falls in the elderly. While this conclusion was definitive, the study was asking the wrong questions.

We know that vitamin D improves bone health for people who are vitamin D-deficient. However, only 1.6% of the people in this study were vitamin D-deficient at the beginning of the study. That means the study was really asking: “If people have adequate, or near adequate, vitamin D status, does vitamin D supplementation provide any additional benefit?” The answer to that question is a “no-brainer.” There is no reason to expect that additional vitamin D would provide benefit.
We know that while vitamin D is essential for building strong bones, it is not sufficient by itself. Strong bones require a holistic approach that includes resistance exercise, adequate calcium, and adequate vitamin D. However, this study only looked at the effect of vitamin D on bone health. Calcium and exercise were excluded from consideration. That means the study was really asking: “Is vitamin D a “magic bullet” that can build strong bones by itself?” Again, there is no reason to expect vitamin D to provide much benefit under those conditions.

My recommendations:

Have your blood levels of 25-hydroxy vitamin D tested on a regular basis. I have them tested each year when I get my physical.
If your blood levels of 25-hydroxy vitamin D are low, you are likely to benefit from vitamin D supplementation. If they are already optimal, vitamin D supplementation is unlikely to provide additional benefit.
Don’t think of vitamin D supplementation as a “magic bullet” that will keep your bones strong by itself. Instead, think of it as just one component of a holistic “bone healthy lifestyle.”

For more details and to see my detailed recommendations, 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.