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

Colon Cancer Prevention and Anti-Inflammatory Diets

June 26, 2018 by Dr. Steve Chaney

How Can You Reduce Colon Cancer Risk?

Author: Dr. Stephen Chaney

Colorectal cancer is third most common form of cancer in the United States. The American Cancer Society estimates that there will be 140,000 new cases and 50,000 deaths from colorectal cancer in 2018. The death rate has been decreasing due to more aggressive screening, but it is still much too high.

Thus, there is considerable interest in discovering colon cancer prevention we can control. Several studies have suggested that inflammatory diets may be one preventable cause of colon cancer. There are many reasons for suspecting that inflammation may increase colon cancer risk. For example, we know:

Inflammation plays an important mechanistic role in cancer development.
Obesity causes a chronic state of low-grade inflammation, and obesity increases colon cancer risk.
Inflammatory bowel disease increases the risk of colon cancer.
Anti-inflammatory medications such as aspirin decrease colon cancer risk.

However, it has been difficult to prove that inflammatory diets increase colon cancer risk. In part, that is because we can’t measure inflammation directly. We must rely on inflammatory markers such as C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor (TNF). Unfortunately, these markers correlate with different inflammatory processes in the body and seldom increase or decrease in unison.

The authors of the current study (FK Tabung et al, JAMA Oncology, 4: 366-373, 2018 ) used a dietary scoring system based on all three inflammatory markers to examine the correlation between an inflammatory diet and colon cancer risk.

How Was The Study Done?

This study made use of data collected from 46,804 men enrolled in the Health Professionals Follow-up Study (conducted between 1986 and 2012) and 74,246 women enrolled in the Nurses’ Health Study (conducted between 1984 and 2012). Lifestyle, medical, and other health-related information were collected every 2 years. A comprehensive dietary questionnaire was administered every 4 years. During the 26-year follow-up period 2699 cases of colon cancer were diagnosed.

The inflammatory potential of the diet was estimated using an index called the empirical dietary inflammation pattern (EDIP) score that the authors had developed in a previous study (FK Tabung et al, Journal of Nutrition, 146: 1560-1570, 2016 ). This index was based on the effects of individual foods on all three markers of inflammation (CRP, IL-6, and TNF). Inflammatory foods had positive EDIP scores (they increased levels of one or more of the inflammatory markers). Anti-inflammatory foods had negative EDIP scores (they decreased levels of one or more inflammatory markers).

Most of the EDIP scores were consistent with previous studies on the inflammatory potential of various foods. For example:

Red meats, processed meats, refined grains, sugar-sweetened beverages, and diet beverages all scored as highly inflammatory.
One serving of beer or wine, coffee, dark yellow vegetables, and leafy green vegetables all scored as highly anti-inflammatory.

Colon Cancer Prevention By Avoiding Inflammatory Diets

The subjects enrolled in the study were divided into five groups based on their inflammatory diet (EDIP) scores. When the investigators compared subjects who had the most inflammatory diet with subjects who had the least inflammatory diet:

The risk of colon cancer was increased by 44% in men and 22% in women.
People who refrain from alcohol consumption received even greater benefit from anti-inflammatory diets. For teetotalers an anti-inflammatory diet decreased colon cancer risk by 62% in men and 33% in women.

The authors concluded: “Findings from this large prospective [that is scientific jargon meaning the study was carried out over a period of many years] study support a role for the inflammatory potential of diet in colorectal cancer development, suggesting inflammation as a potential mechanism linking dietary patterns and colorectal cancer development.”

How To Prevent Colon Cancer Or At Lest Reduce The Risk?

Of course, holistic approaches are always best. Reducing colon cancer risk involves much more than simply consuming an anti-inflammatory diet. To put this study in perspective, let’s look at what the American Cancer Society recommendations about modifiable lifestyle factors that increase your risk of colon cancer. So, consider these when you think about colon cancer prevention. I call this the 10,000-foot view because they only list the biggest contributors to colon cancer – the ones for which there is the most scientific evidence (I have put their exact comments in quotes):

#1: Being overweight or obese. “If you are overweight or obese your risk of developing and dying from colorectal cancer is higher”.

#2: Physical inactivity. “If you are not physically active, you have a greater chance of developing colon cancer.”

#3: Certain types of diets.

“A diet that’s high in red meats (such as beef, pork, lamb, or liver) and processed meats (like bacon, sausage, hot dogs and some luncheon meats) raises your colorectal cancer risk.” My comment: The evidence is stronger for red meats and processed meats than for any other foods. Processed meats are listed as likely carcinogens and red meats are listed as probable carcinogens by the International Agency For Research On Cancer (IARC), an agency of the WHO.
“Cooking meats at very high temperatures (frying, broiling, or grilling) creates chemicals that may raise your cancer risk.”

#4: Smoking. “People who have smoked for a long time are more likely than non-smokers to develop and die from colorectal cancer.”

#5: Heavy alcohol use. “Colorectal cancer has been linked to moderate to heavy alcohol use. Limiting alcohol use to no more than 2 drinks a day for men and 1 drink a day for women could have many health benefits, including a lower risk of many kinds of cancer. “

#6: Early detection. In case you have not heard, the American Cancer Society just released new guidelines recommending that screening for colon cancer begin at age 45.

If you want to take a closer look at the diet – colon cancer connection, you might be interested in the recommendations of Harvard’s Men’s Health Watch newsletter.

In terms of inflammatory foods that increase colon cancer risk, they list red meats, fried foods, sugary beverages, and refined carbohydrates.
In terms of anti-inflammatory foods that likely decrease cancer risk, they list tomatoes, olive oil, green leafy vegetables, nuts like almonds and walnuts, fatty fish, and fruits like strawberries, blueberries, cherries, and oranges.

What Does This Mean For You?

If you are confused about the conflicting information about which foods affect colon cancer risk, start with the American Cancer Society recommendations. Avoid red meats and processed meats as much as possible and don’t cook your meats at high temperatures. I realize this is not popular advice at the time of year when everyone is firing up their grills for summer cookouts, but these recommendations will go a long way towards colon cancer prevention. Don’t shoot the messenger. I’m just conveying information based on the best scientific evidence we have to date.

For best results follow the recommendations of the Harvard Men’s Health Watch newsletter to also avoid fried foods, sugary beverages and refined carbohydrates and add anti-inflammatory foods such as fresh fruits & vegetables, nuts, olive oil, and fatty fish.

With Harvard’s recommendations in mind, let me extend an olive branch to all of you red meat lovers. An ounce or two of red meat in a green salad or a stir fry with lots of fresh, colorful vegetables is much less likely to increase your risk of cancer than a steak or burger with fries. You will find more information on this topic in my book “Slaying The Food Myths.”

The Bottom Line:

A major study has just been published looking at the correlation between an inflammatory diet and colon cancer risk. When the investigators compared subjects who had the most inflammatory diet with subjects who had the least inflammatory diet:

The risk of colon cancer was increased by 44% in men and 22% in women.
People who refrain from alcohol consumption received even greater benefit from anti-inflammatory diets. For teetotalers an anti-inflammatory diet decreased colon cancer risk by 62% in men and 33% in women.

The authors concluded: “Findings from this large study support a role for the inflammatory potential of diet in colorectal cancer development, suggesting inflammation as a potential mechanism linking dietary patterns and colorectal cancer development.”

If you are confused about the conflicting information about which foods are inflammatory and anti-inflammatory, start with the American Cancer Society recommendations. Avoid red meats and processed meats as much as possible and don’t cook your meats at high temperatures. I realize this is not popular advice at the time of year that everyone is firing up their grills for summer cookouts, but these recommendations will go a long way towards colon cancer prevention.

For best results follow the recommendations of the Harvard Men’s Health Watch newsletter to also avoid inflammatory foods such as fried foods, sugary beverages and refined grains and add anti-inflammatory foods such as fresh fruits & vegetables, nuts, olive oil, and fatty fish.

With Harvard’s recommendations in mind, let me extend an olive branch to all of you red meat lovers. An ounce or two of red meats in a green salad or a stir fry with lots of fresh, colorful fruits and vegetables is much less likely to increase your risk of cancer than a steak or burger with fries. You will find more information on this topic in my book “Slaying The Food Myths.”

For more details on the American Cancer Society and Harvard recommendations and colon cancer prevention, 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.

Inner Knee Pain Relief

June 19, 2018 by Dr. Steve Chaney

You Don’t Need To Suffer From Inner Knee Pain

Author: Julie Donnelly, LMT – The Pain Relief Expert

Editor: Dr. Steve Chaney

Inner knee pain will prevent you from straightening your leg. You may feel the pain especially when you go from sitting to standing, or when you walk down stairs. Yet treating a tiny muscle called Popliteus will often stop the pain quickly and easily.

Inner Knee Pain Is Frequently Caused By A Small Muscle

The muscle is called Popliteus and is a muscle that is rarely considered by professionals while searching for solutions to inner knee pain.

Your Popliteus muscle is located deep inside your knee, connecting your thigh bone to your lower leg bone. As you follow the link, move to #2 and #4 to see the Popliteus. You’ll also see a muscle called Plantaris, which may or may not be a part of your problem.

When you are standing up straight, the muscle is at its longest length, but it shortens as your knee bends. The contraction of the muscle initiates the movement, giving the muscle the title of “the key that unlocks the knee.” When you are sitting for hours or doing an activity such as cycling, the muscle is held shortened. This is the beginning of the problem.

A phenomenon called “Muscle Memory” changes the length of the muscle to the now-shorter length. Since the muscle doesn’t lengthen as you go to stand up, it puts pressure on the two bones. You feel pain deep inside your knee joint, and you don’t realize it’s caused by a muscle.

In fact, because of the tension in the muscle, you may not be able to straighten your leg. You may feel the exact same symptoms as arthritis. Fortunately, the muscle can be treated easily, releasing the tension on your knee joint.

Inner Knee Pain Relief By Treating Your Popliteus Muscle

To treat your Popliteus muscle, bend your knee and wrap your hands around it as shown in the picture.

Place your thumbs on the top of your knee cap and press your middle fingers into the back of your knee joint.

Press around with your fingertips until you find a “hot spot.” This is the spasm that is causing the inner knee pain. Once you have found the spasm, hold the pressure for 15 seconds. After 15 seconds, continue pressing on the spasm but slowly straighten your leg. This is releasing the spasm in the muscle and it is also stretching the fibers. Repeat it 3-4 times or until it is no longer painful. You don’t have to suffer from inner knee pain or many other joint pains.

You Can Eliminate Pains Quickly And Easily!

Treat Yourself to Pain-Free Living is an easy-to-read and easy-to-follow guide to other Julstro Method self-treatments for joint pains.

Colorful charts show you the areas of pain, and the location of the spasms that are the source of discomfort. Photographs and clear descriptions show you how to release the spasms.

This is not a book for your library. Treat Yourself to Pain-Free Living is a reference book that will become your favorite “go-to” book when you have aches and pains!

Wishing you well,

Julie Donnelly

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.

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 Eggs Good For You?

June 12, 2018 by Dr. Steve Chaney

Do Eggs Reduce Heart Disease Risk?

Author: Dr. Stephen Chaney

Are eggs good for you?

If you are like most Americans, you are probably confused about whether you should eat eggs or not. It’s no wonder. The story about eggs keeps changing.

Just a few years ago we were told that eggs were full of cholesterol. They would increase our risk of heart disease. We should avoid them. If we did eat eggs, it should just be the egg whites because all the cholesterol was in the yolk.

Then we were told that the latest science showed that dietary cholesterol didn’t have much of an effect on serum cholesterol levels. It was saturated fats, trans fats, and obesity that raised serum cholesterol levels. Several major studies found that eggs didn’t increase heart disease risk. But we were told not to overdo it. Two to three eggs a week were probably OK, but more might be risky.

Now the headlines proclaim that eggs are good for our heart. They decrease heart disease risk. You can eat an egg every day and actually reduce your risk of heart disease. What is the truth? Let’s start by looking at the study (C. Qin et al, Heart, doi: 10.1136/heartjnl-2017-312651 ).

How Was The Study Done?

The study was performed in China. 500,000 adults (aged 30-79 years) from 10 diverse sites in China were enrolled in the study between 2004 and 2008. At the beginning of the study, the participants were asked about the frequency of egg consumption. A subset of the participants was asked about egg consumption at regular intervals during the first year to assess whether egg consumption was constant. The participants were followed for 8.9 years and cardiovascular incidents were determined from multiple health registries in China.

In terms of egg consumption:

9% of the population never consumed eggs or consumed them very infrequently.
20% of the population consumed eggs 1-3 days/month.
47% of the population consumed eggs 1-3 days/week.
11% of the population consumed eggs 4-6 days/week.
13% of the population consumed eggs daily (average = 0.76 eggs/day).

Are Eggs Good For You?

When the scientists conducting the study compared participants reporting daily egg consumption with those who never or rarely consumed eggs:

Overall risk of cardiovascular disease was lowered by 11%
Risk of heart attacks was lowered by 12%
Risk of major cardiovascular events was lowered by 12%.
Risk of hemorrhagic stroke (stroke caused by bleeding in the brain) was lowered by 26%
Risk of ischemic stroke (stroke caused by a blood clot) was lowered by 10%.

In addition, daily egg consumers lowered their risk of:

Cardiovascular death by 18%.
Hemorrhagic stroke death by 28%.

The reduction in hemorrhagic stroke risk is particularly significant for the Chinese. In China stroke is the leading cause of death and disability. The reasons for the high stroke risk in China are not well understood. However, the smoking rate and the incidence of high blood pressure are both higher in China than in the United States.

What Does This Study Mean For You?

There are some weaknesses to this study. For example, participants reporting daily egg consumption had a higher level of education and household income, were more likely to take a multivitamin supplement, and less likely to have high blood pressure than participants reporting little or no egg consumption. The authors did their best to compensate for these differences statistically, but there is always the concern that they might have introduced bias into the conclusions.

More to the point, diet and lifestyle are very different in China than in the United States. That also could have influenced the results. Thus, it is, perhaps, premature to claim the eggs reduce the risk of heart disease. However, several major studies performed in the United States have shown that eggs do not increase heart disease risk. That means eggs can be part of a heart healthy diet. According to the Mayo Clinic : “Most healthy adults can eat up to seven eggs a week with no increase in their risk of heart disease.”

That is fortunate because eggs are a very healthy food. According to the authors of this study:

Studies have shown that egg protein results in better blood sugar control, better satiety (feeling of fullness), and reduced subsequent food intake in healthy and overweight individuals. In layman’s terms that means egg protein can help you achieve and maintain a healthy weight.
Egg yolks are a good source of lutein and zeaxanthin. We think of lutein and zeaxanthin as good for eye health. But, they also play an important role in protecting against oxidation, inflammation, and atherosclerosis.
Egg yolks also contain choline. We think of choline as good for brain and nerves. But, choline and other phospholipids in the yolk also raise HDL levels and enhance HDL function.
Eggs are a good source of vitamin A, vitamin D, vitamin B12, riboflavin, selenium and iron.
Eggs contain almost twice as much monounsaturated and polyunsaturated fats as saturated fats.

There is one other possible takeaway from this study. Let’s return to the differences between the Chinese study and US studies. There is one other major study showing that daily egg consumption reduces heart disease risk, and it was performed in Japan. What is different between Japan, China, and the United States you might ask. The answer is simple. They consume primarily plant-based diets.

That suggests eggs may be healthier as part of a primarily plant-based diet than they are as part of the typical American diet. In short, eggs are healthy. It’s the sausage, bacon, ham, breakfast muffin, and biscuits that are the problem.

Are eggs good for you? Yes.

For more information on heart healthy diets, read my book “Slaying The Food Myths.”

The Bottom Line:

A recent study looked at the effect of egg consumption on heart disease risk in China. It found that people who consumed one egg per day had significantly lower risk of heart disease risk than people who seldom or never consumed eggs.

This study has some shortcomings and may not be directly applicable to those of us in the United States. However, several major studies in the United States have concluded that egg consumption does not increase heart disease risk. That means eggs can be part of a heart healthy diet. According to the Mayo Clinic: “Most healthy adults can eat up to seven eggs a week with no increase in their risk of heart disease.” That is fortunate because eggs are a very healthy food.

There is one other major study showing that daily egg consumption reduces heart disease risk, and it was performed in Japan. What is different between Japan, China, and the United States you might ask. The answer is simple. They consume primarily plant-based diets.

That suggests eggs may be healthier as part of a primarily plant-based diet than they are as part of the typical American diet. Are eggs good for you? Yes, eggs are healthy. It’s the sausage, bacon, ham, breakfast muffin, and biscuits that are the problem.

For more information on heart healthy diets, read my book “Slaying The Food Myths.”

For more details on this study, read the article above:

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

How Does Fast Food Affect Children’s Health?

June 5, 2018 by Dr. Steve Chaney

Are Fast Foods Killing Our Kids?

Author: Dr. Stephen Chaney

How does fast food affect children’s health?

Fast foods are everywhere. They are advertised on radio, TV, and the internet. Our kids crave them. Busy moms rely on them as they ferry their children to all their different activities.

Fast food restaurants surround every school. Fast foods are even on the lunch menu at many schools.

It’s no wonder that one third of US children eat fast foods every day. What are the consequences of this fast food consumption? Previous studies have shown that fast food consumption is associated with obesity and diabetes in teens.

But, what about younger children? We know that obesity and diabetes is on the rise among younger children, but nobody has looked at the health consequences of fast food consumption in younger children – until now. The study I will talk about today was designed to look at the association between fast food consumption and risk markers for obesity, heart disease, and diabetes in children who were only 9-10 years old.

How Was The Study Done?

This study (AG Donin et al, Archives of Disease in Childhood, 103: 431-436, 2018) was actually performed in England where the consumption of fast foods (They call them takeaway meals) is not quite as pervasive as it is in the US. But, fast food consumption is increasing rapidly. According to the authors, fast food consumption had increased by more than 25% between 1996 and 2006 and is continuing to increase.

This study was part of a larger Child Heart And Health Study in England (CHASE), which was designed to measure markers of heart disease and diabetes in a multiethnic population of children aged 9-10 years. The study enrolled 1948 primary school children in grade 5 from 85 primary schools across London, Birmingham, and Leicester.

The students were asked about their eating patterns by trained dietitians. Memory cues were used to add recall and photographs were used to help them estimate portion sizes. Fast food consumption broke down as follows:

26% of the children never or hardly ever consumed fast food meals.
46% of the children consumed fast food meals less than once a week.
28% of the children consumed fast food meals once a week or more.

How Does Fast Food Affect Children’s Health

When the investigators compared data from the children consuming one or more fast food meals a week with the data from children who never or hardly ever ate fast food meals:

#1: Diet quality was poorer:

Total calories consumed, fat, saturate fat, and caloric density of foods consumed were all significantly higher.
Consumption of complex carbohydrates and protein was significantly less. In contrast, sugar consumption was unchanged.
Intakes of vitamin C, iron, calcium, and folate were significantly less.

#2: Markers of health outcomes were poorer:

Fat mass and skinfold thickness (a measure of obesity) were significantly greater.
Total and LDL cholesterol were significantly higher. The authors estimated that if these levels were maintained over a lifetime, long-term cardiovascular risk would be increased by approximately 10%.

The authors concluded:

“Our study suggests that children who regularly eat takeaway (fast food) meals have adverse lipid profiles, higher body fat, and poorer diet quality.
Efforts to reduce takeaway meal consumption in children could have both short-term and long-term health benefits.”

What Does This Study Mean For You?

So, how does fast food affect children’s health? This study is consistent with multiple other studies looking at the effect of consumption of fast food meals on diet quality, obesity, and markers of future disease outcomes in teens and young adults. This study simply showed that the adverse effects of fast food meals are apparent even in younger children.

Clearly, fast foods should be avoided. One needs to go no further than the film “Supersize Me” to understand the dangers of excessive fast food consumption.

But, fast foods are just the tip of the iceberg. This study did not look at fast foods purchased by the parents and eaten at home. Nor did it look at sodas, junk foods, and convenience foods consumed at home.

Finally, while things are probably changing, the English diet, like the American diet, is not known as a particularly healthy diet. In fact, both English and American diets are the worst of all possible worlds. They are high in fat, saturated fat, sugars, and refined carbohydrates. They are meat heavy and light on fresh fruits, vegetables, and whole grains.

Eliminating fast foods from your child’s diet is just the first step towards a healthy diet. We should be focusing on a holistic approach to a healthier diet, such as I have outlined in my book “Slaying The Food Myths.”

The Bottom Line:

A recent study looked at the effect of fast food consumption on diet quality, obesity, and markers of disease risk in English schoolchildren ages 9-10 years. When the investigators compared data from the children consuming one or more fast food meals a week with the data from children who never or hardly ever ate fast food meals:

#1: Diet quality was poorer:

Total calories consumed, fat, saturate fat, and caloric density of foods consumed were all significantly higher.
Consumption of complex carbohydrates and protein was significantly less. In contrast, sugar consumption was unchanged.
Intakes of vitamin C, iron, calcium, and folate were significantly less.

#2: Markers of health outcomes were poorer:

Fat mass and skinfold thickness (a measure of obesity) were significantly greater.
Total and LDL cholesterol were significantly higher. The authors estimated that if these levels were maintained over a lifetime, long-term cardiovascular risk would be increased by approximately 10%.

Clearly, fast foods are to be avoided. But, eliminating fast foods from your child’s diet is just the first step towards a healthy diet. We should be focusing on a holistic approach to a healthier diet, such as I have outlined in my book “Slaying The Food Myths.”

For more details, read the article above:

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

Best Diet To Prevent Prostate Cancer

May 29, 2018 by Dr. Steve Chaney

Reducing Your Risk Of Developing Aggressive Prostate Cancer

Author: Dr. Stephen Chaney

Is there a best diet to prevent prostate cancer?

Prostate cancer is like a tale of two entirely different cancers. For most men, prostate cancer is both inevitable and relatively benign. For example, in one study scientists performed a histological examination of the prostate in men who had died of other causes. They reported detecting prostate cancer in 28% of men who died at age 30-39 and 75% of men who died at age 85. That has lead to the oft-quoted saying: “Most men die with prostate cancer rather than from prostate cancer.”

However, in a small percentage of cases, the prostate cancer turns aggressive and becomes a killer. And, there is some evidence that the incidence of aggressive prostate cancer is increasing. It is this aggressive form of prostate cancer that we want to avoid.

The prevention of aggressive prostate cancer has been controversial. The clinical studies have been conflicting. In part, that is because many of the previous studies did not distinguish between benign and aggressive prostate cancer.

More recent studies have focused specifically on the most aggressive forms of prostate cancer. These studies have provided greater clarity. I will summarize the American Cancer Society’s recommendations of foods to eat and foods to avoid below.

However, while the American Cancer Society’s recommendations are helpful, it is more useful to focus on the overall diet rather than individual foods. The current study (A. Castello et al, The Journal Of Urology, 199: 430-437, 2018) does just that. It compares the effect of the Western Diet, a Prudent Diet, and the Mediterranean diet on the risk of developing aggressive prostate cancer.

What is the best diet to prevent prostate cancer?

How Was The Study Done?

This study was part of the Multicase-Controlled Study On Common Tumors in Spain (MCC-Spain) program. MCC-Spain was conducted in 7 Spanish provinces between September 2008 and December 2013. From this larger population base the authors selected 754 subjects with histologically confirmed prostate cancer and 1,277 matched controls. The ages of men included in this study ranged from 38 to 85 years old.

All the participants in this study participated in an extensive computerized questionnaire to gather information on sociodemographic and lifestyle factors, personal and family medical history, height and weight. The questionnaire included a detailed food frequency questionnaire to assess their diet over the previous year. These questionnaires were administered by trained personnel in face-to-face interviews to assure accuracy.

The authors used a program they had developed previously to analyze the food frequency information and calculate the subject’s adherence to 3 different diets. These diets were:

The Western Diet: This diet is characterized by a high intake of high-fat dairy products, refined grains, processed and red meats, caloric drinks, sweets, convenience foods and sauces, and by a low intake of low-fat dairy products, whole grains, vegetables and fruits.
The Prudent Diet: This diet is characterized by low-fat dairy products, whole grains, vegetables, fruits, and juices. This is essentially a lacto-ovo-vegetarian diet, which has been shown to reduce the risk of some cancers.
The Mediterranean Diet: This diet is characterized by a high intake of fish, boiled potatoes, vegetables, legumes, fruits, whole grains, vegetable oil and olives.

The study compared the adherence to each of these diets to the risk of developing an aggressive form of prostate cancer. Two independent assays were used to identify aggressive tumors.

Best Diet To Prevent Prostate Cancer

The results of the study were as follows:

High adherence to the Western diet tended to increase the risk of aggressive prostate cancer. However, the results were not statistically significant, possibly due to the small number of participants with high adherence to a Western diet in this population.
High adherence to the Prudent diet had no effect on aggressive prostate cancer risk, although it does decrease the risk of some cancers.
High adherence to the Mediterranean diet decreased the risk of aggressive prostate cancer between 32% and 51% depending on the assay used to identify aggressive tumors.

While the authors preferred to focus on whole diets rather than individual foods, they pointed out that the biggest differences between the Mediterranean diet and the Prudent diet were increased consumption of fish and olives and decreased consumption of dairy. They considered the difference in fish consumption to be the most significant difference.

The authors cited previous studies showing that while fish consumption had no effect on prostate cancer incidence, it did significantly decrease prostate cancer mortality. This suggests that fish and fish oil may reduce the progression of benign prostate tumors into more aggressive forms of prostate cancer.

The authors concluded: “If other researchers confirm these results, the promotion of the Mediterranean dietary pattern might be an efficient way of reducing the risk of developing advanced prostate cancer. Dietary recommendations should consider whole patterns instead of focusing on individual foods.”

Of the 3 diets above, the Mediterranean Diet certainly seems to be the best diet to prevent prostate cancer.

What Does The American Cancer Society Say About Diet And Prostate Cancer?

Based on the best available data, the American Cancer Society has made some very specific recommendations for reducing the risk of prostate cancer. They are:

#1: Control Weight.

#2: Be More Active.

#3: Eat Healthy. By that they mean:

Choose foods and drinks in amounts that help you get to and maintain a healthy weight.

Read food labels to become more aware of portion sizes and calories. Be aware that “low-fat” or “non-fat” does not necessarily mean “low-calorie.”
Eat smaller portions when eating high-calorie foods.
Choose vegetables, whole fruit, legumes such as peas and beans, and other low-calorie foods instead of calorie-dense foods such as French fries, potato chips and other chips, ice cream, donuts, and other sweets.
Limit your intake of sugar-sweetened beverages such as soft drinks, sports drinks, and fruit-flavored drinks.
When you eat away from home, be especially mindful to choose food low in calories, fat, and added sugar, and avoid eating large portion sizes.

Limit how much processed meat and red meat you eat.

Minimize your intake of processed meats such as bacon, sausage, lunch meats, and hot dogs.
Choose fish, poultry, or beans instead of red meat (beef, pork, and lamb).

Eat at least 2½ cups of vegetables and fruits each day.

Include vegetables and fruits at every meal and snack.
Eat a variety of vegetables and fruits each day.
Emphasize whole fruits and vegetables; choose 100% juice if you drink vegetable or fruit juices.
Limit your use of creamy sauces, dressings, and dips with fruits and vegetables.

Choose whole grains instead of refined grain products.

Choose whole-grain breads, pasta, and cereals (such as barley and oats) instead of breads, cereals, and pasta made from refined grains, and brown rice instead of white rice.
Limit your intake of refined carbohydrate foods, including pastries, candy, sugar-sweetened breakfast cereals, and other high-sugar foods.

While these recommendations focus on foods rather than diets, they sound a lot like the Mediterranean diet. The only thing that is missing from the American Cancer Society recommendations is olives and olive oil.

Final Thoughts

The American Cancer Society and this study agree that red and processed meats should be minimized in our diet. There is evidence from previous studies that both increase the risk of developing aggressive prostate cancer. The American Cancer Society replaces red and processed meat with fish and poultry. The Mediterranean diet replaces them with fish and legumes. I would be leery of any diet that places a heavy emphasis on red meat consumption.

Don’t think these dietary recommendations are just important for men. In a previous study the same authors reported that adherence to a Western diet increased the risk of developing breast cancer and adherence to the Mediterranean diet reduced risk. In addition, previous studies suggest that red meat consumption also increases the risk of breast cancer.

The Bottom Line:

A recent study looked at the effect of adherence to a Western Diet, a Prudent Diet, and a Mediterranean diet on the risk of developing aggressive prostate cancer. The study found:

High adherence to the Western diet tended to increase the risk of aggressive prostate cancer.
High adherence to the Prudent diet had no effect on aggressive prostate cancer risk.
High adherence to the Mediterranean diet decrease the risk of aggressive prostate cancer between 32% and 51% depending on the assay used to identify aggressive tumors.
Based on their study and previous studies, the authors suggested that fish and fish oil may reduce the progression of benign prostate tumors into more aggressive forms of prostate cancer.

The authors concluded: “If other researchers confirm these results, the promotion of the Mediterranean dietary pattern might be an efficient way of reducing the risk of developing advanced prostate cancer. Dietary recommendations should consider whole patterns instead of focusing on individual foods.”

The authors have also reported similar results for the effects of these 3 diets on the risk of developing breast cancer in women.

For the American Cancer Society recommendations on reducing prostate cancer risk and other 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.

Sleeping On Your Stomach – Pain Reduction

May 22, 2018 by Dr. Steve Chaney

The Right Pillow Can Make All The Difference

Author: Julie Donnelly, LMT – The Pain Relief Expert

Editor: Dr. Steve Chaney

Sleeping on your stomach has several negative outcomes, which fortunately can be overcome. As your spine is twisting to enable you to turn your head, you are impinging on nerves, disks, and veins.

The pressure causes a long list of aches and pains, often far from the source of the problem.

Why Sleeping on Your Stomach is Bad for Your Neck

As you look at the healthy spine graphic, consider what happens to the neck bones when the head is turned. The cervical vertebrae are twisted, which puts a strain on your spinal cord, at the base of your brain. Plus, your carotid artery is potentially being squeezed, and your nerves are being pressed on by the bones.

If your head is turned to the left, your neck and shoulder muscles on the left are being held tight. Meanwhile, the muscles on your right are being overstretched, and then held that way for hours. This puts great pressure on all the structures of your neck.

While prevention is optimal, you can learn how to treat each of the muscles that are being strained as you sleep on your stomach. Releasing tight muscles every day will help avoid some of the damage that is done by having your head twisted.

Why Sleeping on Your Stomach is Bad for Your Lower Back

Your spinal cord runs from your brain all the way to your feet. As your nerves break off to every area of your body, an impingement causes pain, numbness and tingling

When you are sleeping on your stomach, your lower back (lumbar) vertebrae will drop forward. This causes your lumbar vertebrae to press into your spinal cord.

The muscles of your lower back; psoas, quadratus lumborum and erector spinae, are affected while sleeping on your stomach.

You can learn how to do simple self-treatments to eliminate lower back pain in my book “The 15 Minute Back Pain Solution.” This is a step-by-step program that treats each muscle involved in lower back pain, sciatica, and more.

How to Reduce Pain From Sleeping on Your Stomach

It’s best to stop sleeping on your stomach, but habits are a challenge to break. While you’re working to change this habit, here are a few tips to help relieve muscle tension and pain now.

In my therapy practice I have used a cushion that holds the body in a perfect face down position. A cushion holds the clients head, which is face down, and their abdomen is supported to prevent the lumbar curve. Some of my clients who sleep on their stomach feel it’s so comfortable they have bought it for their home. Here’s how you can create the same effect without the expense of buying the cushions.

Click on the link above to see how the Body Support cushion works, and then follow along with me.

Begin to change the way you sleep by buying a very dense king-size pillow. Lie on top of the pillow with your trunk and have your knees on the bed. Put pillows under your ankles, which will help support the curve of your lower back.

It’s challenging to re-create the face cradle, and the odds of sleeping with your face down are slim. However, if the pillow under your trunk comes all the way up to your chin, you can have your head bent forward and only slightly turned. The idea is to have as little of a twist as possible in your neck.

You also want to avoid having your lower back collapse into the mattress. The dense pillow under your trunk will support your lumbar vertebrae and prevent low back pain.

Whenever possible, try to start to sleep on your side, supporting your head to keep your spine straight. It’s a challenge, but it’s worth the effort.

Wishing you well,

Julie Donnelly

About The Author

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

Does Protein Supplement Timing Matter?

May 15, 2018 by Dr. Steve Chaney

How Do You Gain Muscle Mass & Lose Fat Mass?

Author: Dr. Stephen Chaney

Most of what you read about protein supplements on the internet is wrong. That is because most published studies on protein supplements:

Are very small
Are not double blinded.
- Both the subjects and the investigators knew who got the protein supplement.
Are done by individual companies with their product.
- You have no idea which ingredients are in their product are responsible for the effects they report.
- You have no idea how their product compares with other protein products.
- There is no standardization with respect to the amount or type of protein or the addition of non-protein ingredients.

Because of these limitations there is a lot of misleading information on the benefits of protein supplements timing and maximal benefit. Let’s start by looking at why people use protein supplements. Let’s also look at what is generally accepted as true with respect to the best supplement timing.

There are 4 major reasons people consume protein supplements:

Enhance the muscle gain associated with resistance training: In this case, protein supplements are customarily consumed concurrently with the workout.
Preserve muscle and accelerate fat loss while on a weight loss diet: In this case, protein supplements are customarily consumed with meals or as meal replacements.
Provide a healthier protein source. In this case, protein supplements are customarily consumed with meals in place of meat protein.
Prevent muscle loss associated with aging or illness. There is no customary pattern associated with this use of protein supplements.

How good are the data supporting the customary timing of protein supplementation? The answer is: Not very good. The timing is based on a collection of weak studies which do not always agree with each other.

The current study (J.L. Hudson et al, Nutrition Reviews, 76: 461-468, 2018 ) was designed to fill this void in our knowledge. It is a meta-analysis that compares all reasonably good studies that have looked at the effect of protein supplement timing on weight gain or loss, lean muscle mass gain, fat loss, and the ratio of lean muscle mass to fat mass.

How Was The Study Done?

The authors started by doing a literature search of all studies that met the following criteria:

The study was a randomized control trial with parallel design. This means that study contained a control group. It does not mean that the investigators or subjects were blinded with respect to which subjects used a protein supplement and which did not.
The subjects were engaged in resistance training.
The study lasted 6 weeks or longer.
Reliable methods were used to measure body composition (lean muscle mass and fat mass).
The subjects were healthy and at least 19 years old.
There was no restriction on the food the subjects consumed.

The authors started with 2074 published studies and ended up with 34 that met all their criteria. They then separated the studies into two groups – those in which the protein supplements were used with meals and those in which the protein supplements were used between meals.

Both groups were diverse.

Group 1 included subjects who consumed their protein supplement with their meal and those who consumed their protein supplement as a meal replacement.
Group 2 included subjects who consumed their protein supplement concurrent with exercise (usually immediately after exercise) and those who consumed their protein supplement at a fixed time of day not associated with exercise.

Does Protein Supplement Timing Matter?

Because the individual studies were very diverse in the way they were designed, the authors could not calculate a reliable estimate of how much lean muscle mass was increased or fat mass was decreased. Instead, they calculated the percentage of studies showing an increase in lean muscle mass or a decrease in fat mass.

When the authors compared protein supplements consumed with meals versus protein supplements consumed between meals:

Weight gain was observed in 56% of the studies of protein supplementation with meals compared to 72% of the studies of protein supplementation between meals. In other words, protein supplements consumed with meals were less likely to lead to weight gain than protein supplements consumed between meals.
An increase in lean muscle mass was observed in 94% of the studies of protein supplementation with meals compared to 90% of the studies of protein supplementation between meals. In other words, timing of protein supplementation did not matter with respect to increase in muscle mass.
A loss of fat mass was observed in 87% of the studies of protein supplementation with meals compared to 59% of the studies of protein supplementation between meals. In other words, protein supplements consumed with meals were more likely to lead to loss of fat mass.
An increase in the ratio of lean muscle mass to fat mass was observed in 100% of the studies of protein supplementation with meals compared to 87% of the studies of protein supplementation between meals. In short, protein supplements consumed with meals were slightly more likely to lead to an increase in the ratio of lean muscle mass to fat mass.

The following seem to suggest protein supplement timing matters:

The authors pointed out that their findings were consistent with previous studies showing that when protein supplements are consumed with a meal they displace some of the calories that otherwise would have been consumed. Simply put, people naturally compensate by eating less of other foods.

In contrast, the authors stated that previous studies have shown that when foods, especially liquid foods, are consumed as snacks (between meals), people are less likely to compensate by reducing the calories consumed in the next meal.

The others concluded: “Concurrently with resistance training, consuming protein supplements with meals, rather than between meals, may more effectively promote weight control and reduce fat mass without influencing improvements in lean [muscle] mass.”

What Are The Limitations Of The Study?

Meta-analyses such as this one, are only as good as the studies included in the meta-analysis. Unfortunately, most sports nutrition studies are very weak studies. Thus, this meta-analysis is a perfect example of the “Garbage In: Garbage Out (GI:GO)” phenomenon.

For example, let’s start by looking at what the term “protein supplement” meant.

Because the studies were done by individual companies with their product, the protein supplements in this meta-analysis:
- Included whey, casein, soy, bovine colostrum, rice or combinations of protein sources.
- Were isolates, concentrates, or hydrolysates.
- Contained various additions like creatine, amino acids, and carbohydrate.
As I discuss in my book, Slaying the Food Myths, previous studies have shown that optimal protein and leucine levels are needed to maximize the increase in muscle mass and decrease in fat mass associated with resistance exercise. However, neither protein nor leucine levels were standardized in the protein supplements included in this meta-analysis.
Previous studies have shown that protein supplements that have little effect on blood sugar levels (have a low glycemic index) are more likely to curb appetite. However, glycemic index was not standardized for the protein supplements included in this meta-analysis.

In short, the conclusions of this study might be true for some protein supplements, but not for others. We have no way of knowing.

We also need to consider the composition of the two groups.

Protein supplements used as meal replacements are more likely to decrease weight and fat mass than protein supplements consumed with meals. Yet, both were included in group 1.
Some studies suggest that protein supplements consumed concurrent with resistance exercise are more likely to increase muscle mass than protein supplements consumed another time of day. Yet, both are included in group 2. We also have no idea whether the meals with protein supplements in group 1 were consumed shortly after exercise or at an entirely different time of day.

This was the most glaring weakness of the study because it was completely avoidable. The authors could have grouped the studies into categories that made more sense.

In other words, there are multiple weaknesses that limit the predictive power of this study.

What Can We Learn From This Study?

Despite its many limitations, this study does remind us that protein supplements do have calories. This is of relatively little importance for people whose primary goal is to increase lean muscle mass.

However, most of us are using protein supplements to lose weight or to increase our lean mass to fat mass ratio. Simply put, we are either trying to lean out (shape up) or lose weight. And, we want to lose that weight primarily by getting rid of excess fat. For us, calories do matter. With that in mind:

If we are consuming a protein supplement immediately after exercise or between meals we probably should make a conscious effort to reduce our daily caloric intake elsewhere in our diet.
Alternatively, we could consume the protein supplement with a meal, but time the meal so it occurs shortly after exercise.

The Bottom Line:

A recent study looked at the optimal timing of protein supplements consumed by subjects who were engaged in resistance exercise. Specifically, the study compared protein supplements consumed with meals versus protein supplements consumed between meals on weight, lean muscle mass, fat mass, and the ratio of lean muscle mass to fat mass. The study reported:

Protein supplements consumed with meals were less likely to lead to weight gain than protein supplements consumed between meals.
Timing of protein supplementation did not matter with respect to increase in muscle mass.
Protein supplements consumed with meals were more likely to lead to loss of fat mass.
Protein supplements consumed with meals were slightly more likely to lead to an increase in the ratio of lean mass to fat mass.

The authors pointed out that their findings were consistent with previous studies showing that when a protein supplement was consumed with a meal it displaces some of the calories that would have been otherwise consumed. Simply put, people naturally compensate by eating less of other foods.

In contrast, the authors said that previous studies have shown that when foods, especially liquid foods, are consumed as snacks (between meals), people are less likely to compensate by reducing the calories consumed in the next meal.

As discussed in the article above, the study has major weaknesses. However, despite its many weaknesses, this study does remind us that protein supplements do have calories. This is of relatively little importance for people whose primary goal is to increase lean muscle mass.

However, for those of us who are using protein supplements to lose weight or to increase our lean mass to fat mass ratio, calories do matter. With that in mind:

If we are consuming a protein supplement immediately after exercise or between meals we probably should make a conscious effort to reduce our daily caloric intake elsewhere in our diet.
Alternatively, we could consume the protein supplement with a meal, but time the meal so it occurs shortly after exercise.

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.

Vitamin D and Cancer Risk?

May 8, 2018 by Dr. Steve Chaney

Does Vitamin D Reduce Cancer Risk?

Author: Dr. Stephen Chaney

The relationship between vitamin D and cancer risk is controversial. Some studies suggest that vitamin D reduces cancer risk. In those studies, the risk reduction was strongest for colon cancer, lung cancer, and breast cancer. However, other studies have found no association between vitamin D status and cancer risk.

Most previous studies have been conducted in European and American populations. Very few of the studies have been done in Asian populations. So, the authors of the current study (S. Budhathoki et al, BMJ 2018; 360:k671, doi: 10.1136/bmj.k671 ) focused their attention on the Japanese population.

How Was The Study Done?

The data for this study were drawn from the much larger Japanese Public Health Center (JPHC) Study. THE JPHC Study is an ongoing study investigating the role of lifestyle and other factors on the risk of cancer and other diseases. The study began in 1990 and enrolled 140, 420 participants aged 40-59.

All participants in the JPHC study filled out a detailed food frequency questionnaire at the time of entry into the study. A subset of participants also donated blood upon entry into the study for determination of 25-hydroxyvitamin D levels (the most reliable measurement of vitamin D status). It is this subset of participants who formed the basis of the current study.

There were 33,736 participants in this study. Based on plasma 25-hydroxyvitamin D levels at entry into the study, the participants were divided into four groups of around 1000 participants.

Group 1 had a median serum 25-hydroxyvitamin D level of 36.9 nmol/L.
Group 2 had a median serum 25-hydroxyvitamin D level 48.4 nmol/L.
Group 3 had a median serum 25-hydroxyvitamin D level of 56.9 nmol/L.
Group 4 had a median serum 25-hydroxyvitamin D level of 72.6 nmol/L.

For reference, the NIH considers < 30 nmol/L to be deficient, 30 to < 50 nmol/L to be insufficient for bone and overall health, > 50 nmol/L to be sufficient, and > 150 nmol/L to be potentially associated with adverse effects. By these criteria, group 1 had insufficient serum levels of 25-hydroxyvitamin D, group 2 was borderline, and groups 3 and 4 had sufficient serum levels of 25-hydroxyvitamin D.

The participants were followed for a total of 19 years. During this time 3301 participants developed cancer. The cancer incidence in groups 2, 3 and 4 were compared to the cancer incidence in group 1 to determine the effect of vitamin D status on cancer risk.

Vitamin D and Cancer Risk

The results of the Vitamin D and cancer risk study were:

Vitamin D reduced total cancer risk by up to 25%.
Vitamin D reduced the risk of liver cancer by up to 55%.
Vitamin D reduced the risk of pre-menopausal breast cancer by up to 44%.
There was a trend towards reduction of colon, liver, and prostate cancer by vitamin D, but the results did not quite reach significance.
There were too few cases for most other cancers to assess whether vitamin D status had any effect.
Risk reduction was not linear. Except for liver cancer, risk reduction for group 4 (72.6 nmol/L) was not greater than the risk reduction for group 3 (56.9 nmol/L). The significance of this observation will be discussed below.

The authors concluded: “Our findings support the hypothesis that vitamin D may confer protection against cancer. Nevertheless, the lower risk associated with higher circulating vitamin D concentrations seemed to show a ceiling effect, which may suggest that although maintaining an optimal 25-hydroxyvitamin D concentration is important for prevention of cancer, having a concentration beyond this optimal level may provide no further benefit.”

Why Is The Association of Vitamin D And Cancer Risk So Confusing?

So why do some studies demonstrate confusing data on Vitamin D and cancer risk? The “ceiling effect” mentioned by the authors of this study may explain much of the variation in results from previous trials. As I say in my upcoming book, “Slaying The Supplement Myths” , supplementation is most likely to be effective when the subjects are deficient in that nutrient at the beginning of the study. If they are starting with adequate levels of the nutrient, supplementation is unlikely to provide additional benefit.

While that statement seems to be obvious, many previous studies have ignored the beginning nutritional status. Some have not measured 25-hydroxyvitamin D levels at the beginning of the study. Others have measured starting 25-hydroxyvitamin levels but have not considered the starting levels in interpretation of their data.

Group 1 in the current study clearly had inadequate 25-hydroxyvitamin D levels. That may be why the groups with sufficient 25-hydroxyvitamin D levels showed a reduction in risk. The low baseline 25-hydroxyvitamin D is logical because most of Japan lies north of the United States, so sun exposure is less. In addition, the authors stated that food fortification and supplementation with vitamin D is much less in Japan than the US. In contrast, the baseline 25-hydroxyvitamin D status in many US studies is significantly higher.

The authors did a thorough analysis of previous studies. In general, studies with a low baseline level of 25-hydroxyvitamin D showed a reduction in cancer risk by vitamin D. Studies with a higher baseline level of 25-hydroxyvitamin D showed no effect.

This analysis does not permit a definitive conclusion, but it clearly defines how future studies should be designed. Simply put, to reliably test whether vitamin D reduces cancer risk, the experiment must be designed in such a way that the baseline 25-hydroxyvitamin D level is in the inadequate range. Otherwise, there is no reason to expect that higher levels of 25-hydroxyvitamin D will confer any benefit.

The Bottom Line:

A recent study looked at the effect of vitamin D status (serum 25-hydroxyvitaminD levels) on cancer risk. The study reported:

Vitamin D reduced total cancer risk by up to 25%.
Vitamin D reduced the risk of liver cancer by up to 55%.
Vitamin D reduced the risk of pre-menopausal breast cancer by up to 44%.
There was a trend towards reduction of colon, liver, and prostate cancer by vitamin D, but the results did not quite reach significance.
There were too few cases for most other cancers to assess whether vitamin D status had any effect.
Risk reduction was not linear. Except for liver cancer, risk reduction for group 4 (72.6 nmol/L) was not greater than the risk reduction for group 3 (56.9 nmol/L).

The “ceiling effect” mentioned by the authors of this study may explain much of the variation in results from previous trials.

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.

Protein and Heart Disease: Meat vs Plant-Based

May 1, 2018 by Dr. Steve Chaney

Does Meat Protein Increase Heart Disease Risk?

Author: Dr. Stephen Chaney

Is a plant-based diet better than eating meat when it comes to protein and heart disease?

There are a multitude of studies showing the long-term health benefits of plant-based diets. Among the best of these studies are the Seventh-Day Adventist Studies. That’s because the Adventist church advocates a vegan diet but allows personal choice. This means Seventh-Day Adventists eat a more plant-based diet than most Americans. However, there is also significant variation in the diet of Adventists.

Not all Adventists are vegans. Significant numbers of Adventists choose lacto-ovo-vegetarian (dairy, eggs & vegetarian), pesco-vegetarian (fish & vegetarian), and semi-vegetarian (meat & vegetarian).

Because of this variation, Adventists provide a rich database for clinical studies. You can compare health outcomes of a vegetarian diet to the standard American diet by comparing Adventists to the non-Adventist population living in the same area. You can also use the Adventist population to compare the health outcomes of the various types of vegetarian diets.

I have described the Adventist Health Studies in detail in my new book, Slaying The Food Myths. Let me briefly summarize the results with an emphasis on heart disease risk:

Compared to the standard American Diet, vegetarian diets decrease cardiovascular deaths by 41% in men and 51% in women.
The reduction in cardiovascular death is greater for vegans than for lacto-ovo-vegetarians.
If we look at the average of multiple studies, the risk of heart disease, diabetes, and cancer is less for vegans than for lacto-ovo-vegetarians, which is less than the risk for pesco-vegetarians, which is less than the risk for semi-vegetarians, which is much less than the risk for people consuming the standard American diet.

There are multiple reasons why vegetarian diets decrease the risk of heart disease compared to the standard American diet. These will be discussed below. The current study was designed to look at the proteins found in vegetarian and non-vegetarian diets and ask what effect these proteins had on heart disease. This was a good study of protein and heart disease.

How Was The Study Done?

This study (M. Tharrey et al, International Journal of Epidemiology, 2018, 1-10 doi: 10.1093/ije/dyy030 ) utilized a database of 81,337 men and women over age 25 who were enrolled in the Adventist Health Study-2 between 2002 and 2007.

At the time of enrollment, a very detailed food frequency questionnaire was administered. The participants were divided into groups based on the most prevalent protein source in their diet as follows:

Grains: This group averaged 44% of their protein intake from grains.
Processed foods: This category included protein from cheese, eggs, and milk. However, it also included processed plant proteins and protein from cold breakfast cereals.
Meats: The largest protein contributors to this category were red meat, processed meat, and poultry. Fish made only a minor contribution.
LFV (Legumes, fruits & vegetables): Legumes were the biggest protein contributors in this category.
Nuts and seeds: This included peanuts, tree nuts and seeds.

The participants in the study were followed for an average of 9.4 years during which there were 2276 cardiovascular deaths. The study then asked what effect protein intake from each of these food groups had on cardiovascular risk.

Meat Protein and Heart Disease?

Some of the findings from this study were expected, but some were surprising. When studying protein and heart disease for example:

When they compared people getting the most protein from meat with those getting the least (24% versus 1% of their protein intake from meat), the risk of cardiovascular death was increased by 61%. This is consistent with several previous studies suggesting that meat, particularly red meat, increases the risk of heart disease.
When they compared people getting the most protein from nuts and seeds with those getting the least (18% versus 2%), the risk of cardiovascular death was decreased by 40%. Again, this is consistent with previous studies suggesting that nuts and seeds reduce the risk of heart disease.
They found no significant effect of protein intake from grains on cardiovascular death. This could be considered as surprising because whole grains are an excellent source of fiber, which reduces the risk of heart disease. However, the difference in protein intake between the groups getting the most protein from grains versus the least was relatively small (34% versus 19%). In addition, the study did not differentiate between whole grains and refined grains.
There was a slight, but non-significant, increased risk of cardiovascular death for people getting the highest amount of protein from processed foods. This is also a bit surprising. It may be because the survey included both meat-based and vegetarian processed foods in the processed foods classification, and there are many processed foods that are marketed specifically to vegetarians.
There was also no significant effect of protein from legumes, fruits and vegetables on cardiovascular death. This is also surprising and will be discussed below.

The authors concluded “Our results suggest that healthy choices can be advocated based on protein sources, specifically preferring diets low in meat intake and with a higher intake of plant proteins from nuts and seeds.”

What Does This Mean For You?

This study does not fundamentally alter what we know about diet and heart disease risk. That is because this study focused solely on the protein and heart disease not on the foods and heart disease. The data were statistically corrected for every other beneficial and detrimental effect of those foods. For example:

The people in this study with the highest intake of processed foods were more likely to be overweight and physically inactive. They were also more likely to be smokers. These factors increase the risk of cardiovascular disease. However, the data were statistically adjusted to remove these considerations from the analysis.
The people in this study with the highest intake of whole grains, legumes, fruits and vegetables also had the highest intake of fiber, antioxidants, and B vitamins. These factors decrease the risk of heart disease. However, the data were statistically adjusted to remove these considerations from the analysis.

In short, processed foods are still probably bad for the heart, but that is not due to the protein component of processed foods. Similarly, whole grains, legumes, fruits, and vegetables are still good for the heart, but it is not the protein component of these foods that conveys the heart-healthy benefits.

Where the study breaks new ground and leaves some unanswered questions is with the effect of meat, nuts, and seeds on heart disease risk. For example:

The American Heart Association has recently released a Presidential Advisory statement warning that the saturated fat in meats increases heart disease risk. However, the data in the present study were statistically adjusted to remove the effect of saturated fat from the analysis. Thus, this study suggests that the protein in red meat also contributes to heart disease risk. If this is confirmed by subsequent studies, it is an important advance. It might mean, for example, that grass-fed beef is no healthier than conventionally raised beef.

However, it is unclear why meat protein increases heart disease risk. One recent study has suggested that meat-based diets favor a population of gut bacteria that metabolize a compound called carnitine, also found in meat, into a metabolite that increases heart disease risk. However, this mechanism has not yet been confirmed.

[Note: The effects of saturated fats and carnitine on heart disease risk are covered in detail in my new book “Slaying the Food Myths.” In my book I carefully analyze the arguments of saturated fat proponents as well as saturated fat opponents.]

Conventional wisdom has attributed the heart health benefits of nuts and seeds to their omega-3 fatty acids. However, the data in this study were statistically adjusted to remove the effect of omega-3 fatty acids from the analysis. Thus, this study suggests that the protein in nuts and seeds decreases heart disease risk.

Once again, the mechanism of this effect is unclear. The authors suggest it might be due to higher levels of the amino acids glutamate and arginine in seed and nut protein. However, these two amino acids are abundant in a variety of plant-based proteins. Their presence in nut and seed proteins would not appear to be sufficient to confer a special heart health benefit.

In short, this is the first study of this kind and the mechanisms of the effects described are unclear. Thus, one cannot yet definitively claim that meat protein is bad for the heart and nut and seed proteins are good for the heart.

Whether it is the protein component of these foods that affects heart health is relatively unimportant. It does not change what we know about diet and heart health. As discussed in “Slaying The Food Myths,” multiple studies show that meat-based diets increase heart disease risk and primarily plant-based diets decrease heart disease risk. Multiple studies also show that nuts and seeds decrease heart disease risk.

The Bottom Line:

A recent study looked at the effect of the protein content of various foods on heart disease risk. The study reported:

Meat protein increased the risk of cardiovascular deaths by 61%.
Proteins from nuts and seeds decreased the risk of heart disease deaths by 40%.
Proteins from processed foods, grains, legumes, fruits, and vegetables had no effect on cardiovascular deaths.

This study does not fundamentally alter what we know about diet and heart disease risk. That is because this study focused solely on the protein component of various foods rather than the foods themselves. The data were statistically corrected for every other beneficial and detrimental effect of those foods. Because of that:

Processed foods are still probably bad for the heart
Whole grains, legumes, fruits and vegetables are still good for the heart.
Meat, especially red meat, is probably bad for the heart, while nuts and seeds are good for the heart.

The major new information provided by this study is that:

The increased risk of heart disease associated with meats is not just due to their saturated fat content. Meat protein may also increase heart disease risk. If confirmed by subsequent studies, this is an important finding because it suggests that lean cuts of meat and grass-fed beef may not eliminate heart disease risk.
The decreased risk of heart disease associated with nuts and seeds is not just due to their omega-3 content. Nut and seed proteins may also decrease heart disease risk.

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.

The Economic Benefits of Plant-Based Diets

April 24, 2018 by Dr. Steve Chaney

Could Plant-Based Diets Cut Healthcare Costs?

Author: Dr. Stephen Chaney

Could saving the healthcare system be one of the economic benefits of plant-based diets?

I don’t need to tell you that our healthcare system is in crisis. Costs are out of control. The Centers for Medicare and Medicaid Services (CMS) estimates that healthcare costs will account for 25% of the gross domestic product by 2025. They also predict that 47% of that spending will be financed by federal. State, and local governments. That is unsustainable.

Our politicians have no answer. Neither political party has a viable plan to cut costs. Perhaps it is time to take matters into our own hands. What if there were a way to improve our own health and the viability of our healthcare system? A recent study suggests there may be a way to accomplish both goals.

How Was The Study Done?

In a recent study (L. Annemans and J. Schepers, Nutrition, 48: 24-32, 2018 ) scientist at Ghent university in Belgium set out to investigate the effect on public health and healthcare costs if just 10% of the population of Belgium and England switched to a primarily plant-based diet. They started with two diets for which the health benefits have been well established by multiple studies. These diets are:

#1: A Soy-Containing Diet: This is defined as a diet in which soy protein foods were consumed in place of animal protein foods more than 5 times per week. The soy foods included in their study were soybeans, tofu, miso, soy protein drinks, and soy yoghurt.

The soy-containing diet was chosen because previous studies have shown it protects against obesity, heart disease, stroke, diabetes, and breast, colon, stomach, lung, and prostate cancer. (Yes. In spite of the erroneous information you find on the internet, soy foods decrease cancer risk.)

#2: The Mediterranean Diet: This is defined as a diet rich in fruits, vegetables, whole grains, nuts, seeds and large amounts of olive oil. It includes a moderate to high consumption of fish and other seafood and a low intake of meat and dairy products.

The Mediterranean diet was chosen because previous studies have shown it protects against heart disease, stroke, diabetes, and breast cancer. I have documented these health benefits in more detail in my book “Slaying The Food Myths.”

This study did not look at the benefits of other plant-based diets. For example, as discussed in “Slaying The Food Myths,” the Seventh-Day Adventist studies have shown comparable health benefit for a variety of vegetarian diets.

This study looked at the prevalence of each of these diseases in Belgium and England and estimated what the effect would be if the prevalence of these diseases were reduced by the amounts reported in previous studies of soy-based and Mediterranean diets.

The study reported two outcomes: the increase in Quality of Life Years (QALYs) and the decrease in healthcare costs. Increased Quality of Life Years simply means the increase in disease-free years. That is the outcome most important to each of us personally. However, we should be equally interested in the decreased healthcare costs. The dollars our government spends on healthcare don’t grow on trees. They come out of our pockets.

Economic Benefits of Plant-Based Diets: Decreasing Healthcare Costs?

With that buildup, you are probably wondering what the outcome of the study was. The news was good:

If 10% of the population switched to a soy-based diet there would be:

An increase of 154 Quality of Life Years/1,000 people and a decrease in healthcare costs of $1.9 billion/20 years in Belgium.
An increase of 130 Quality of Life Years/1,000 people and a decrease in healthcare costs of $10.7 billion/20 years in England.

If 10% of the population switched to a Mediterranean diet there would be:

An increase of 166 Quality of Life Years/1,000 people and a decrease in healthcare costs of $1.6 billion/20 years in Belgium.
An increase of 116 Quality of Life Years/1,000 people and a decrease in healthcare costs of $7.4 billion/20 years in England.

[Note: In case you were wondering, the authors said the reason why plant-based diets had less of an effect on Quality of Life Years in England than in Belgium is because public health interventions have already significantly decreased the incidence of heart attack and stroke in England. Conversely, the reason healthcare savings are higher in England is because healthcare costs are higher there.]

Finally, if one were to extrapolate the British healthcare savings to the costs of the US healthcare system, one would predict:

If 10% of the US population were to switch to a soy-based diet, healthcare savings might amount to $17 billion/20 years.
If 10% of the US population were to switch to a Mediterranean diet, healthcare savings might amount to $12 billion/20 years.

The authors concluded: “The result of the present analysis suggests that both a soy-containing diet and the Mediterranean diet could contribute to health promotion because they are predicted to lead to substantial health benefits and societal savings.”

How Accurate Are These Estimates?

The benefits of soy-based and Mediterranean diets on which these estimates are based are very solid. The benefits are based on association studies, but the studies are very well done and are remarkably consistent.

The major weakness of these estimates is the benefits of these diets have been demonstrated in other parts of the world and are being extrapolated to a region of the world where neither of those diets are commonly followed. The authors tried very hard to control for all confounding variables, but the possibility remains that lifestyle differences unique to those geographic regions also contributed to the health benefits of soy-based and Mediterranean diets.

The authors acknowledged that some of the foods that are normally part of soy-based and Mediterranean diets were not as readily available in Belgium and England. They raised the possibility that something like the “New Nordic Diet”, which is also primarily plant-based but incorporates more familiar foods, might be equally effective. The equivalent diet in the US might be the DASH diet.

The economic benefits of plant-based diets may not depend so much on the diet, as long as it is plant-based and those foods are readily available.

The Bottom Line:

A recent study looked at the effect of a plant-based diet on Quality Of Life Years (disease free years) and healthcare costs in Belgium and England. The study estimated:

If 10% of the population switched to a soy-based diet there would be:

An increase of 154 Quality of Life Years/1,000 people and a decrease in healthcare costs of $1.9 billion/20 years in Belgium.
An increase of 130 Quality of Life Years/1,000 people and a decrease in healthcare costs of $10.7 billion/20 years in England.

If 10% of the population switched to a Mediterranean diet there would be:

An increase of 166 Quality of Life Years/1,000 people and a decrease in healthcare costs of $1.6 billion/20 years in Belgium.
An increase of 116 Quality of Life Years/1,000 people and a decrease in healthcare costs of $7.4 billion/20 years in England.

If one were to extrapolate the British healthcare savings to the costs of the US healthcare system, one would predict:

If 10% of the US population were to switch to a soy-based diet, healthcare savings might amount to $17 billion/20 years.
If 10% of the US population were to switch to a Mediterranean diet, healthcare savings might amount to $12 billion/20 years.

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.