Congenital Heart Defects Prevention with Folic Acid?

Does Methyl Folate Work As Well?

Author: Dr. Stephen Chaney

 

congenital heart defects preventionCan folic acid aid in congenital heart defects prevention?

Every once in a while, a scientific study revolutionizes the practice of medicine and transforms how we lead our lives. The study showing that folic acid supplementation reduced the risk of neural tube defects in newborns was such a study.

First a little history: Dr. Richard Smithells and his colleague Elizabeth Hibbard first started to suspect that folic acid deficiencies were linked to neural tube defects such as spina bifida in the early 60s. By the early 70’s there was enough circumstantial evidence for this link that most doctors were recommending pregnant women start on a prenatal supplement containing folic acid once their pregnancy was confirmed by the obstetrician.

That was when Dr. Smithells convinced the Medical Research Council (MRC) of England to conduct a major, multi-center trial to definitively test his hypothesis. The MRC study (MRC Vitamin Study Research Group, Lancet 338: 131–137, 1991) was terminated in 1991 when it became clear that it was unethical to continue withholding folic acid from the placebo group. The study clearly showed:

  • Folic acid supplementation reduced the incidence of neural tube defects in newborns by 72%.
  • Supplementation with folic acid must start prior to conception for maximum efficacy. If women waited until their pregnancy was confirmed by their doctor, the benefits of folic acid supplementation were much weaker. By then, as the old saying goes: “The horse was already out of the barn”.
  • Subsequent studies have shown that folic acid supplementation is effective at reducing neural tube defects even when the mother and/or baby have MTHFR deficiencies.

As I mentioned before, this study revolutionized medicine and public health in this country.

  • The U. S. Public Health Service and CDC changed their recommendation to “All women of childbearing age should consume at least 400 micrograms of folic acid daily to prevent neural tube defects.
  • Starting in 1998, the United States and Canada mandated folic acid fortification of all flour, enriched pasta, and cornmeal.

 

What About Congenital Heart Defects Prevention?

 

folic acid congenital heart defectsWith the clear success of folic acid reducing the risk of neural tube defects, it was natural to ask whether folic acid supplementation might also help with congenital heart defects prevention. Heart defects affect 1% of all newborn babies. While they can often be treated with surgery, that is horribly expensive and not always successful.

As with neural tube defects, previous clinical studies have provided clear evidence that supplementation with at least 400 mcg/day of folic acid reduces the risk of heart defects in newborns. A meta-analysis of 18 clinical studies estimates the risk-reduction at 28% (Scientific Reports, 5: 8506, DOI: 10.1038/srep08506 ).

The authors of this study (Liu et al, Circulation 134: 647-655, 2016 ) set out to determine whether folic acid fortification had significantly reduced newborn heart defects in Canada. They utilized a database of the Canadian Institute for Health Information that covered 98% of births and stillbirths between 1990 and 2011.

Did folic acid supplementation aid in congenital heart defects prevention?

Of the 5,901,701 births and stillbirths in this database, 72,591 were diagnosed with some type of heart defect. The investigators then compared the prevalence of heart defects before and after 1998 to determine the effect of folic acid fortification on heart defects.

 

Does Folic Acid Aid in Congenital Heart Defects Prevention?

 

folic acid fortifiedThe results of the study were clear cut. Folic acid fortification of flour:

  • Reduced heart outflow abnormalities by 27%.
  • Reduced narrowing of the aorta by 23%.
  • Reduced holes in the heart wall separating the chambers by 15%.

Some types of heart defects were not significantly affected by folic acid fortification, so the overall reduction in newborns with heart defects was 11%.

The paper concluded “Although food fortification with folic acid was aimed primarily at reducing neural tube defects, this population based intervention may also have had a beneficial effect on specific types of [heart defects], which in aggregate are more common.”

Overall, folic acid fortification (providing an extra 100 mcg/day folic acid) did not appear to be as effective as supplementation with 400 mcg/day folic acid at reducing total heart defects in newborns. Perhaps because of that, the senior investigator in the study was quoted as saying “Women who are likely to get pregnant should start taking folic acid supplements before getting pregnant as they may not necessarily receive adequate folate from diet alone.”

 

Does Methyl Folate Aid in Congenital Heart Defects Prevention as Well?

methyl folate mythMethyl folate is being widely promoted as safer, more natural, better absorbed, and more effective than folic acid. I have thoroughly debunked the first three claims in my video “The Truth About Methyl Folate.

What about the claim that methyl folate is more effective than folic acid?

The fact is we don’t even know whether methyl folate is even as effective as folic acid. The studies on neural tube defects and heart defects were done with folic acid, not methyl folate. There are literally thousands of studies on the health benefits of folic acid. Almost all of them were done with folic acid, not methyl folate. It is reasonable to assume that methyl folate might be as beneficial as folic acid, but without clinical studies we simply don’t know.

The few clinical studies that have used methyl folate have not included patients that were given folic acid instead of methyl folate. Without that kind of direct comparison, it is impossible to know whether methyl folate is less effective, the same, or more effective than folic acid.

Finally, there is the claim that methyl folate is more effective than folic acid in people with MTHFR deficiencies. Until we start seeing clinical studies directly comparing the effect of methyl folate and folic acid supplementation on health outcomes in people with MTHFR deficiencies, it is impossible to verify that claim. Once again, methyl folate might be less effective, the same, or more effective than folic acid. We simply don’t know.

Folic Acid does aid in congenital heart defects prevention and methyl folate may.

 

The Bottom Line

 

  • It has been clearly established that folic acid supplementation reduces the risk of neural tube defects in newborns, and that food fortification with folic acid has also helped reduce the incidence of neural tube defects.
  • Previous studies have also shown that folic acid supplementation reduces the risk of heart defects in newborns.
  • A recent study has shown that food fortification with folic acid also contributes to a reduction in the risk of giving birth to babies with heart defects.
  • The U. S. Public Health Service and CDC recommend “All women of childbearing age should consume at least 400 micrograms of folic acid daily to prevent neural tube defects.” Based on the latest studies, folic acid aids in congenital heart defects prevention as well.
  • The studies on neural tube defects and heart defects were done with folic acid, not methyl folate. It is reasonable to assume that methyl folate might be as beneficial as folic acid, but without clinical studies we simply don’t know whether it is even as effective as folic acid.
  • As for other claims about methyl folate, there are no clinical studies I am aware of directly comparing methyl folate and folic acid. Without that kind of study, it is impossible to know whether methyl folate is less effective, the same, or more effective than folic acid.

 

For 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.

DHA During Pregnancy; Yes or No?

Are Pregnant Women Deficient In Omega-3s?

Author: Dr. Stephen Chaney

 

dha during pregnancyDo women need DHA during pregnancy?  Most experts agree that omega-3 fatty acids, especially DHA, are essential for fetal development during pregnancy and for brain development through at least the first two years of a child’s life. That’s because DHA is an important component of the myelin sheath that coats and protects our brain neurons.

During the last two trimesters of pregnancy and the first two years of a child’s life, their brains are growing and maturing at a remarkable rate. The need for DHA during this critical period is huge, and most of that DHA comes from the mom. That’s why the mom’s intake of DHA during pregnancy and breastfeeding is so important.

For example, higher intakes of omega-3s during pregnancy and breastfeeding have been associated with:

  • Decreased maternal depression.
  • Increased birth weight.
  • Reduced risk of preterm birth.
  • Reduction in ADHD symptoms.
  • Reduction in allergies and asthma.
  • Improved developmental and cognitive outcomes such as:
    • Increased visual acuity.
    • Better problem-solving skills.

I do wish to acknowledge that there is still debate in the scientific literature about the strength of some of these associations. However, there is enough cumulative evidence for the beneficial effects of omega-3s especially DHA during pregnancy and breastfeeding that virtually all experts agree adequate maternal omega-3 intake is important during this crucial period in a child’s life.

 

How Much DHA During Pregnancy & Breastfeeding Is Needed?

fish oil dha during pregnancyThe National Academies of Science have not yet set a Daily Value for omega-3s. However, a group of experts met in 1999 to recommend adequate dietary intake of omega-3s (Simopoulos et al, Prostaglandins, Leukotrienes & Essential Fatty Acids, 63: 119-121, 2000 ). They concluded that an adequate intake of omega-3 fatty acids in adults was at least 650 mg/day with at least 440 mg/day of that coming from EPA + DHA (220 mg/day each of EPA and DHA). They further recommended that DHA intake in pregnant and lactating women should be at least 300 mg/day.

However, because of concerns about seafood contamination with heavy metals and PCBs (both of which are neurotoxins), the FDA recommended in 2004 that pregnant and lactating women limit seafood consumption to two servings a week, which amounts to about 200 mg/day of DHA. This has been subsequently adopted by the American College of Obstetricians and Gynecologists and the European Union as the recommended amount of DHA during pregnancy and lactation (Coletta et al, Reviews in Obstetrics & Gynecology, 3, 163-171, 2010 ).

How Was The Study Done?

The authors of this study (Nordgren et al, Nutrients, 2017, 9, 197; doi:10.3390/nu9030197 ) utilized a nationwide database called NHANES (National Health and Nutrition Examination Survey). NHANES data are based on an annual survey conducted by the National Center for Health Statistics (NCHS) to assess the health and nutritional status of adults and children in the United States, and to track changes over time.

Dietary intake of nutrients is based on two interviewer-administered, 24-hour dietary recalls conducted 3-10 days apart. Omega-3 intake was calculated based on the USDA database of nutrient composition of foods.

The investigators combined NHANES data from the years 2003 to 2012. This included 6478 women of childbearing years (14-45 years old), of which 788 were pregnant at the time of the survey.

Are Pregnant Women Deficient In Omega-3s?

omega3 deficiency in pregnant womenThe results of this study were alarming:

  • Mean EPA + DHA intake was only 89 mg/day with no difference between pregnant and non-pregnant women of childbearing age.
  • This contrasts to the expert committee’s recommendation of at least 440 mg/day for EPA + DHA (220 mg/day each from EPA and DHA).
  • Mean DHA intake was only 66 mg/day in pregnant and 58 mg/day in non-pregnant women of childbearing status.
  • This contrasts to the recommendations of 200 – 300 mg/day for pregnant women.
  • These intakes did not include dietary supplements, but only 1.8% of non-pregnant and 9% of pregnant women in this survey took supplements containing EPA and/or DHA.

The authors concluded “Our results demonstrate that omega-3 fatty acid intake is a concern in pregnant women and women of childbearing age…” They went on to say: ‘Strategies to increase omega-3 fatty acid intake in these populations could have the potential to improve maternal and infant health outcomes.”

What Do Other Studies Show?

This study is not an outlier. In a previous issue  Do Women Get Enough Omega-3 During Pregnancy of “Health Tips From the Professor” I reported on a study showing that 90% of Canadian women were not getting enough DHA in their diet. A similar study in Germany concluded that 97% of middle-aged women had suboptimal omega-3 status (Gellert et al, Prostaglandins, Leukotrienes and Essential Fatty Acids, doi: 10.1016/j.plefa.2017.01.009 ).

More importantly, these omega-3 deficiencies matter. In another issue DHA Supplements During Pregnancy of “Health Tips From the Professor” I reported on a study showing that DHA supplementation significantly reduced preterm births. Based on that effect alone, the authors concluded that DHA supplementation during pregnancy could save the US healthcare system close to $6 billion/year.

Women do need DHA during pregnancy.

The Bottom Line

  • Optimal intake of omega-3s during pregnancy and breastfeeding is associated with:
    • Decreased maternal depression.
    • Increased birth weight.
    • Reduced risk of preterm birth.
    • Reduction in ADHD symptoms.
    • Reduction in allergies and asthma.
    • Improved developmental and cognitive outcomes such as:
      • Increased visual acuity.
      • Better problem-solving skills.
  • In 1999, a panel of experts met to set standards for omega-3 intake. They recommended:
    • At least 650 mg/day for adults with at least 440 mg/day coming from EPA + DHA (220 mg/day each of EPA and DHA).
    • At least 300 mg/day of DHA for pregnant and breastfeeding women.
  • Because of concerns about seafood contamination with heavy metals and PCBs (both of which are neurotoxins), the FDA reduced the recommendation for pregnant and breastfeeding women to 200 mg/day of DHA. That recommendation has been subsequently adopted by the American College of Obstetricians and Gynecologists and the European Union.
  • A recent study has found:
    • Mean EPA + DHA intake was only 89 mg/day with no difference between pregnant and non-pregnant women of childbearing age.
      • This contrasts to the expert committee’s recommendation of at least 440 mg/day (with 220 mg/day each from EPA and DHA).
    • Mean DHA intake was only 66 mg/day in pregnant and 58 mg/day in non-pregnant women of childbearing status.
      • This contrasts to the recommendations of 200 – 300 mg/day for pregnant and breastfeeding women.
    • These intakes did not include dietary supplements, but only 1.8% of non-pregnant and 9% of pregnant women in this survey took supplements containing EPA and/or DHA.
    • This study is in line with recent studies in Canada and Germany. Clearly pregnant and Breastfeeding women in developed countries like the US are getting suboptimal amounts of omega-3s in their diet.
    • This is alarming because these findings come amidst mounting evidence that optimal omega-3 intake during pregnancy and breastfeeding is important for the health of both mother and child.

     

    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.

6 Tips For Choosing The Best Multivitamin Supplement

Don’t Fall For Misleading Marketing Claims

Author: Dr. Stephen Chaney

best multivitamin supplementThere are lots of multivitamin-multimineral products in the marketplace. Every company must differentiate their product from the competition to win their market share. When that differentiation is based on quality, purity, and clinical proof the product works, I am all for it. May the best company win.  Many claim to offer the best multivitamin supplement.

However, the pressure to win market share is intense. Quality controls and clinical studies are expensive. All too often companies try to differentiate their multivitamin-multimineral products based on marketing hype and/or worthless ingredients that subtract money from your wallet without adding anything of value to your health.

With so many claims and counter claims in the marketplace, it has become almost impossible for the average consumer to know which claims are true and which are false. Everyone wants to get the best multivitamin-multimineral for their health at the least possible cost. Perhaps that is why I am so frequently asked for guidance on how to choose the best multivitamin supplement.

In this week’s article, I will give you 6 tips you can use to select the multivitamin-multimineral product that is best for you. I will tell you what to look for in a good multivitamin and which marketing claims you should just ignore.

How Are Nutritional Standards Set?

The standards for nutritional supplements are set in a two-step process.

Step 1: In the first step, The Institute of Medicine (IOM) of the National Academies of Sciences selects a committee of experts called the Food and Nutrition Board to set standards for a specific set of nutrients. They set 3 kinds of standards:

  • Recommended Dietary Allowances or RDAs are the average daily dietary intake level sufficient to meet the nutrient requirements of nearly all (97-98 percent) healthy individuals in a group.
  • Adequate Intakes or AIs are established when evidence is insufficient to develop an RDA and are set at a level assumed to ensure nutritional adequacy.
  • Where toxicity is a potential concern, Tolerable Upper Limits or ULs represent the maximum daily intake unlikely to cause adverse health effects.
  • Just to confuse things, all three standards are all part of what is called Dietary Reference Intakes or DRIs.

Step 2: The DRIs are specific for age, gender, pregnancy & lactation. It would be hopelessly complicated to use DRIs for the nutrition labels on foods and supplements. Therefore, the FDA sets a Daily Value (DV) for the purposes of food and supplement labeling. Originally, DVs were set based on the highest DRI for a specific nutrient. However, the FDA has recently devised a new set of DV standards that will be appearing on food and supplement labels between now and July 26, 2018.

How to Choose the Best Multivitamin Supplement

nutritional supplement#1: Good Product Design Still Matters

Comparing nutrition labels on multivitamin-multimineral supplements can be tricky. Some supplements only provide 5-10% the Daily Value (DV) for some nutrients. Are those nutrients unimportant? Some supplements provide hundreds or thousands % of the DV for other nutrients. Is more better?

Often companies will quote some random scientist or one or two clinical studies to support the mix of nutrients they include in their multivitamin-multimineral supplement. Don’t fall for their marketing hype.

The only valid nutritional standards for multivitamin-multimineral products in the United States are set by the Food & Nutrition Board of the Institute of Medicine. They are the standards you should look for in evaluating nutrition labels.

That’s because the National Academies of Sciences is the real deal. The National Academies represents the top 1-2% of scientists in the country. To be selected to the National Academies you must be nominated by an Academy member, and voted on by the entire Academy. Selection is based on your research contributions over decades. (No, I am not a member of the Academy, but thanks for thinking that question).

The Institute of Medicine of the National Academies of Sciences selects the best of the best to serve on the Food and Nutrition Board. They are world renowned experts who review all the pertinent literature (not just one or two studies). They decide on which nutrients are essential and how much of them we need.

It always amazes me that some companies pretend they know more than the Food and Nutrition Board. It amazes me even more that some people believe those companies.

With that in mind, this is what to look for when comparing nutrition labels and trying to choose the best multivitamin supplement:

  • The FDA has set Daily Value (DV) recommendations for 24 vitamins and minerals (23 if the supplement is for adult men or postmenopausal women and does not contain iron). Make sure your multivitamin-multimineral has all 24. Count them. If a company leaves out an essential nutrient, they are not required to list it on the label.
  • The Food and Nutrition Board has classified several other nutrients as essential, but does not feel there have been enough studies to establish a DRI. Without a DRI, the FDA cannot set a DV. Those nutrients are represented with a “dagger” symbol on the label with the footnote “Daily Value not established.”  These are useful additions to a multivitamin-multimineral supplement, provided they are not present in excess.
  • Ignore anything companies list on their nutrition labels that does not have a %DV value or a “dagger” symbol. This is often just marketing hype. In some cases, the ingredients have no proven benefit. In many other cases, it’s just not possible to put enough of them in a multivitamin-multimineral tablet to provide any real benefit.

vitmain and minerals#2: Look For Balance

This is another area in which we need to be guided by the recommendations of the Food and Nutrition Board of the IOM. One of the reasons many experts recommend that people get their vitamins and minerals from foods rather than from supplements is because many supplements are unbalanced. That’s a problem because there are many cases in which too much of one nutrient can interfere with the absorption or metabolism of related nutrients. For example,

  • Zinc and copper compete for absorption. For best absorption and maximal utilization by the body, the zinc to copper ratio should be close to 1:1 based on DV.
  • B vitamins should be in balance. Look for a multivitamin-multimineral supplement that provides 100-200% of the DV for all 8 essential B vitamins. (The levels can be higher in a B Complex supplement, but they should still be in balance.)

Some manufacturers will leave out the expensive B vitamins and load up on the cheap ones. This saves them money. It also allows them to use marketing terms like “mega” or “super.”  A supplement that provides 50% or less of the DV for some B vitamins and 1,000% or more of the DV for others is ridiculous. There is absolutely no rationale for a ratio like that except to mislead consumers.

  • As for the other nutrients in multivitamin-multimineral supplements, they should not be significantly below 50% or significantly above 250% of the DV.
  • Unfortunately, the new DVs will introduce some confusion when they start appearing on supplement labels. That’s because in some cases, the new DVs are significantly different than the RDAs established by the Institute of Medicine. I would not fault a company for basing their ingredient amounts based on RDA recommendation rather than DVs. However, there is no good rationale for providing 500% DV or more for any nutrient in a multivitamin-multimineral supplement.
  • Calcium, magnesium, and phosphorous are a special case. They are bulky, so many manufacturers only provide 5-10% of them in their multivitamin-multimineral supplements. This is not ideal because many of the nutrients in a multivitamin-multimineral supplement are required for optimal utilization of calcium and magnesium in bone formation.

Many Americans get only 50% of the DV for calcium and magnesium in their diet. Thus, it makes good sense to provide 30-50% of the DV for calcium and magnesium in a multivitamin multimineral supplement. Most Americans get close to the DV for phosphorous from their diet, so the amount of phosphorous in a supplement is not particularly important.

hype#3: Don’t Fall For The Hype

In their attempts to differentiate themselves, many companies claim that they use a more natural or a better utilized form of the vitamin or mineral than their competitors. Ignore those claims. They are just marketing hype. For example,

  • In previous issues of “Health Tips From the Professor” I have debunked the claims that folate and methyl folate  are more natural, safer and more effective than folic acid. The claims that alternate chemical forms of other vitamins are more natural, safer, and more effective are equally bogus.
  • The claims by some manufacturers that they use a form of calcium that is more readily absorbed is not just misleading. It is the wrong question. Calcium in our bloodstream can do bad things (like calcification and hardening of the arteries) if it is not quickly utilized for bone formation.

Thus, the important question is how well the calcium is utilized for bone formation. Look for clinical studies showing that the calcium in their multivitamin-multimineral supplement is efficiently utilized for bone formation rather than hype about how quickly it gets into the bloodstream.

  • There is a good reason that many supplement companies continue to use ingredients like folic acid for B9, cyanocobalamin for B12, pyridoxine for B6, etc. All of them are supported by hundreds of clinical studies showing that they are safe and effective. I have no issue with companies choosing to use different forms of these vitamins. Just don’t fall for their hype that the forms they are using are somehow more natural, safer or more effective than the traditionally-used forms of the same vitamin.

buzz words#4: Don’t Fall For Buzz Words

Some manufacturers attempt to differentiate their products by claiming they are natural, organic, non-GMO, or are made from food. The companies are attaching buzz words to their product that they know resonate with the American people. Don’t believe them. Those claims are all bogus. They are marketing hype. For example,

  • There is no standard for “natural” so companies are not required to provide any evidence to back up their claim. If they claim that their product is natural, ask for a detailed list of the source and processing method for all their ingredients. If they are unwilling or unable to provide you with that information, don’t believe their claim of natural.
  • “Organic” certification for a supplement simply means that ingredients come from crops raised using organic methods. It is no guarantee of purity. Organically grown crops can still be contaminated if the air, soil or water is contaminated from any nearby pollution source. For example, ground water pollution is the major source of the heavy metal contamination often seen in rice-derived ingredients. It is far more important to select your supplement based on rigorous quality control standards that assure it is pure.
  • A “non-GMO” designation is useful for foods and for protein, but it is meaningless for the ingredients in a multivitamin-multimineral supplement. Those ingredients have been extensively purified. They contain no genetic information. They are chemically indistinguishable from purified ingredients obtained from GMO sources. If you would like more detailed information about the GMO controversy, I have provided a balanced perspective on GMO in a recent video.
  • Claims by some companies that their vitamins are derived from foods are completely bogus. That is a physical impossibility. For example, let’s look at what it would take to provide the DV for just 3 of the nutrients in a single multivitamin pill, assuming they started with the best food sources of those 3 nutrients:
  • It would take 1 cup of cooked lentils, 2 cups of cooked spinach, or 4 cups of cooked broccoli to provide the DV for folic acid.
  • It would take 1 cup of sunflower seeds, 1.5 cups of pistachio nuts, or 7 ounces of cooked tuna to provide the DV for vitamin B6.
  • It would take 5 ounces of cooked chicken breast, 1 cup of peanuts, or 6 cups of green peas to provide the DV for niacin.

That’s just 3 nutrients and one multivitamin tablet. You do the math. If they will lie to you about their vitamins coming from foods, they will probably lie about other things as well.

#5: Don’t Fall For Scare Tactics

Some companies try to scare you into buying their products by claiming their competitors are using unsafe ingredients. These claims are usually bogus, but it is useful to understand where this misinformation comes from.

dark sideThere is a lot of unfounded hysteria on the internet about product ingredients. Much of this hysteria has been fueled by a few well-known bloggers. I believe their intentions were pure in the beginning. They started by warning the public about truly dangerous ingredients like artificial colors, flavors, preservatives and sweeteners.

However, blogging has a dark side. To capture a large audience, your blog posts need to be sensational every week. As the weeks go by it becomes harder and harder to find subject matter that is both sensational and accurate. That’s when some bloggers go over to “the dark side.”

They become more concerned about the size of their audience than the accuracy of the information they post. They start vilifying ingredients that are perfectly safe as long as the manufacturer purifies them correctly and tests them for purity. These are ingredients which might be of concern for products made by a company with poor quality controls, but pose no concern for products made by a company with high quality control standards. In other words, they should not be spreading hysteria about the ingredient. They should be focusing on some of the real quality control issues in our industry.

To help you sort through all the hysteria about product ingredients, I have previously published a two-part series on ingredients in which I sorted through the claims and divided common ingredients into the good, the bad, and the ugly.

clinically proven#6: Demand Proof

This is the most important tip of all. Many companies make wild claims about their products but feel no need to back up their claims. Ignore their hype and demand they give proof to back up their claims.

  • If they claim their products are pure, ask how many quality control tests they run on their products.
  • If they claim their products work, ask for proof. Ask for clinical studies:
    • That have been done with people, not with animals, cell culture, or test tubes*
    • That have been published in peer-reviewed scientific journals.
    • That have been done with their product, not studies done with another product.

*Animal, cell culture and test tube studies are valid if they are used to identify a potential mechanism of action, but should not be cited as proof the product works. For ethical reasons, I prefer companies that do not use animal studies.

 

The Bottom Line: 6 Tips For Choosing The Best Multivitamin Supplement

 

Everyone would like to get the best multivitamin-multimineral for their health at the least possible cost. However, there are lots of multivitamin-multimineral products in the marketplace. The pressure to win market share is intense. Quality controls and clinical studies are expensive. All too often companies try to differentiate their multivitamin-multimineral products based on marketing hype.

With so many claims and counter claims in the marketplace, it has become almost impossible for the average consumer to know how to choose the best multivitamin-multimineral product. In this week’s article, I give you 6 tips you can use to select the best multivitamin supplement for you. I will tell you what to look for in a good multivitamin and which marketing claims you should just ignore.

  • Start with the nutrition label. A good multivitamin-multimineral supplement should contain all 24 essential nutrients recommended by the Food and Nutrition Board of the Institute of Medicine (23 if the supplement is without iron). Anything else is probably marketing hype.
  • Make sure the nutrients are in the correct balance. Again, your evaluation should be guided by the Institute of Medicine.
  • Don’t fall for the hype. Many companies claim that they use a more natural, safer, or better utilized form of the vitamin or mineral than their competitors. Ignore those claims. They are usually just marketing hype
  • Don’t fall for buzz words. Some companies attempt to differentiate their products by claiming they are natural, organic, non-GMO, or are made from food. The companies are attaching buzz words to their product that they know resonate with the American people. Don’t believe them. Those claims are all bogus. They do nothing to improve your health. They are marketing hype.
  • Don’t fall for scare tactics. Some companies try to scare you into buying their products by claiming their competitors are using unsafe ingredients. These claims are usually bogus.
  • Demand poof. This is the most important tip of all. Many companies make wild claims about their products but feel no need to back up their claims. Ignore their hype and demand they give proof to back up their claims.
  • If they claim their products are pure, ask how many quality control tests they run on their products.
  • If they claim their products work, ask for proof. Ask for clinical studies:
    • That have been done with people, not with animals, cell culture, or test tubes.
    • That have been published in peer-reviewed scientific journals.
    • That have been done with their product, not studies done with another product.

For more details about each of those tips, 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 To Treat Tight Hamstrings

Stretching Hamstrings Can Cause Them To Tear

Author: Julie Donnelly, LMT – The Pain Relief Expert

Editor: Dr. Steve Chaney

 

how to treat tight hamstrings“Don’t stretch your hamstrings” is the opposite advice to that given to the vast majority of athletes, especially runners. There is good reason to stop before you stretch, and consider why your hamstrings feel tight in the first place before determining how to treat tight hamstrings.

I received a message about a hamstring injury on one of the forums that I moderate. The message came from a father who was concerned about his 12YO son, an avid athlete. While stretching his hamstrings, he heard a “pop” and immediately felt pain at his butt and behind his knee. A few days had passed and the boy was still having hamstring pain while sitting and walking.

The first thing someone may tell him is to stretch, and that’s the last thing that should be done. He needs to get an MRI to make sure that his hamstring tendon isn’t torn. If that’s okay, then he needs to look more in depth to find out why his hamstrings are tight.

Why Your Hamstrings May Be Overstretched

overstretched hamstringsVery often your hamstrings will feel tight even though they are actually being overstretched!  Your hamstrings originate on your posterior pelvis, and one of your quadriceps muscles originates on the front of your pelvis. The quadriceps muscle is Rectus Femoris which goes from your pelvis, over your kneecap and down to your shin bone.

When your Rectus Femoris is tight, it will pull your pelvis down in the front. This causes your pelvis to move up in the back, and your hamstrings get overstretched. Your hamstrings feel tight, but if you then try to stretch them, you could tear them. In fact, if they are tight enough, you could actually pull the tendon away from the bone.

I’ve found that your hamstrings will often release on their own when you treat your quadriceps. As your quadriceps aren’t pulling down on the front of your pelvis, it allows your posterior pelvis to go down. As your posterior pelvis goes down, it releases the over-stretch from your hamstrings.

How to Treat Tight Hamstrings

release quadricep tensionPay attention to tight quadriceps when deciding how to treat tight hamstrings.

Fortunately, it’s really easy to release the tension in your quadriceps. I teach these treatments, and many more, in my book: Treat Yourself To Pain-Free Living.

In this picture, I’m using the Julstro Power Roller to push (don’t roll) from the top of my thigh to just above my knee.

I’ve found that the Power Roller gives more focused strength than using a foam roller. Also, tools that have beads that roll can’t go deep enough to reach the lower fibers of this thick muscle.

You’ll find a big spasm, which feels like a bump, at the point shown in this picture. When you go over the spasm, it will hurt so start out slow and build up strength to go deeper.

Also, treating your quadriceps will not only help release your hamstrings, but it is also the treatment for knee pain. This helps you eliminate two painful conditions, not just one! This is also one of the series of treatments for releasing low back, hip, and groin pain. It’s an especially good self-treatment to learn. You can also do this treatment while sitting in a chair with your knee slightly bent.

 How to Treat Tight Hamstrings While Treating Spasms

treat tight hamstringsAFTER you treat your quadriceps, then you can treat your hamstrings. The picture on the left not only treats the spasms, but it also stretches your hamstrings.

I prefer the Julstro Perfect Ball  over any other type of ball.  The Perfect Ball is solid in the middle and soft on the outside, giving great pressure without hurting the muscle.

Put the Perfect Ball on a hard surface such as a wooden stool or corner of a desk.

Rest your hamstrings on top of the ball, moving until you find the spasm in the muscle.

Finish by straightening your leg which will stretch your hamstrings. Go slowly and don’t strain the muscle, just move to a “hurts so good” level.

pain free living bookTreat Yourself to Pain-Free Living  shows you how to treat spasms from your head to your feet. If you are in pain, or if you love sports and your joints feel tight, this book will become your favorite “tool!”

Now, you know how to treat tight hamstrings.

Wishing you well,

Julie Donnelly

 

About The Author

julie donnelly

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.

Premature Death: Reduce Your Risk by 31%

Add 3.4 Disease-Free Years To Your Life

Author: Dr. Stephen Chaney

reduce premature deathIf you could reduce your risk of:

  • Heart Disease (primarily heart attack) by 24%,
  • Stroke by 33%,
  • Cancer by 14%
  • Premature death by 31% (That would add approximately 3.4 years of disease-free years to your lifespan),

Would you be interested in knowing more?

What if you could enjoy all these benefits:

  • Without it costing you an extra penny?
  • Without any side effects?
  • And you felt great?

Would you like to know the secret?  The secret is a diet rich in fruits and vegetables – probably a lot more fruits and vegetables than you are currently eating. Let’s look at the evidence.

How Was The Study Done?

reduce heart attacksYou may be saying “That’s not news. I’ve heard that before.” Yes, there have probably been hundreds of clinical studies looking at the benefits of diets rich in fruits and vegetables. There have also been several meta-analyses that have combined the data from many individual studies to improve that statistical power of their conclusions.

However, this study (Aune et al, International Journal of Epidemiology, DOI: 10.1093/ije/dyw319 ) is unique.

  • It is the largest and most comprehensive meta-analysis looking at the benefits of fruit & vegetable consumption ever undertaken.
  • It analyzed 142 published clinical studies with over 2.1 million subjects from around the globe.
  • There were 43,000 cases of heart disease, 47,000 cases of stroke, 112,000 cases of cancer, and 94,000 deaths in these studies.
  • It had enough statistical power to determine even minor effects of fruit and vegetable intake.
  • It is the first meta-analysis with enough data to accurately determine the optimal intake of fruits and vegetables.

 

Premature Death:  Reduce Your Risk By 31%

reduce premature death by eating fruits and vegetablesFor most of the health outcomes examined in this study, the optimal intake of fruits and vegetables was 10 servings a day. When they compared people who were consuming 10 servings a day to people who were consuming less than one serving a day,

  • Heart disease was reduced by 28%.
  • Stroke was reduced by 33%.
  • Premature death was decreased by 31%.
  • The fruits and vegetables most strongly associated with this benefit were apples, pears, citrus fruit, green leafy vegetables, and cruciferous vegetables.

For cancer, the optimal intake of fruits and vegetables was 6 servings a day. When they compared people who were consuming 6 servings a day to people who were consuming less than one serving a day,

  • Cancer was reduced by 14%.
  • The fruits and vegetables most strongly associated with reduced cancer risk were green vegetables such as green beans, yellow vegetables such as peppers and carrots, and cruciferous vegetables.

The authors speculated that the relatively small reduction in cancer risk they observed may have been because they were looking at total cancer cases rather than looking at individual cancers. Previous studies have suggested that fruits and vegetables reduce the risk of some cancers much more than others.

Finally, the authors estimated that:

  • 6 million premature deaths/year worldwide could be prevented if people consumed 6 servings of fruits and vegetables a day, and…
  • 8 million premature deaths/year worldwide could be prevented if people consumed 10 servings of fruits and vegetables a day.

What Does This Mean For You?

When the USDA rolled out the “Food Guide Pyramid” in 1992, they recommended 2-4 servings of fruit and 3-5 servings of vegetables a day. They tried educating the American public for almost a decade to no avail. Only 3% of Americans even came close to that recommendation.

In 2011 they threw in the towel and introduced “My Plate”, which recommended 5 servings (2 fruits and 3 vegetables). This is also the current recommendation of the WHO and England. “How well are we doing with this recommendation?”, you might ask.

good news bad newsThe answer is “not very well.”  The bad news is the CDC estimates that less than 13% of Americans eat 2 servings of fruit and 2-3 servings of vegetables a day. An average American eats one serving of fruit a day and less than 2 servings of vegetables a day. Clearly, we have a long way to go.

My guess is that only vegans come close to the recommended 10 servings a day, and that’s only if they skimp on beans, nuts, and grains so they can load up on fruits and vegetables.

The good news is every added serving of fruits and vegetables is beneficial. The authors of the study estimate that for every increase of 2.5 servings a day:

  • Heart disease would be reduced by 8%
  • Stroke would be reduced by 13%
  • Cancer would be reduced by 3%.
  • Premature death would be reduced by 10%

If we were to increase our intake of fruits and vegetables to even 6 servings a day:

  • Heart disease would be reduced by 16%
  • Stroke would be reduced by 22%
  • Cancer would be reduced by 13%.
  • Premature death would be reduced by 27%.

What About Supplementation?

The authors of the study stated: “Most likely it is the whole package of beneficial nutrients you obtain by eating fruits and vegetables that is crucial to health. This is why it is important to eat whole plant foods to get the benefit, instead of taking antioxidant or vitamin supplements…”

I agree in principle. It is impossible to duplicate the myriad of nutrients found in whole foods in a supplement. More importantly, we can do better. We should all work towards increasing the amount of fruits and vegetables in our diet.

However,

  • When there is such a huge gap between what Americans are eating and the optimal intake of fruits and vegetables, and…
  • The USDA has tried for decades to get Americans to eat more fruits and vegetables without success, and…
  • We know many of the beneficial nutrients found in those fruits and vegetables…

Supplementation also makes sense. Choose a company that you can trust and try to fill the gap between what you need and what you are getting from your diet.  And, increase your intake of fruits and vegetables to decrease your risk of premature death.

 

The Bottom Line

 

  • A new meta-analysis that combined the data from 142 published clinical studies with over 2.1 million subjects has concluded that increasing our intake of fruits and vegetables to 10 servings a day would:
    • Reduce heart disease (primarily heart attacks) by 24%.
    • Reduce strokes by 33%.
    • Reduce cancer by 14%.
    • Reduce premature death by 31% (That would add approximately 3.4 years of disease-free years to your lifespan).
    • Result in 7.8 million fewer premature deaths/year worldwide.
  • The bad news is that:
    • The CDC estimates that less than 13% of Americans eat even 2 servings of fruit and 2-3 servings of vegetables a day.
    • The CDC also estimates that the average American eats one serving of fruit and less than 2 servings of vegetables per day.
  • My guess is that only vegans come close to the recommended 10 servings a day, and that’s only if they skimp on beans, nuts, and grains so they can load up on fruits and vegetables.
  • The good news is every added serving of fruits and vegetables is beneficial. The authors of the study estimate that for every increase of 2.5 servings a day:
    • Heart disease would be reduced by 8%
    • Stroke would be reduced by 13%
    • Cancer would be reduced by 3%.
    • Premature death would be reduced by 10%
  • We can do better. We should all work towards increasing the amount of fruits and vegetables in our diet.
  • However,
    • When there is such a huge gap between what Americans are eating and the optimal intake of fruits and vegetables, and…
    • The USDA has tried for decades to get Americans to eat more fruits and vegetables without success, and…
    • We know many of the beneficial nutrients found in those fruits and vegetables…
  • Supplementation also makes sense. Choose a company that you can trust and try to fill the gap between what you need and what you are getting from your diet.

 

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 Diet for Children with ADHD Matter?

Could A Healthy Diet Help Your Child?

Author: Dr. Stephen Chaney

 

diet for children with adhdDoes diet for children with ADHD matter?

The prevalence of ADHD appears to be skyrocketing. It increased by 42% in just 8 years between 2003 and 2011. Currently, 4.5 million children in the US are on ADHD medication, at a cost to taxpayers of $45 billion.

Unfortunately, ADHD medications come with serious side effects like loss of appetite and delayed growth, sleep disorders, nausea & stomach pains, headaches, moodiness and irritability. Even more worrisome is that many children say they “just don’t feel right” while they are on the drugs. Finally, there is the unintended message we are sending our children that drugs are the solution to their problems.

It is no wonder that millions of parents are looking for more natural solutions for their child’s ADHD. That is why recent headlines like “The Mediterranean Diet Could Help Children with ADHD” generate such interest.

In this issue of Health Tips From the Professor I have looked at the studies behind the headlines to answer your most pressing questions:

  • Would something as simple as the Mediterranean diet help my child control their ADHD symptoms?
  • Do they have to adhere to the Mediterranean diet, or would other healthy diets work just as well?

Answering these questions will tell us if diet for children with ADHD matters.

adhd dietHow Was The Study Designed?

The study behind the headlines (A Rios-Hernandez et al, Pediatrics DOI: 10.1542/peds.2016-2027) looked at 60 children and adolescents (ages 6-16) from southern Spain who were newly diagnosed with ADHD and compared them with 60 sex- and age-matched controls without ADHD from the same schools.

A food frequency questionnaire was administered by a trained interviewer and a scoring system called KIDMED was used to evaluate adherence to a Mediterranean-type diet. The study excluded children with more severe psychological problems and any children taking ADHD medications or nutritional supplements.

Does Diet for Children with ADHD Matter?

 

  • In a preliminary analysis of the data, the investigators discovered:
    • Breastfeeding was associated with decreased risk of ADHD.
    • Inactivity was associated with increased risk of ADHD.
    • Obesity was associated with increased risk of ADHD.

    child adhd dietOf course, the main point of the study was to investigate whether adherence to a Mediterranean-type diet influenced the risk of developing ADHD. The answer to this question was clear cut.

    • Adherence to a Mediterranean-type diet significantly reduced the risk of ADHD in both children and adolescents.

    So, clearly diet for children with ADHD does matter.

    Next, the investigators used the data obtained from the food frequency questionnaires to ask what components of a Mediterranean diet were most influential in reducing the risk of developing ADHD. These results were also very interesting:

    Dietary components that decreased the risk of ADHD included:

    • Consuming two or more servings of fruit every day (In Spain, the extra servings of fruit were primarily citrus, but presumably other fruits would be just as effective).
    • Consuming fresh or cooked vegetables more than once a day.
    • Consuming fatty fish on a regular basis (2-3 times a week).
    • Consuming grains or rice almost every day.
    • Starting the day with a healthy breakfast.

    Dietary components that increased the risk of ADHD included:

    • Eating at fast food restaurants more than once a week.
    • Skipping breakfast.
    • High consumption of soft drinks.
    • High consumption of candy and sugar.

    What Does This Mean For You?

    foods adhd dietThis study clearly showed that adherence to a Mediterranean diet is associated with a significantly lower incidence of ADHD.

    Of course, this study was conducted in southern Spain where a healthy diet is the Mediterranean diet. The question for people in other parts of the world is whether other healthy diets would work just as well.

    Based on their detailed study of the effect of individual dietary components, it is reasonable to assume that any healthy diet that…

    …emphasized fresh fruits & vegetables, whole grains, omega-3-rich fish, and…

    …started the day with a healthy breakfast, and…

    …minimized (or eliminated) fast foods, sodas, candy & other sweets…

    …would reduce the risk of ADHD.

    Plus, this is an approach that has no side effects. Just side benefits.

    Finally, if you read the study carefully, it is clear a holistic approach is always best. For example:

    • Individual dietary components had small effects on ADHD symptoms.
    • When those individual components were combined into a healthy diet, a major reduction in ADHD symptoms was observed.
    • The study suggested that reduction in ADHD symptoms would be even greater with a healthy lifestyle that included regular exercise and weight control.
    • The authors stated that supplementation could also play a role in reducing ADHD symptoms. They felt the best evidence was for supplementation with omega-3 fatty acids and a multivitamin multimineral supplement.

We can certainly conclude that diet for children with ADHD matters.

 

The Bottom Line

 

A recent study in southern Spain has looked at the relationship between adherence to a healthy Mediterranean diet and the risk of developing ADHD symptoms in children and adolescents.

  • In a preliminary analysis of the data, the investigators discovered:
    • Breastfeeding was associated with decreased risk of ADHD.
    • Inactivity was associated with increased risk of ADHD.
    • Obesity was associated with increased risk of ADHD.
  • These factors were independent of adherence to a Mediterranean diet.
  • Adherence to a Mediterranean-type diet significantly reduced the risk of ADHD in both children and adolescents. This was the major finding of the study.
  • The dietary components in the study that decreased the risk of ADHD were:
    • Consuming two or more servings of fruit every day (In Spain, the extra servings of fruit were primarily citrus, but presumably other fruits would be just as effective).
    • Consuming fresh or cooked vegetables more than once a day.
    • Consuming fatty fish on a regular basis (2-3 times a week).
    • Consuming grains or rice almost every day.
    • Starting the day with a healthy breakfast.
  • The dietary components that increased the risk of ADHD were:
    • Eating at fast food restaurants more than once a week.
    • Skipping breakfast.
    • High consumption of soft drinks.
    • High consumption of candy and sugar.
  • Based on their detailed study of the effect of individual dietary components, it is reasonable to assume that any healthy diet that…
    • …emphasized fresh fruits & vegetables, whole grains, omega-3-rich fish, and…
    • …started the day with a healthy breakfast, and…
    • …minimized (or eliminated) fast foods, sodas, candy & other sweets……would reduce the risk of ADHD.
  • Plus, this is an approach that has no side effects. Just side benefits.
  • Finally, if you read the study carefully, it is clear a holistic approach is always best. That would include:
    • A healthy diet
    • regular exercise and weight control.
    • Supplementation with omega-3 fatty acids and a multivitamin multimineral supplement.

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 Mediterranean Diet For Heart Health

Can You Cut Your Heart Disease Risk In Half?

Author: Dr. Stephen Chaney

 

what ifShould you use the Mediterranean diet for heart health?

What if…

  • You could reduce your risk of heart disease by almost 50%…and…
  • It didn’t cost you an extra penny?
  • You didn’t need to lose weight (although you would probably get even better results if you did)?
  • You didn’t need to buy a gym membership and start a workout program (although you would probably get even better results if you did)?
  • There were absolutely no side effects?
  • There were considerable side benefits like reduced risk of type 2 diabetes, high blood pressure, inflammation, and cognitive decline as you aged?

Would you be interested? I’m willing to bet if this were a TV ad, you would be on the edge of your seat. If it were a new “magic” supplement, you might be reaching for your credit card before the ad was over. If it was the latest “miracle” workout machine, you might order it right away.

However, I am not talking about a magic pill or a miracle workout machine. I’m talking about a way of eating called the Mediterranean diet. Recent headlines have claimed that the Mediterranean diet can cut heart disease risk almost in half. This would lead you to believe you could use the Mediterranean diet for heart health.  Let’s look at the evidence behind that claim.

 

How Was The Study Designed?

omega-3 lowers heart disease riskThe study behind the headlines (C-M. Kastorini et al. Atherosclerosis, 246: 87-93, 2016) enrolled 2583 adults, ages 18-89, from the region around Athens, Greece in a 10-year study beginning in 2001-2002.

At the beginning of the study and at the 5 and 10-year mark, participants completed in-depth surveys about their medical records, lifestyle, and dietary habits. These surveys were conducted by trained personnel (cardiologists, general practitioners, dietitians, and nurses). Participants with active cardiovascular disease in the first survey were excluded from the study.

The study evaluated 4 things:

  • Cardiovascular disease risk factors including obesity, high cholesterol, high triglycerides, high blood pressure, diabetes, and inflammation.
  • Adherence to the Mediterranean diet (see below).
  • Heart disease incidence based on heart attacks, stroke, angina, ischemia, cardiac arrhythmias and deaths due to heart disease.
  • Confounding variables such as age, sex, family history of heart disease, smoking, and lack of physical activity. All comparisons were corrected for these confounding variables so that they did not influence the results.

Adherence to the Mediterranean diet was based on a diet analysis scoring system called MedDietScore. The Mediterranean diet is one which emphasizes fresh fruits and vegetables, whole grains, beans, nuts, fish, olive oil, and moderate consumption of red wine.  You can see this might lead you to believe in the Mediterranean diet for heart health.

The MedDietScore gives positive points based on how often these foods are consumed. It gives negative points based on how often meats, meat products, poultry, and full-fat dairy products are consumed. For alcohol, modest consumption is considered a positive, with either no or excess alcohol consumption rating a score of 0. The composite score ranges from 0 to 55, with higher values indicating greater adherence to the Mediterranean diet.

As an aside, you might think that everyone in Greece consumes a Mediterranean diet. Unfortunately, our unhealthy Western diet and our fast foods restaurants are making inroads in the birthplace of the Mediterranean diet.

 

The Mediterranean Diet for Heart Health?

Mediterranean diet for heart healthEven after correcting for confounding variables, the study results were impressive.

  • Each 10% increase in adherence to the Mediterranean diet was associated with a 15% decreased risk of developing heart disease during the 10-year study period.
  • When they compared participants in the upper third for adherence to the Mediterranean diet to those in the lower third, their risk of developing heart disease was decreased by 47%. That’s huge.

However, the results were even more impressive when they looked at the effects of the Mediterranean diet on other risk factors for heart disease.

  • For individuals with low adherence to the Mediterranean diet, each of those risk factors (obesity, high cholesterol, high triglycerides, high blood pressure, diabetes, and inflammation) independently increased the risk of developing heart disease. These results are identical to almost every other published study looking at those risk factors.
  • However, for individuals with high adherence to the Mediterranean diet, those same risk factors had only small, non-significant effects on the risk of developing heart disease. If this finding is verified by future studies, it would suggest that adherence to a Mediterranean diet has the potential to override risk factors like obesity, diabetes, high blood pressure and elevated cholesterol.

Of course, I would not recommend that you ignore obesity and other cardiovascular risk factors and just focus on following a Mediterranean diet. I’m pretty sure you will get even better results if you get your weight, blood sugar, cholesterol, and blood pressure under control in addition to following a Mediterranean diet. Who knows, you might even reduce your risk of heart disease by 75% or more.  So, should we believe in the Mediterranean diet for heart health?

What Does This Mean For You?

If this were the only published study showing that adherence to the Mediterranean diet reduces heart disease risk I would consider it speculative. However, it is only one of several recent studies that have come to a similar conclusion. At this point in time, the evidence is strong that following a Mediterranean-type diet will reduce your heart disease risk.  The Mediterranean diet for heart health seems to be true.

That brings me back to my opening statement. Following a Mediterranean diet:

  • Won’t cost you a penny. You are just spending your food budget on healthier foods.
  • May reduce your risk of heart disease by up to 47% even if you don’t lose weight, but I recommend that you do lose weight.
  • May be as effective as exercise at reducing your heart disease risk. That statement comes from a talk given by one of the authors when he was describing the study.
  • Has no side effects. You could probably achieve a 47% reduction in heart disease using a cardiologist-approved cocktail of 3-5 drugs, but those drugs would come with significant side effects and a considerable cost for someone.
  • Will likely come with side benefits like reduced risk of type 2 diabetes, high blood pressure, inflammation, and cognitive decline.

My question to you is: Now that you know that a simple dietary change could have all those benefits and no downside, are you willing to give it a try? If so, your heart may just thank you for it.

However, I don’t mean to imply that the Mediterranean diet is the only way to reduce your heart disease risk. If your blood pressure is elevated, you might want to try the DASH diet . If you want to reduce heart disease risk and also minimize cognitive decline as you age, you might want to consider the MIND diet .

Those three diets are actually quite similar. They all emphasize fruits, vegetables, whole grains, nuts, seeds, fish, and moderate amounts of healthy fats. They all minimize refined flour, pastries, sweets, red & processed meats. You won’t find a Twinkie or a Big Mac in any of them.

The Mediterranean diet for heart health?  Sure!

The Bottom Line

 

  • A recent study suggests that adherence to a Mediterranean type diet could reduce the risk of developing heart disease by up to 47%.
  • The beneficial effect of the Mediterranean diet was so strong that it overcame other cardiovascular risk factors such as obesity, high cholesterol, high triglycerides, high blood pressure, diabetes, and inflammation.
  • This study is likely to be accurate because it is fully consistent with several other studies looking at the effect of the Mediterranean diet on heart disease risk.
  • To put it into perspective, this simple dietary change.
    • Won’t cost you a penny. You just redirect your food budget.
    • Has zero side effects. You could probably achieve a similar 47% reduction in heart disease risk with a cardiologist-approved cocktail of 3-5 drugs, but that would come with multiple side effects.
    • Has side benefits such as reduced risk of type 2 diabetes, high blood pressure, inflammation, and cognitive decline
  • However, the Mediterranean diet is not the only game in town. Other studies suggest that the DASH diet and MIND diet are also effective at reducing heart disease risk.
  • Those three diet patterns (Mediterranean, DASH & MIND) are actually quite similar. They all emphasize fruits, vegetables, whole grains, nuts, seeds, fish, and moderate amounts of healthy fats. They all minimize refined flour, pastries, sweets, red & processed meats. You won’t find a Twinkie or a Big Mac in any of them.
  • Finally, I am not suggesting that you go on the one of these diets and just throw away your heart medicines without talking to your doctor. However, I would recommend that you talk with your doctor about implementing what the National Institutes of Health calls Therapeutic Lifestyle Change. All three dietary patterns are fully consistent with the NIH-recommended Therapeutic Lifestyle Change. The NIH recommends that Therapeutic Lifestyle Change be tried before considering cholesterol lowering drugs or be used along with cholesterol lowering drugs so that drug dosage can be minimized.

 

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.

Frozen Shoulder Pain Relief

Frozen Shoulder, Rotator Cuff Pain, No More!

Author: Julie Donnelly, LMT –The Pain Relief Expert

Editor: Dr. Steve Chaney

frozen shoulder pain reliefA frozen shoulder is a mild sounding name for a seriously painful condition that prevents your shoulder and arm from moving. Muscles in your entire shoulder are responsible for frozen shoulder and rotator cuff injuries. Each one needs to be treated for relief, and each impacts the others so it’s important to treat all of them to achieve frozen shoulder pain relief.

Last month I showed you how to do the treatment for the Infraspinatus muscle in the back of your shoulder. This month we’ll talk about two muscles in your chest that prevent your arm from going back.

Muscles that Cause Frozen Shoulder and Rotator Cuff Injuries

The muscles are your Pectoralis Minor and Pectoralis Major which are on the front of your shoulder. If you put your hand on your chest as shown, you are right on top of both muscles.  You can also move your hand down a bit to treat the rest of the two muscles.

frozen shoulder pain relief treatmentThe deeper muscle is your Pectoralis Minor which goes from your ribs up to the top of your shoulder. This muscle pulls your shoulder forward and causes your back to round. When it is in spasm, you have poor posture and can’t bring your shoulder back.

The surface muscle is your Pectoralis Major which goes from your chest bone (sternum) to your upper arm. When this muscle contracts normally, you bring your arm in toward your trunk and/or across the front of your body. If it is in spasm, you can’t bring your arm out away from your body.

You can see how these two muscles will cause frozen shoulder by holding your arm tight to your body.

Since they both move your shoulder and arm, while they aren’t technically rotator cuff muscles, they impact your rotator cuff.  So, these muscles have to be addressed as well for frozen shoulder pain relief.

Frozen Shoulder Pain Relief Treatment and Rotator Cuff Injury Treatment

Place your opposite hand onto your chest as shown.  For example, if you are treating your left shoulder, you will put your right hand on the bottom. Press your fingertips into your chest and place your left hand on top of your right hand.  Press into the muscles with both hands to add strength to the movement.

pain free dvdIf you don’t feel the tender point at first, just move your fingertips around and keep pressing.  When you hit a sore point, you are on top of the spasm. Hold the pressure for 30 seconds and repeat. Do this 2-3 times, and then look for another tender point.

It is most beneficial if you combine this treatment with the treatment for the Infraspinatus that was shown previously.

There are so many shoulder treatments involved in the release of frozen shoulder and rotator cuff injuries that I can’t show all of them. If you suffer from shoulder pain or limited flexibility, I suggest you look at my book Treat Yourself to Pain-Free Living. This book will help you with frozen shoulder pain relief.

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.

julie donnellyShe 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.

Is Red Yeast Rice Safe?

Is Natural Always Better?

Author: Dr. Stephen Chaney

is red yeast rice safeIs red yeast rice safe?  First, let’s take a quick look at statins.

Statin drugs save lives. When taken by people who have survived a heart attack, they have proven effectiveness at lowering the risk of a second heart attack.

But, statins are also dangerous. They can cause muscle damage, liver damage, and even kidney failure (statin side effects ). Statins can also cause diabetes  and memory loss.

Because of these side effects, many people are looking for more natural alternatives for lowering their cholesterol. Many other people are unable to take the statin drugs because of muscle pain and/or elevated liver enzymes.

One popular alternative to statin drugs is red yeast rice. Red yeast rice comes from traditional Chinese medicine, so it is natural. However, just because a supplement is natural doesn’t necessarily mean that it is either safe or effective. Red yeast rice is a perfect example. Many people think that red yeast rice is as effective as statins for reducing cholesterol levels. They believe red yeast rice side effects are non‐existent. Nothing could be further from the truth!

Is Red Yeast Rice Safe and Effective?

Is Red Yeast Rice Effective?

is red yeast rice effectiveIs red yeast rice safe and effective.  The active ingredients in red yeast rice are a class of compounds called monacolins, which are close analogs of the statin drugs. In fact, the most abundant monacolin in red yeast rice, monacolin K, is identical to the statin drug lovastatin (Mevacor). That destroys one myth. If a red yeast rice product contains as much monacolin K as a lovastatin pill, it would have the same benefits and the same side effects.

It only gets worse! In fact, you have no way of knowing how much monacolin K is in your red yeast rice supplement. Because lovastatin is a drug, the manufacturers of red yeast rice are caught in a Catch‐22 situation. If the manufacturers were to actually standardize or disclose the levels of monacolin K in their product, the FDA would consider it an unapproved drug and remove it from the market.

When manufacturers don’t standardize their active ingredients, bad things happen.

How bad, you might ask? A recent study (RY Gordon, Archives of Internal Medicine, 170: 1722‐1727, 2010) analyzed the concentration of active ingredients in 12 commercially available red yeast rice supplements. The results were appalling:

  • Total monacolins in the supplements ranged from 0.31 to 11.15 mg/capsule.
  • Monacolin K (lovastatin) ranged from 0.10 to 10.09 mg/capsule.

To put that into perspective, therapeutic doses of lovastatin range from 10 to 80mg/day. Most of the red yeast rice supplements had an insignificant amount of monacolin K. Only a few of the samples tested had enough monacolin K to be equivalent to the lowest therapeutic dose of lovastatin.

 

Is Red Yeast Rice Safe?

is red yeast rice dangerousAnother study (Mazzanti et al, British Journal of Clinical Pharmacology, DOI:10.1111/bcp.13171) found that red yeast rice with 5-7 mg of monacolin K had the same frequency of side effects as 20-40 mg of pure, pharmaceutical grade lovastatin. The most frequent side effects were muscle pain, muscle damage, liver injury, gastrointestinal reactions, and skin reactions. Hospitalization was required in 25% of the cases.

It gets even worse! The first study (RY Gordon, Archives of Internal Medicine, 170: 1722‐1727, 2010) also measured levels of a toxin called citrinin that is produced by a fungus that grows on red yeast rice. Citrinin is potentially toxic to the kidneys. This is not a toxin that you would find in a pharmaceutical product like lovastatin, but it was present at high levels in one third of the red yeast rice formulations tested.

What Does This Mean For You?

Is red yeast rice safe?  To sum it all up, if you were to go out and purchase a red yeast rice supplement.

  • You might get a batch with no active ingredients. It wouldn’t have any of the side effects of a statin drug, but it wouldn’t have any efficacy either.
  • You might get a batch that would have the same efficacy and the same side effects as a low dose statin drug.
  • You would have a 33% chance of getting a batch that was contaminated with a toxin that you would never find in a statin drug—one that might damage your kidneys.

I don’t know about you, but after reading those studies I have no desire to ever try a red yeast rice supplement.

If you are looking for a natural cholesterol-lowering supplement that is both safe, effective, and recommended by the National Institutes of Health, choose one containing 2 grams of plant stanols and sterols.

Is red yeast rice safe?  Not always.

 

The Bottom Line

Just because a supplement is natural doesn’t necessarily mean that it is either safe or effective. Red yeast rice is a perfect example. Many people think that red yeast rice is as effective as statins for reducing cholesterol levels. They believe red yeast rice side effects are non‐existent. Nothing could be further from the truth!

  • The active ingredients in red yeast rice are a class of compounds called monacolins, which are close analogs of the statin drugs. In fact, the most abundant monacolin, monacolin K, is identical to the statin drug lovastatin (Mevacor).
  • There is no standardization of red yeast rice supplements. One study looked at 12 red yeast rice supplements and found that the dose of monacolin K ranged from almost nothing to the equivalent of the lowest therapeutic dose of lovastatin.
  • Another study found that the side effects of red yeast rice were identical in type and frequency to low dose lovastatin.
  • Even worse, one third of the red yeast rice supplements tested contained a toxin called citrinin that is potentially toxic to the kidneys.
  • To sum it all up, if you were to go out and purchase a red yeast rice supplement,
    • You might get a batch with no active ingredients. It wouldn’t have any of the side effects of a statin drug, but it wouldn’t have any efficacy either.
    • You might get a batch that would have the same efficacy and the same side effects as a low dose statin drug.
    • You would have a 33% chance of getting a batch that was contaminated with a toxin that you would never find in a statin drug—one that might damage your kidneys.

Natural isn’t always better! I don’t know about you, but after reading those studies I have no desire to ever try a red yeast rice supplement.

If you are looking for a natural cholesterol-lowering supplement that is both safe, effective, and recommended by the National Institutes of Health, choose one containing 2 grams of plant stanols and sterols.

 

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

Omega-3 and Heart Disease Risk

Why Is There So Much Confusion About Omega-3 and Heart Disease Risk?

Author: Dr. Stephen Chaney

 

omega-3 heart diseaseConcerning omega-3 and heart disease, the pendulum keeps swinging. In the 1990’s several strong clinical studies showed that omega-3s reduced heart disease risk. In fact, a major clinical study in Italy, (Lancet 354: 447 – 455, 1999 , Circulation 105 : 1897 – 1903, 2002 ), found omega-3s to be just as effective as statin drugs for preventing heart attacks, but without any of the side effects of statins.

At that time, everyone was talking about the benefits of omega-3s in reducing heart disease risk. The American Heart Association recommended an intake of 500-1,000 mg/day of omega-3s for heart health. Some experts were recommending even more if you were at high risk of heart disease.

In the 2000’s the pendulum swung in the other direction. Several clinical studies found no benefit of omega-3s in reducing heart disease risk. Suddenly, experts were telling us that omega-3s were overrated. They were a waste of money. The American Heart Association kept their omega-3 recommendations for heart health, but put more emphasis on omega-3s for people with elevated triglycerides (where the benefits of omega-3s are non-controversial).

Suddenly regarding omega-3 and heart disease, the pendulum is swinging back again. A recent meta-analysis (Alexander et al, Mayo Clinic Proceedings, 92: 15-29, 2017) reported that omega-3s do appear to be beneficial at reducing heart disease risk. An editorial accompanying that article (O’Keefe et al, Mayo Clinic Proceedings, 92: 1-3, 2017) called the meta-analysis “the most comprehensive of its kind to date…” Those experts went on to say “…omega-3-fatty acid intake of at least 1 gram of EPA + DHA per day, either from seafood or supplementation (as recommended by the American Heart Association) continues to be a reasonable strategy.”

This was followed by publication of three clinical studies that came to essentially the same conclusion (Kieber et al, Atherosclerosis, 252: 175-181, 2016 ; Sala-Vila et al, Journal of the American Heart Association, In Press ; and Greene et al, American Journal of Cardiology, 117: 340-346, 2016 ).

Why is there so much confusion about omega-3 and heart disease? Let’s start by reviewing the recently published meta-analysis.

 

Do Omega-3s Lower Heart Disease Risk?

omega-3 lowers heart disease riskThis study (Alexander et al, Mayo Clinic Proceedings, 92: 15-29, 2017) combined the data from 18 randomized controlled trials with 93,000 patients and 16 prospective cohort studies with 732,000 patients. This was the largest meta-analysis on omega-3s and heart health performed to date. The results were as follows:

  • The combined data from the randomized controlled studies showed that omega-3 supplementation resulted in a non-significant 6% reduction in heart disease risk. This is similar to other recently published studies (more about that later).
  • However, when the investigators looked at high risk populations within the randomized controlled studies, the results were strikingly different.
    • In patients with elevated triglycerides, omega-3 supplementation caused a significant 16% reduction in heart disease risk.
    • In patients with elevated LDL cholesterol, omega-3 supplementation caused a significant 18% reduction in heart disease risk.
  • In addition, the combined data from the prospective cohort studies showed that omega-3 supplementation resulted in a significant 18% decrease in heart disease risk.

The authors concluded “[Our] results indicate that EPA + DHA may be associated with reducing heart disease risk, with greater benefits observed among higher-risk populations…”

 

Why Is There So Much Confusion About Omega-3s and Heart Disease Risk?

confusionThere are several major clinical studies in progress looking at the effect of omega-3s on heart health. Some experts predict that the confusion will be cleared up once they are published. I predict they will only add to the confusion. Let me explain why.

You’ve heard the old saying “Garbage in – garbage out.”  Proper design of clinical studies is essential. If a study is poorly designed, it provides incorrect information. When you analyze the previous clinical studies carefully, you find that many of them are flawed. Their results are, therefore, incorrect. My fear is that many of the ongoing clinical studies will contain the same flaws and will provide the same incorrect information.

Let’s look at the flaws, and why they provide incorrect information.

Flaw #1: Omega-3 supplementation will only be beneficial for people who are omega-3 deficient. The authors of the Mayo Clinic Proceedings editorial provided a useful analogy. They said: “Vitamin C bestows dramatic and lifesaving benefits to persons with scurvy, but is no better than placebo for persons who are replete with vitamin C.”

That means a well-designed study should measure omega-3 levels in red blood cells both prior to and at the end of the clinical study. The data analysis should focus on those individuals who started the study with low omega-3 status and whose omega-3 status improved by the end of the study. Unfortunately, few of the previously published studies have done that, and I am not confident that the ongoing studies have incorporated that into their experimental design.

Flaw #2: Omega-3 supplementation will be of most benefit for those people who are at highest risk for heart disease. This has been a recurrent pattern in the literature. Many of the clinical studies focusing on high-risk individuals have shown a beneficial effect of omega-3 supplementation on heart disease risk. Most of the studies focusing on the general population (most of which are of low risk for heart disease) have failed to show a benefit of omega-3 supplementation. The current meta-analysis is no exception. When they looked at the general population, there was a non-significant reduction in heart disease risk. However, when they looked at high-risk populations the beneficial effect of omega-3s was highly significant.

I can’t predict how the ongoing studies will analyze their data. If they focus on high-risk groups they are more likely to report a beneficial effect of omega-3s on heart health. If they only report on the results with the general population, they are likely to conclude that omega-3s are ineffective.

I do need to make an important distinction here. The inability to demonstrate a beneficial effect of omega-3 supplementation in the general population does not mean that there is no effect. It turns out to be incredibly difficult to demonstrate a beneficial effect of any intervention, including statins , in a healthy, low-risk population. Because of that, we may never know for sure about the relationship between omega-3 and heart disease. Do omega-3s reduce heart disease risk for the young and healthy. At the end of the day, you will need to make your own decision about whether omega-3s make sense to you.

omega-3 supplementationFlaw #3: Heart medications mask the beneficial effects of omega-3 supplementation. When the public hears about the results of a randomized controlled study they assume that the placebo group received no treatment and the omega-3 group was only receiving omega-3s. That is not how it works.  Medical ethics guidelines require that the placebo group receive the standard of care treatment – namely whatever drugs are considered appropriate for that population group.

That means that it has become very difficult to demonstrate that high-risk populations benefit from omega-3 supplementation. Back in the 90s, the standard of care for high risk patients was only one or two drugs. In those days, many studies were reporting beneficial effects of omega-3 supplementation in high risk populations. However, for the past 5-10 years the standard of care for high risk patients is 4-5 medications.

These are medications that reduce cholesterol levels, lower triglyceride levels, lower blood pressure, reduce inflammation, and reduce clotting time. In other words, the drugs mimic all the beneficial effects of omega-3s. (The only difference is that the drugs come with side-effects. The omega-3s don’t.) It is no coincidence that many of the recent studies have come up empty-handed.

The current studies are asking a fundamentally different question. In the 90s, clinical studies asked whether omega-3s reduced heart disease risk in high-risk patients. Today’s clinical studies are asking whether omega-3s provide any additional benefits for patients who are already taking multiple drugs. Personally, I think my readers are more interested in the first question than the second.

Once again, the current meta-analysis is perfectly consistent with this interpretation. The high-risk groups who clearly benefited from omega-3 supplementation were not ones with pre-existing heart disease or who had previously had a heart attack. They were the ones with elevated LDL cholesterol or triglycerides. They were patients who were, either not taking drugs for those risk factors, or patients for whom the drugs were ineffective.

Because subjects in future studies will be taking multiple medications, I predict that even those ongoing studies focusing on high-risk populations will come up empty-handed.

Now you understand why I started this section by saying that I predict many of the ongoing studies will provide incorrect results. I predict that you will see more headlines proclaiming that omega-3s don’t work. However, you won’t be swayed by those headlines because you now know the truth about the flaws in the clinical studies behind the headlines!

What Does This Mean For You?

omega-3 fish oilThe most recent meta-analysis and a careful evaluation of previous studies make two things clear:

  • If you are at high risk of heart disease, omega-3 supplementation is likely to reduce your risk.

We can divide risk factors for heart disease into those we know about, and those we don’t.

  • Risk factors we know about include previously diagnosed heart disease or heart attack, genetic predisposition, age, elevated LDL cholesterol levels, high triglycerides, high blood pressure, inflammation, obesity, metabolic syndrome and diabetes.
  • Unfortunately, there are also risk factors we don’t know about. For too many Americans the first sign of heart disease is sudden death – sometimes just after receiving a clean bill of health from their doctor.
  • If you are not getting enough omega-3s in your diet, omega-3 supplementation is likely to reduce your heart disease risk.

If you are young and healthy, the unfortunate truth is that we may never completely understand the relationship between omega-3 and heart disease. We may not know whether omega-3 supplementation reduces your risk of heart disease. However, I think the overall evidence is strong enough that you should consider adding omega-3s to your diet.

In short, I agree with the authors of the Mayo Clinic Proceedings editorial and the American Heart Association that omega-3-fatty acid intake of at least 1 gram of EPA + DHA per day, either from seafood or supplementation, is a prudent strategy for reducing heart disease risk.

 

The Bottom Line

  • There has been a lot of confusion about the role of omega-3s in reducing heart disease risk.
  • In the 90s, several clinical studies reported that omega-3 supplementation reduced heart disease risk. Most experts, including the American Heart Association, were recommending that most Americans would benefit from adding 500-1,000 mg of omega-3s to their daily diet.
  • In recent years, several clinical studies have reported that omega-3 supplementation has no effect on heart disease risk. [There were some important flaws in those studies, which I discuss in the article above]. Experts started saying that omega-3s were overrated. They were a waste of money.
  • The largest meta-analysis ever undertaken in this area of research has recently reported that omega-3 supplementation decreases risk of heart disease in high-risk population groups. Three subsequent clinical studies have come to essentially the same conclusion.
  • Other studies suggest that omega-3 supplementation is also likely to reduce heart disease risk in individuals with poor omega-3 status, and most Americans have poor omega-3 status.
  • We may never know whether omega-3 supplementation reduces heart disease risk if you are young and healthy. Simply put, not enough young & healthy people develop heart disease within the time-frame of a clinical study for the results to be statistically significant. For this group, the old saying about “An ounce of prevention…” just makes sense.
  • I agree with those experts who recommend at least 1,000 mg/day of omega-3s as a prudent strategy for reducing heart disease risk.
  • There are several major clinical trials in progress studying the efficacy of omega-3s for reducing heart disease risk. Some experts predict that the confusion will be cleared up once they are published. I predict they will only add to the confusion. I predict that many of those studies will show no benefit of omega-3 supplementation, and you will see more headlines proclaiming that omega-3s play no role in heart health. If you have read the article above, you won’t be swayed by those headlines because you will know the truth about the flaws in the studies behind the headlines.

 

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

Health Tips From The Professor