Dr. Steve Chaney

The Mediterranean Diet For Heart Health

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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

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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?

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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

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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.

Is The Jellyfish Memory Supplement A Hoax

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Are The Claims Too Good To Be True?

Author: Dr. Stephen Chaney

jellyfish memory supplementDid another phony nutritional supplement, the jellyfish memory supplement, just bite the dust? You’ve seen the TV ads reminding us that our memory starts to fade as we age. You’ve heard the claims about a protein derived from a jellyfish improving your memory. You’ve seen graphs summarizing a clinical study proving the product works. It all sounds so compelling. Are those claims too good to be true? According to the FTC and the New York Attorney General’s Consumer Protection Division, the answer is yes.

Is The Jellyfish Memory Supplement A Hoax?

On January 9th 2017, the FTC and the New York Attorney General’s office sued the makers of the “jellyfish memory supplement,” accusing the company of making false and unsubstantiated claims that the product improves memory, provides cognitive benefits, and is “clinically shown” to work.The FTC complaint alleged that the marketers relied on a study that failed to show that their product works better ftcthan a placebo on any measure of cognitive function. In their joint press release the FTC said “The marketers of [the jellyfish supplement] preyed on the fears of older consumers experiencing age-related memory loss. But one critical thing these marketers forgot is that their claims need to be backed up by real scientific evidence.” The New York Attorney General said “The marketing for [the jellyfish supplement] is a clear-cut fraud, from the label on the bottle to the ads airing across the country. It’s particularly unacceptable that this company has targeted vulnerable citizens like seniors in its advertising for a product that costs more than a week’s groceries, but provides none of the health benefits that it claims.”

Why Were The Clinical Study Results So Misleading?

clinical studyI am a strong supporter for innovation in supplement development. However, innovative products should be backed up by published clinical studies showing significant benefit before being marketed to the public. Unfortunately, the clinical study cited for the “jellyfish memory supplement” does not meet this standard.

  • The study has not been published in a peer-reviewed scientific journal. That means the study has not been independently reviewed by anyone not associated with the manufacturer.
  • When you actually analyze the data, it turns out that the improvement in memory was inconsistent from subject to subject, and the overall results were not statistically significant.
  • The graph shown on TV shows a 20% improvement in memory in just 90 days. In fact, that degree of improvement was only experienced by a very small subset of users. Most users experienced either no improvement or an insignificant 5-10% improvement. The graph the company used to market their product was clearly misleading.

Why Was The Scientific Rationale For The Product So Misleading?

misleading studyApoaequorin, the jellyfish protein in question, is a calcium binding protein. The manufacturer claims that it improves calcium balance in the body, which improves brain function. There are numerous fallacies in that model. For example:

  • Apoaequorin is not found in humans. In fact, the manufacturer does not even use the protein found in jellyfish. They use a synthetic version produced through genetic engineering.
  • Calcium balance is very tightly regulated in the human body. There is no evidence that the addition of apoaequorin, or any other calcium binding protein, improves calcium balance or brain function in humans.
  • Proteins do not enter our bloodstream intact. They have to be degraded to individual amino acids before they can be absorbed. That means when you take a pill containing apoaequorin protein, all you get is a release of amino acids into your bloodstream.
  • Finally, even if you were magically able to get apoaequorin protein into your bloodstream, it couldn’t cross the blood-brain barrier. The only reliable means of getting proteins into the brain is by cranial injection, and I don’t think anyone is going to be doing that for mild cognitive impairment.

The emperor has no clothes! Don’t get me wrong. As someone who is moving into my “golden years,” I would love to see this product succeed. I would love for them to produce clinical evidence that their product makes a statistically significant improvement in memory. I would love for the data to be good enough that it could be published in a peer reviewed journal. I would love for the jellyfish memory supplement to be legitimate. However, I suspect the FTC will win this one. I suspect another bogus product is about to bite the dust.

What Does This Mean For You?

This is just one of many examples of supplements that have first rate marketing, but second rate science. As a consumer, you need to be eternally vigilant. Unfortunately, most of you are not scientists, so it is very difficult for you to evaluate the claims. The FDA does it’s best to shut down products that are dangerous to your health. The FTC does it’s best to shut down products that make unfounded claims. I will do my best to warn you about about bogus products. However, none of us can keep up with all the dangerous and bogus products that flood the marketplace. At the end of the day, your best defense is to remember that famous quote “If it sounds too good to be true…” The jellyfish memory supplement sounds too good to be true.

The Bottom Line

  • The FTC and New York Attorney General have sued the manufacturers of the “jellyfish memory supplement” that has been so widely advertised on TV. The FTC alleges that the claims for that product are “false and unsubstantiated.”
  • The clinical study cited by the manufacturer was flawed because:
    • The results had not been published in a peer reviewed scientific journal. That means the study has not been independently reviewed by anyone not associated with the manufacturer.
    • The results were not statistically significant.
  • The scientific rationale for the product was flawed because:
    • The “jellyfish protein” is not found in humans. In fact, the manufacturer does not even use the protein found in jellyfish. They use a synthetic version produced through genetic engineering.
    • Proteins must be degraded to individual amino acids before they can be absorbed into the bloodstream. That means when you take a pill containing “jellyfish protein”, all you get is a release of amino acids into your bloodstream.
  • Even if you were magically able to get the protein into your bloodstream, it couldn’t cross the blood-brain barrier. The only reliable means of getting proteins into the brain is by cranial injection, and I don’t think anyone is going to be doing that for mild cognitive impairment.
  • I will do my best to alert you about bogus supplements. The FDA and FTC will do their best to protect you. However, none of us can keep up with all the dangerous and bogus products that flood the marketplace. At the end of the day, your best defense is to remember that famous quote “If it sounds too good to be true…”

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 Latest Health Articles

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200th Issue Celebration:  Highlights From the Past Two Years on Health, Nutrition, and Fitness

Author: Dr. Stephen Chaney

latest health articlesFor four years I have been providing you with the latest health articles on various health, nutrition, and fitness topics by publishing “Health Tips From The Professor.”  I have tried to go behind the headlines to provide you with accurate, unbiased health information that you can trust and apply to your everyday life. The 200th issue of any publication is a major cause for celebration and reflection – and “Health Tips From The Professor” is no different.

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

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

The Latest Health Articles on Weight Loss

Weight Loss Secrets

 

latest health articles weight lossOf the latest health articles and since this review is being written in January,  let’s start with some of the most insightful articles about healthy weight loss. For example, some assumptions people have about losing weight are just plain wrong. Even worse, they are counter-productive. They actually prevent you from losing weight if you accept them. The article “8 Weight Loss Myths” debunks those myths.

The article “8 Tips For Eating Less” gives you some useful “tricks” for controlling both food choices and portion sizes, based on the research of Dr. Brian Wansink. “Exercise and Weight Loss” gives you valuable information on how much exercise you need to be doing if you want to lose weight. Finally, “Lose Weight Without Counting Calories” highlights recent research showing that healthy food choices are more important for weight control than counting calories or fad diets.

The Latest Health Articles on Protein

How Much Protein Do We Need?

latest health articles proteinIn recent years, we have gained new appreciation for the importance of dietary protein in maintaining muscle mass. We have also learned that leucine, one of the essential amino acids, plays an important role in regulating the protein synthesis required to maintain or increase muscle mass.

The article “Are High Protein Diets Your Secret To Weight Loss?” summarized the latest research on how much dietary protein is required to maintain muscle mass when you are trying to lose weight. “Leucine and Muscle Gain” discusses the optimal protein and leucine levels for optimal muscle gain after a workout. Hint: The science-based amounts are more than the RDA but less than what many “muscle madness” websites claim.  When you are looking for the latest health articles, be sure your source is giving you all the information.

Most of us lose muscle mass when we age. In “Do Protein Needs Increase As We Age?” I summarize the latest research on the amount of protein and leucine we need to maintain muscle mass in our golden years. Finally, In “How Much Protein Do You Need?” I point out the fallacies of a New York Times article proclaiming that most Americans get too much protein. However, I also summarize all of the latest research on the protein needs of individual groups. Many of you will find this a useful resource.

The Latest Health Articles on Food Nutrition

How Foods Affect Our Health In Surprising Ways

latest health articles food effectsMost Americans understand that the food choices we make can affect our weight and our health.  Although, we sometimes disagree on what foods are good for us. When we think about foods affecting our health, we are usually thinking about major diseases like heart disease, cancer, and diabetes. However, food choices can affect our health in some unexpected ways as well.

For example, in “Do Foods Make Them Fidget?” I discuss research showing that food allergies may be a major contributor to ADHD in children. In “Can Foods Affect Our Mood?” and “Does Diet Affect Depression In Women?” I discuss research showing that what we eat can affect our mood in some pretty significant ways.

In “Can What We Eat Affect Our Kids?” I explore some thought provoking research suggesting that what we eat prior to conception and during the first trimester of pregnancy may influence our children’s health throughout their life. There is much more research to be done, but even the possibility of that occurring should serve as a wake-up call for everyone thinking of becoming a parent.

Finally, in “Is There A Simple Solution To Gas & Bloating?” I summarize some ground-breaking research into a new approach for identifying the foods that cause you digestive problems. If you’ve eliminated the most obvious problem foods from your diet and still have digestive issues, you will definitely want to read this article.

The Truth About Omega-3s

latest health articles omega3After years of unchallenged popularity, omega-3s have become controversial. Some doctors are claiming that they don’t really provide any health benefits and we get plenty in our diet. Nothing could be further from the truth.

In “Are Americans Deficient in Omega-3s?” I report on a recent survey showing that most Americans have very poor omega-3 nutritional status. In “The Good News About Omega-3s & Blood Pressure” I discuss recent research suggesting that omega-3s provide an effective natural approach for lowering blood pressure. In an upcoming issue, I will review a recent meta-analysis suggesting that omega-3s may reduce heart attack risk. I’m not suggesting throwing away your medications, but I would suggest a discussion with your doctor about including omega-3s as part of a holistic approach to lower blood pressure and heart disease risk.

Finally, there are a lot of claims in the marketplace that some forms of omega-3s are better utilized than others. In “Are Some Omega-3 Supplements Better Than Others?” I report on a recent study that debunks those claims so please check this out as a part of your latest health articles research.

The Truth About Calcium Supplements

latest health articles calciumWe have been told for years that calcium supplements are a safe and effective way to prevent osteoporosis. However, those assumptions have recently been called into question. There have been claims that calcium supplements increase heart attack risk, and that calcium supplements don’t prevent osteoporosis. I have written articles to put both of those claims into perspective.

After the study came out claiming that calcium supplementation does not prevent osteoporosis, I wrote a two-part review called “Do Calcium Supplements Prevent Bone Fractures?”. In Part 1  I pointed out the many shortcomings of the study. In Part 2 I discussed a holistic approach, including calcium supplementation, to build healthy bones and prevent osteoporosis. Finally, in “Should We Take Calcium Supplements?” I reported on studies showing convincingly that calcium does not increase heart attack risk. It turns out the experts were right all along.

 

The Truth About Heart Disease

latest health articles heart diseaseIn today’s world doctors rely almost exclusively on drugs to prevent and treat heart disease. Unfortunately, those drugs have significant side effects. In “Do Statins Increase Diabetes Risk?” and “Do Statins Cause Memory Loss?” I highlight research on the side effects of statins. In “Do Blood Pressure Medications Cause Memory Loss?” I highlight research into a major side effect of blood pressure medications. Again, I am not recommending that you throw away medications your doctor has prescribed. I am suggesting you discuss holistic approaches with your doctor.

 

Unfortunately, most doctors believe that nutritional approaches don’t work. That is because some major clinical studies have been misinterpreted. In “Do B Vitamins Reduce Heart Disease Risk?” and “Does Vitamin E Reduce Heart Attack Risk?” I report on a more detailedevaluation of those studies by Dr. Jeffrey Blumberg, who isa Professor in the Friedman School of Nutrition Science and Policy at Tufts. He agrees that B vitamins and vitamin E cannot be shown to influence heart attack risk in people who are low risk of having a heart attack. However, his analysis of the data shows that supplementation with both B vitamins and vitamin E reduces heart attack risk for high-risk populations. I will discuss the evidence that omega-3s decrease heart attack risk in an upcoming issue.

 

Children’s Nutrition

latest health articles child nurtritionDrugs for controlling ADHD have some fairly severe side effects, and many experts feel that they are over prescribed. In “Is Nutrition Better Than Drugs For ADHD Control?” I summarize a recent review by two pediatricians specializing in ADHD patients. The review evaluated the effectiveness of various natural approaches for controlling ADHD.

In “Do Bad Diets Begin In Infancy?” I reviewed a set of studies showing that what we feed our infants in their first year influences their diet and their health at age 6 – and perhaps for long after that.

These latest health articles are very important concerning kid’s health.

 

Nutrition During Pregnancy

latest health articles pregnancy nutritionMost pregnant moms are told that a prenatal supplement provides everything they need for a successful pregnancy. Is that true? Many prenatal supplements do not contain DHA, and only 15% of American women take supplements containing iodine.

In “DHA And Pregnancy” I report on a study showing that up to 75% of North American women aren’t getting enough DHA in their diet. I also discussed the still confusing research suggesting that DHA supplementation may be important for supporting optimal brain development during pregnancy. In “Should Pregnant Women Take A DHA Supplement?” I discuss recent research showing that DHA supplementation improved pregnancy outcomes. In “The Dangers Of Iodine Deficiency During Pregnancy” I discuss a study showing that 1/3 of pregnant women in this country are iodine deficient and studies showing the importance of iodine for a successful pregnancy.

 

The Latest Health Articles Concerning The “Dark Side” Of The Food Supplement Industry

 

latest health articles nutrition liesUnfortunately, the food supplement industry has a “dark side.” I do my best to expose as much of that as possible. In “Are Food Labels Deceptive?” I expose some of the ways that food and food supplement companies try to deceive us.

In “Are Herbal Supplements Bogus?” and “Do Your Supplements Contain Carcinogens?” I expose the quality control issues in the industry. In “The Fake Chocolate Study” I show just how easy it is to create a fake clinical study that supports their product.

 

What Does The Future Hold?

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

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

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

 

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.

Painful Shoulder Relief

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Surgery Is Not the Only Option

Author: Julie Donnelly, LMT –The Pain Relief Expert

Editor: Dr. Steve Chaney

painful shoulderI was at my sailing club and a man was sitting watching the water, rubbing his painful shoulder.  I asked him what was wrong and he said he had a sore shoulder for the past three months. He told me he desperately wanted to find some pain relief. He loves to sail and this sore shoulder pain was preventing him from going out on the water.  He’d already been to a massage therapist, a physical therapist, and a chiropractor. He finally went to an orthopedic surgeon and was told that surgery was the only way to get relief from his painful shoulder. However, he had decided that he didn’t want to take that path…yet.

Why Muscles Can Cause a Painful Shoulder

I use an analogy that makes it clear why muscle spasms in your shoulder will cause joint pain.  If you pull your hair, your scalp will hurt. But, you don’t need to massage your scalp or take aspirin for your headache, and you definitely don’t need brain surgery.  You simply need to let go of your hair!

pull hairYour shoulder has more muscle attachments than any joint in your body.Each muscle pulls your shoulder in a different direction. As any of the muscles get tight it puts pressure on the bone. Your painful shoulder is the end result – just like pulling your hair hurts your head.

To get relief all you need to do is release the tension in the muscles.

Stretching WON’T Help Ease a Painful Shoulder!

It is important to untie the knots (spasms) in the muscles before stretching. Think of what happens if you take a 12″ length of rope, tie enough knots in it so it is 11″ long, and then try to stretch it back to 12″ without first untying the knots.  This is what will happen to your muscle fibers if you stretch without first releasing the spasms.

flexibility dvdI’ve worked for years with people who not only have sore shoulder pain, but also have pain in every joint. Frequently pain is caused by repetitive muscle strain while working or playing sports and it needs to be released. Working with athletes it was vital to teach them how to do self-treatments they could use during a race or competition. And my other clients have found self-treatments give them permanent relief from aches and pains.

This has led to several books and DVD programs, including Focused Flexibility Training.  On one DVD I demonstrate how to self-treat every muscle, from your head to foot. And then, on two DVDs (1 Upper Body and 1 Lower Body) Ana Johnson, a fantastic yoga instructor, leads you through self-treating the muscles you will be stretching followed by a 30-minute yoga program.  It works to quickly eliminate a painful shoulder, as well as pain and stiffness throughout your body.

pain free dvdFocused Flexibility Training has a foundation of self-treatments that come from my book, Treat Yourself to Pain-Free Living. The exciting part is people from all over the world have confirmed that the treatments really work!

There are several treatments for sore shoulder pain. Each addresses a different group of muscles that move your shoulder and arm. There are uncountable motions you make every day without even thinking about it, and each muscle can be strained.

Treatment for a Painful Shoulder

shoulder pain treatmentThe photo to the left show you how to treat your infraspinatus muscle. This muscle brings your shoulder back, like you’re taking a tennis serve. When your Infraspinatus muscle is in spasm, it causes shoulder pain as you try to bring your arms forward.

Place the Perfect Ball as shown in the picture, and lean your weight into the ball.  Look for the “hot spot,” which will be tender.  As you lean into the ball take the pressure off, and then lean again. You’ll find the painful shoulder becoming less and less painful each time you again add pressure.

Move the ball to different areas of your shoulder, finding the various painful points.  Each one is a spasm that is causing your sore shoulder pain. You can enhance this treatment by slowly drawing your arm across your body while you are still pressing into the ball. Since the spasms have been released, this movement will safely stretch the muscle fibers. As you release each spasm, and then stretch, you’ll find pain relief and you’ll know how to stop pain quickly and easily should it return.

As for the man mentioned at the beginning of this blog, I taught him how to do the self-treatments.  I’m happy to say that today he told me he slept through the night for the first time in weeks. He’s getting better every time he does the self-treatments and he’s back to sailing again.  That is so fulfilling — I LOVE my work!

With some knowledge of how to find spasms, how to self-treat them, and how to stretch properly, you can Stop Pain FAST!  This, of course, goes for a painful shoulder as well.

Wishing you well,

Julie Donnelly

julie donnellyAbout 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.

Which Foods Lower Blood Sugar?

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Can You Believe The “Experts”?

Author: Dr. Stephen Chaney

which foods lower blood sugarYour blood sugar levels have been creeping up. Your doctor has been bugging you to do something about it – even threatening to put you on medications if you don’t get your blood sugar under control. So, which foods lower blood sugar?

Now it’s the first of the year, and you’ve vowed to do something about it. You have vowed to make better food choices. That should be easy. There is lots of great advice about foods that lower blood sugar on the internet. For example, in a recent search, I found articles proclaiming “9 foods that lower blood sugar”, “7 foods that control blood sugar”, and “12 power foods to beat diabetes”.

But, are those foods the right ones for you? What if we are remarkably different in our blood sugar responses to the same food? This is just what a recent study suggests.

How Was The Study Designed?

A group of scientists in Isreal set out to test the hypothesis that people eating identical meals might have a high variability in their post-meal blood glucose response (Zeevi et al, Cell, 163, 1079-1094, 2015).

measure glucoseThe investigators enrolled 800 subjects ages 18-70 into their study. None of the individuals had diabetes. However, 54% of them were overweight (BMI ≥ 25 kg/m2) and 22% of them were obese (BMI ≥ 30 kg/m2). Thus, their subject population was typical of the adult population of almost every Western, industrialized country.

All 800 subjects were followed for one week during which time:

  • They were connected to a continuous glucose monitor, which measured their blood glucose levels every 5 seconds.
  • They were given a Smartphone app and instructed to log their food intake, exercise, and sleep in real time.
  • They were told to follow their normal daily routine and dietary habits except for the first meal of every day, which consisted of five different types of standardized “meals” (glucose, fructose, bread, bread with butter, bread with chocolate), all providing 50 gm of available carbohydrate.

The glucose monitor recorded blood sugar responses for 2 hours following each meal. From that information, the investigators calculated a PPGR (post-prandial glycemic response), which I will mercifully refer to as “blood sugar response”, for every meal eaten by every subject throughout the week.

The standardized “meals” eaten at the beginning of the day were used to validate the study. For example:

  • Two of the standardized meals were given to each subject twice during the study separated by at least one day.
    • There was very little variability in blood sugar response when the same standardized meal was given to the same subject on different days.
    • However, there was a significant amount of variability in blood sugar response when the same standardized meal was given to different subjects.
  • The average blood sugar response to each of the standardized meals was very similar to literature values from previous studies (Most previous studies have reported only average blood sugar responses, not individual variability).

In short, the results from the standardized “meals” validated both the reliability and reproducibility of the data.

Finally, to eliminate as many confounding variables as possible, the investigators compared blood sugar response only for those meals in which a single food was the major component of the meal and that food provided 20-40 gm of carbohydrate.

Here is where things got really interesting!

Which Foods Lower Blood Sugar?

breadThis study showed that there is tremendous individual variability in the blood sugar response to any given food. For example, individual blood sugar responses varied by:

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

Put another way:

  • Some people had almost no blood sugar response to cookies, but a very high blood sugar response to a banana.
  • Other people had almost no blood sugar response to bananas, but a very high blood sugar response to cookies.

That is a pretty striking result. Which foods lower blood sugar? This study suggests that some people trying to control their blood sugar can eat bananas, while others should avoid them. It might even mean that some people trying to control blood sugar can eat cookies. I know that is what many people would like to hear, but I’m not ready to make that recommendation.

Why Is There So Much Individuality in Blood Sugar Response?

good food choicesYou are probably wondering why there is such variability in blood sugar response to the same foods. There are several factors that influence individual blood sugar response. For example,

  • Overweight and obesity (Both tend to increase blood sugar response).
  • Dietary habits (Meats, particularly fatty meats, processed grains, and simple sugars tend to increase blood sugar response to a given amount of carbohydrate. Unprocessed grains, fresh fruits & vegetables tend to decrease blood sugar response to a given amount of carbohydrate).
  • What we eat with a given meal (Protein, fiber, and fat in a meal can decrease blood sugar response to the carbohydrate in that meal).
  • Physical activity (Increased muscle mass decreases blood sugar response to a given amount of carbohydrate).
  • The bacteria in our intestine (This may be a chicken-and egg thing. The bacteria in our intestine are influenced by our dietary habits.)
  • Genetics.
  • Things we don’t yet know about.

The good news is that we can actually control some of these variables. The ones over which we have the most control are weight, dietary habits, what we eat along with the carbohydrates in our meals, and physical activity.

What Does This Mean For You?

blood sugarThe authors concluded that “universal dietary recommendations [for lowering blood sugar levels] may have limited utility.”  That is because dietary recommendations are based on average responses and none of us are average. As the saying goes “We are all wonderfully [and differently] made”.

So, when you read about diets and foods that will help you keep your blood sugar levels under control, take those recommendations with a grain of…sugar. They are a good starting place, but you need to listen to your body, and eat the foods that work best for you.  So, which foods lower blood sugar?  It is different for different people, but there are some variables you can control.

Don’t get carried away, however. I’m pretty sure Twinkies washed down with a soft drink are bad for just about everyone.

More importantly, control the variables you can – weight, dietary habits, foods you eat along with carbohydrates, and physical activity. If you control those four variables, you will be well on your way to ideal blood sugar control.

 

The Bottom Line

 

  • A recent study has shown that there is tremendous variability in blood sugar response to identical meals from one individual to the next.
  • The authors of the study concluded that “universal dietary recommendations [for lowering blood sugar levels] may have limited utility.” That is because dietary recommendations are based on average responses, and none of us are average.
  • So, when you read about diets and foods that will help you keep your blood sugar levels under control, take those recommendations with a grain of…sugar. They are a good starting place, but you need to listen to your body, and eat the foods that work best for you.
  • There are variables influencing our blood sugar response that we cannot control, such as genetics. However, there are some very important variables that we can control. For example, we can improve our blood sugar response by:
    • Attaining and maintaining ideal weight. Losing as little as 5-10 pounds can result in a significant improvement.

 

    • Eating a diet that emphasizes fresh fruits & vegetables, nuts, and whole grains and minimizes meats, especially fatty meats, processed grains, and simple sugars. This may act by influencing the bacteria that populate our intestine.

 

    • Consuming carbohydrates along with protein, fiber-rich foods, and even some fat in the same meal.

 

    • Increasing physical activity, especially activity that increases lean muscle mass.

 

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.

Lose Weight Without Counting Calories

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Choose Healthy Foods, Not Diet Foods

Author: Dr. Stephen Chaney

dieting adviceHow do you lose weight without counting calories?

Most adult Americans gain at least a pound or two each year. That may not sound like much on a yearly basis, but over a lifetime it is huge – if you’ll pardon the pun.

Because the health consequences of weight gain are so devastating, everyone has their favorite dietary advice for keeping those extra pounds away. For some it is diet plans – low fat, low carb, paleo, Mediterranean – you name it. For others, it is counting calories or avoiding sugars of all kinds. The list goes on.

But what if all those approaches were wrong? What if we could keep our weight under control solely based on the foods we eat? A recent study seems to suggest that we just might.

How Was The Study Designed?

A group of scientists from Tufts University and Harvard decided to look at how the food choices we make on a daily basis influence our weight gain or loss over time (Smith et al, AJCN 101: 1216-1224, 2015).

lose weight without counting caloriesMost studies of this kind look at what foods people are eating at the time of the study and compare that to how much they weigh. This group of scientists looked at changes that people made in their diets and correlated that with how much weight they gained or lost over time.

When you think of it, that’s the information most of us really want to know. We are less interested in why the foods we used to eat got us into trouble in the first place than we are in how the changes we make in our diet might influence future weight loss or gain.

This study combined the data from three very large, long term studies – the Nurses’ Health Study, the Nurses’ Health Study II, and the Health Professionals Follow-Up Study. Altogether that is a group of 120,784 men and women who were followed for 16-24 years. All three of these studies measured weight and evaluated dietary habits using food-frequency questionnaires every 4 years.

The scientists conducting the study measured changes in food choices and changes in weight over the duration of the studies. In analyzing the data, they looked at 3 variables: choices of protein foods, total carbohydrate, and the glycemic load (GL) of the carbohydrates.

Glycemic load is the effect on blood sugar of the carbohydrates in a food times the total amount of carbohydrate in that food. You can think of glycemic load as a measure of carbohydrate quality. Foods with low glycemic load have little effect on blood sugar. Foods with high glycemic load cause a major increase in blood sugar. You probably already know that is not a good thing.

You probably also have a pretty good idea of which foods have a high glycemic load. For example, white bread, pastries, muffins, pancakes, white rice, chocolates, candy bars, cookies, brownies, cakes, pies, and pretzels would all be examples of foods with a high glycemic load. Fruits, whole grain foods and starchy vegetables would be examples of foods with a moderate glycemic load. Vegetables and beans would be examples of foods that generally have a low glycemic load.

 

Lose Weight Without Counting Calories Means Foods  Are More Important Than Calories?

 

Now let’s get to the good stuff – the results of this study. When the authors analyzed the data they found that:

  • Most of the subjects did not exchange one protein food for another over the course of the study. They exchanged protein foods for carbohydrate-rich foods and vice versa.

This was a surprise. Since many experts have been recommending that people substitute chicken and fish for red meat, they had expected to see that kind of dietary shift when they analyzed the data. Apparently, people have not been listening to the experts!

  • When the subjects replaced a serving of carbohydrate-rich foods with a serving of red meats, processed meats, chicken with skin or most cheeses, they gained between 0.5 to 2.3 pounds per year. Within this category, the greatest weight gain was seen when hamburgers were substituted for carbohydrates, and the least weight gain was seen when cheese was substituted for carbohydrates. These are substitutions that pack on the pounds.
  • bad protein dietWhen the subjects replaced a serving of carbohydrate-rich foods with a serving of milk, peanuts or eggs, there was no net change in weight. These appear to be substitutions that are good for weight maintenance.
  • When the subjects replaced a serving of carbohydrate-rich foods with a serving of yoghurt, peanut butter, beans, walnuts, other nuts, chicken without skin, low-fat cheese or seafood, they lost between 0.5 and 1.5 pounds/year. These appear to be substitutions that are good for weight loss.
  • When they focused on carbohydrate-rich foods, replacing one serving of high glycemic load foods with low glycemic load foods was associated with one pound of weight loss per year. Simply put, if you switch from cookies, pastries and candies to fruits and vegetables, you are likely to lose weight. No surprise here.  This would seem to be a method to lose weight without counting calories.

The study really got interesting when they looked at the effect of adding different proteins in the context of the carbohydrate-rich foods that the subjects were eating. For example,

  • When the subjects added a serving of red meat to a diet containing carbohydrate foods with a high glycemic load, they gained an average of 2.5 pounds per year. When they added that same serving of red meat to a diet containing carbohydrate foods with a low glycemic load, they gained only around 1.5 pounds per year.

Simply put, that means eating a hamburger on a white flour bun with fries is going to pack on more pounds than a hamburger patty with brown rice and a green salad.

  • The effect of glycemic load was particularly interesting when you looked at the protein foods that were good for weight maintenance overall. For example, adding a serving of eggs to a high glycemic load diet resulted in a 0.6 pound/year weight gain, while adding that same serving of eggs to a low glycemic load diet resulted in a 1.75 pound/year weight loss. The results were similar for cheeses.
  • Finally, glycemic load also influenced the effectiveness of protein foods associated with weight loss. For example, addition of a serving of beans to a high glycemic load diet resulted in 0.5 pound/year weight loss, but adding a serving of beans to a low glycemic load diet resulted in a 1.5 pound/year weight loss.

New Insights From This Study

This study broke new ground in several areas. For example,

  • good protein dietWe have heard over and over that substituting beans, chicken and fish for red meats is healthier. This is the first study I have heard of that says those same substitutions can prevent or reverse weight gain.
  • Many people advocate a high protein diet for weight control or weight loss, but many of them will tell you the type of protein doesn’t matter. This study suggests that the type of protein foods we eat are important in determining whether we lose or gain weight.
  • Everyone knows that switching from white grains, pastries and candy to whole grains, fruits and vegetables will help you lose weight, but this is the first study I’m aware of that suggests those same changes will influence whether the protein foods we eat lead to weight gain or weight loss.
  • Many people focus on fats and calories when trying to avoid weight gain. While this study is not really fat and calorie neutral (see below), it does suggest that if we focus on eating healthy foods, we don’t need to be counting every fat gram and every calorie.  In other words, you can lose weight without counting calories by eating healthy foods.
  • Finally, this study suggests that if we forget all of those crazy diets and focus on eating healthy foods, our weight will take care of itself. Not exactly a novel concept, but one worth repeating.

 

Can We Lose Weight Without Counting Calories?

 

The head author of this study stated in an interview “The idea that the human body is just a bucket for calories is too simplistic. It’s not just a matter of thinking about calories or fat. What’s the quality of the foods we are eating? And how do we define quality.” This has been picked up by the media with statements like “not all calories are created equal”.

The real message is not that fat content and calories don’t count. Nor is it that calories in some foods count more than the same calories in other foods. The take home lesson from this study should be that we don’t have to focus on fat and calories. We don’t need to jump on the latest fad diet. If we focus on healthy foods, the fat and calories tend to take care of themselves.

But, even that message is a bit too simplistic. Choosing healthy foods is not all that there is for weight control. We also need consider:

  • Portion sizes. Half a chicken could easily add more calories than a small hamburger.
  • How the food is cooked. Fish cooked in a cream sauce may not be any better for weight control than a slab of red meat.
  • Exercise. We need to maintain muscle mass to keep metabolic rate high.

 

The Bottom Line

 

  • A recent study has broken new ground and provided some new insights into how to prevent those extra pounds from sneaking up on us over time. This study evaluated how some simple changes we could make in the foods we eat can influence whether we gain or lose weight.
  • One part of the study looked at the effects of replacing a serving of carbohydrate rich foods with a serving of protein rich foods. If that protein rich food were a hamburger, we could expect to gain about 2.3 pounds/year. If that protein rich food were seafood, we could expect to lose about 1.5 pounds/year. Other protein foods fall in between those extremes. The specifics are covered above.

This is a new insight. Many people advocate a high protein diet for weight control or weight loss, but many of them will tell you the type of protein doesn’t matter. This study suggests that the type of protein foods we eat are important in determining whether we lose or gain weight.

  • Another part of the study looked at the effect of different carbohydrate foods based on their glycemic load (the effect they have on blood sugar). Simply replacing 1 serving of high glycemic load foods (refined grain foods, cookies, cakes, candy) with low glycemic load foods (whole grains, fruits and vegetables) was associated with a one pound/year weight loss. This should surprise no one.
  • Finally, one part of the study looked at the influence of glycemic load on the effect that various proteins have on weight gain or loss. For example, adding a serving of eggs to a high glycemic load diet resulted in a 0.6 pound/year weight gain, while adding that same serving of eggs to a low glycemic load diet resulted in a 1.75 pound/year weight loss. Other examples are given above.

This is also a new insight. Everyone knows that switching from white grains, pastries and candy to whole grains, fruits and vegetables will help you lose weight, but this is the first study I’m aware of that suggests those same changes will influence whether the protein foods we eat lead to weight gain or weight loss.

  • Some in the media have interpreted this study as saying that fat and calories don’t count. However, this study was not designed to be fat and calorie neutral. The real take home message from this study is that we may not need to focus so much on fat and calories. When we focus on eating healthy foods the fat and calories tend to take care of themselves.
  • Even that message is a bit too simplistic. It is not enough to just focus on healthy foods. We need to consider things like portion size, how the food is prepared, and our exercise habits among other things.
  • I would be the first to acknowledge that many people need strict guidelines and a well-designed diet program to lose the extra pounds that have built up over the years. However, to keep the weight off they simply need to embrace a lifestyle that includes healthy food choices and regular exercise.  You can lose weight without counting calories.

 

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 Much Protein Do You Need?

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Are You Getting Too Much Protein?

Author: Dr. Stephen Chaney

 

breaking newsHow much protein do you need?  In a recent article entitled “Can You Get Too Much Protein?” the New York Times asserted that most Americans were getting too much protein in their diet. They went on to imply that protein supplements were useless at best and might be downright harmful at worst.

If you happened to read this article, you are probably wondering whether it is true or just another example of media bias. If you have read other articles about supplementation in the New York Times, you may have already suspected that they are biased against the use of supplements.

However, the problem goes way beyond media bias. In today’s online world everyone is a writer and everyone is an editor. More importantly, news is instant. Newspapers and journalists no longer have the time and resources to fully research a topic before they publish it. When a story comes along that fits their bias, the temptation is strong to publish it immediately.

In this issue of “Health Tips From the Professor” I will try to give you a more balanced perspective. If you would like other examples of a more balanced perspective, you might want to read articles from Harvard Medical School’s Health Publications newsletter  or WebMD .

 

What Did The New York Times Get Right?

The New York Times didn’t completely miss the mark. Here are a few things that they got right:

  • Most Americans are getting more than the RDA for protein in their daily diets. They imply that is too much. However, the prevailing view among nutrition experts today is that the RDA is too low for some groups, and many Americans are getting too little protein, not too much.
  • They do acknowledge that there are groups who aren’t getting enough protein, for example – teenage girls, pregnant and lactating women, people over 60, and professional athletes. I would add, based on recent studies, that any adult who is engaged in a weight loss program and/or couch potatoregular, vigorous workouts will also benefit from extra protein, especially after their workout. If you combine all those categories, we are talking about the majority of Americans not getting enough protein. The only exception is the otherwise healthy adults who are “couch potatoes”.
  • They are correct in saying that the average “couch potato” adult in the US doesn’t need more protein. However, even the “couch potatoes” among us would benefit from a healthy protein supplement in place of some of the high fat, high cholesterol animal protein they are eating. They don’t need more protein. They just need better protein.
  • Finally, they are correct in saying many protein supplements are either unsafe or suffer from poor quality control, topics I have covered in previous issues of “Health Tips From the Professor”. My advice is simple. Avoid those protein supplements making extravagant claims about “exploding” your muscles and giving you boundless energy. Also, choose protein supplements made by reputable companies that employ rigorous quality controls.

 

What Did The New York Times Get Wrong?

  • The main theme of their article was that most Americans were getting too much protein. They acknowledged that some nutritionists advocated consuming more protein but implied that most experts did not agree. That paradigm is 20 years old. The evidence has shifted. Most experts today feel that many Americans aren’t getting enough protein.
  • They warned high protein intake could be harmful. It could lead to increased risk of cancer, heart disease, diabetes and kidney disease. Let’s put how much protein do you needthose claims into perspective.
    • Increased risk of cancer is linked to high intake of animal protein, especially red meat and processed meats.
    • Increased risk of heart disease and diabetes is linked to high intake of fat and cholesterol rich animal proteins.
    • In short, for these diseases it’s the kind of protein, not the amount, that is the problem.
    • As for kidney disease, it is clear that protein intake should be restricted when you have kidney disease. It is not clear that high protein intake can cause kidney disease in healthy adults.
  • Finally, they assumed that most people just added protein supplements to the protein they were already eating. If that were true, it might be a problem. However, most people use protein supplements in place of some of the high fat animal protein in their diet. They aren’t necessarily eating more protein. They are eating healthier protein.

 

What Do Recent Studies Show?

If we look at recent publications on the subject, it is clear the New York Times article did not accurately report what current studies show about protein needs of Americans. Here are just a few examples:

High protein diets improve physical function and weight loss in older adults. In this study participants on the high protein diet:

  • Lost 15% more weight than those on the low protein diet. More importantly, the high protein group had:
    • 60% better retention of lean body mass (muscle).
    • 25% better loss of fat mass.
  • They also performed substantially better on physical function tests than the low protein group. There was no exercise component to this study. The improvement in physical function was solely related to the better retention of muscle mass and the greater loss of fat mass in the high protein group.

protein shakeHigh protein diets improve fat mass loss and muscle mass gain in young adults on a weight loss diet(American Journal of Clinical Nutrition, 103: 738-746, 2016). In this study the high protein group:

  • Had 33% greater loss of fat mass than the low protein group.
  • Increased muscle mass by an average of 2.6 pounds compared to no change in the low protein group.

High protein diets improve satiety (The Journal of Nutrition, 146: 637-645, 2016). In this study the high protein group:

  • Reported greater satiety and less hunger between breakfast and lunch.
  • Consumed 12% fewer calories at lunch.

These are just a few recent studies. There are dozens of other studies that come to the same conclusions about how much protein you need. This is the new paradigm.

 

Why do some studies still come up with negative results?

The problem may be in the experimental design of those studies. Here are two recent papers that give some hints as to why some studies might fail to see the benefit of protein supplementation.

Protein quality matters (Nutrition & Metabolism, doi: 10.1186/s12986-016-0124-8).  This review concluded that protein quality, particularly the leucine content of the protein, was important in determining the effectiveness of that protein supplement in enhancing muscle mass increases following resistance training,

Spread protein throughout the day(American Journal of Physiology, endocrinology & Metabolism, 308: E734-E743, 2015 ). This study concluded that high protein intake is most effective at promoting muscle gain and weight loss when protein intake is spread evenly throughout the day.

In short, these studies suggest that good quality protein and good experimental design are essential if you wish to evaluate the role of additional protein on things like muscle mass and weight loss.

 

How Much Protein Do You Need?

What Do RDAs and Dietary Guidelines Say? Let’s start by looking at the RDA and how it has changed over the years. You probably have heard protein dietshakes for proteinthat the RDA is 46 grams of protein a day for women and 56 grams a day for men. However, that is misleading. The RDA for protein is based on body weight. The conversion is 0.36 grams of protein for every pound of body weight.

A simple calculation will tell you that 46 grams per day for women assumes they weigh 127 pounds, and 56 grams for men assumes they weigh 155 pounds. We haven’t seen those weights since the 50’s. Today the average weight for a 50-year-old woman is 170 pounds. The average weight for a 50-year-old man is 201 pounds. That translates into an RDA of 61 grams for the average woman and 72 grams for the average man.

You may have also heard that 10% of our calories from protein would meet our RDA requirements, and most Americans are currently getting around 16% of their calories from protein. The New York Times article implied that 16% of calories from protein was too much. Anything above that would be excessive, perhaps even dangerous.

What do the guidelines say? The current Dietary Guidelines for Americans  recognizes individual variations in protein needs and recommends we get between 10% and 35% of our daily calories from protein. For a 2,000 calorie diet that represents between 50 and 175 grams of protein/day.

 

What Are The Experts Saying? Experts are not just recommending more protein for some groups. They are making specific recommendations for how much protein people in those groups should be getting. How much protein do you need?

 

  • If you are an inactive, otherwise healthy, middle-aged adult, 10% of your calories from protein or 0.36 grams of protein a day per pound of body weight is sufficient. However, you would probably benefit from healthier protein choices.
  • If you are a teenage girl, your protein requirements are only slightly higher than a woman in your 20s. However, teenage diets are often not what they should be. You may not be getting the protein you need. Aim for around 0.38 grams of protein per pound of body weight per day.
  • If you are pregnant or lactating, your protein requirements are between 0.47 and 0.56 grams per pound of body weight per day. That represents a 30-55% increase in protein requirements. Your developing baby needs the extra protein. Be sure you are getting enough.
  • If you are over 50, you are probably losing a little muscle mass every day (a condition referred to as sarcopenia). To offset that muscle loss, most experts on aging recommend seniors increase their protein intake to around 0.5 grams of protein per pound of body weight per day. Ideally, that protein should be spread evenly throughout the day with about 25-30 grams of protein per meal. Leucine needs are increased as well, so leucine-rich protein sources are best. I’ve covered this topic in detail in a previous issue Protein Needs of Older Adults of “Health Tips From the Professor.”
  • If you are not an athlete, but work out on a regular basis, you will achieve better muscle gain from your workouts if you consume leucine-rich protein after each workout. If you are a young adult, 15-20 grams will suffice. If you are an older adult 20-25 grams is a better target. I’ve also covered this topic in a previous issue Leucine Trigger Muscle Growth of “Health Tips From the Professor.”
  • If you are trying to lose weight, diets providing about 0.72 grams of leucine-rich protein per pound (~ 2X the RDA or 28% of the total calories) appear to be more effective than RDA levels of protein at preserving muscle mass and reducing fat mass. Again, this topic is covered in a previous issue High Protein Diets and Weight Loss of “Health Tips From the Professor.”
  • Higher protein intake is most effective when coupled with resistance (weight bearing) exercise.
  • Higher protein intake is also most effective when spread throughout the day rather concentrated in a post-workout supplement or at a single meal.

 

The Bottom Line

  • A recent New York Times article asserted that most Americans were already getting too much protein in their diets and that dietary protein supplements were either unnecessary or dangerous.
  • That paradigm is at least 20 years out of date. Today, most experts agree that many Americans are getting too little protein in their diet.
  • Groups most likely to need additional protein are teenage girls, pregnant and lactating women, adults over 50, elite athletes, people who work out regularly, and people on weight loss diets.
  • The only group routinely getting more than enough protein from their diets are otherwise healthy, adult “couch potatoes,” and most of them would benefit from healthier protein choices in their diet.
  • Increased protein intake is best utilized when coupled with resistance (weight-bearing) exercise. It is also best utilized when spread out evenly throughout the day rather than being concentrated in a single post-workout supplement or a single meal.
  • The most current guidelines for protein needs of various groups are given in the article above.

 

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

Health Tips From The Professor