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

7 Easy Ways To Spot Fad Diets

December 30, 2014 by Dr. Steve Chaney

If It Sounds Too Good To Be True…

Author: Dr. Stephen Chaney

I think it was P. T. Barnum who said “There’s a Sucker Born Every Minute”. That’s particularly true in the diet world where hucksters seem to be all around us – especially this time of year.

You’ve seen the weight loss ads touting:

Pills or powders that suppress your appetite or magically prevent you from absorbing calories.

Fat burners that melt the pounds away.
New discoveries (juices, beans, foods) that make weight loss effortless.
The one simple thing you can do that will finally banish those extra pounds forever.

You already know that most of those ads can’t be true. You don’t want to be a sucker. But, the ads are so compelling:

Many of them quote “scientific studies” to “prove” that their product or program works.

Their testimonials feature people just like you getting fantastic results from their program. [You can do wonders with “computer enhanced” photographs.]
Many of those products are endorsed by well known doctors on their TV shows or blogs. [It is amazing what money can buy.]

So it is easy to ask yourself: “Could it be true?” “Could this work for me?”

Fortunately, the Federal Trade Commission (FTC) has stepped up to the plate to give you some guidance. Just in time for weight loss season, they have issued a list of seven claims that are in fact too good to be true. If you hear any of these claims, you should immediately recognize it as a fad diet and avoid it.

7 Easy Ways To Spot Fad Diets

Here are the seven statements in ads that the FTC considers as “red flags” for fad diets that should be avoided:

Causes weight loss of two pounds or more a week for a month or more without changing your diet and exercise routine.

Causes substantial weight loss no matter what or how much you eat.

Causes permanent weight loss without lifestyle change even after you stop using the product.

Blocks absorption of fat or calories to enable you to lose substantial weight.

Safely enables you to lose more than 3 pounds per week for more than 4 weeks.

Causes substantial weight loss for all users

Causes substantial weight loss by wearing a product on your body or rubbing it on your skin.

I’m sure you have heard some of these claims before. You may have actually been tempted to try the products or program. You should know that the FTC said that it considers these to be “Gut Check” claims that simply can’t be true.

The Bottom Line

There are no magical pills or potions that will make the pounds melt away. You need to change your diet, change your activity level and make significant lifestyle changes if you want to achieve long term weight control.

For more science-based health tips visit https://www.chaneyhealth.com/healthtips

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

Do Diets Work?

December 16, 2014 by Dr. Steve Chaney

Obesity in America?

Author: Dr. Stephen Chaney

If you are like most Americans, you are either overweight yourself or have close friends and family who are overweight. That’s because 69% of Americans are currently overweight, and 36% of us are obese. Worldwide the latest estimates are that 1.5 billion adults are overweight or obese.

A new report, How The World Could Better Fight Obesity, estimates that obesity is a $2 trillion drain on the world’s economy. That is equivalent to the global cost of war & terrorism and of smoking – and is double the global costs of alcoholism and global warming!

If you are like most Americans you have tried a number of diets over the years. All of them promised that they had the “secret” to permanent weight loss. You lost some weight initially, but here you are a few years later weighing as much as ever.

You are probably beginning to wonder whether any diets work long term. According to the latest study, the answer may just be “no”.

Really, Do Diets Work?

This study (Atallah et al, Circulation Cardiovascular Quality and Outcomes, 7: 815-827, 2014) was a systemmatic review of all of the randomized controlled studies of the four most popular diet plans – Weight Watchers, Akins, Zone and South Beach.

In case, you are unfamiliar with these diets, here is their philosophy:

Weight watchers is a food, physical activity and behavior modification plan that utilizes a point system to control calorie intake and features weekly group sessions.
Atkins is based on very low carbohydrate intake, with unlimited fat and protein consumption.
South Beach is relatively low carbohydrate, high protein diet that focuses on low-glycemic index carbohydrates, lean proteins, and mono- and polyunsaturated fats.
Zone is a low carbohydrate diet that focuses on low-glycemic load carbohydrates, low-fat proteins and small amounts of good fats.

The investigators restricted their analysis to studies that were greater than 4 weeks in duration and either compared the diets to “usual care” or to each other. (The term usual care was not defined, but most likely refers to a physician giving the advice to eat less and exercise more).

Twenty six studies met their inclusion criteria. Fourteen of those studies were short-term (< 12 months) and 12 were long-term (>12 months). Of the long-term studies, 10 compared individual diet plans to usual care and 2 were head-to-head comparisons between the diet plans (1 of Atkins vs Weight Watchers vs Zone and 1 of Weight Watchers vs Zone vs control). The majority of participants in these studies were young, white, obese women. Their average age was 45 years and their average weight at the beginning of the studies was 200 pounds.

What Did This Study Show?

If you have struggled with your weight in the past, you probably won’t be surprised by the result of the study.

Short-term weight loss was similar for Atkins, Weight Watchers and Zone in the two head-to-head studies.
At 12 months, the 10 studies comparing individual diets to usual care (physician’s advice to eat less and exercise more) showed that only Weight Watchers was slightly more effective than usual care (physician’s advice to lose weight). The average weight loss at 12 months was 10 pounds for Weight Watchers and 7 pounds for usual care. That is a 3 pound difference for all of the additional effort and expense of Weight Watchers!
When they looked at the two head-to-head studies at 12 months, there was no significant differences between the diets. Average weight loss in these studies was 7 pounds for Weight Watchers, 7 pounds for Atkins, 5 pounds for Zone and 5 pounds for usual care. There was only one study comparing the South Beach diets with usual care. It was a study comparing the results with severely obese patients following gastric bypass surgery, and it also found no difference between the diet program and usual care. Based on hype about these diets, you were probably expecting more than a 5 to 7 pound weight loss 12 months later!
By 24 months 30-40% of the weight had been regained for the Atkins and Weight Watchers diets, which was comparable to the results for patients who were just told to eat less and exercise more. Not only was the weight loss modest, it also did not appear to be permanent.
Finally, many of the studies included in this review also looked at improvement in other health parameters such as HDL cholesterol levels, LDL cholesterol levels, triglycerides, blood pressure and blood sugar control. The Atkins diet gave slightly better results with HDL levels, triglyceride levels and blood pressure in the short-term studies, but there was no significant differences for any of these parameters in the long-term head-to-head studies. None of the diets were any healthier than the others.

The investigators concluded: “Our results suggest that all 4 diets are modestly efficacious for short-term weight loss, but that these benefits are not sustained long-term.

A similar study in 2005 compared the Weight Watchers, Jenny Craig and LA Weight Loss diets (Tsai et al, Annals of Internal Medicine, 142: 56-66, 2005) and concluded “…the evidence to support the use of major commercial and self-help weight loss programs is suboptimal”.

A Weight Loss Diet That Actually Works?

My personal recommendation for the initial weight loss is a high protein diet – one that provides about 30% of calories from healthy protein and moderate amounts of healthy carbohydrates and healthy fats. The protein should be high enough quality so that it provides 10-12 gram of the essential amino acid leucine because leucine specifically stimulates muscle growth. The combination of high protein and leucine preserves muscle mass while you are losing weight. That is important because it keeps your metabolic rate high without dangerous herbs or stimulants.

However, the high protein, high leucine diet is still just a diet. It is an excellent choice for the initial weight loss, but what about long-term weight control?

The authors of this study said: “Comprehensive lifestyle interventions aimed at curbing both adult and childhood obesity are urgently needed. Interventions that include dietary, behavioral and exercise components…may be better suited to [solve] the obesity epidemic.” I agree.

The Bottom Line:

Your suspicions are correct. Diets don’t work!

A recent systematic review of 26 randomized controlled clinical trials of the Weight Watchers, Atkins, Zone & South Beach diets compared to the usual standard of care (recommendations to eat less and exercise more) concluded:

1) Contrary to what the advertisements promise, after 12 months all four diets gave comparable and very modest (5-7 pounds) total weight loss. The results with the diets were not significantly different than for patients who were simply told to eat less and exercise more.

2) By 24 months 30-40% of the weight had already been regained.

3) A previous systematic review of the Weight Watchers, Jenny Craig, and LA Weight Loss diet programs came to a similar conclusion.

4) My personal recommendation for the initial weight loss is a diet that is high in protein and the amino acid leucine because that type of diet preserves muscle mass.

5) For permanent weight control the authors of the recent systematic review recommended comprehensive lifestyle interventions that include permanent changes in diet, behavior and exercise. I agree. Diets never work long term – lifestyle change does!

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.

Can Resveratrol Improve Memory Performance In The Elderly ?

December 9, 2014 by Dr. Steve Chaney

Will Red Wine Make You Smarter?

Author: Dr. Stephen Chaney

It seems like every other day a new headline pops up telling us of yet another nutrient that might improve memory and slow cognitive decline. Perhaps it’s because we having a greying population. Lots of Americans are looking for that magic pill that will allow us to remember where we left the car keys.

This week the banner headlines were about resveratrol, a polyphenol from red wine. The headlines suggested that resveratrol could improve memory performance in healthy older adults. Are those headlines true, and what does that information mean for you?

What is Resveratrol?

Resveratrol is a member of a very large class of compounds called polyphenols that are found in red wine, green tea, and a variety of fresh fruits and vegetables. Polyphenols are very diverse structurally, but most of them are excellent antioxidants. They are one of the reasons that we are constantly being told to eat more fresh fruits and vegetables.

However, resvertrol and a few structurally similar polyphenols are unique in that they also bind to proteins called sirtuins which regulate metabolic processes related to the aging process. In fact, resveratrol garnered a lot of attention a few years ago when Dr. David Sinclair at Harvard Medical School published a study showing that obese mice given resveratrol escaped many of the metabolic consequences of obesity and actually lived longer than mice who were not given resveratrol.

In animal studies resveratrol appears to improve insulin sensitivity and mitochondrial function, lower cholesterol levels and blood pressure, and reduce inflammation and oxidative damage. Human studies have been limited to date, but suggest that resveratrol may impart many of these metabolic benefits to humans as well.

A recent study showed that resveratrol improved memory performance in grey mouse lemurs, a non-human primate species. However, no one had previously looked at whether resveratrol might improve memory in humans.

Can Resveratrol Improve Memory In Healthy Older Adults?

In this study (A. V. Witte et al, The Journal of Neuroscience, 34: 7862-7870, 2014) investigators recruited 46 older (average age 64), overweight (BMI 25-30), adults from Berlin, Germany. All of the subjects were healthy and none of them had any sign of cognitive impairment. For a six month period half of them were given 100 mg of resveratrol twice a day, and half of them were given a placebo (sunflower oil).

At the beginning of the test period they were given a memory test which measures how many of 15 listed words they could recall 30 minutes later. They also underwent a MRI scan that measured brain volume and functional connectivity of the hippocampus, a key region implicated in memory function. Finally, hemoglobin A1c, a measure of long term blood sugar control was measured.

Here are the results:

There was a significant effect of resveratrol on retention of words over 30 minutes compared to placebo. Memory improved significantly in the resveratrol group, while it declined slightly in the placebo group.

There was no effect of resveratrol on brain volume compared to the placebo (most interventions showing significant effects on brain volume required 2-3 years to demonstrate a significant effect).

Subjects in the resveratrol group showed significant increases in functional connectivity of the hippocampus to other brain regions involved learning and memory compared to the placebo group.

Subjects in the resveratrol group had lower hemoglobin A1c (better long term blood sugar control) compared to the placebo group.

When they statistically evaluated individual patients, the degree of improvement in the word memory test correlated with the increase in functional connectivity of the hippocampus and both of those measures correlated with decreased hemoglobin A1c.

What Does This Study Mean?

This study is promising in that it is well done and is consistent with previous animal studies. However, we need to keep in mind that this is the very first study of this kind. Similar to most first studies, it is small (only 46 subjects) and short in duration (6 months). It also only tested one dose of resveratrol (200 mg/day).

Now that this study has shown that resveratrol might improve memory in healthy older adults, it provides a strong rationale for more clinical studies to test this hypothesis. There is a need for larger, longer term studies in other population groups. Future studies should also evaluate different doses of resveratrol so that we know how much is needed to positively impact mental function.

Can resveratrol improve memory?

The Bottom Line:

A recent study suggests that resveratrol, a polyphenol from red wine, improves memory (measured by a word recall test) and functional connectivity of the hippocampus, a region of the brain involved in memory function.

This is the very first study of its kind. It was small (46 subjects) and short (6 months). However, it was well designed and consistent with previous animal results. Thus, it should be considered preliminary, but promising. More studies are clearly needed to test this hypothesis.

If the results of this study are substantiated, it will not necessary mean that other polyphenols will exert similar effects on memory. The action mechanism of resveratrol is different than most other polyphenols.

It also does not necessarily mean that red wine will make you smarter. The 100 glasses of red wine a day that you would need to drink to get the amount of resveratrol used in this study would probably kill more brain cells than the resveratrol could help.

Finally, as I said in a recent “Health Tips From the Professor” , there are no “magic bullets” when it comes to preventing cognitive decline. Your chances of reducing cognitive decline are best with a holistic approach that includes healthy diet, exercise, socialization, mental exercises, maintaining a healthy weight, B vitamins and omega-3 fatty acids. If this study is confirmed by future studies, you may be able to add resveratrol supplements to the list.

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.

Can Antioxidant Supplements Cause Cancer?

December 2, 2014 by Dr. Steve Chaney

The Truth About Vitamins C & E

Author: Dr. Stephen Chaney

I am always amazed at how certain nutrition myths take on a life of their own. A single study gets sensationalized. The study may not be very good, but some nutrition guru publicizes it even though it may be contradicted by other studies that come to the opposite conclusion.

Other blogs and news feeds pick it up. It gets repeated over and over until it becomes generally accepted as true. It becomes what I call an “urban nutrition myth”. Once these myths become well established they are hard to correct. When contrary information is published, it is ignored because everyone already knows the “truth”.

Can Antioxidant Supplements Cause Cancer?

The risks of antioxidant supplements are a perfect example. Most web sites and health experts warn that you should be careful about using antioxidant supplements. You are told that they may just increase your risk of cancer. They may just kill you!

The antioxidant vitamins C and E have generated the most scrutiny in recent years. There were a number of reasons to suspect that they might decrease cancer risk:

1) They destroy free radicals.
2) They decrease cancer risk in animal studies.
3) Increase consumption of vitamins C & E is associated with decreased risk of cancer in human population studies.

Because there was so much circumstantial evidence that vitamins C & E might decrease cancer risk, there have been a number of double-blind, placebo controlled human clinical trials to test that hypothesis.

• 6 clinical studies showed no effect of vitamin C and/or E on cancer incidence.
• 1 study suggested that vitamin E might decrease prostate cancer risk, and another study suggested that vitamin E might decrease colon cancer risk.
• 1 study (Kristal et al, Journal of the National Cancer Institute, doi: 10.1093/jnci/djt456, 2014) suggested that vitamin E alone might increase prostate cancer risk, but when vitamin E was combined with selenium there was no increased risk. I have discussed a likely explanation of those confusing results in a previous “Health Tips From the Professor” (https://www.chaneyhealth.com/healthtips/selenium-vitamin-e-increase-prostate-cancer-risk/).

That’s it. Six clinical studies show no effect of vitamins C & E on cancer risk, two studies suggest that vitamin E decreases cancer risk and one study suggests that vitamin E increases cancer risk. Yet all the “experts” are warning that antioxidant supplements might increase your cancer risk. It has become an urban nutrition myth.

You may remember that I said that the final characteristic of an urban nutrition myth is that when contrary information is published, it is ignored. In fact, an excellent study showing no effect of vitamins C and E on cancer risk has just been published – and it is being ignored because it doesn’t fit the “truth” that most experts have come to believe.

What Does the Latest Study Show?

The study in question (Wang et al, American Journal of Clinical Nutrition, 2014; doi: 10.3945/ajcn.114.085480) was a post-trial follow-up to the Physicians’ Health Study II. It followed 14,641 US male physicians (average age 64 at the beginning of the trial) for 10.3 years. The subjects were randomly assigned to receive 400 IU of vitamin E every other day, 500 mg of vitamin C daily, or their respective placebos.

The investigators in charge of the study recognized that cancer takes many years to develop and that the effects of supplementation might not be recognized until years later. Because of that, the subjects were followed for an additional 2.8 years after the close of the trial to allow additional time for cancers to develop.

The results were clear cut:

• Vitamin E supplementation had no effect on the incidence of prostate cancer or total cancers.
• Vitamin C supplementation also had no effect on the incidence of prostate cancer or total cancers.
• Vitamin C supplementation decreased the incidence of colon cancer during the post-trial period by 46%, which was marginally significant.

The Bottom Line:

1) Can antioxidant supplements cause cancer? You can ignore the dire warnings that antioxidant supplements may increase your risk of cancer. The only case where this appears to be true is for high dose beta-carotene supplements in smokers. The weight of evidence for vitamins C and E suggests that they are unlikely to increase your risk of cancer.

2) As I have said previously if there is any risk of antioxidant supplements, it is most likely to arise from using high purity individual antioxidant supplements. I recommend vitamin E supplements containing the full spectrum of tocopherols and tocotrienols, carotenoid supplements containing all the naturally occurring carotenoids, and supplements that combine complementary antioxidant nutrients – vitamin E and selenium, for example.

3) That doesn’t mean that you should run out and stock up on antioxidant supplements in the hope that they will prevent cancer. The same clinical studies that showed no harm from vitamin C and E supplementation also showed no consistent benefit.

4) This is also consistent with my comments in previous “Health Tips from the Professor”. For example:

• It is very difficult to prove, and unreasonable to expect, that supplementation will have a measurable effect on risk of a particular disease like cancer for everyone. People who are healthy and have very low risk of cancer, may experience other benefits from supplementation but are unlikely to experience a measurable decrease in cancer risk.

• Supplementation is most likely to be advantageous in select populations, generally populations with increased need for a particular nutrient or at highest risk of disease. It is clinical studies looking at the effect of supplementation in these select populations that often show the greatest benefit of supplementation.

• Supplementation is just one component of a holistic approach for reducing disease risk. Diet, weight control, exercise, adequate rest and stress reduction all play a major role as well. You can’t weigh 250 pounds and eat all your meals at McDonalds and expect supplementation to save you from disease.

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.

Healthy Thanksgiving

November 25, 2014 by Dr. Steve Chaney

The Holidays Don’t Have To Be Unhealthy

Author: Dr. Stephen Chaney

While “Healthy Thanksgiving” doesn’t quite have the appeal of the more familiar “Happy Thanksgiving” greeting, I used it here to make the point that Thanksgiving dinner (and many other holiday meals) doesn’t have to be an unhealthy affair.

After all, there is a lot to like about the ingredients in Thanksgiving dinner. Turkey can be a healthy, low- fat meat, if prepared correctly. Sweet potatoes, yams, winter squash and pumpkin are all loaded with vitamin A and other important nutrients. And cranberries are a nutrition powerhouse.
Healthy Thanksgiving

Here are some healthy Thanksgiving ideas:

1) Skip the basting. Choose a plain bird and cook in a bag to seal in the moisture. Remove the skin before serving.

2) Refrigerate the turkey juices and skim off the hardened fat before making gravy and use a gravy cup that pours from the bottom to minimize fat.

3) Use ingredients like whole wheat bread, vegetables, fruits (cranberries, raisins, dates or apples), nuts and your favorite spices for the stuffing and bake it in the oven rather than in the turkey.

4) Serve your sweet potatoes or yams baked rather than candied and let your guests add butter to taste.

5) Use skim milk or buttermilk rather than whole milk and skip the butter for your mashed potatoes.

6) Give your meal gourmet appeal by cooking your green vegetables with garlic, nuts and herbs rather than creamy or fat-laden sauces.

7) Don’t serve the meal on your largest plates. By using smaller plates you ensure smaller portion size and even that second helping isn’t quite so damaging.

8) Use the Shaklee 180 meal replacement products for one or more meals the day before and/or after Thanksgiving so that your total caloric intake over the three day period is not excessive.

By now you have the idea. There are lots of little things that you can do to make your Thanksgiving dinner one that your waist and your heart will thank you for. Bon Appetit and have a Happy, Healthy Thanksgiving!

The Bottom Line

• If you make healthy food choices and choose your portion sizes wisely, you can make this a Healthy Thanksgiving as well as a Happy Thanksgiving.

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.

Can Milk Be Bad For You?

November 18, 2014 by Dr. Steve Chaney

Got Milk? Maybe Not

Author: Dr. Stephen Chaney

You’ve probably seen the ads featuring your favorite celebrities sporting a white mustache and saying “Got milk?” Those ads all suggest that milk is essential for strong bones and a healthy body.

And you are probably aware of dietary recommendations from learned experts saying that you should be consuming at least 2-3 servings of milk every day – more if you’re over 65.

If so, you are probably really confused by the recent headlines saying things like: “Milk Consumption May Increase the Risk of Fractures” and “High Consumption of Milk May Increase Mortality Risk”.

Can milk be bad for you?

Before you pour all your milk down the drain and put Bessie the cow out to pasture, we should examine the study behind the headlines.

Does Milk Actually Increase Fracture Risk?

The study in question (Michaelsson et al, British Medical Journal, 2014; 349; g6015 doi: 10.1136/bmj.g6015) followed 61,433 Swedish women (aged 39-74) for an average of 20.2 years and 45,339 Swedish men (aged 45-79) for an average of 11.2 years. The women filled out two food frequency questionnaires, one at the beginning of the study and another approximately 10 years later. The men filled out one food frequency questionnaire at the beginning of the study.

Mortality and cause of death were obtained from the Swedish Cause of Death Registry. Bone fracture information was obtained from the Swedish National Patient Registry (In countries like Sweden big brother knows everything about you).

The results were pretty dramatic. When they compared women who were drinking three or more glasses of milk per day to women who drank less than one glass of milk a day, the highest level of milk consumption was associated with a:

• 93% increased risk of dying from all causes.
• 90% increased risk of dying from cardiovascular disease.
• 44% increased risk of dying from cancer.
• 16% increased risk of having a bone fracture of any kind.
• 60% increased risk of having a hip fracture.

In contrast, consumption of fermented milk products (cheeses, soured milk and yoghurt) was associated with a decreased risk of mortality and bone fracture in women (a 10-15% decrease in risk for every serving consumed).

What Are The Dangers of Drinking Milk?

The authors speculated that that the increased mortality and fracture risk was due to galactose (a sugar formed from lactose, the primary naturally occurring sugar in unfermented milk). Their argument supporting this hypothesis was four fold:

1) In our intestines lactose is split into two sugars, glucose and galactose.

2) In animal models (primarily mice and rats) lifelong consumption of galactose is associated with shortened lifespan caused by, among other things, oxidative damage and chronic inflammation.

3) There is a rare genetic disease called galactosemia in humans that is caused by the lack of a crucial enzyme required to metabolize galactose. Patients with this disease die at a very early age without treatment. Even with dietary restriction of galactose they experience oxidative damage, inflammation and an increased risk for chronic diseases, including osteoporosis.

4) In a subset of patients enrolled in this study, high milk consumption was associated with an increase in blood markers of oxidative stress and inflammation.

While the results seem clear and the hypothesis seems plausible, we should perhaps look at the limitations of the study before making significant dietary changes.

Limitations of the Study

There are a number of significant limitations to this study.

1) It simply measures associations, not cause and effect.

2) The statistics were not entirely consistent. For example, while consumption of three or more glasses of milk (average = 3.4 glasses/day) was associated with 90% increased risk of mortality and cardiovascular mortality in women, there was only a 15% increase in risk associated with every glass of milk consumed. 15%/glass times 3.4 glasses/day = 51% – not 90%. A little bit of higher math tell us that these numbers don’t quite add up.

3) In men the effects were much smaller to nonexistent. In men high milk consumption was associated with a 10% increased risk in overall mortality and a 16% increased risk cardiovascular mortality, but milk consumption had essentially no effect on cancer mortality, fracture risk or hip fracture risk.

4) The galactose hypothesis is interesting, but far from convincing. Mice and rats don’t necessarily metabolize galactose in the same way as humans. Furthermore, in humans galactosemia is a very rare disease, and there is currently no evidence that dietary galactose poses a problem for people without the genetic defect that causes galactosemia.

5) Most importantly, there have been a number of previous studies examining the effects of milk consumption on both fracture risk and mortality, and those studies have been remarkably inconsistent. Some show increased risk and others show decreased risk. Meta-analyses of all previous clinical studies have shown no significant association between milk consumption and mortality (American Journal of Clinical Nutrition, 93: 158-171, 2011) or hip fracture (Journal of Bone Mineral Research, 26: 833-839, 2011).

While some of the media articles were characterizing this study as ground-breaking and one that should lead to changes in dietary recommendations, the authors were far more cautious in their interpretation of the data. They said: “The results of this study should be interpreted cautiously given the observational design of our study. The findings merit independent replication before they can be used for dietary recommendations.” I agree.

Where Else Can You Find The Nutrients That Milk Provides?

In summary, there is no consistent evidence that milk consumption increases your risk of mortality and bone fractures. However, there is also no consistent evidence that milk consumption decreases your risk of mortality or fracture.

Since milk provides no proven benefit and may pose some risk many of you may be wondering where else you can get the nutrients that milk provides.

Milk is an excellent source of calcium, magnesium, vitamin D, protein and riboflavin. When you carefully evaluate alternative food sources for these nutrients you will quickly discover that your choices are not straight forward. You need to be a knowledgeable consumer and careful label reader. For example:

• Green leafy vegetables are a high in calcium, but many of them also contain oxalate, which chelates the calcium and reduces its bioavailability. In short, green leafy vegetables are a healthy source for some of the calcium we need for healthy bones, but they should not be our primary source because of the relatively low calcium bioavailability.

• Cheeses are an excellent source of calcium, but many cheeses are high in fat and sodium.

• Yoghurts and other fermented milk products are an excellent source of calcium, but many of them are high in added sugars and artificial ingredients, which I do not recommend (see my article “Do Artificial Colors Cause Hyperactivity?” (https://www.chaneyhealth.com/healthtips/do-artificial-colors-cause-hyperactivity/).

• Tofu and tempeh provide only 1/3 to ½ the calcium found in milk and provide no vitamin D.

• “Milk substitutes” made from soy, rice or other sources are often high in added sugars and may not provide the same nutrient profile as real milk. You have to read the labels carefully.

• Calcium supplements are an excellent source of calcium, but they have been controversial in recent years (see my article “Does Calcium Increase Heart Attack Risk?” (https://www.chaneyhealth.com/healthtips/calcium-supplements-increase-heart-attack-risk/). My take on the controversy is that the latest studies have shown fairly convincingly that calcium supplements do not increase heart attack risk. However, if there is any risk, it is associated with calcium supplements that were not designed properly for incorporation of calcium into bone. My recommendation is to only choose calcium supplements that have been clinically proven to increase bone density.

• Well designed protein supplements can also be a good source of calcium and vitamin D, but many of them contain artificial sweeteners, which I do not recommend (see my articles “Do Diet Sodas Make You Fat?” (https://www.chaneyhealth.com/healthtips/do-diet-sodas-make-you-fat/), “Does Sugar Cause Heart Disease?” (https://www.chaneyhealth.com/healthtips/does-sugar-cause-heart-disease/), and “Can Soft Drinks Cause Heart Disease?” (https://www.chaneyhealth.com/healthtips/soft-drinks-and-heart-disease/).

The Bottom Line:

1) A recent study suggested that high milk consumption (> 3 glasses per day) in women might be associated with a:

2) That study has a number of limitations and is not consistent with previous studies. Even the authors of the study stated: “The results [of this study] should be interpreted cautiously…”

3) Previous studies looking at the association of milk consumption and both fractures and mortality have been inconsistent. Meta-analyses of all previous studies show no significant association between milk consumption and either fractures or mortality.

4) In short, there is no consistent evidence to support the recent headlines suggesting that milk consumption might increase your risk of mortality and bone fractures, but there is also no consistent evidence that milk consumption decreases your risk of mortality or fractures.

5) Since milk provides no proven benefits and might pose some risk, you may be asking where else you can find the nutrients that milk provides. While there are a number of other dietary sources of the calcium needed for strong bones, each of them has potential limitations (for details, see the article above). You have to be a knowledgeable consumer and careful label reader if you are looking for non-milk sources of calcium.

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.

Supplements To Avoid

November 11, 2014 by Dr. Steve Chaney

What You Don’t Know Could Kill You

Author: Dr. Stephen Chaney

There are a few bad apples in every barrel, and the supplement industry is no different, especially when it comes to sports nutrition, weight loss products and supplements to avoid. In previous health tips from the professor I have exposed some of the more dangerous sports nutrition and weight loss products on the market at the time. For example, I have reported on the dangers of weight loss and sports nutrition products containing the amphetamine-like compounds DMAA and DEPA .

The DMAA story was a real scandal. Not only did sports nutrition products containing DMAA kill people, but the FDA actually had to raid the warehouses of a major nutrition retailer to force them to stop selling it.

You might ask why would supplement manufacturers even make products like that? The bottom line is that some companies are far more interested in their profit margin than they are in the safety of their customers. Amphetamine-like ingredients burn off calories and give athletes an artificial energy boost. Those results sell products.

The fact that those same ingedients also kill people is of little concern to unscrupulous manufactures. In fact, as soon as one amphetamine-like ingredient is banned, they just reformulate by adding another amphetamine-like ingredient to their product.

Sports Supplements To Avoid

The unscrupous manufacturers are at it again. A recent paper by a group of scientists in the United States and the Netherlands (Cohen et al., Drug Testing and Analysis, 2014: DOI 10.1002/dta.1735) reported that DMBA, another amphetamine-like ingredient that is a close analog of DMAA, was found in at least 12 products marketed to improve athletic performance, increase weight loss and enhance brain function.

DMBA (1,3-dimethylbutylamine) is a synthetic compound that has never been tested for safety in humans, something that the FDA is supposed to require for every new dietary ingredient added to a supplement. Because DMBA is chemically similar to DMAA (1,3-dimethylamylamine), the scientists conducting the study suspected that manufacturers may have started adding it to their products.

The scientists surveyed the listed ingredients on all supplements distributed in the United States for any ingredient name that might be a synonym for DMBA. They identified 14 supplements that fit that criteria and analyzed them for the presence of DMBA. 12 tested positive for DMBA.

The supplements they identified that contained DMBA were Contraband, Redline White Heat, Evol, MD2 Meltdown, Oxyphen XR AMP’D, OxyTHERM Pro, Oxyfit Extreme, Synetherm, AMPitropin, Decimate Amplified, AMPilean, and Frenzy – but they warned that there could be many more out there that they didn’t identify.

The authors of the study stressed that DMBA is a synthetic pharmaceutical ingredient, has the potential to cause the same health risks as DMAA, and has never been tested in humans. They stated: “Given the potential risks of untested pharmacologic stimulants, we strongly recommend that manufacturers immediately recall all DMBA in dietary supplements…The FDA and other regulatory bodies should, without delay, warn consumers about the presence of DMBA in [certain] dietary supplements.”

The Council for Responsible Nutrition, an industry group, sent a letter to the FDA on September 12th urging regulatory action…noting that it has a similar chemical structure to the banned ingredient [DMAA] and that none of those selling it have filed required “new dietary ingredient” paperwork with the FDA to substantiate its safety.” The FDA has yet to respond.

This story is all too familiar. The unscrupulous manufacturers won’t remove unsafe ingredients until they are forced to, and the FDA is far too slow to act. Often the FDA doesn’t act until the product actually kills people, as was the case for products containing DMAA.

Label Deception

If you are like me, you are probably outraged that manufacturers would even consider selling products like these. But the story only gets worse. None of the labels actually list DMBA as an ingredient. That’s probably because DMBA looks enough like DMAA that intelligent consumers might be scared off.

Instead, they list the ingredient as AMP citrate. They can do that because they are using AMP to stand for 4-amino-2-methylpentane. But that is not the common usage for AMP.

To any biochemist, and probably most high school biology students, AMP stands for 5’-adenosylmonophosphate – a normal and harmless cellular metabolite. Citrate is also a normal cellular metabolite.

In short, the manufacturers are purposely masquerading a synthetic and potentially dangerous stimulant under a pseudonym that looks like naturally occurring cellular metabolites. That is shameful!

Lack of Quality Control

But wait, it gets even worse. The scientists analyzed 14 products that had AMP citrate on the label and the amount of DMBA ranged from 0 to 120 mg. Apparently these manufacturers have no quality control process either. That is a huge concern because this ingredient has never been tested for safety in humans. We have no idea how much it takes to harm people!

The highest, and potentially most dangerous, levels of DMBA were found in:

• AMPilean, a fat burner from Lecheek Nutrition
• Frenzy, a pre-workout powder from Driven Sports
• MD2 Meltdown, a weight loss product from VPX Sports
• AMPitrophin, a brain enhancer sold by Lecheek Nutrition

What Can You Do?

Every time you read something like this, you might be tempted to avoid all sports nutrition and weight loss supplements. However, you should realize that unsafe products like these represent a very small part of the industry. You just need to be an informed consumer so that you are aware of supplements to avoid. For example:

Be skeptical of flamboyant claims. For example, some of the claims made by the products listed in this article are “The ultimate stimulant experience”, “Fat incinerator”, “Rapid energy surge”. When you see claims like that you should run the other direction.
Research your manufacturer. Only choose companies with a long track record of integrity and product quality.
Insist on published clinical studies showing that the product is both safe and effective.

The Bottom Line:

1) A recent report identified a number of sports nutrition and weight loss products containing the amphetamine-like ingredient DMBA. This is a synthetic compound that closely resembles DMAA, a stimulant that was recently banned by the FDA.

2) Because DMBA is potentially dangerous and has never been tested for safety in humans both the authors of this article and the Council for Responsible Nutrition have recommended that the FDA issue a recall of products containing this ingredient. To date the FDA has not acted.

3) You cannot identify products containing this dangerous ingredient by searching for DMBA on the label. That is because the manufacturers selling these products have chosen to use the harmless sounding pseudonym AMP citrate on their ingredient list rather than DMBA.

4) The amount of DMBA in products listing AMP citrate on their label ranged from 0 to 120 mg. That means you have no idea how much DMBA you are getting from the label. Even worse, because this ingredient has never been tested in humans we have no idea how much is safe.

5) Unscrupulous manufacturers who put untested and potentially dangerous ingredients in their supplements represent only a tiny fraction of the industry, but reports like this emphasize the importance of being an informed consumer. I recommend that you:

Use your common sense. Avoid supplements promising magic gains in energy, muscle mass or weight loss.
Research your manufacturer. Only choose companies with a long track record of integrity and product quality.
Insist on published clinical studies showing that the product is both safe and effective.

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 Soda One of The Causes of Arthritis?

November 4, 2014 by Dr. Steve Chaney

Author: Dr. Stephen Chaney

Recently, I came across an article which claimed an association between soda and arthritis. So, is soda one of the causes of arthritis? In previous health tips from the professor I have shared that soda consumption can cause weight gain and heart disease . As if that weren’t reason enough to avoid sodas, recent headlines suggest that sodas can also cause rheumatoid arthritis. That is a pretty strong claim, so let’s look at the study behind those headlines.

Do Sodas Cause Arthritis?

This study (Hu et al., American Journal of Clinical Nutrition, 100: 959-967, 2014) followed 79, 570 women enrolled in the first Nurse’s Health Study (NHS) and 107,330 women enrolled in the second Nurse’s Health Study (NHS II) – that’s a total of 186,900 women – for at least 20 years. The women were aged 25-55 at the beginning of the studies and 857 of them developed rheumatoid arthritis over the next 20+ years.

All of the participants in the study filled out a questionnaire covering medical history, lifestyle and chronic disease at entry into the study and every two years afterwards. Compliance to this protocol was >90%, which is excellent for this type of study. The results were pretty impressive:

· Women who consumed ≥ 1 serving of sugar sweetened soda/day had a 63% higher risk of developing rheumatoid arthritis compared to women who consumed no sugar sweetened soda or consumed < 1 serving/month.

· The association between sugar-sweetened soda consumption and rheumatoid arthritis was much stronger for late-onset rheumatoid arthritis than it was for early-onset rheumatoid arthritis. When the authors restricted their analysis to women who developed rheumatoid arthritis after age 50, consumption of sugar sweetened sodas was associated with a 2.64-fold higher risk of developing rheumatoid arthritis (That’s a 264% increase).

· The type of sugar did not appear to matter. Sodas sweetened with sucrose and high-fructose corn syrup were equally likely to increase the risk of rheumatoid arthritis.

· There was no association between diet soda consumption and rheumatoid arthritis.

What Are The Strengths and Weaknesses Of The Study?

Strengths of The Study: The strengths of the study are fairly obvious.

This was a very large study and the effects (64%) and (264%) were also large. Those aren’t trivial differences. The size of the study and the magnitude of the effects bolster confidence in the outcome of the study.

Weaknesses of The Study:

This type of study measures associations. It doesn’t prove cause and effect. Therefore, the headlines saying “Soda Consumption is Associated With Arthritis” are more accurate than those saying “Sodas May Cause Arthritis”.

In studies of this kind we can never be sure whether the variable that was measured (soda consumption in this case) was responsible for the outcome or whether it was some other variable that wasn’t measured that was responsible for the outcome. In particular, the women who developed rheumatoid arthritis were also more likely to:

· Have lower incomes.
· Exercise less.
· Have higher energy (calorie) intake.
· Have poorer diets.
· Take fewer multivitamins and other supplements.

The authors tried their best to compensate for these differences statistically, and the fact that the very large effects of soda consumption on rheumatoid arthritis occurrence were not significantly affected when these differences were taken into account adds confidence to their conclusions. However, it is never possible to exclude the possibility that some other variable they did not measure was responsible for the increase in rheumatoid arthritis.

Are Diet Sodas Off the Hook? Or,could They Be One of The Causes of Arthritis?

Could diet sodas be one of the causes of arthritis? This study showed no association between diet soda consumption and rheumatoid arthritis. Previous studies have suggested that diet sodas don’t increase the risk of heart disease to the same extent as sugar-sweetened sodas. Does that mean that you should just start drinking diet sodas rather than sugar sweetened sodas?

The answer is probably not. As I have pointed out in an earlier issue of “Health Tips From the Professor” , and has been confirmed by a recent meta-analysis of 24 clinical studies (Miller and Perez, American Journal of Clinical Nutrition, 100: 765-777, 2014), double blind studies in which all other caloric intake is carefully controlled generally show that people tend to gain slightly less weight when consuming diet sodas than when consuming sugar sweetened sodas.

But in the real world, people consuming diet sodas are just as likely to be overweight as people consuming sugar sweetened sodas. People seem to compensate for the calories saved with diet sodas by consuming more Big Macs, Mrs. Fields cookies and extra large Stabucks Lattes. In the real world, water is the only non-caloric beverage that is actually associated with lower weight.

Is It Enough To Just Stop Drinking Sodas?

I have often paraphrased that famous line from Western movies: “Just put down that soda and back away, and nobody gets hurt”. But is it that simple? Can you prevent rheumatoid arthritis just by drinking less soda?

Once again, the answer is probably no. There are a number of factors that can increase your risk of developing rheumatoid arthritis. Experts will tell you that the causes of rheumatoid arthritis are largely unknown, but that genetic predisposition, smoking and excessive alcohol use can increase your risk.

However, because rheumatoid arthritis is an inflammatory disease I would add overweight; diets high in animal protein, saturated fats, trans fats and sugar; food allergies; gut health issues; stress & exhaustion and chronic infections – and lack of fresh fruits and vegetables, omega-3 fatty acids and regular exercise.

The clinical study I described above found that soda consumption was much more strongly associated with late onset rheumatoid arthritis than early onset rheumatoid arthritis. Based on those data I would speculate that early onset rheumatoid arthritis may be more strongly influenced by genetics and other lifestyle factors, whereas late onset rheumatoid arthritis may be more strongly influenced by sugar sweetened sodas and other sugary foods. Only time will tell if my hypothesis is true.

Is soda one of the causes of arthritis?

The Bottom Line:

1) A recent study reported that women who consume ≥ 1 serving of sugar sweetened soda/day have a 63% higher risk of developing rheumatoid arthritis compared to women who consume no sugar sweetened soda or consume < 1 serving/month.

2) The association between sugar-sweetened soda consumption and rheumatoid arthritis is much stronger for late-onset rheumatoid arthritis than for early-onset rheumatoid arthritis. For women who first develop rheumatoid arthritis after the age of 50, consumption of sugar sweetened sodas is associated with a 2.64-fold higher risk of developing rheumatoid arthritis (That’s a 264% increase).

3) The type of sugar does not appear to matter. Sodas sweetened with sucrose and high-fructose corn syrup are equally likely to increase the risk of rheumatoid arthritis.

4) There was no association between diet soda consumption and rheumatoid arthritis. However, this does not mean that diet sodas are a good thing. Consumption of diet sodas is just as likely to be associated with obesity as is consumption of sugar sweetened sodas, and some recent studies suggest that consumption of diet sodas is associated with high blood pressure.

5) This was a very large and well done study, but it only measures associations, not cause and effect. Further studies will be needed to confirm this observation. However, we already know that sodas are bad for us. This may be just one more reason to minimize our consumption of sodas.

6) We shouldn’t assume that we can prevent rheumatoid arthritis by simply cutting sodas out of our diet. Arthritis has multiple causes (see article above). We should aim for a healthier overall lifestyle if we wish to reduce our risk of developing rheumatoid arthritis and other diseases.

7) Osteoarthritis is much more common than rheumatoid arthritis. This study did not include women with osteoarthritis, so it is uncertain whether these results will apply to osteoarthritis as well.

8) Men are much less likely to develop rheumatoid arthritis than women, so it will be difficult to do a comparable study in men. However, it is likely that the same association between soda consumption and rheumatoid arthritis would be seen in men as well.

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

Are There Health Benefits of Beetroot Juice for Athletes?

October 28, 2014 by Dr. Steve Chaney

Should You Add Beetroot Juice To Your Training Diet?

Author: Dr. Stephen Chaney

When I saw the headline “Beetroot Juice May Boost Aerobic Fitness For Swimmers” I did a double take. Could something as simple as eating more beets actually improve exercise performance? Are there real health benefits of beetroot juice for athletes? So I looked up recent papers on the topic. But, before I review those I should give you a little science behind the idea that beetroot juice might affect performance.

The Science Behind Beetroot Juice And Exercise

Nitric oxide is a colorless, odorless gas that serves as an important signaling molecule in the human body. Among its many beneficial effects is increased blood flow to muscle. This increased blood flow appears to be preferentially distributed to the type 2 muscle fibers which support moderate to high intensity exercise. Thus, nutrients that enhance nitric oxide levels might be expected to improve moderate to high intensity exercise.

There are two naturally occurring pathways for producing nitric oxide in the body. The first pathway utilizes arginine, an amino acid found in dietary protein. The second pathway utilizes nitrates, which are found in fruits and vegetables. The best dietary sources of nitrates are beetroot, spinach and other leafy green vegetables.

Arginine has been widely used in sports supplements for some time to enhance performance. However, clinical studies on arginine have been mixed, with some showing small enhancements in performance and others showing no significant effect. Most experts now think that the benefits of arginine are primarily seen with untrained or moderately trained athletes (people like you and me) – not for highly trained or elite athletes.

It is logical that natural sources of nitrates, such as beetroot juice, would have a similar beneficial effect on exercise, but it is only in the last couple of years that scientists have started to evaluate that possibility. I looked up six recent publications for this review.

Does Beetroot Juice Improve Exercise Performance?

Study # 1: In this study (Bailey et al, J. Appl. Physiol., 107: 1144-1155, 2009) untrained men (aged 19-38) were given beetroot juice or a placebo for 6 days and then put through a series moderate-intensity and severe-intensity step exercise tests on days 4-6. The amount of oxygen required to support the moderate intensity exercise was decreased by 19% in the beetroot juice group. For severe intensity exercise, the amount of oxygen needed to support the exercise was decreased by 23% and the time to exhaustion was increased by 16% in the beetroot juice group. Those effects were statistically significant.

Study # 2: In this study (Kelly et al, Am. J. Physiol. Regul. Integr. Comp. Physiol., 304: R73-83, 2013) untrained older adults (aged 60-70) were given beetroot juice or a placebo for 3 days and then put through a treadmill exercise test. Resting blood pressure and oxygen uptake kinetics during exercise were significantly improved in the beetroot group.

Study # 3: In this study (Breese et al, Am. J. Physiol. Regul. Integr. Comp. Physiol., 305: R1441-14505, 2013) physically active subjects were given beetroot juice or a placebo for 6 days and then put through a double step exercise protocol involving a transition from stationary to moderate intensity exercise followed immediately by a transition from moderate intensity to severe intensity exercise. No significant differences were observed between the beetroot juice group and the placebo group during the transition from stationary to moderate intensity exercise. However, for the transition from moderate intensity to high intensity exercise both efficiency of oxygen utilization and endurance were increased by 22% in the beetroot juice group.

Study # 4: In this study (Pinna et al, Nutrients, 6: 605-615, 2014) moderately trained male master swimmers were given beetroot juice for 6 days. Swimming tests were conducted at the beginning and end of the 6 day period. After 6 days of beetroot juice supplementation, the workload was increased by 6% and the energy cost was decreased by 12% when the swimmers were performing at their maximal capacity.

Studies # 5 & 6: These studies (Lanceley et al, British Journal of Sports Medicine, 47: doi: 10.1136/bjsports-2013-093073.8; Hoon et al, Int. J. Sports Physiol. Perform., 9: 615-620, 2014) were both done with highly trained athletes and no significant improvement in performance was observed. This is fully consistent with previous studies utilizing arginine supplements.

In short, these studies suggest that beetroot juice is similar to arginine supplements in that:

It improves exercise performance at moderate to severe exercise levels, but not at low exercise levels.

It improves exercise performance for untrained or moderately trained athletes, but not for highly trained athletes.

The effects are modest. However, you should keep in mind that even a 20% increase in endurance during high intensity exercise can result in a significant incremental increase in muscle mass if the exercise is repeated on a regular basis.

What Are The Strengths & Weaknesses Of These Studies?

Strengths: The strengths of these studies are:

Most of the studies were double-blind, placebo controlled studies

The studies were internally consistent and were consistent with previous studies done with arginine supplements.

Weaknesses: The weaknesses of these studies are:

The studies were all very small and were of short duration. Larger, longer term studies are needed to validate the results of these studies.

So, are there health benefits of beetroot juice for athletes?

The Bottom Line:

Nitrates and arginine are both converted to nitric oxide in the body, so it is plausible that they will have similar effects.

Arginine supplements have been around for years and appear to have a modest affect on exercise performance with untrained and moderately trained athletes, but not with highly trained athletes. This is most likely because one of the effects of training is to increase blood supply to the muscles. Thus, highly trained athletes already have enhanced blood flow to the muscles, and the effect of arginine supplementation on blood flow is less noticeable.

Nitrate supplements are just starting to be evaluated for their effects on exercise performance. Most of the research so far has been with beetroot juice, but the results should be similar for any naturally sourced nitrate supplement.

The clinical studies published so far suggest that nitrate supplements are similar to arginine supplements in that they have a modest effect on high intensity exercise in untrained and moderate trained athletes (people like most of us). They appear to have little or no effect for highly trained athletes. Thus, the effect of nitrate supplements on exercise appears to be very similar to the effect of arginine supplements on exercise.

Most of the studies performed to date have been small, short duration studies. They need to be validated by larger, longer term studies.

If the effects of nitrate supplementation published to date are accurate they should be most beneficial for weight training and high intensity exercise because even modest increases in exercise endurance can result in an incremental increase in muscle mass and strength over time.

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.

Should I Get a Flu Shot?

October 21, 2014 by Dr. Steve Chaney

The Truth About About Flu Shots That Nobody Else Is Telling You

Author: Dr. Stephen Chaney

It is flu season again, and the annual debate about whether everyone should get a flu shot is heating up. On the one hand we are told that the flu shot saves thousands of lives and everyone should be vaccinated. On the other hand we are being told that the flu shot is deadly and we should avoid it. As usual, the truth is somewhere in between.

When you examine the scientific literature it is clear that:

The risks of the flu shot have been greatly exaggerated.
The benefits of the flu shot have been greatly exaggerated.
The medical profession has not leveled with us about the real reason they recommend that everyone get a flu shot.

Flu Shot Side Effects

The greatest fear of vaccination and therefor flu shot side effects for children has been the claim that the flu vaccine causes autism. It is easy to understand how the hypothesis arose that vaccinations and autism might be linked, because the first symptoms of autism usually appear around the time that children are completing their initial series of vaccinations.

However, clinical research has not substantiated that any causal relationship between vaccinations and autism. It isn’t that scientist haven’t looked. A number of clinical studies have looked for a link between vaccinations and autism and have failed to find any. The age of onset and prevalence of autism are virtually identical in vaccinated and unvaccinated children.

However, most vaccines still contain mercury, and mercury is a neurotoxin. So if you are getting your child vaccinated, I recommend that you insist on getting a mercury free vaccine. You may want to inquire about the preservatives and additives in the flu vaccine as well, because some of them are also toxic.

Beyond that the biggest concerns are severe allergic reactions and an autoimmune response called Guillian-Barré syndrome which causes symptoms ranging from muscle weakness and fatigue to partial paralysis. These side effects are real and they are serious, but they are also quite rare. They affect somewhere between 1 in a million to 1 in 100,000 children, depending on the vaccine.

In short, flu shot side effects risks are real, but they have been greatly exaggerated by some in the media.

Let’s Talk Science

It turns out that the benefits of the flu shot have been greatly exaggerated by health professionals and the media as well. However, to properly understand why the messages you hear are a bit misleading you need to understand some scientific jargon, namely the difference between relative risk and absolute risk.

Relative risk describes the effect of an intervention for people with a certain condition. In this case, relative risk would be the effect of the flu shot (intervention) for people who have been infected with the flu virus (condition). Relative risk is often used in media reports because it magnifies the effect of the intervention. In short, it makes the intervention look really good.

Absolute risk describes the effect of an intervention on the probability that you will develop a certain condition. In this case absolute risk would be the effect of the flu shot on you actually getting the flu. Since this takes into account your probability of being infected by the flu virus as well as the relative risk reduction once you have become infected, it is a much smaller number. Absolute risk is a much better measure of the actual benefit you can expect to receive.

Is The Flu Shot Effective?

There is always year to year variation in the severity of the flu and the effectiveness of flu vaccines. In addition, many other viruses that cause flu-like symptoms and are completely unaffected by the flu vaccine.

For example, both enterovirus D68 and the Ebola virus are in the headlines – enterovirus D68 because it has hospitalized so many kids this fall and Ebola virus because it is so deadly. Unfortunately, the flu vaccine has no efficacy against either of those viruses.

In addition, there is also significant variation in both the efficacy and evidence for efficacy in different population groups that is generally not acknowledged during the annual campaigns recommending that everyone should get a flu shot. To better understand that we need to look at the efficacy of the flu shot in each population group individually.

Is The Flu Shot Effective in Children Age 6 Months To 2 Years?

In 2010, the US Advisory Committee on Immunization Practices began recommending flu vaccination for all healthy children older than 6 months. However, in 2012 the Cochrane Collaboration conducted a systematic review of all published clinical studies and concluded that for children in that age group currently licensed flu vaccines “are not significantly more effective than placebo”. [To fully understand the significance of that statement you need to know that the Cochrane Collaboration is an independent, non-profit organization that promotes evidence-based medicine. In fact, in the medical community Cochrane Collaboration systematic reviews are considered to be the gold standard for evidence based medicine.]

Summary: This is one of the groups at greatest risk for developing severe complications to the flu, so it is disappointing that the flu vaccine is not more effective for this group. I will talk about the best way to protect this group below.

Is The Flu Shot Safe & Effective in Healthy Children Age 2 To 7 Years?

This is the age group for which immunization makes the greatest sense, and the nasal spray gives the best results for this group. According to the 2012 Cochrane Collaboration review the flu shot reduces the relative risk of the flu by 48% and the nasal spray with attenuated live virus reduces the relative risk by 83%.

Since around 16% of unvaccinated children catch the flu in an average year this translates to an absolute risk reduction of 3.6% for the flu shot and 17% for the nasal spray. That is a smaller number, but still significant. This, of course, varies from year to year dependent on how well the vaccine matches the strains of virus that are actually circulating through the population.

Summary: The science behind vaccination for this group has shifted significantly in the past few years. The evidence for the efficacy of the flu shot in this age group has increased while the evidence for harm has deceased. The fear of the flu shot causing autism has been largely disproven by recent clinical studies. That leaves severe allergic reactions and the Guillian-Barré syndrome as the major complications of the flu vaccination.

Proponents of the flu vaccinations have estimated that if all children in this age range were vaccinated, around 200 would develop severe complications to the flu shot, and if all children in this age range were unvaccinated 20,000 would develop severe complications from the flu. I have not been able to independently substantiate those statistics. We also need to keep in mind that in those rare years, such as during the 1976 swine flu epidemic, when approximately 1 in 100,000 vaccinated children developed Guillian-Barré syndrome the incidence of severe complications to the flu shot could have reached the 2-3,000 range if the vaccination program had not been terminated early.

I realize that this is an emotional issue for parents, and there is no perfect answer. However, at present the weight of evidence is slightly in favor of vaccination for this age group.

Is The Flu Shot Effective in Healthy Children Age 8 To 18 Years?

According to a recent meta-analysis of all available clinical studies (Oosterholm et al, The Lancet Infectious Diseases, 12: 36-44, 2012), we simply don’t know whether the flu vaccine will be effective in this age group because no reliable studies have been conducted.

Even worse than that, we may never know whether the flu shot offers any protection for this age group because of a Catch 22 situation in modern clinical research. Once a particular treatment becomes “the standard of care” it is considered unethical to withhold that treatment in a clinical trial. Since the CDC is now recommending the flu shot for everyone over age 2, it would be considered unethical to conduct a clinical trial in which half the population received flu shots and half did not.

Summary: I suspect that the flu shot may offer some protection in this age group, but there is no convincing clinical evidence to support that belief at present and for the foreseeable future.

Is The Flu Shot Effective in Healthy Adults Age 18 To 65 Years?

Here the answer is yes. According to a 2012 meta-analysis of 31 published clinical studies (Oosterholm et al, The Lancet Infectious Diseases) the flu shot gives an impressive 75% reduction in the relative risk of catching the flu. However, in an average year only 4% of this population will catch the flu if unvaccinated, so the absolute risk reduction is a modest 3%.

This is also the group that has the least to fear from the flu. Only about 1 in 100 people in this age range develop severe complications as a result of getting the flu, and these are usually the people with severe diseases and/or compromised immune systems. For most healthy adults in this age range, the flu is merely a one or two day inconvenience.

Summary: For healthy adults in this age range the flu vaccine offers only a modest decrease in the absolute risk of catching the flu, and this group has a relatively low risk of developing severe complications from the flu. If the self interest of this group were the only consideration, it is hard to understand the insistence of the medical community that everyone in this age range get a flu shot. It would appear to be a matter of personal choice.

Is The Flu Shot Effective in Seniors Age 65 And Older?

Flu shot proponents will tell you that flu shots cut the risk of death in this group by 50% based on a meta-analysis published in 2002 (Vu et al, Vaccine, 20: 1831-1836, 2002).

However, more recent research has come to the opposite conclusion. A recent meta-analysis (Oosterholm et al, The Lancet Infectious Diseases, 12: 36-44, 2012) concluded “Evidence for protection in adults aged 65 years or older is lacking”. The 2010 Cochrane Collaboration systematic review concluded “Due to the poor quality of available evidence, any conclusions regarding the affects of influenza vaccines for people aged 65 years or older cannot be drawn.”

The lack of protection of the flu virus in seniors is most likely due to the fact that, in many cases, their immune systems have weakened with age.

Summary: This is another group where you would most like to see protection by the flu shot, because this group is likely to suffer severe complications and death from the flu, so it is disappointing that the flu vaccine is not more effective for this group.

Who Has Most To Fear From The Flu?

When you hear that the flu shot significantly reduces the risk of severe complications and death from the flu, you should know that the risks are not spread evenly over the population. The very young are at risk because their immune systems haven’t fully developed. The very old are at risk because their immune systems have weakened with age and they may already be in precarious health because of other diseases. And, of course, anyone at any age who is in precarious health because of disease or who has a compromised immune system is at risk as well.

Why Do Health Professionals Recommend That Everyone Get A Flu Shot?

If you are a healthy adult in the 18-65 age range, your risk of severe complications and death is from the flu is very low. It is not zero, but it is low. So why are health professionals so insistent that you need to get a flu shot?

The reason is straight forward, but it is not the reason that they are giving you. It is a public health measure, pure and simple.

The very young, the very old, the sick and the infirm are the ones most likely to develop severe complications and die from a flu infection. However, the flu shot doesn’t offer them much protection because their immune systems are often compromised. The best way to protect those groups is to immunize everyone else. If the flu virus can’t gain a foothold in the rest of the population, those at greatest risk will never be exposed to the flu.

So the constant warnings that you need to get a flu shot is less about protecting you than it is about protecting those whom you might infect. Now you know the truth. If you decide to get a flu shot it will be for the right reason, not the reason you are being given by the medical profession.

In a similar vein, many health departments are warning about hospitalizations and deaths from enterovirus D68 infections and urging people to get flu shots. They are not telling people that the flu shot has no efficacy against enterovirus D68.

I understand the concept that the rare combination of the regular flu and enterovirus D68 infection in the same patient would be particularly deadly. But, I also believe in truth in advertising. The medical profession needs to level with people about why they are recommending flu shots, not use scare tactics that make promises the flu shot can’t deliver.

Should I Get A Flu Shot?

As you can see, your decision about whether or not the flu shot is the right thing for you is not an easy one. Both the benefits and risks of the flu shot have been greatly exaggerated in the media. I have tried not to be an advocate either for or against flu vaccinations. I have evaluated the scientific literature and tried to give you the unvarnished truth. It is now up to you to make an educated decision – one that is right for you.

My personal decision about the flu shot is influenced by my father’s example. He dutifully got his flu shot every year, and every year he came down with the flu shortly after getting the flu shot. I’ve seen the same phenomenon with several of my friends who work at area hospitals and are required to get an annual flu shot. I know that the experts claim you can’t get the flu from the flu shot. I don’t know about that. I only know what I have observed.

In addition, I do not have young children or elderly parents at home who might be compromised if I were to develop even a mild case of the flu. So I chose to follow the kind of lifestyle that keeps my immune system strong rather than relying on a flu shot to protect me from the flu. That immune-healthy lifestyle, of course, will be a topic for a future “Health Tips From the Professor”.

The Bottom Line:

Both the effectiveness and risks of the flu shot have been greatly exaggerated.
The flu shot has no proven effectiveness in children ages 6 months to 2 years, children aged 8-18 years and seniors 65 years and older.
In children, aged 2 to 7, nasal sprays with partially inactive flu virus give a 17% decrease in absolute risk of catching the flu. Side effects of the flu vaccine in this population group are severe allergic reactions and an autoimmune response called Guillian-Barré syndrome. Both severe complications from the flu virus and side effects of the flu vaccine are very rare, but complications from the flu virus are several fold more common than side effects from the vaccine.
Fears that the flu vaccine could trigger autism have not been validated by clinical studies. However, mercury is a neurotoxin so I recommend that you insist on mercury-free vaccines for your children. You may also wish to inquire about other preservatives and additives in the vaccine, because some of them are toxic.
In healthy adults, aged 18 to 65, flu shots give a 3% decrease in absolute risk of catching the flu. This is also the population group with the lowest risk of severe complications from the flu. For most adults in this age group the flu is nothing more than a one or two day inconvenience.
The groups most likely to develop severe complications and die from flu infections are the very young, the very old, and the sick. They are also the groups least likely to benefit from the flu shot because their immune systems are weak.
If you are a healthy adult in the 18 to 65 age group, the constant warnings that you need to get a flu shot is less about protecting you than it is about protecting those whom you might infect if you catch the flu. It is a public health measure to protect the very young, the very old, and the sick. Now you know the truth. If you decide to get a flu shot it will be for the right reason, not the reason you have been given by the health profession.
In addition, the flu shot has no efficacy against either enterovirus D68 or Ebola virus. Although both of these viruses are real concerns, neither is a justification for recommending that people get flu shots.
As for me, I am influenced by the example of my father who got the flu from the flu shot every year. I chose to follow the kind of lifestyle that keeps my immune system strong rather than relying on a flu shot to protect me from the flu. That, of course, will be a topic for a future “Health Tips From the Professor”.

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.