Chronic Disease

What Diet Is Best For Healthy Aging?

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What About Primarily Meat-Based Diets?

Author: Dr. Stephen Chaney

Pinochio

It’s so confusing. Everyone claims they have clinical proof that their diet is the best. You will be healthier and live longer.

But the diets are so different. They range from vegan to keto. They can’t all be equally healthy. What is the truth?

To answer that question, we first need to understand how the proponents of each diet can claim theirs is the perfect diet for health and longevity. It’s because they base their claims on:

  • Short-term studies. Most of their claims are based on studies that range from a few weeks to a few months. You need 20- or 30-year studies to measure the effects of a particular diet on health outcomes.
  • Biological markers (Things like cholesterol and triglyceride levels, blood sugar control, and/or inflammation). Biological markers can predict possible health outcomes. But without long-term studies on actual health outcomes, you don’t know whether those predictions are accurate.
  • Comparisons with the typical American diet. Any diet looks good compared with the American diet.
  • Elimination of highly processed foods. While these diets emphasize different foods, they are all whole food diets. Again, any diet that eliminates processed foods is an improvement.
    • It doesn’t matter whether you restrict calories, restrict certain foods or food groups, or restrict the time you allow yourself to eat. You unconsciously eat less.
    • And when you eat less, you lose weight.
    • And when you lose weight, your cholesterol and triglyceride levels fall, your blood sugar control improves, and inflammation decreases.
    • That’s why short-term weight loss and improvement in biological markers are virtually identical with vegan and keto diets. Those diets are as different as any two diets could be. But they are both highly restrictive diets.

The take-home lesson is clear. Don’t be confused by claims based on short-term studies. What you should look for is:

  • Long-term studies (20 years or more)…
  • that look at the effect of diet on health outcomes, and…
  • do not compare their diet with the typical American diet.

When I first reviewed this topic 8 years ago, I could only find a few studies that met these criteria:

  • One study showed that people consuming primarily plant-based diets weighed less than people who consumed primarily meat-based diets for 20 years or more.
  • Other studies showed that people consuming primarily plant-based diets had a reduced risk of diabetes and heart disease compared to people consuming primarily meat-based diets for 20 years or more.

These are valuable observations, but they are limited. That’s why I was so excited when I came across a recent 30-year study (A-J Tessier et al, Nature Medicine, volume 31, pages 1644-1652, 2025) looking at the effect of 9 different diets on longevity and health outcomes. In short, this study looked at the effect of different diets on healthy aging.

How Was This Study Done?

Clinical StudyThe authors of this study used data from 105,015 participants in the Nurses’ Health Study (NHS) and Health Professionals Follow Up Study (HPFS). Both studies enrolled participants in 1986 and followed them through 2016. In short, they were both 30-year studies. Participants with preexisting chronic diseases were excluded from the study.

  • Lifestyle factors and medical histories were assessed every two years.
  • A detailed dietary assessment was conducted every four years. The assessments measured the intake of 152 foods. Food intakes were averaged over the duration of the study for each participant.

[Note: This study did not measure how the diets of participants changed between 1986 and 2016, although that is an interesting question. Perhaps a future study is planned.]

Based on the foods eaten, the diets of the participants were evaluated for adherence to 9 dietary patterns, which I have described in more detail below.

[Note: To be clear, the participants were not trying to follow these diets. They ate what they ate, and the investigators subsequently compared their dietary pattern with various healthy diets.]

For each of the diets included in this study, participants were divided into quintiles based on how closely their food intake adhered to the recommendations for that diet. Then the highest quintile was compared to the lowest quintile to determine how well that diet predicted “healthy aging” after a 30-year follow-up.

The term “healthy aging” was based on 5 criteria:

  • Longevity – achieving an age of 70 or more.
  • Absence of the top 11 major chronic diseases (cancer, diabetes, myocardial infarction (heart attack), coronary artery disease, congestive heart failure, stroke, Parkinson’s disease, multiple sclerosis, and ALS).
  • No impairment of cognitive function.
  • No impairment of physical health.
  • No mental health issues.

In other words, these were not just individuals who survived 70 years or more. They survived and thrived. They were enjoying their golden years because they still had good health and excellent quality of life.

Diets Included In This Study

The diets included in this study were:

  • AHEI – Alternative Healthy Eating Index (A scoring system developed by Harvard researchers to measure overall diet quality based on its ability to predict lower risks of heart attacks, strokes, and diabetes).
  • aMed – Alternative Mediterranean Diet Index (The aMed diet index differs from the original Med index by separating fruits and nuts into different groups, eliminating dairy, emphasizing whole grains, and excluding red and processed meats in favor of chicken and fish).
  • DASH – Dietary Approaches to Stop Hypertension (The name speaks for itself. But I also sometimes refer to this diet as “the Americanized version of the Mediterranean diet’ because it features foods more familiar to Americans. For example, it allows more red meat options than most of the other diets in this list.
  • MIND – Mediterranean-Dash intervention for Neurogenerative Delay (It is a dietary pattern designed to reduce the risk of Alzheimer’s disease and other forms of dementia. It combines elements of the Mediterranean and DASH diets but differs from both by emphasizing berries as a major fruit source, among other things.)
  • hPDI – Healthy Plant-Based Diet Index (It is a scoring system that measures adherence to a diet rich in healthy plant-based foods and lower consumption of less-healthy plant foods and animal foods.)
  • PHDI – Planetary Health Diet Index (It emphasizes foods (primarily plant foods) that are healthy and are good for the environment. Of the diets on this list, it is the most restrictive and closest to a vegan diet)
  • EDIH – Empirical Dietary Index For Hyperinsulinemia (It is a scoring system that measures the potential of a diet to cause chronically high insulin levels, which is associated with type 2 diabetes and certain cancers.)
  • EDIP – Empirical Dietary Inflammation Pattern (It is a scoring system that measures the inflammatory potential of a diet.)
  • UPF – Consumption of Ultraprocessed Foods (Since recent studies have shown that most Americans get between 55 and 70% of their calories from ultraprocessed foods, this is fast becoming a measure of the typical American diet.)

Note: Except for the UPF diet, these are all whole food, primarily plant-based diets.

What Diet Is Best For Healthy Aging?

Here are the results of the study (drum roll, please):

  • Of the 105,015 participants in this study, only 9.3% achieved healthy aging.
  • Adherence to any of the 8 healthy diets improved the probability of achieving healthy aging.
  • The odds of achieving healthy aging ranged from 1.45 for the Healthy Plant-Based Diet to 1.86 for the Alternative Healthy Eating Index.
  • If you were to pick one winner, it would be the Alternative Healthy Eating Index. And if you were to define healthy aging as achieving an age of 75 or more with the other 4 criteria, the odds increase to 2.24 (more than double) for the Alternative Healthy Eating Index.
  • As you might expect, adherence to a diet high in ultraprocessed foods had the opposite effect. It decreased the odds of achieving healthy aging by 32%.

When you look at each of the criteria for healthy aging individually, the results were a bit more nuanced:

  • For survival to 70+ years, the Alternative Healthy Eating Index and the Planetary Health Diet Index were tied. Both increased the odds of survival by more than 2-fold.
  • The Alternative Healthy Eating Index and the Planetary Health Diet Index were also tied for surviving to 70 with intake cognitive health and intact physical function.
  • The Empirical Dietary Index For Hyperinsulinemia edged out the Alternative Healthy Eating Index for freedom from 11 chronic diseases.

The effect of healthy diets on the odds of achieving healthy aging is independent from BMI, smoking, and physical activity. This means that:

  • The effects of healthy diets on healthy aging were not because people consuming healthy diets weighed less, smoked less, or exercised more.
  • Even if some of your lifestyle choices are suboptimal, choosing a healthy diet will increase your odds of surviving and thriving.

Finally, the study looked at the effects of individual foods on healthy aging. The results were:

  • Higher intakes of fruits, vegetables, whole grains, unsaturated fats, nuts, legumes, and low-fat dairy products increase your odds of healthy aging.
  • Higher intakes of trans fats, sodium, sugary beverages, and red or processed meats decrease your odds of achieving healthy aging.

The effects of these foods on healthy aging aren’t novel. They are consistent with dozens of other studies that have looked at the effect of individual foods on long-term health outcomes. In fact, the diets included in this study were chosen because they included foods that positively affect health outcomes and minimize foods that negatively affect health outcomes.

What About Primarily Meat-Based Diets?

the paleo dietI have good friends who advocate for primarily meat-based diets such as keto, paleo, and carnivore. I’m sure they are going to say, “This study is a sham. It only included primarily plant-based diets, so, of course, it is only going to show benefits for primarily plant-based diets.” I can hear their their questions now:

  • Why didn’t this study include any of the primarily meat-based diets? My answer is: “All the popular meat-based diets exclude one or more of the food groups associated with health and longevity and emphasize one or more of the food groups associated with a shorter, less healthy life. And these food associations are consistent among multiple long-term studies looking at the effect of various foods on health outcomes. 

The authors could have constructed a similar index for each of the popular meat-based diets. But they would have been the inverse of the plant-based diet indices because the foods included and excluded from plant-based and meat-based diets are opposite. Therefore, just like the UPF index, they would have been associated with a decreased probability of achieving healthy aging.”

  • Why did the scientists designing this study ignore the proven health benefits of primarily meat-based diets? My answer is: “The “proven benefits” of primarily meat-based diets are based on short-term studies showing the effects of those diets on biological markers. Long-term studies looking at health outcomes are lacking.”
  • But modern primarily meat-based diets are a special case because they limit carbohydrates and cause ketosis. Why weren’t they included in the study? My answer is: “The Atkins diet limits carbohydrates and causes ketosis. It has been around for more than 50 years. And, to my knowledge, there are no studies showing it is beneficial long term. If the Atkins diet cannot be shown to have long-term health benefits, it is unlikely that modern diets that mimic it are healthy long term.

What Does This Study Mean For You?

confusionThe answer is clear. If you want to survive and thrive in your 70s and beyond, choose a whole food, primarily plant-based diet.

If you want the absolute best diet, follow the Alternative Healthy Eating Index recommendations. There are many online resources to guide you.

However, any whole food, primarily plant-based diet will do. The ones with the most online resources are the Mediterranean, DASH, and MIND diets. Choose the one that best fits your food preferences and lifestyle.

If you want to go more vegetarian, the Healthy Plant-Based Diet is a bit easier than a strict vegan diet.

If you are concerned about the environment, the Planetary Diet is best for you.

If you have specific health issues like hypertension, diabetes, or inflammation, there are diets designed just for you.

And if following structured diets is not your style, just:

  • Eat more fruits, vegetables, whole grains, unsaturated fats, nuts, legumes, and low-fat dairy products.
  • Eat less trans fats, sodium, sugary beverages, and red or processed meats, and ultraprocessed foods.

Finally, even if some of your lifestyle choices are suboptimal, this study shows choosing a healthy diet will increase your odds of surviving to your 70s and thriving.

The Bottom Line

A recent 30-year study looked at the effect of 8 whole food, primarily plant-based diets on healthy aging defined as:

  • Achieving an age of 70 or more.
  • The absence of the top 11 major chronic diseases.
  • No impairment of cognitive function.
  • No impairment of physical health.
  • No mental health issues.

The key findings were:

  • Adherence to any of 8 whole food, primarily plant-based diets improved the probability of achieving healthy aging.
  • The odds of achieving healthy aging ranged from 1.45 for the Healthy Plant-Based Diet to 1.86 for the Alternative Healthy Eating Index.

For more information on this study, why primarily meat-based diets were not considered healthy enough to be included in this study, and what this study means for you, read the article above.

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

 ____________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

 _______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”. Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading Biochemistry textbooks for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

 

Protein – The Longevity Nutrient

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How Much Protein Do You Need?

Author: Dr. Stephen Chaney 

breaking newsIn 2016 the New York Times ran an article with the title, “Can You Get Too Much Protein?” The article asserted that most Americans were getting too much protein in their diet and that protein supplements were useless and perhaps dangerous.

At the time I wrote a “Health Tips From the Professor” article summarizing recent research showing that many people needed more than the RDA for protein and that those people were often consuming too little, rather than too much, protein.

In the 9 years since then the evidence that many Americans may not be getting enough protein has only gotten stronger.

  • The standard for protein intake used to be a “one size fits all” recommendation of 46g gm/day for women and 56 gm/day for men with slight increases recommended for pregnant and lactating women. Today we know:
    • That standard was based on outdated methodology from the 1930’s. Recent studies suggest protein intake should be at least 50% higher.
    • That standard was based on studies with healthy, sedentary adults (the adult “couch potato” crowd). Protein requirements are significantly higher for anyone who doesn’t fit that description.
  • We used to think in terms of total daily protein intake. Today we know that:
    • Protein intake should be divided equally between the 3 primary meals.
    • Protein quality is important. Protein requirements should be increased if low-quality proteins are consumed.
  • We used to worry that high protein intake might damage your kidneys. Today we know that:
    • Protein intake does not cause kidney disease. It is not a concern as long as hydration is adequate and excess alcohol is avoided.
    • Protein intake is only a concern if someone has kidney disease.

Protein – Your Longevity Nutrient

If you want to delve into the latest protein research and what it means for you, I highly recommend the book, “Forever Strong: A New, Science-Based Strategy For Aging Well” by Dr. Gabrielle Lyon.

Her book is focused on helping each of us create adequate healthy muscle mass. She says, “Adequate muscle mass is essential for health and longevity. And muscle is the only organ over which we have voluntary and complete control.”

Of course, adequate muscle mass requires both exercise and adequate protein. Dr. Lyon covers both in her book, but exercise is not my expertise, so I will only cover adequate protein intake in this “Health Tips From the Professor” article.

In her book, Dr. Lyons details recent research on the amount of protein needed to optimize muscle mass. Dr. Lyon was the one who alerted me to the fact that the current protein RDA is based on outdated methodology from the 1930’s and that actual protein needs are much higher.

Dr. Lyon concludes that most Americans are not consuming enough protein to optimize their muscle mass and that adequate protein intake is essential for longevity, metabolic function, and quality of life. Specifically, she says that optimal muscle mass:

  • Improves strength and mobility.
  • Improves blood sugar control.
  • Decreases blood triglyceride levels.
  • Strengthens the immune system.
  • Improves bone mineral density and strength.
  • Reduces all-cause mortality (risk of dying) and morbidity (risk of disease).

I will use the latest science on protein needs described in her book and in recently published clinical studies to answer the important question, “How much protein do you need?” But first I want to help you understand the dynamics of protein metabolism.

The Dynamics Of Protein Metabolism 

ProfessorMost people associate muscle mass with strength and endurance. Many understand the important role muscle mass plays in burning off excess calories and keeping us slim. But few people understand the important role that muscle protein plays in our everyday energy metabolism.

Whenever we eat a meal containing protein, we store some of the protein we eat as increased muscle mass, especially when protein intake is coupled with exercise. But muscle protein plays other very important functions. It is a precious resource.

The synthesis of new muscle in the fed state is driven by:

  • Insulin, which is released into the blood stream whenever we eat a meal.
  • Exercise because it makes muscle more sensitive to the effects of insulin.
  • The amino acid leucine, which is most abundant in high quality protein sources.

In the fed state most of our energy is derived from blood glucose. This is primarily controlled by insulin.  As blood glucose levels fall, we move to the fasting state and start to call on our stored energy sources to keep our body functioning. This process is primarily controlled by a hormone called glucagon.

  • In the fasting state most tissues easily switch to using fat as their main energy source, but…
    • Red blood cells and a few other tissues in the body are totally dependent on glucose as an energy source.
    • Our brain is normally dependent on glucose as an energy source, and our brains use a lot of energy. [Note: Our brain can switch to ketones as an energy source with prolonged starvation or prolonged carbohydrate restriction, but that’s another story for another day.]
  • Because our brain and other tissues need glucose in the fasting state, it is important to maintain a constant blood glucose level between meals.
    • Initially, blood glucose levels are maintained by calling on carbohydrate reserves in the liver.
    • But because those reserves are limited, our body starts to break down muscle protein and convert it to glucose as well – even in the normal dinner/sleep/breakfast cycle.

Simply put, in addition to its other important roles in the body, muscle protein is also an energy store. You can think of it like a bank.

When we eat, we make a deposit to that energy store. Between meals we make a withdrawal from that energy store. When we are young the system works perfectly. Unless we fast for prolonged periods of time, we are always adding enough muscle protein in the fed state to balance out the withdrawals between meals.

But there are many physiological situations where protein metabolism becomes unbalanced, either because protein breakdown is accelerated or because protein synthesis is diminished. In each of those situations, our protein needs are increased.

I will describe each of these situations and how they affect our protein needs in the section below.

How Much Protein Do You Need? 

couch potatoThe Coach Potato Group: If this is you, I won’t be judgmental. But I highly recommend you read Dr. Lyon’s book. It may just inspire you to increase your fitness level and your protein intake.

As I said before the standard RDA recommendation for the coach potato group is 46 gm/day for women and 56 gm/day for men. That’s based on 0.36 grams of protein per pound of body weight and assumes that women weigh around 127 pounds and men weigh around 155 pounds.

There are two major problems with the standard protein RDAs:

1) The protein RDA should not be a “one-size-fits-all” recommendation. The standard used to calculate the RDA is based on weight. If you are a woman weighing 127 pounds or a man weighing 155 pounds, you are to be congratulated. But in today’s world the average woman weighs 170 pounds, and the average man weighs 201 pounds.

  • That means the average protein requirement should be 61 gm/day for women and 72 gm/day for men.
  • And that’s just the average. Your protein requirement is based on your weight.

2) As I mentioned earlier, the 0.36 gm/pound standard is based on outdated methodology from the 1930’s. Based on current technology, Dr. Lyon says the standard should be closer to 0.54 gm/pound.

  • If you use that standard and use the current average weight for men and women, the average protein requirement for the couch potato group is closer to 91.5 gm/day for women and 108 gm/day for men.
  • And since protein intake should be divided equally between meals, that amounts to 30 gm/meal for women and 36 gm/meal for men. If you weigh significantly more or less than the average American, you should adjust your intake accordingly.

The Over 50 Group: When we are young muscle protein deposits in the fed state and muscle protein withdrawals during the fasting state are in balance. And if we add exercise and increase our protein intake, it’s pretty easy to increase our muscle mass.

But once we reach our Golden Years things start to change. Muscle protein synthesis becomes less efficient. We need to increase the intensity of our workouts and increase our protein intake just to maintain our muscle mass.

If we fail to do that, we gradually lose muscle mass as we age, a process referred to as sarcopenia. Between 50 and 60 we lose 5-8% of our muscle mass, and the rate that we lose muscle accelerates with each subsequent decade. And that loss of muscle mass has severe consequences. For example:

  • It interferes with daily activities like playing with our grandchildren and engaging in activities we love.
  • It decreases our metabolic rate which increases our risk of obesity and obesity-related diseases.
  • It increases our risk of falls.

In short, our quality of life is diminished, and we become unhealthy and frail.

Dr. Lyon describes the training program needed to prevent sarcopenia as we age in her book Forever Strong. But we also need more protein.

On average older adults need around 35 – 45 gm of protein per meal to prevent sarcopenia. There are not enough published studies for me to provide more specific recommendations. But here are some guidelines:

  • If you are at ideal weight and in your 50’s or 60’s, you can probably do well at the lower end of the range.
  • If you are overweight or in your 70’s or 80’s, you should probably aim for the upper end of the range.
  • I recommend getting a body composition test on an annual basis and adjusting your exercise and protein intake based on your change in muscle mass. My doctor has a simple device for measuring my body composition as part of my annual physical. If your doctor doesn’t have a device like that, find out who does in your community.

Happy woman on scaleThe Weight Loss Group: If you are actively trying to lose excess weight, I congratulate you. But the sad fact is that up to 35% of weight loss on most diets comes from muscle, not fat.

That’s because your body interprets caloric restriction as starvation and increases the rate of protein breakdown.

But you can prevent that by adding resistance training to your diet plan and increasing your protein intake. By increasing your protein intake from 15% of calories (which is what most Americans get) to 30% of calories, you can rebalance muscle metabolism by increasing muscle protein synthesis. When you do this, you can reduce muscle loss to less than 10% of weight loss.

You may be wondering, “Why set the recommendation as a percentage of calories rather than gm/pound or gm/meal”. The answer is simple. Your caloric intake changes significantly you are on a diet, so expressing protein as a percentage of calories makes more sense.

For example, 30% of calories on a 1,000-calorie diet translates into 25-30 gm/meal. You might look at that recommendation and say, “That’s less than you recommended for the couch potato who is not trying to lose weight.” My answer would be, “Yes, but the couch potato is eating 2-3-times more calories.

So, the recommendation that’s easiest to understand if you are trying to lose weight is to aim for 25-30 gm of protein/meal/1,000 calories per day.  

  • Adjust your protein intake per meal based on the daily calories allowed on your diet. 
  • And if you are on a diet that restricts the kinds of food that you can eat or the amount of time you can eat, track your actual caloric intake for a few days. The “hidden secret” behind those diets is that most people eat fewer calories because of the restrictions.

Final thought: The latest data suggest that GLP-1 drugs accelerate the muscle loss associated with dieting. This is a significant concern, especially for people over 50. Some experts are recommending as much as 35-50 gm of protein/meal if you are using a GLP-1 drug to aid your weight loss.

Weight TrainingThe Fitness Group: The question I get most often from the fitness group is, “How much protein do I need after my workout to maximize recovery and muscle gain?” This has been well researched, and the answer is age dependent.

  • If you are in your 30’s, most experts recommend 15-20 grams of protein after your workout.
  • If you are in your 60s, most experts recommend 30-35 grams of protein after your workout.
  • While precise recommendations are not available for every age, you can extrapolate from these numbers.

Does Protein Quality Matter? 

I’m often asked whether all proteins are equally effective at building muscle mass or does protein quality matter? The answer is, “Yes. Protein quality matters, but not in the way that we have thought about it in the past.”

We used to think that protein quality was measured by the balance of all the essential amino acids. While balance is important, the increase in muscle mass is driven primarily by the amino acid leucine. That’s because leucine is the only amino acid that directly stimulates muscle protein synthesis.

Simply put, proteins that are high in leucine are used more efficiently by our bodies to increase muscle mass. In fact, Dr. Lyon measures protein quality solely based on its leucine content.

Many studies have looked at the optimal amount of leucine content in protein. The numbers vary somewhat from study to study, but they average around 1 gram of leucine for every 10 grams of protein.

If you look at the leucine contents of various proteins, it is clear that a 1:10 ratio is primarily found in animal proteins. Soybeans are the only vegetable protein source that comes close.However, there are many health reasons for consuming a primarily plant-based diet. Dr. Lyon doesn’t tell her patients to avoid plant proteins. But if they are consuming primarily plant proteins, she recommends that they increase their protein intake by 35-45%, so they will be getting enough leucine to maximize muscle protein synthesis.

What Role Do Protein Supplements Play? 

Protein SupplementRemember that New York Times article that said protein supplements were useless and perhaps dangerous? That’s outdated advice. In fact, you should view protein supplements as essential for reaching your protein goals.

That’s because our protein intake needs to be divided equally between our 3 major meals, but that’s not how we eat. Most of us have no trouble getting 30-40 grams of protein at dinner, but…

  • We only get around 15 grams of protein at breakfast, and…
  • 15-20 grams of protein at lunch.

But that’s assuming we eat a typical breakfast or lunch. If we eat…

  • An unhealthy breakfast of croissants and coffee or a healthy breakfast of cornflakes, skim milk, and fruit slices, we only get around 6 grams of protein.
  • A healthy green salad for lunch, we may get as little as 2 grams of protein.

A recent study has shown that adding a protein supplement to your low protein meals can help you increase your muscle mass in as little as 24 weeks.

What Does This Mean For You? 

how much protein do athletes needProtein is your longevity nutrient. My advice is:

  • Use the information in this article to set your protein goals (Talk with your doctor first if you have any health issues that may limit your protein intake).
  • Use a simple protein tracker to identify your low-protein meals.
  • Add additional protein foods or supplements to your low-protein meals to bring your protein up to recommended levels.
  • Focus on high-leucine protein foods and supplements. (If you eat more plant protein than animal protein, as I do, increase your recommended protein intake by 35-45% to make sure you are getting the leucine you need to maximize your muscle mass.)

As for what kind of protein supplement, I recommend a plant protein supplement with added leucine.

The Bottom Line 

In her book, “Forever Strong”, Dr. Gabrielle Lyon says, “Adequate muscle mass is essential for health and longevity. And muscle is the only organ over which we have voluntary and complete control.” She goes on to state that the current RDAs for protein intake are outdated. And if we look at protein needs based on the latest research, most Americans aren’t getting enough protein in their diet to achieve adequate muscle mass.

In this article, I summarize her findings. And based on the latest research, I provide protein intake recommendations for:

  • Adult couch potatoes.
  • Fitness enthusiasts.
  • People over 50.
  • People who are trying to lose weight.

I also discuss protein quality and protein supplements.

For more information on these topics and what they mean for you, read the article above.

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

 _____________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

 

Are Weekend Warriors As Healthy As Regular Exercisers?

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What Does This Study Mean For You? 

Author: Dr. Stephen Chaney 

It’s a new year and once again you have set New Year’s goals. If you are like millions of Americans your top 3 goals are probably to eat healthier, exercise more, and lose weight – not necessarily in that order. Now comes the hard part:

  • Setting realistic weight loss goals and developing strategies for achieving those goals.
  • Deciding on food choices and eating behaviors you will change.
  • Deciding on what kind of exercises you will do and how often you will do them.

With respect to exercise, the consensus is clear. We should be aiming for ≥150 minutes of moderate-to-vigorous physical activity per week. But how often should we be exercising? Here the answer is a bit murkier.

Most experts recommend we exercise 3-5 times a week. But that advice doesn’t work for everyone. For some people, their work schedule and family responsibilities make it difficult to find time during the week to exercise.

However, many of these individuals are very active during the weekend with things like yard work, organized sports, long hikes, and/or cycling excursions. We refer to these people as Weekend Warriors.

If you are one of these individuals, you are probably wondering if that’s enough. Are weekend warriors as healthy as people who exercise every day, or must you squeeze some exercise into your busy week?

Some recent studies have suggested that frequency of exercise is not important as long as you exceed the magical 150 minutes per week. However, each of these studies had limitations. For example:

  • They only looked at a few kinds of exercise and a few diseases.
  • Some studies depended on self-assessments of exercise frequency and intensity, which are notoriously unreliable.

The study (Circulation, 150: 1236-1247, 2024) I am reviewing today compares the health outcomes of weekend warriors and people who exercise throughout the week and was designed to eliminate the limitations of previous studies.

How Was This Study Done?

clinical studyThe authors used data obtained from the UK Biobank Study, which is an ongoing study following the health outcomes of individuals from all corners of the United Kingdom who enrolled in the study between 2006 and 2010. Each participant underwent a health assessment when they enrolled.

This study used data from a subset of 89,573 participants (average age 62, percent women 56%) who wore a wrist accelerometer to measure activity levels for one week between June 8, 2013, and December 30, 2015. The accelerometer measured activity levels every 5 seconds, so it was able to record the intensity, frequency, and duration of exercise during the week.

Participants were divided into three groups based on their accelerometer measurements:

  • Inactive: <150 minutes per week of moderate-to vigorous physical activity (34% 0f participants).
  • Weekend Warriors: ≥150 minutes per week of moderate-to vigorous physical activity with the bulk of the activity spread over 1-2 days (42% of participants).
  • Regular Exercisers: ≥150 minutes per week of moderate-to vigorous physical activity with the activity spread over multiple days (24% of participants).

The participants were followed for an average of 6.3 years with 94% of participants having >5 years of follow up. The outcome was frequency of incident diseases (diseases that were not present during the accelerometer measurements but were diagnosed during the follow-up period).

Because the United Kingdom is one of the countries with a “Big Brother knows all” health care system, the investigators were able to correlate the exercise levels of each participant with 678 diseases and health conditions. The study compared the disease incidence of weekend warriors with the inactive group, regular exercisers with the inactive group and weekend warriors with the regular exercisers.

Are Weekend Warriors As Healthy As Regular Exercisers?

Let me start with the big picture and then I will give some specific statistics.

  • Both the weekend warrior and regular exercise patterns were associated with lower risk for >200 diseases compared to the inactive group.
    • For both exercise patterns there were a small number of associations with higher disease risks – primarily musculoskeletal disorders and dermatological conditions (think sports injuries and excessive sun exposure).
    • However, both exercise patterns were associated with a lower risk of over a dozen musculoskeletal conditions such as osteoarthritis and spinal degenerative spinal conditions.
  • While both exercise patterns were associated with the risk of >200 diseases, the risk reduction was greatest for cardiometabolic diseases associated with obesity. For example, the risk reduction for:
    • Hypertension was reduced by 23% and 28%, respectively, for weekend warriors and regular exercisers.
    • Diabetes was reduced by 43% and 46%, respectively, for weekend warriors and regular exercisers.
    • Obesity was reduced by 45% and 56%, respectively, for weekend warriors and regular exercisers.
    • Sleep apnea (which is associated with obesity) was reduced by 43% and 51%, respectively, for weekend warriors and regular exercisers.
    • Chronic renal failure (Chronic renal failure can be caused by a fatty liver, which is associated with obesity) was reduced by 36% and 35%, respectively, for weekend warriors and regular exercisers.
    • Gallstones (which are associated with obesity) were reduced by 36% and 43%, respectively, for weekend warriors and regular exercisers.
  • You will notice that risk reduction was generally greater for regular exercisers than for weekend warriors. That is because the regular exercisers averaged higher weekly totals for moderate-to-vigorous activity levels than weekend warriors. When the two groups were compared at the same weekly activity level, there was no significant difference between the two groups.

What Did The Authors Say About This Study?

The authors discussed the limitations of the study in detail in the discussion section of their paper. The three biggest limitations are:

  • This study measured associations. It does not prove cause and effect.
  • The study only measured exercise patterns and intensities for one week. Some participants may have changed their exercise patterns during the follow-up period.
  • The wrist accelerometer used in this study has been validated for a variety of aerobic activities. It may be less accurate at measuring some strength training exercises. And it will be unable to measure isometric exercises, which have been shown to have some cardiometabolic health benefits.

However, this is a very large, well-designed study which is consistent with several earlier studies.

The authors also expanded on the significance of their findings with these comments:

1) “Efforts to optimize physical activity may be expected to have wide-ranging health benefits that extend beyond previously published associations with cardiovascular disease…We observed strong associations between physical activity and lower risk of up to 264 diseases.”

2) “Our results suggest that the achievement of guideline-adherent physical activity volumes [≥150 minutes per week of moderate-to-vigorous activity] is the key factor relevant to incident disease risk, as opposed to the pattern by which physical activity may be accrued…We did not identify a single condition for which risk appeared substantially different for one pattern versus the other.”

3) “Although we noted beneficial associations across a wide variety of diseases, our findings suggest that physical activity may be particularly effective for modifying risk of cardiometabolic conditions, including hypertension, obesity, diabetes, and sleep apnea.”

The authors concluded, “Achievement of measured physical activity volumes consistent with guideline recommendations [≥150 minutes per week of moderate-to-vigorous activity] is associated with lower risk of >200 diseases, with prominent effects on cardiometabolic conditions. Associations appear to be similar whether the physical activity follows a weekend warrior pattern or is spread more evenly throughout the week.”

What Does This Study Mean For You?

QuestionsThis study has three major take-home messages:

1) If you weren’t already motivated to increase your exercise levels in 2025, this study is a wake-up call. You already know that exercise improves your mood, makes weight control easier, and reduces the risk of major diseases like diabetes, hypertension, and heart disease.

This study just added another 200 reasons to increase your exercise levels. (If you want to know the 200+ diseases that are positively impacted by exercise, read the study.

2) If you are someone whose schedule makes it difficult to find time during the week, this study is good news. This study suggests that weekend warriors can be as fit and healthy as people who exercise daily. However, there are a couple of important caveats:

    • This study used a wrist accelerometer, so it was able to select only those weekend warriors whose total activity exceeded 150 minutes of moderate-to-vigorous activity. Unfortunately, many weekend warriors overestimate how much exercise they get during the weekend. For example:
      • Mowing the lawn is exercise, but the amount of exercise you get is vastly different if you use a riding mower instead of a push mower.
      • Weekend sports are a fun way to exercise, but the amount of exercise you get from an hour of soccer is probably different from an hour of softball.
    • I could go on, but you get the idea. If you choose the weekend warrior route, be realistic about the amount of exercise you are getting.

3) This study found that people who exercised often during the week were likely to accumulate higher weekly totals of activity than weekend warriors. Simply put, it is easier to accumulate higher exercise totals when you exercise more frequently.

So, even if your schedule is busy, it’s worthwhile to try and find some time to exercise during the week rather than limiting all your exercise to the weekend.

The Bottom Line

A recent study asked whether weekend warriors got the same benefits from exercise as people who exercised on multiple days during the week (regular exercisers). The key findings from the study were:

  • Weekly exercise levels of ≥150 minutes of moderate-to-vigorous activity were associated with reduced risk of over 200 diseases.
  • The reduction in risk was greatest for obesity and cardiometabolic diseases like diabetes and hypertension.
  • Once the ≥150 minutes of moderate-to-vigorous activity was reached, there was no significant difference in risk reduction between the weekend warrior and regular exercise patterns of activity.

For more details on this study and what this means for you read the article above.

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

 ______________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance 

___________________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

 

For the past 45 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

Are Calcium Supplements Safe?

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What Does This Study Mean For You?

Author: Dr. Stephen Chaney 

Pendulum
Pendulum

Should you avoid calcium supplements because they increase your risk of heart disease? Some headlines and blog posts would have you believe that. You may have been told that by your doctor. But is it true?

Unfortunately, this is another example of the swinging pendulum that we often see in supplement studies. One day a study comes out saying that calcium supplements increase the risk of heart disease. A few months later another study comes out saying that is not true. Calcium supplements don’t increase heart disease risk.

The pendulum keeps swinging until you are totally confused. You don’t know what to believe. And “experts” (including your doctor) pick one side or the other depending on what they believe about supplements in general.

I have told you before that good scientists wait until multiple studies have been done and base their opinion based on what the preponderance of studies show. I can tell you that multiple studies have been done and the preponderance of studies show that calcium supplements do not increase the risk of heart disease. But that doesn’t prove that calcium supplements are safe. It just shows they are likely to be safe.

That is why the authors of the current study (X Huo et al, Current Developments In Nutrition, volume 7, Issue 3: 100046, March 2023) analyzed the weaknesses of previous studies and tried to design a study that lacked those weaknesses.

How Was This Study Done?

clinical studyThe investigators searched through the literature to identify all placebo-controlled, randomized clinical trials (the gold standard for clinical studies) assessing the effects of calcium supplements alone or calcium supplements with vitamin D on heart disease, stroke, and all-cause mortality.

They restricted their analysis to studies with at least 500 participants that lasted for at least a year. They further restricted their analysis to studies whose authors were willing to share unpublished data on the number of participants in each treatment group who had a heart attack, stroke, or any other kind of heart disease; died from heart disease; or died from all causes during the study.

They ended up with 11 clinical studies in their analysis. The breakdown was as follows:

  • Seven studies with 8,634 participants compared calcium alone with placebo.
    • Participants in these studies averaged 71 years old and were 79% female.
    • The daily calcium dose varied from 1.0 to 1.5 g/day.
    • The mean duration of treatment was 4.1 years (range = 2-5 years).
  • Six studies with 46,804 participants compared calcium plus vitamin D with placebo.
    • Participants in these studies averaged 65 years old and were 98% female.
    • The daily calcium dose varied from 1.0 to 1.5 g/day and the daily vitamin D dose ranged from 400 to 2,000 IU/d.
    • The mean duration of treatment was 6 years (range = 1.5-7 years).
  • In case you were wondering about the math, some studies included both calcium alone versus placebo and calcium plus vitamin D versus placebo.

The authors then combined the data from all 11 studies and performed a meta-analysis on the effect of calcium alone on adverse heart outcomes and calcium plus vitamin D on adverse heart outcomes.

Are Calcium Supplements Safe? 

calcium supplementsThe results were clear-cut.

  • Calcium alone was not significantly associated with any increased risk of heart attack, stroke, heart disease of any kind, deaths from heart disease, and deaths from all causes.
  • Calcium with vitamin D was not significantly associated with any excess risk of heart attack, stroke, heart disease, deaths from heart disease, and deaths from all causes.

In their discussion, the authors pointed out two caveats to their conclusions:

  • In the calcium only portion of the meta-analysis the number of participants who experienced a stroke or types of heart disease other than heart attack and stroke was very small. So, they could not exclude an absolute increased risk of 0.3-0.5% per year for these types of rare events.
  • The participants in the 11 studies included in their meta-analysis were not selected based on their risk of heart disease. So, the authors could not exclude the possibility that calcium supplements might increase the risk of heart disease in people who were already at high risk of heart disease.

The authors concluded, “This meta-analysis demonstrated that calcium supplements were not associated with any significant hazard for heart disease, stroke, or all-cause mortality…Hence, for people with low bone density and low absolute risks of heart disease, the present report demonstrates no concern about excess heart disease risks associated with calcium supplements.

However, further large trials are needed to assess the efficacy and safety of combined supplementation with calcium and vitamin D for the prevention of osteoporotic fracture in older people at high risk of heart disease.”

What Does This Study Mean For You?

Questioning WomanAs I said above, the preponderance of evidence suggests that calcium supplementation does not increase your risk of heart disease. This study reinforces that conclusion.

I can’t guarantee that some future study won’t come to the opposite conclusion, and the pendulum will swing again. And I can’t guarantee that your doctor has kept up with the most recent literature on calcium supplementation and heart disease risk.

The authors of this study also pointed out that we don’t have any clinical studies on the effect of calcium on heart disease risk if you are already at high risk of heart disease. So, if you are at high risk of heart disease, any advice that I or your doctor give you about calcium supplementation might be wrong. We simply don’t know.

Finally, I realize that you may be equally confused about whether calcium supplementation can strengthen your bones and reduce your risk of osteoporosis. I won’t discuss that question today. Instead, I will refer you to two previous articles I have written in “Health Tips From the Professor” on that topic.

The first article discusses the flaws in previous studies claiming that calcium supplements are ineffective at increasing bone density and preventing osteoporotic fracture.

The second article describes a bone-healthy lifestyle.

The Bottom Line

While the preponderance of studies have shown that calcium supplementation does not increase the risk of heart disease, that conclusion remains controversial.

To clarify that issue, a group of investigators searched through the literature to identify all placebo-controlled, randomized clinical trials (the gold standard for clinical studies) assessing the effects of calcium supplements alone or calcium supplements with vitamin D on heart disease, stroke, and all-cause mortality. They then performed a meta-analysis of those clinical studies.

Their meta-analysis showed that:

  • Calcium alone was not significantly associated with any increased risk of heart attack, stroke, heart disease of any kind, deaths from heart disease, and deaths from all causes.
  • Calcium with vitamin D was not significantly associated with any excess risk of heart attack, stroke, heart disease, deaths from heart disease, and deaths from all causes.

This study strengthens the conclusion that calcium supplementation does not increase the risk of heart disease.

For more details about the study and references discussing the effect of calcium supplementation on bone density, read the article above.

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

______________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

_______________________________________________________________________

About The Author

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”. Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 45 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

What Kind Of Protein Is Best For Strength?

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What Kind Of Protein Is Best For You?

Author: Dr. Stephen Chaney 

Sport DrinkEvery bodybuilder “knows” that whey is the best protein for building strong muscles. After all, it:

  • Is absorbed more rapidly than some other proteins.
  • Contains all nine essential amino acids.
  • Is naturally rich in leucine, a branched chain amino acid that stimulates increased muscle mass.

However, as someone who is not a vegan but who follows the vegan literature, I frequently come across testimonials from bodybuilders and elite athletes who say they get all the strength and muscle mass they need from plant proteins.

I’ve always assumed they must have dietitians designing the perfect plant protein diet for them. But a recent study surprised me. It challenged that assumption.

Before I talk about this study, let me change our focus. Most of us will never be bodybuilders or elite athletes, but all of us face a common challenge. We all tend to lose muscle mass as we age, something referred to as sarcopenia. I have discussed this in a previous issue of “Health Tips From the Professor”.

Simply put, sarcopenia results in:

  • Loss of muscle strength. Even the simple act of picking up a grandchild or a bag of groceries can become problematic.
  • Increased risk of falls and fractures.
  • Lower quality of life.

Sarcopenia is a major health issue for those of us in our golden years. If you are younger, it is a concern for your parents or grandparents. Sarcopenia is a health issue that affects everyone.

In my previous article I discussed the role of adequate protein intake and exercise in preventing age-related sarcopenia. But I did not discuss what kind of protein was best for preventing muscle loss, and the frailty that comes with it, as we age.

The article (EA Struijk et al, Journal of Cachexia, Sarcopenia and Muscle, 13: 1752-1761, 2022) I will discuss today suggests that plant protein is best for preventing frailty in women as they age. It’s a surprising conclusion, so join me as I evaluate this study.

How Was This Study Done?

Clinical StudyThe data for this study came from the Nurses Health Study which started in 1976 with 121,700 women nurses and is still ongoing. This study followed 85, 871 female nurses for an average of 22 years starting when they were 60.

Food frequency questionnaires were administered to the participants in the study every four years starting in 1980. The questionnaires were used to calculate:

  • Total calories consumed.
  • Percent of calories from protein, carbohydrate, and fat.
  • Percent of calories from different kinds of protein.
  • The overall quality of the diet.
  • Saturated fat, polyunsaturated fat, cholesterol, and alcohol intake.

For this study the investigators used the cumulative average values from all questionnaires completed by participants in the study from age 60 until the onset of frailty.

Frailty was assessed every four years starting in 1992 using something called the FRAIL scale. The FRAIL scale defines frailty based on five self-reported criteria: fatigue, low strength, reduced aerobic capacity, having 5 or more chronic illnesses, and recent significant unintentional weight loss.

  • It is important to note that strength is only one of the five criteria used to identify frailty, although decreased muscle mass can contribute to lack of energy and reduced aerobic activity.
  • It is also worth pointing out that multiple studies have shown that primarily plant-based diets are associated with a decrease in chronic diseases.

I will come back to both of these points when I discuss the results of this study.

What Kind Of Protein Is Best For Strength? 

I will start with the “big picture” results from this study and then cover some of the important details.

Average intake of:

  • Total protein was 18.3% of calories consumed.
  • Animal protein was 13.3% of calories consumed.
  • Plant protein was 5.0% of calories consumed.
  • Dairy protein was 3.8% of calories consumed.

When protein intake was divided into quintiles (5 equal parts) and women consuming the most protein were compared to those consuming the least protein for an average of 22 years:

  • Those consuming the most total protein had a 7% increased risk of developing frailty.
  • Those consuming the most animal protein had a 7% increased risk of developing frailty. (It is perhaps not surprising that the results were essentially the same for total and animal protein since animal protein was 73% of the total protein consumed by women in this study.)
  • Those consuming the most plant protein had a 14% decreased risk of developing frailty.
  • Consumption of dairy protein did not affect frailty.

Substituting as little as 5% of calories of plant protein for:

  • Dairy protein decreased the risk of developing frailty by 32%.
  • Animal protein decreased the risk of developing frailty by 38%.
  • Non-dairy animal protein (meat, fish, and eggs) decreased the risk of developing frailty by 42%.

In addition, substituting as little as 5% of calories of dairy protein for non-dairy animal protein decreased the risk of developing frailty by 14%.

But, as I said above, the frailty scale used in this study included the criteria of developing 5 or more chronic illnesses, and long-term consumption of plant protein is known to reduce the risk of developing chronic illnesses. So, it is important to break the study down into its component parts. When that was done the statistically significant results were:

  • Those consuming the most total protein had a 7% increased risk of low strength and a 25% increased risk of developing 5 or more chronic diseases.
  • Those consuming the most animal protein had a 9% increased risk of low strength and a 35% increased risk of developing 5 or more chronic diseases.
  • Those consuming the most plant protein had an 18% decreased risk of low strength. (It is interesting to note that plant protein consumption did not have a statistically significant effect on the development of chronic diseases in this study. That suggests that the “protective” effect of plant protein may simply be due to the absence of animal protein from the diet.)
  • Consumption of dairy protein did not affect any of the frailty criteria.

Finally, prevention of strength loss due to age-related sarcopenia is known to require exercise as well as adequate protein intake.

So, it was somewhat surprising that no difference in the association between protein intake and frailty was seen in women with high physical activity compared with those with lower physical activity levels. However, this may be because the range in activity level between the women in this study was relatively small. There didn’t appear to be a significant number of “gym rats” among the women in this study.

What Kind Of Protein Is Best For You?

Questioning WomanOne take-away from this study is clear. If you are a woman and want to minimize sarcopenia (loss of muscle mass and strength as you age), plant protein is an excellent choice.

  • A variety of plant proteins is best, so you get all the essential amino acids.
  • You don’t need to become a vegan. This study showed that replacing as little as 5% of your calories from animal protein with plant protein can have a significant benefit. Any healthy primarily plant-based diet will do.
  • This study enrolled only women aged 60 or above, so we don’t know whether the results apply to men or to younger women.

We don’t know why plant protein is better than animal protein at preventing age-related sarcopenia.

  • It could be because primarily plant-based diets are anti-inflammatory, and inflammation plays a role in sarcopenia.
  • Or it could be because primarily plant-based diets reduced the risk of chronic diseases, and chronic diseases can lead to loss of strength.

To be clear, this is a study that focuses on the type of protein that is best for long-term health and strength as we age. This is not a study of the best protein for increasing muscle mass following a workout.

  • Multiple studies show that whey protein can be a good post-workout choice.
  • However, other studies show that plant protein can also be a good post-workout choice if extra leucine is added to make it equivalent to whey protein in terms of leucine content.

The Bottom Line

You have probably heard that it is all downhill after age 30. But it doesn’t have to be.

One of the downhill slopes we all face is something called sarcopenia (age-related muscle loss). The resulting loss of strength and agility can severely impact our quality of life in our golden years.

We can prevent sarcopenia with the combination of a high protein diet and resistance training (weight bearing exercise).

But what kind of protein is best? In this issue of “Health Tips From the Professor” I review a large, well-designed study that suggests plant protein is the best choice for women if they wish to reduce age-related muscle loss and the weakness that comes with it.

For more details about the study and what it means for you, read the article above.

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

 ______________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

 _____________________________________________________________________

About The Author

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”. Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 45 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

Can You Create Your Personal Fountain Of Youth?

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Can A Healthy Lifestyle Improve Your Healthspan?

Author: Dr. Stephen Chaney

Fountain Of YouthEver since Ponce de Leon led an expedition to the Florida coast in 1513, we have been searching for the mythical “Fountain Of Youth”. What does that myth mean?

Supposedly, just by immersing yourself in that fountain you would be made younger. You would experience all the exuberance and health you enjoyed when you were young. There have been many snake oil remedies over the years that have promised that. They were all frauds.

But what if you had it in your power to live longer and to retain your youthful health for most of those extra years. The ability to live healthier longer is something that scientists call “healthspan”. But you can think of it as your personal “Fountain Of Youth”.

Now comes the important question, “Can a healthy lifestyle improve your healthspan?” We know a healthy lifestyle is good for us. Most of us know what a healthy lifestyle is. But it’s so hard. Is it worth it? Will it actually increase our lifespan? Will it increase our healthspan?

Today I am sharing two studies from the prestigious Harvard T.H. Chan School of Public Health that answer those questions.

How Were The Studies Done?

clinical studyThese studies started by combining the data from two major clinical trials:

  • The Nurse’s Health Study, which ran from 1980 to 2014.
  • The Health Professional’s Follow-Up Study, which ran from 1986-2014.

These two clinical trials enrolled 78,865 women and 42,354 men and followed them for an average of 34 years. During this time there were 42,167 deaths. All the participants were free of heart disease, type 2 diabetes, and cancer at the time they were enrolled. Furthermore, the design of these clinical trials was extraordinary.

  • A detailed food frequency questionnaire was administered every 2-4 years. This allowed the investigators to calculate cumulative averages of all dietary variables.
  • Participants also filled out questionnaires that captured information on disease diagnosis every 2 years with follow-up rates >90%. This allowed the investigators to measure the onset of disease for each participant during the study. More importantly, 34 years is long enough to measure the onset of diseases like heart disease, diabetes, and cancer – diseases that require decades to develop.
    • The questionnaires also captured information on medicines taken and lifestyle characteristics such as body weight, exercise, smoking and alcohol use.
  • For analysis of diet quality, the investigators use something called the “Alternative Healthy Eating Index”. [The original Healthy Eating Index was developed about 10 years ago based on the 2010 “Dietary Guidelines for Americans”. Those guidelines have since been updated, and the “Alternative Healthy Eating Index” is based on the updated guidelines.] You can calculate your own Alternative Healthy Eating Index below, so you can see what is involved.
  • Finally, the investigators included five lifestyle-related factors – diet, smoking, physical activity, alcohol consumption, and BMI (a measure of obesity) – in their estimation of a healthy lifestyle. Based on the best available evidence, they defined “low-risk” in each of these categories. Study participants were assigned 1 point for each low-risk category they achieved. Simply put, if they were low risk in all 5 categories, they received a score of 5. If they were low risk in none of the categories, they received a score of 0.
  • Low risk for each of these categories was defined as follows:
    • Low risk for a healthy diet was defined as those who scored in the top 40% in the Alternative Healthy Eating Index.
    • Low risk for smoking was defined as never smoking.
    • Low risk for physical activity was defined as 30 minutes/day of moderate or vigorous activities.
    • Low risk for alcohol was defined as 0.5-1 drinks/day for women and 0.5-2 drinks/day for men.
    • Low risk for weight was defined as a BMI in the healthy range (18.5-24.9 kg/m2).

Can A Healthy Lifestyle Improve Your Healthspan?

Older Couple Running Along BeachThe investigators compared participants who scored as low risk in all 5 categories with participants who scored as low risk in 0 categories (which would be typical for many Americans). For simplicity, I will refer to people who scored as low risk in 5 categories as having a “healthy lifestyle” and those who scored as low risk in 0 categories as having an “unhealthy lifestyle”.

The results of the first study were:

  • Women who had had a healthy lifestyle lived 14 years longer than women with an unhealthy lifestyle (estimated life expectancy of 93 versus 79).
  • Men who had a healthy lifestyle lived 12 years longer than men with an unhealthy lifestyle (estimated life expectancy was 87 versus 75).
  • It was not necessary to achieve a perfect lifestyle. Life expectancy increased in a linear fashion for each low-risk lifestyle behavior achieved.

The authors of the study concluded: “Adopting a healthy lifestyle could substantially reduce premature mortality and prolong life expectancy in US adults. Our findings suggest that the gap in life expectancy between the US and other developed countries could be narrowed by improving lifestyle factors.”

The results of the second study were:

  • Women who had a healthy lifestyle lived 11 years longer free of diabetes, heart disease, and cancer than women who had an unhealthy lifestyle (estimated disease-free life expectancy of 85 years versus 74 years).
  • Men who had a healthy lifestyle lived 8 years longer free of diabetes, heart disease, and cancer than men who had an unhealthy lifestyle (estimated disease-free life expectancy of 81 years versus 73 years).
  • Again, disease-free life expectancy increased in a linear fashion for each low-risk lifestyle behavior achieved.

The authors concluded: “Adherence to a healthy lifestyle at mid-life [They started their analysis at age 50] is associated with a longer life expectancy free of major chronic diseases. Our findings suggest that promotion of a healthy lifestyle would help reduce healthcare burdens through lowering the risk of developing multiple chronic diseases, including cancer, cardiovascular disease, and diabetes, and extending disease-free life expectancy.”

Can You Create Your Personal Fountain Of Youth?

questionsI posed the question at the beginning of this article, “Can you create your personal Fountain Of Youth”?” These two studies showed that you can improve both your life expectancy and your disease-free life expectancy by simply changing your lifestyle. So, the answer to the original question appears to be, “Yes, you can improve your healthspan. You can create your personal “Fountain of Youth.”

However, as a nation we appear to be moving in the wrong direction. The percentage of US adults adhering to a healthy lifestyle has decreased from 15% in 1988-1992 to 8% in 2001-2006.

Finally, I know you have some questions, and I have answers.

Question: What about supplementation? Will it also improve my healthspan?

Answer: When the investigators analyzed the data, they found that those with the healthiest lifestyles were also more likely to be taking a multivitamin. So, they attempted to statistically eliminate any effect of supplement use on the outcomes. That means these studies cannot answer that question.

However, if you calculate your Alternate Healthy Eating Index below, you will see that most of us fall short of perfection. Supplementation can fill in the gaps.

Question: I cannot imagine myself reaching perfection in all 5 lifestyle categories? Should I even try to achieve low risk in one or two categories?

Answer: The good news is that there was a linear increase in both life expectancy and disease-free life expectancy as people went from low-risk in one category to low-risk in all 5 categories. I would encourage you to try and achieve low risk status in as many categories as possible, but very few of us, including me, achieve perfection in all 5 categories.

Question: I am past 50 already. Is it too late for me to improve my healthspan?

Answer: Diet and some of the other lifestyle behaviors were remarkably constant over 34 years in both the Nurse’s Health Study and the Health Professional’s Follow-Up Study. That means that the lifespan and healthspan benefits reported in these studies probably resulted from adhering to a healthy lifestyle for most of their adult years.

However, it is never too late to start improving your lifestyle. You may not achieve the full benefits described in these studies, but you still can add years and disease-free years to your life.

How To Calculate Your Alternative Healthy Eating Index 

You can calculate your own Alternative Healthy Eating Index score by simply adding up the points you score for each food category below.

Vegetables

Count 2 points for each serving you eat per day (up to 5 servings).

One serving = 1 cup green leafy vegetables or ½ cup for all other vegetables.

Do not count white potatoes or processed vegetables like French fries or kale chips.

Fruits

Count 2½ points for each serving you eat per day (up to 4 servings).

One serving = 1 piece of fruit or ½ cup of berries.

          (do not count fruit juice or fruit incorporated into desserts or pastries). 

Whole Grains

Count 2 points for each serving you eat per day (up to 5 servings).

One serving = ½ cup whole-grain rice, bulgur and other whole grains, cereal, and pasta or 1 slice of bread.

(For processed foods like pasta and bread, the label must say 100% whole grain).

Sugary Drinks and Fruit Juice

Count 10 points if you drink 0 servings per week.

Count 5 points for 3-4 servings per week (½ serving per day).

Count 0 points for 7 or more servings per week (≥1 serving per day).

One serving = 8 oz. fruit juice, sugary soda, sweetened tea, coffee drink, energy drink, or sports drink.

Nuts and Beans

Count 10 points if you eat 7 or more servings per week (≥1 serving per day).

Count 5 points for 3-4 servings per week (½ serving per day).

Count 0 points for 0 servings per week.

One serving = 1 oz. nuts or seeds, 1 Tbs. peanut butter, ½ cup beans, 3½ oz. tofu.

Red and Processed Meat

Count 10 points if you eat 0 servings per week.

Count 7 points for 3-4 servings per week (½ serving per day).

Count 3 points for 3 servings per week (1 serving per day).

Count 0 points for ≥1½ servings per day.

One serving = 1½ oz. processed meats (bacon, ham, sausage, hot dogs, deli meat)

          Or 4 oz. red meat (steak, hamburger, pork chops, lamb chops, etc.)

Seafood

Count 10 points if you eat 2 servings per week.

Count 5 points for 1 serving per week.

Count 0 points for 0 servings per week.

1 serving = 4 oz.

Now that you have your total, the scoring system is:

  • 41 or higher is excellent
  • 37-40 is good
  • 33-36 is average (remember that it is average to be sick in this country)
  • 28-32 is below average
  • Below 28 is poor

Finally, for the purposes of these two studies, a score of 37 or higher was considered low risk.

The Bottom Line 

Two recent studies have developed a healthy lifestyle score based on diet, exercise, body weight, smoking, and alcohol use. When they compared the effect of lifestyle on both lifespan (life expectancy) and healthspan (disease-free life expectancy), they reported:

  • Women who had had a healthy lifestyle lived 14 years longer than women with an unhealthy lifestyle.
  • Men who had a healthy lifestyle lived 12 years longer than men with an unhealthy lifestyle.
  • Women who had a healthy lifestyle lived 11 years longer free of diabetes, heart disease, and cancer than women had an unhealthy lifestyle.
  • Men who had a healthy lifestyle lived 8 years longer free of diabetes, heart disease, and cancer than men who had an unhealthy lifestyle.
  • It is not necessary to achieve a perfect lifestyle. Lifespan and healthspan increased in a linear fashion for each low-risk lifestyle behavior (diet, exercise, body weight, smoking, and alcohol use) achieved.
  • These studies did not evaluate whether supplement use also affects healthspan.
    • However, if you calculate your diet with the Alternate Healthy Eating Index they used (see above), you will see that most of us fall short of perfection. Supplementation can fill in the gaps.

The authors concluded: “Our findings suggest that promotion of a healthy lifestyle would help reduce healthcare burdens through lowering the risk of developing multiple chronic diseases, including cancer, cardiovascular disease, and diabetes, and extending disease-free life expectancy.”

For more details, including how to calculate your Alternative Healthy Eating Index, read the article above.

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

Does Olive Oil Help You Live Longer?

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Which Fat Is Healthiest?

Author: Dr. Stephen Chaney

If you believe the headlines, olive oil is a superfood. It is often described as the star of the Mediterranean diet. It is referred to as the healthiest of dietary fats. Is this true, or is it hype?

Olive oil’s resume is impressive:

  • It is rich in monounsaturated fatty acids, which…
    • Are less susceptible to oxidation than polyunsaturated oils.
    • Make our arteries more flexible, which lowers blood pressure.
    • Lower LDL-cholesterol levels, which reduces the risk of heart disease.
  • Extra-virgin olive oil contains phytonutrients and tocopherols (various forms of vitamin E), which…
    • Have anti-inflammatory properties.
    • Improve insulin sensitivity and blood sugar control.
  • Olive oil consumption is also associated with healthier gut bacteria, but it is not clear whether this is due to olive oil or to the fact that a Mediterranean diet is also richer in fresh fruits, vegetables, and whole grains.

Several recent studies have shown that olive oil consumption is associated with a lower risk of heart disease. However, these studies were conducted in Mediterranean countries where the average intake of olive oil (3 tablespoons/day) is much greater than in the United States (0.3 tablespoons/day).

The current study (M Guasch-Ferré et al, Journal of the American College of Cardiology, 79: 101-112, 2022) was designed to test whether:

  • The amount of olive oil Americans consume decreases the risk of heart disease.
  • Whether olive oil consumption had benefits beyond a reduction in heart disease risk.

How Was This Study Done? 

Clinical StudyThis study combined data from 60,582 women enrolled in the Nurses’ Health Study and 31,801 men enrolled in the Health Professionals Follow-Up Study). The participants:

  • Were free of heart disease and diabetes at the start of the study.
  • Were 56 at the start of the study with an average BMI of 25.6 (Individuals with BMIs in the 25-30 range are considered overweight, so they were at the lowest end of the overweight range).

The Nurses’ Health Study and Health Professional Follow-Up Study are both association studies, meaning they looked at the association between olive oil consumption and health outcomes. They cannot directly prove cause and effect. However, they are very strong association studies because:

  • Every 2 years, participants filled out a questionnaire that updated information on their body weight, smoking status, physical activity, medications, multivitamin use, and physician-diagnosed diseases.
  • Every 4 years, participants filled out a comprehensive food frequency questionnaire.
  • In other words, this study did not just rely on the participant’s lifestyle, dietary intake, and health at the beginning of the study, as so many association studies do. It tracked how each of these variables changed over time.

The participants were followed for an average of 28 years and their average olive oil intake over those 28 years was correlated with all-cause mortality and mortality due to specific diseases.

  • Deaths were identified from state vital statistics, the National Death index, reports by next of kin, or reports by postal authorities.
  • Causes of death were determined by physician review of medical records, medical reports, autopsy reports, or death certificates.

Does Olive Oil Help You Live Longer?

During the 28 years of this study:

  • Olive oil consumption in the United States increased from an average of ~1/3 teaspoon/day to ~1/3 tablespoon/day.
  • Margarine consumption decreased from 12 g/day to ~4 g/day.
  • The consumption of all other fats and oils remained about the same.

As I mentioned above, olive oil consumption was averaged over the life of the study for each individual. When the investigators compared people consuming the highest amount of olive oil (>0.5 tablespoon/day) with people consuming the least olive oil (0 to 1 teaspoon/day):

  • Mortality from all causes was decreased by 35% for the group consuming the most olive oil.

However, the group consuming the most olive oil also was more physically active, had a healthier diet, and consumed more fruits and vegetables than the group who consumed the least olive oil.

  • After correcting for all those factors, mortality from all causes was decreased by 19% for the group consuming the most olive oil.

The authors concluded, “We found that greater consumption of olive oil was associated with lower risk of total…mortality… Our results support current dietary recommendations to increase the intake of olive oil…to improve overall health and longevity.” (I will fill in the blanks in this statement once I have covered other aspects of this study)

The authors also said, “Of note, our study showed that benefits of olive oil can be observed even when consumed in lower amounts than in Mediterranean countries.”

Are There Other Benefits From Olive Oil Consumption?

Mediterranean dietThe study didn’t stop there. The investigators also looked at the effect of olive oil consumption on the major killer diseases in the United States and other developed countries. When they compared the effect of olive oil consumption on cause-specific mortality, they found that the group who consumed the most olive oil reduced their risk of dying from:

  • Cardiovascular disease by 19%.
  • Cancer by 17%
  • Respiratory disease by 18%.
  • Neurodegenerative disease (cognitive decline and Alzheimer’s disease) by 29%.
    • The reduction in neurodegenerative disease was much greater for women (34% decrease) than for men (19% decrease).

With this information I can fill in one of the blanks in the author’s conclusions: “We found that greater consumption of olive oil was associated with lower risk of total and cause-specific mortality… Our results support current dietary recommendations to increase the intake of olive oil…to improve overall health and longevity.”

Which Fats Are Healthiest?

Good Fat vs Bad FatThe sample size was large enough and the dietary information complete enough for the investigators to also estimate the effect of substituting olive oil for other dietary fats and oils.

They found that every ¾ tablespoon of olive oil substituted for an equivalent amount of:

  • Margarine decreased total mortality by 13%.
  • Butter decreased total mortality by 14%.
  • Mayonnaise deceased total mortality by 19%
  • Dairy fat decreased total mortality by 13%.
    • The same beneficial effects of substituting olive oil for other fats were seen for cause-specific mortality (cardiovascular disease, cancer, respiratory disease, and neurodegenerative disease).
    • There was a linear dose-response. This means that substituting twice as much olive oil for other dietary fats doubled the beneficial effects on total and cause-specific mortality.
  • However, substituting olive oil for polyunsaturated vegetable oils had no effect on total and cause-specific mortality.

Now I can fill in the remaining blanks in the author’s conclusion: “We found that greater consumption of olive oil was associated with lower risk of total and cause-specific mortality. Replacing other types of fat, such as margarine, butter, mayonnaise, and dairy fat, with olive oil was also associated with a lower risk of mortality. Our results support current dietary recommendations to increase the intake of olive oil and other unsaturated vegetable oils in place of other fats to improve overall health and longevity.”

What Does This Study Mean For Us?

ConfusionAs I said above, this is an association study, and association studies do not prove cause and effect. However:

1) This is a very strong association study because:

    • It is a very large study (92,383 participants).
    • It followed the participants over a long time (28 years).
    • It utilized a very precise dietary analysis.
    • Most importantly, it tracked the participant’s lifestyle, dietary intake, and health at regular intervals throughout the study. Most association studies only measure these variables at the beginning of the study. They have no idea how they change over time.

2) This study is consistent with several previous studies showing that olive oil consumption decreases the risk of dying from heart disease.

3) This study draws on its large population size and precise dietary analysis to strengthen and extend the previous studies. For example:

    • The study showed that increased olive oil consumption also reduced total mortality and mortality due to cancer, respiratory disease, and neurodegenerative disease.
    • The study measured the effect of substituting olive oil for other common dietary fats.
    • The study showed that increased olive oil consumption in the context of the American diet was beneficial.

I should point out that the headlines you have seen about this study may be misleading.

  • While the headlines may have depicted olive oil as a superfood, this study did not find evidence that olive oil was more beneficial than other unsaturated vegetable oils. Again, this is consistent with many previous studies showing that substituting vegetable oils for other dietary fats reduces the risk of multiple diseases.
  • The headlines focused on the benefits of increasing olive oil consumption. However, they neglected the data showing that increasing olive oil (and other vegetable oils) was even more beneficial (35% reduction in total mortality) in the context of a healthy diet – one with increased intake of fruits, vegetables, whole grains, nuts, legumes, and long-chain omega-3s and decreased intake of red & processed meats, sodium, and trans fats.

So, my recommendation is to follow a whole food, primarily plant-based diet and substitute extra-virgin olive oil and cold pressed vegetable oils for some of the animal fats in your diet.

Some vegan enthusiasts recommend a very low-fat whole food plant-based diet. They point to studies showing that such diets can actually reverse atherosclerosis. However:

  • Those studies are very small.
  • The overall diet used in those studies is a very healthy plant-based diet.
  • The studies did not include a control group following the same diet with olive oil or other vegetable oils added to it, so there is no comparison of a healthy vegan diet with and without vegetable oils.

If you have read my book, “Slaying the Food Myths”, you know that my recommendations encompass a variety of whole food, primarily plant-based diets ranging all the way from very-low fat vegan diets to Mediterranean and DASH diets. Choose the one that best fits your food preferences and the one you will be most able to stick with long term. You will be healthier, and you may live longer.

The Bottom Line

A recent study looked at the effect of olive oil consumption on the risk dying from all causes and from heart disease, cancer, respiratory disease, and neurodegenerative diseases. When the study compared people consuming the highest amount of olive oil (>0.5 tablespoon/day) with people consuming the least olive oil (0 to 1 teaspoon/day):

  • Mortality from all causes was decreased by 19% for the group consuming the most olive oil.

They also found that the group who consumed the most olive oil reduced their risk of dying from:

  • Cardiovascular disease by 19%.
  • Cancer by 17%
  • Respiratory disease by 18%.
  • Neurodegenerative disease (cognitive decline and Alzheimer’s disease) by 29%.

They also found that every ¾ tablespoon of olive oil substituted for an equivalent amount of:

  • Margarine decreased total mortality by 13%.
  • Butter decreased total mortality by 14%.
  • Mayonnaise deceased total mortality by 19%
  • Dairy fat decreased total mortality by 13%.
  • However, substituting olive oil for polyunsaturated vegetable oils had no effect on total and cause-specific mortality.

The authors concluded, “We found that greater consumption of olive oil was associated with lower risk of total and cause-specific mortality. Replacing other types of fat, such as margarine, butter, mayonnaise, and dairy fat, with olive oil was also associated with a lower risk of mortality. Our results support current dietary recommendations to increase the intake of olive oil and other unsaturated vegetable oils in place of other fats to improve overall health and longevity.”

For more details and a summary of what this study means for you, read the article above.

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

Can Vegans Have Strong Bones?

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When Is Supplementation Important? 

Author: Dr. Stephen Chaney

Healthy BoneWhole food, vegan diets are incredibly healthy.

  • They have a low caloric density, which can help you maintain a healthy weight.
  • They are anti-inflammatory, which can help prevent all the “itis” diseases.
  • They are associated with reduced risk of diabetes, heart disease, and some cancers.
  • Plus a recent study has shown that vegans age 60 and older require 58% fewer medications than people consuming non-vegetarian diets.

But vegan diets are incomplete, and as I have said previously, “We have 5 food groups for a reason”. Vegan diets tend to be low in several important nutrients, but for the purposes of this article I will focus on calcium and vitamin D. Vitamin D is a particular problem for vegans because mushrooms are the only plant food that naturally contain vitamin D, and the vitamin D found in mushrooms is in the less potent D2 form.

Calcium and vitamin D are essential for strong bones, so it is not surprising that vegans tend to have less dense bones than non-vegans. But are these differences significant? Are vegans more likely to have broken bones than non-vegans?

That is the question the current study (DL Thorpe et al, American Journal of Clinical Nutrition, 114: 488-495, 2021) was designed to answer. The study also asked whether supplementation with calcium and vitamin D was sufficient to reduce the risk of bone fracture in vegans.

How Was This Study Done?

Clinical StudyThe data for this study were obtained from the Adventist Health Study-2. This is a study of ~96,000 members of the Seventh-day Adventist Church in North America who were recruited into the study between 2002 and 2007 and followed for up to 15 years.

Seventh-day Adventists are a good group for this kind of study because the Adventist church advocates a vegan diet consisting of legumes, whole grains, nuts, fruits, and vegetables. However, it allows personal choice, so a significant number of Adventists choose modifications of the vegan diet and 42% of them eat a nonvegetarian diet.

This diversity allows studies of the Adventist population to not only compare a vegan diet to a nonvegetarian diet, but also to compare it with the various forms of vegetarian diets.

This study was designed to determine whether vegans had a higher risk of hip fractures than non-vegan Adventists. It was performed with a sub-population of the original study group who were over 45 years old at the time of enrollment and who were white, non-Hispanic. The decision to focus on the white non-Hispanic group was made because this is the group with the highest risk of hip fractures after age 45.

At enrollment into the study all participants completed a comprehensive lifestyle questionnaire which included a detail food frequency questionnaire. Based on the food frequency questionnaire participants were divided into 5 dietary patterns.

  • Vegans (consume only a plant-based diet).
  • Lacto-ovo-vegetarian (include dairy and eggs in their diet).
  • Pesco-vegetarians (include fish as well as dairy and eggs in their diet).
  • Semi-vegetarians (include fish and some non-fish meat (primarily poultry) as well as dairy and eggs in their diet).
  • Non-vegetarians (include all meats, dairy, and eggs in their diet). Their diet included 58% plant protein, which is much higher than the typical American diet, but much less than the 96% plant protein consumed by vegans.

Every two years the participants were mailed follow-up questionnaires that included the question, “Have you had any fractures (broken bones) of the wrist or hip after 2001? Include only those that came from a fall or minor accident.”

Can Vegans Have Strong Bones?

Unhealthy BoneThe results of this study were striking.

  • When men and women were considered together there was an increasing risk of hip fracture with increasing plant-based diet patterns. But the differences were not statistically significant.
  • However, the effect of diet pattern on the risk of hip fractures was strongly influenced by gender.
    • For men there was no association between diet pattern and risk of hip fractures.
    • For women there was an increased risk of hip fractures across the diet continuum from nonvegetarians to vegans, with vegan women having a 55% higher risk of hip fracture than nonvegetarian women.
  • The increased risk of hip fractures in vegan women did not appear to be due to other lifestyle differences between vegan women and nonvegetarian women. For example:
    • Vegan women were almost twice as likely to walk more than 5 miles/week than nonvegetarian women.
    • Vegan women consumed more vitamin C and magnesium, which are also important for strong bones, than nonvegetarian women.
    • Vegan women got the same amount of daily sun exposure as nonvegetarian women.
  • The effect of diet pattern on the risk of hip fractures was also strongly influenced by supplementation with Calcium Supplementcalcium and vitamin D.
    • Vegan women who did not supplement with calcium and vitamin D had a 3-fold higher risk of hip fracture than nonvegetarian women who did not supplement.
    • Vegan women who supplemented with calcium and vitamin D (660 mg/day of calcium and 13.5 mcg/day of vitamin D on average) had no increased risk of hip fracture compared to nonvegetarian women who supplemented with calcium and vitamin D.
  • In interpreting this study there are a few things we should note.
    • The authors attributed the lack of an effect of a vegan diet on hip fracture risk in men to anatomical and hormonal differences that result in higher bone density for males.
    • In addition, because the average age of onset of osteoporosis is 15 years later for men than for women, this study may not have been adequately designed to measure the effect of a vegan diet on hip fracture in men. Ideally, the study should have enrolled participants who were at least 60 or older if it wished to detect an effect of diet on hip fractures in men.
    • Finally, because the study enrolled only white, non-Hispanic women into the study, it does not tell us the effect of a vegan diet on women of other ethnicities. Once again, if there is an effect, it would likely occur at an older age than for white, non-Hispanic women.

The authors concluded, “Without combined supplementation of both vitamin D and calcium, female vegans are at high risk of hip fracture. However, with supplementation the excessive risk associated with vegans disappeared.”

Simply put, vegan diets are very healthy. They reduce the risk of heart disease, high blood pressure, diabetes, some cancers, and inflammatory diseases.

However, the bad news is:

  • Vegan women have a lower intake of both calcium and vitamin D than nonvegetarian women.
  • Vegan women have lower bone density than nonvegetarian women.
  • Vegan women have a higher risk of hip fracture than nonvegetarian women.

The good news is:

  • Supplement with calcium and vitamin D eliminates the increased risk of hip fracture for vegan women compared to nonvegetarian women.

When Is Supplementation Important?

Supplementation PerspectiveMuch of the controversy about supplementation comes from a “one size fits all” mentality. Supplement proponents are constantly proclaiming that everyone needs nutrient “X”. And scientists are constantly proving that everyone doesn’t need nutrient “X”. No wonder you are confused.

I believe in a more holistic approach for determining whether certain supplements are right for you. Dietary insufficiencies, increased need, genetic predisposition, and diseases all affect your need for supplementation, as illustrated in the diagram on your left. I have discussed this approach in more detail in a previous issue (https://www.chaneyhealth.com/healthtips/do-you-need-supplements/) of “Health Tips From the Professor”.

But today I will just focus on dietary insufficiencies.

  • Most Americans consume too much highly processed fast and convenience foods. According to the USDA, we are often getting inadequate amounts of calcium, magnesium, and vitamins A, D, E and C. Iron is also considered a nutrient of concern for young children and pregnant women.
  • According to a recent study, regular use of a multivitamin is sufficient to eliminate most these deficiencies except for calcium, magnesium, and vitamin D. A well-designed calcium, magnesium and vitamin D supplement may be needed to eliminate those deficiencies.
  • In addition, intake of omega-3 fatty acids from foods appears to be inadequate in this country. Recent studies have found that American’s blood levels of omega-3s are among the lowest in the world and only half of the recommended level for reducing the risk of heart disease. Therefore, omega-3 supplementation is often a good idea.

Ironically, “healthy” diets are not much better when it comes to dietary insufficiencies. That is because many of these diets eliminate one or more food groups. And, as I have said previously, we have 5 food groups for a reason.

Take the vegan diet, for example:

  • There is excellent evidence that whole food, vegan diets reduce the risk of heart disease, diabetes, inflammatory diseases, and some cancers. It qualifies as an incredibly healthy diet.
  • However, vegan diets exclude dairy and meats. They are often low in protein, vitamin B12, vitamin D, calcium, iron, zinc, and long chain omega-3 fatty acids. Supplementation with these nutrients is a good idea for people following a vegan diet.
  • The study described above goes one step further. It shows that supplementation with calcium and vitamin D may be essential for reducing the risk of hip fractures in vegan women.

There are other popular diets like Paleo and keto which claim to be healthy even though there are no long-term studies to back up that claim.

  • However, those diets are also incomplete. They exclude fruits, some vegetables, grains, and most plant protein sources.
  • A recent study reported that the Paleo diet increased the risk of calcium, magnesium, iodine, thiamin, riboflavin, folate, and vitamin D deficiency. The keto diet is even more restrictive and is likely to create additional deficiencies.
  • And it is not just nutrient deficiencies that are of concern when you eliminate plant food groups. Plants also provide a variety of phytonutrients that are important for optimal health and fiber that supports the growth of beneficial gut bacteria.

In short, the typical American diet has nutrient insufficiencies. “Healthy” diets that eliminate food groups also create nutrient insufficiencies. Supplementation can fill those gaps.

The Bottom Line

Vegan diets are incredibly healthy, but:

  • They eliminate two food groups – dairy, and meat protein.
  • They have lower calcium and vitamin D intake than nonvegetarians.
  • They also have lower bone density than nonvegetarians.

The study described in this article was designed to determine whether vegans also had a higher risk of bone fractures. It found:

  • Vegan women who don’t supplement have a 3-fold higher risk of hip fracture than nonvegetarian women.
  • The increased risk of hip fractures in vegan women did not appear to be due to other lifestyle differences between vegan women and nonvegetarian women.
  • Supplementation with calcium and vitamin D (660 mg/day of calcium and 13.5 mcg/day of vitamin D on average) eliminated the difference in risk of hip fracture between vegan women and nonvegetarian women.

In the article above I discuss the importance of supplementation in assuring diets are nutritionally complete.

  • In short, the typical American diet has nutrient insufficiencies. “Healthy” diets that eliminate food groups also create nutrient insufficiencies. Supplementation can fill those gaps.

For more details about the study and a discussion of which supplements may be needed to assure nutritionally adequate diets, read the article above.

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

Are Vegan Diets Bad For Your Bones?

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The Secrets To A Healthy Vegan Diet

Author: Dr. Stephen Chaney

Frail ElderlyOsteoporosis is a debilitating and potentially deadly disease associated with aging. It affects 54 million Americans. It can cause debilitating back pain and bone fractures. 50% of women and 25% of men over 50 will break a bone due to osteoporosis. Hip fractures in the elderly due to osteoporosis are often a death sentence.

As I discussed in a previous issue of “Health Tips From The Professor”, a “bone-healthy lifestyle requires 3 essentials – calcium, vitamin D, and weight bearing exercise. If any of these three essentials is presence in inadequate amounts, you can’t build healthy bones. In addition, other nutrients such as protein, magnesium, zinc, vitamin B12, and omega-3 fatty acids may play supporting roles.

Vegan and other plant-based diets are thought to be very healthy. They decrease the risk of heart disease, diabetes, and some cancers. However, vegan diets tend to be low in calcium, vitamin D, zinc, vitamin B12, protein, and omega-3 fatty acids. Could vegan diets be bad for your bones?

A meta-analysis of 9 studies published in 2009 (LT Ho-Pham et al, American Journal of Clinical Nutrition 90: 943-950, 2009) reported that vegans had 4% lower bone density than omnivores, but concluded this difference was “not likely to be clinically relevant”.

However, that study did not actually compare bone fracture rates in vegans and omnivores. So, investigators have followed up with a much larger meta-analysis (I Iguacel et al, Nutrition Reviews 77, 1-18, 2019) comparing both bone density and bone fracture rates in vegans and omnivores.

How Was This Study Done?

Clinical StudyThe investigators searched the literature for all human clinical studies through November 2017 that compared bone densities and frequency of bone fractures of people consuming vegan and/or vegetarian diets with people consuming an omnivore diet.

  • Vegan diets were defined as excluding all animal foods.
  • Vegetarian diets were defined as excluding meat, poultry, fish, seafood, and flesh from any animal but including dairy foods and/or eggs. [Note: The more common name for this kind of diet is lacto-ovo vegetarian, but I will use the author’s nomenclature in this review.]
  • Omnivore diets were defined as including both plant and animal foods from every food group.

The investigators ended up with 20 studies that had a total of 37,134 participants. Of the 20 studies, 9 were conducted in Asia (Taiwan, Vietnam, India, Korea, and Hong-Kong), 6 in North America (the United States and Canada), and 4 were conducted in Europe (Italy, Finland, Slovakia, and the United Kingdom).

Are Vegan Diets Bad For Your Bones?

Here is what the investigators found:

Unhealthy BoneBone density: The clinical studies included 3 different sites for bone density measurements – the lumbar spine, the femoral neck, and the total body. When they compared bone density of vegans and vegetarians with the bone density of omnivores, here is what they found:

Lumbar spine:

    • Vegans and vegetarians combined had a 3.2% lower bone density than omnivores.
    • The effect of diet was stronger for vegans (7% decrease in bone density) than it was for vegetarians (2.3% decrease in bone density).

Femoral neck:

    • Vegans and vegetarians combined had a 3.7% lower bone density than omnivores.
    • The effect of diet was stronger for vegans (5.5% decrease in bone density) than it was for vegetarians (2.5% decrease in bone density).

Whole body:

    • Vegans and vegetarians combined had a 3.2% lower bone density than omnivores.
    • The effect of diet was statistically significant for vegans (5.9% decrease in bone density) but not for vegetarians (3.5% decrease in bone density). [Note: Statistical significance is not determined by how much bone density is decreased. It is determined by the size of the sample and the variations in bone density among individuals in the sample.]

Bone FractureBone Fractures: The decrease in bone density of vegans in this study was similar to that reported in the 2009 study I discussed above. However, rather than simply speculating about the clinical significance of this decrease in bone density, the authors of this study also measured the frequency of fractures in vegans, vegetarians, and omnivores. Here is what they found.

  • Vegans and vegetarians combined had a 32% higher risk of bone fractures than omnivores.
  • The effect of diet on risk of bone fractures was statistically significant for vegans (44% higher risk of bone fracture) but not for vegetarians (25% higher risk of bone fractures).
  • These data suggest the decreased bone density in vegans is clinically significant.

The authors concluded, “The findings of this study suggest that both vegetarian and vegan diets are associated with lower bone density compared with omnivorous diets. The effect of vegan diets on bone density is more pronounced than the effect of vegetarian diets, and vegans have a higher fracture risk than omnivores. Both vegetarian and vegan diets should be appropriate planned to avoid dietary deficiencies associated with bone health.”

The Secrets To A Healthy Vegan Diet

Emoticon-BadThe answer to this question lies in the last statement in the author’s conclusion, “Both vegetarian and vegan diets should be appropriate planned to avoid dietary deficiencies associated with bone health.” 

The problem also lies in the difference between what a nutrition expert considers a vegan diet and what the average consumer considers a vegan diet. To the average consumer a vegan diet is simply a diet without any animal foods. What could go wrong with that definition? Let me count the ways.

  1. Sugar and white flour are vegan. A vegan expert thinks of a vegan diet as a whole food diet – primarily fruits, vegetables, whole grains, beans, nuts, and seeds. A vegan novice includes all their favorites – sodas, sweets, and highly processed foods. And that may not leave much room for healthier vegan foods.

2) Big Food, Inc is not your friend. Big Food tells you that you don’t need to give up the taste of animal foods just because you are going vegan. They will just combine sugar, white flour, and a witch’s brew of chemicals to give you foods that taste just like your favorite meats and dairy foods. The problem is these are all highly processed foods. They are not healthy. Some people call them “fake meats” or “fake cheeses”. I call them “fake vegan”.

If you are going vegan, embrace your new diet. Bean burgers may not taste like Big Macs, but they are delicious. If need other delicious vegan recipe ideas, I recommend the website https://forksoverknives.com.

3) A bone healthy vegan diet is possible, but it’s not easy. Let’s go back to the author’s phrase “…vegan diets should be appropriate planned to avoid dietary deficiencies associated with bone health.” A vegan expert will do the necessary planning. A vegan novice will assume all they need to do is give up animal foods. 

As I said earlier, vegan diets tend to be low in calcium, vitamin D, zinc, vitamin B12, protein, and omega-3 fatty acids. Let’s look at how a vegan expert might plan their diet to get enough of those bone-healthy nutrients.

    • Calcium. The top plant sources of calcium are leafy greens and soy foods at about 100-250 mg (10-25% of the DV) of calcium per serving. Some beans and seeds are moderately good sources of calcium. Soy foods are a particularly good choice because they are a good source of calcium and contain phytoestrogens that stimulate bone formation.

A vegan expert makes sure they get these foods every day and often adds a calcium supplement.

    • Protein. Soy foods, beans, and some whole grains are the best plant sources of protein.soy

It drives me crazy when a vegan novice tells me they were told they can get all the protein they need from broccoli and leafy greens. That is incredibly bad advice.

A vegan expert makes sure they get soy foods, beans, and protein-rich grains every day and often adds a protein supplement.

    • Zinc. There are several plant foods that supply around 20% the DV for zinc including lentils, oatmeal, wild rice, squash and pumpkin seeds, quinoa, and black beans.

A vegan expert makes sure they get these foods every day and often adds a multivitamin supplement containing zinc.

    • Vitamin D and vitamin B12. These are very difficult to get from a vegan diet. Even vegan experts usually rely on supplements to get enough of these important nutrients.

4) Certain vegan foods can even be bad for your bones. I divide these into healthy vegan foods and unhealthy “vegan” foods. 

    • Healthy vegan foods that can be bad for your bones include.
      • Pinto beans, navy beans, and peas because they contain phytates.
      • Raw spinach & swiss chard because they contain oxalates.
      • Both phytates and oxalates bind calcium and interfere with its absorption.
      • These foods can be part of a healthy vegan diet, but a vegan expert consumes them in moderation.
    • Unhealthy “vegan” foods that are bad for your bones include sodas, salt, sugar, and alcohol.
      • The mechanisms are complex, but these foods all tend to dissolve bone.
      • A vegan expert minimizes them in their diet.

5) You need more than diet for healthy bones. At the beginning of this article, I talked about the 3 Weight Trainingessentials for bone formation – calcium, vitamin D, and exercise. You can have the healthiest vegan diet in the world, but if you aren’t getting enough weight bearing exercise, you will have low bone density. Let me close with 3 quick thoughts:

    • None of the studies included in this meta-analysis measured how much exercise the study participants were getting.
    • The individual studies were generally carried out in industrialized countries where many people get insufficient exercise.
    • The DV for calcium in the United States is 1,000-1,200 mg/day for adults. In more agrarian societies dietary calcium intake is around 500 mg/day, and osteoporosis is almost nonexistent. What is the difference? These are people who are outside (vitamin D) doing heavy manual labor (exercise) in their farms and pastures every day.

In summary, a bone healthy vegan lifestyle isn’t easy, but it is possible if you work at it.

The Bottom Line 

A recent meta-analysis asked two important questions about vegan diets.

  1.     Do vegans have lower bone density than omnivores?

2) Is the difference in bone density clinically significant? Are vegans more likely to suffer from bone fractures?

The study found that:

  • Vegans had 5.5%–7% lower bone density than omnivores depending on where the bone density was measured.
  • Vegans were 44% more likely to suffer from bone fractures than omnivores.

The authors of the study concluded, ““The findings of this study suggest that…vegan diets are associated with lower bone density compared with omnivorous diets, and vegans have a higher fracture risk than omnivores…Vegan diets should be appropriate planned to avoid dietary deficiencies associated with bone health.”

In evaluating the results of this study, I took a detailed look at the pros and cons of vegan diets and concluded, “A bone healthy vegan lifestyle isn’t easy, but it is possible if you work at it.”

For more details about study and my recommendations for a bone healthy vegan lifestyle read the article above.

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

Can You Improve Your Healthspan?

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Can You Live Healthier, Longer?

Ever since Ponce de Leon led an expedition to the Florida coast in 1513, we have been searching for the mythical “Fountain Of Youth”. What does that myth mean?

Supposedly, just by immersing yourself in that fountain you would be made younger. You would experience all the exuberance and health you enjoyed when you were young. There have been many snake oil remedies over the years that have promised that. They were all frauds.

But what if you had it in your power to live longer and to retain your youthful health for most of those extra years. The ability to live healthier longer is something that scientists call “healthspan”. But you can think of it as your personal “Fountain Of Youth”.

Where are we as a nation? Americans ranked 53rd in the world for life expectancy. We have the life expectancy of a third-world country. We are in sore need of a “Fountain Of Youth”.

That is why I decided to share two recent studies from the prestigious Harvard T.H. Chan School of Public Health with you today.

How Were The Studies Done?

Clinical StudyThese studies started by combining the data from two major clinical trials:

  • The Nurse’s Health Study, which ran from 1980 to 2014.
  • The Health Professional’s Follow-Up Study, which ran from 1986-2014.

These two clinical trials enrolled 78,865 women and 42,354 men and followed them for an average of 34 years. During this time there were 42,167 deaths. All the participants were free of heart disease, type 2 diabetes, and cancer at the time they were enrolled. Furthermore, the design of these clinical trials was extraordinary.

  • A detailed food frequency questionnaire was administered every 2-4 years. This allowed the investigators to calculate cumulative averages of all dietary variables.
  • Participants also filled out questionnaires that captured information on disease diagnosis every 2 years with follow-up rates >90%. This allowed the investigators to measure the onset of disease for each participant during the study. More importantly, 34 years is long enough to measure the onset of diseases like heart disease, diabetes, and cancer – diseases that require decades to develop.
  • The questionnaires also captured information on medicines taken and lifestyle characteristics such as body weight, exercise, smoking and alcohol use.
  • For analysis of diet quality, the investigators use something called the “Alternative Healthy Eating Index”. [The original Healthy Eating Index was developed about 10 years ago based on the 2010 “Dietary Guidelines for Americans”. Those guidelines have since been updated, and the “Alternative Healthy Eating Index” is based on the updated guidelines.] You can calculate your own Alternative Healthy Eating Index below, so you can see what is involved.
  • Finally, the investigators included five lifestyle-related factors – diet, smoking, physical activity, alcohol consumption, and BMI (a measure of obesity) – in their estimation of a healthy lifestyle. Based on the best available evidence, they defined “low-risk” in each of these categories. Study participants were assigned 1 point for each low-risk category they achieved. Simply put, if they were low risk in all 5 categories, they received a score of 5. If they were low risk in none of the categories, they received a score of 0.
  • Low risk for each of these categories was defined as follows:
    • Low risk for a healthy diet was defined as those who scored in the top 40% in the Alternative Healthy Eating Index.
    • Low risk for smoking was defined as never smoking.
    • Low risk for physical activity was defined as 30 minutes/day of moderate or vigorous activities.
    • Low risk for alcohol was defined as 0.5-1 drinks/day for women and 0.5-2 drinks/day for men.
    • Low risk for weight was defined as a BMI in the healthy range (18.5-24.9 kg/m2).

Can You Live Healthier Longer?

Older Couple Running Along BeachThe investigators compared participants who scored as low risk in all 5 categories with participants who scored as low risk in 0 categories (which would be typical for many Americans). For the purpose of simplicity, I will refer to people who scored as low risk in 5 categories as having a “healthy lifestyle” and those who scored as low risk in 0 categories as having an “unhealthy lifestyle”.

The results of the first study were:

  • Women who had had a healthy lifestyle lived 14 years longer than women with an unhealthy lifestyle (estimated life expectancy of 93 versus 79).
  • Men who had a healthy lifestyle lived 12 years longer than men with an unhealthy lifestyle (estimated life expectancy was 87 versus 75).
  • It was not necessary to achieve a perfect lifestyle. Life expectancy increased in a linear fashion for each low-risk lifestyle behavior achieved.

The authors of the study concluded: “Adopting a healthy lifestyle could substantially reduce premature mortality and prolong life expectancy in US adults. Our findings suggest that the gap in life expectancy between the US and other developed countries could be narrowed by improving lifestyle factors.”

The results of the second study were:

  • Women who had a healthy lifestyle lived 11 years longer free of diabetes, heart disease, and cancer than women who had an unhealthy lifestyle (estimated disease-free life expectancy of 85 years versus 74 years).
  • Men who had a healthy lifestyle lived 8 years longer free of diabetes, heart disease, and cancer than men who had an unhealthy lifestyle (estimated disease-free life expectancy of 81 years versus 73 years).
  • Again, disease-free life expectancy increased in a linear fashion for each low-risk lifestyle behavior achieved.

The authors concluded: “Adherence to a healthy lifestyle at mid-life [They started their analysis at age 50] is associated with a longer life expectancy free of major chronic diseases. Our findings suggest that promotion of a healthy lifestyle would help reduce healthcare burdens through lowering the risk of developing multiple chronic diseases, including cancer, cardiovascular disease, and diabetes, and extending disease-free life expectancy.”

Can You Improve Your Healthspan?

Questioning ManI posed the question at the beginning of this article, “Can you improve your healthspan?” These two studies showed that you can improve both your life expectancy and your disease-free life expectancy. So, the answer to the original question appears to be, “Yes, you can improve your healthspan. You can create your personal “Fountain of Youth.”

However, as a nation we appear to be moving in the wrong direction. The percentage of US adults adhering to a healthy lifestyle has decreased from 15% in 1988-1992 to 8% in 2001-2006.

The clinical trials that these studies drew their data from were very well designed, so these are strong studies. However, like all scientific studies, they have some weaknesses, namely:

  • They looked at the association of a healthy lifestyle with life expectancy and disease-free life expectancy. Like all association studies, they cannot prove cause and effect.
  • The clinical trials they drew their data with included mostly Caucasian health professionals. The results may differ with different ethnic groups.
  • These studies did not look at the effect of a healthy lifestyle on the onset of Alzheimer’s disease and other forms of dementia. However, other studies have shown that people who were low risk for each of the 5 lifestyle factors (diet, exercise, body weight, smoking, and alcohol use) individually have a reduced risk of developing Alzheimer’s and/or dementia.

Finally, I know you have some questions, and I have answers.

Question: What about supplementation? Will it also improve my healthspan?

Answer: When the investigators analyzed the data, they found that those with the healthiest lifestyles were also more likely to be taking a multivitamin. So, they attempted to statistically eliminate any effect of supplement use on the outcomes. That means these studies cannot answer that question.

However, if you calculate your Alternate Healthy Eating Index below, you will see that most of us fall short of perfection. Supplementation can fill in the gaps.

Question: I cannot imagine myself reaching perfection in all 5 lifestyle categories? Should I even try to achieve low risk in one or two categories?

Answer: The good news is that there was a linear increase in both life expectancy and disease-free life expectancy as people went from low-risk in one category to low-risk in all 5 categories. I would encourage you to try and achieve low risk status in as many categories as possible, but very few of us, including me, achieve perfection in all 5 categories.

Question: I am past 50 already. Is it too late for me to improve my healthspan?

Answer: Diet and some of the other lifestyle behaviors were remarkably constant over 34 years in both the Nurse’s Health Study and the Health Professional’s Follow-Up Study. That means that the lifespan and healthspan benefits reported in these studies probably resulted from adhering to a healthy lifestyle for most of their adult years.

However, it is never too late to start improving your lifestyle. You may not achieve the full benefits described in these studies, but you still can add years and disease-free years to your life.

How To Calculate Your Alternative Healthy Eating Index

You can calculate your own Alternative Healthy Eating Index score by simply adding up the points you score for each food category below.

Vegetables

Count 2 points for each serving you eat per day (up to 5 servings).

One serving = 1 cup green leafy vegetables or ½ cup for all other vegetables.

Do not count white potatoes or processed vegetables like French fries or kale chips.

Fruits

Count 2½ points for each serving you eat per day (up to 4 servings).

One serving = 1 piece of fruit or ½ cup of berries.

          (do not count fruit juice or fruit incorporated into desserts or pastries). 

Whole Grains

Count 2 points for each serving you eat per day (up to 5 servings).

One serving = ½ cup whole-grain rice, bulgur and other whole grains, cereal, and pasta or 1 slice of bread.

(For processed foods like pasta and bread, the label must say 100% whole grain).

Sugary Drinks and Fruit Juice

Count 10 points if you drink 0 servings per week.

Count 5 points for 3-4 servings per week (½ serving per day).

Count 0 points for 7 or more servings per week (≥1 serving per day).

One serving = 8 oz. fruit juice, sugary soda, sweetened tea, coffee drink, energy drink, or sports drink.

Nuts, Seeds and Beans

Count 10 points if you eat 7 or more servings per week (≥1 serving per day).

Count 5 points for 3-4 servings per week (½ serving per day).

Count 0 points for 0 servings per week.

One serving = 1 oz. nuts or seeds, 1 Tbs. peanut butter, ½ cup beans, 3½ oz. tofu.

Red and Processed Meat

Count 10 points if you eat 0 servings per week.

Count 7 points for 3-4 servings per week (½ serving per day).

Count 3 points for 3 servings per week (1 serving per day).

Count 0 points for ≥1½ servings per day.

One serving = 1½ oz. processed meats (bacon, ham, sausage, hot dogs, deli meat)

          Or 4 oz. red meat (steak, hamburger, pork chops, lamb chops, etc.)

Seafood

Count 10 points if you eat 2 servings per week.

Count 5 points for 1 serving per week.

Count 0 points for 0 servings per week.

1 serving = 4 oz.

Now that you have your total, the scoring system is:

  • 41 or higher is excellent
  • 37-40 is good
  • 33-36 is average (remember that it is average to be sick in this country)
  • 28-32 is below average
  • Below 28 is poor

Finally, for the purposes of these two studies, a score of 37 or higher was considered low risk.

The Bottom Line

Two recent studies have developed a healthy lifestyle score based on diet, exercise, body weight, smoking, and alcohol use. When they compared the effect of lifestyle on both lifespan (life expectancy) and healthspan (disease-free life expectancy), they reported:

  • Women who had had a healthy lifestyle lived 14 years longer than women with an unhealthy lifestyle.
  • Men who had a healthy lifestyle lived 12 years longer than men with an unhealthy lifestyle.
  • Women who had a healthy lifestyle lived 11 years longer free of diabetes, heart disease, and cancer than women had an unhealthy lifestyle.
  • Men who had a healthy lifestyle lived 8 years longer free of diabetes, heart disease, and cancer than men who had an unhealthy lifestyle.
  • It is not necessary to achieve a perfect lifestyle. Lifespan and healthspan increased in a linear fashion for each low-risk lifestyle behavior (diet, exercise, body weight, smoking, and alcohol use) achieved.
  • These studies did not evaluate whether supplement use also affects healthspan.
    • However, if you calculate your diet with the Alternate Healthy Eating Index they use (see above), you will see that most of us fall short of perfection. Supplementation can fill in the gaps.

The authors concluded: “Our findings suggest that promotion of a healthy lifestyle would help reduce healthcare burdens through lowering the risk of developing multiple chronic diseases, including cancer, cardiovascular disease, and diabetes, and extending disease-free life expectancy.”

For more details, including how to calculate whether you are low risk in each of the 5 lifestyle categories, read the article above.

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

Health Tips From The Professor