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Folic Acid vs. Folate

October 11, 2016 by Dr. Steve Chaney

Are Supplement Manufacturers Trying to Mislead You?

Author: Dr. Stephen Chaney

There has been much confusion on folic acid vs. folate. For example, I recently received this question from a reader:

“I have gotten so much clarification about folic acid from your video – thank you!
But I have another question I was hoping you could answer.

When a supplement label states there is “folate” rather than “folic acid”, is there really a difference between the two? I hear women telling each other to only use the one that says folate because it’s made from food. And folic acid isn’t. These women are also paying more money for these products because of this. Is this true? (And I’m not talking about tetrahydrafolate, either)
I’ve been told by one manufacturer that they label it as folic acid, but they know other companies who use the exact same source of folic acid. Still, they put folate on their label, possibly to avoid controversy.
Are these women being duped? Should they be asking the manufacturer certain questions for clarification?”

The video, this reader is referring to is my “The Truth About Methyl Folate” video in which I debunk the many myths about methyl folate circulating on the internet, and, unfortunately, repeated by some doctors.

However, the reader is correct. I did not address the folic acid vs. folate nomenclature in that video. I will attempt to clarify it in this article.

Folic Acid vs. Folate

A Rose By Any Other Name

I call this section “A Rose By Any Other Name” from the famous Shakespeare quote from Romeo and Juliet “A rose by any other names would smell as sweet”.

Biochemists and nutritionists use the terms folic acid and folate interchangeably. There is a sound chemical rationale for that.

Folic acid has a glutamic acid residue on one end. Thus, folic acid is what chemists refer to as an organic acid, specifically a carboxylic acid. Under acidic conditions the appropriate suffix for an organic acid is “ic”. However, under neutral or alkaline conditions, organic acids lose their protons. Once that happens, the appropriate suffix is “ate”.

The exact pH of vitamin pills may vary from brand to brand. In our body our stomach is acidic, our intestines are alkaline, and our blood and cells are normally near neutral. Thus, vitamin B9 could correctly be labeled either folic acid or folate in supplements. It will be folic acid in our stomach and will be folate in our intestines, bloodstream, and cells. Beginning to see the difference between folic acid vs. folate?

The bottom line is that nobody is trying to trick you by using the term folate for the vitamin B9 on their supplement label. Furthermore, whether the label says folic acid or folate, the actual vitamin B9 will be in both the folic acid and folate form as it travels through your body.

In answer to your other question, since folic acid and folate are two names for the same molecule, folate is not more natural than folic acid. If someone is charging you extra because they use the term folate on their label, they are ripping you off.

What About Tetrahydrofolate?

The person who sent me the question also asked about tetrahydrofolates. Here the story gets a bit murkier. As folic acid or folate enters our cells, three things immediately happen:

It is reduced to tetrahydrofolate. That terminology simply means that 4 hydrogens have been added to the molecule.

A string of glutamic acid residues is added. That traps it inside the cells.

It is converted to a half dozen different derivatives that play important metabolic roles in the cell. N5-methyltetrahydrofolate (commonly referred to as methyl folate) is one of these metabolically active compounds.

This is where it gets confusing. Nutritionists also refer to all of these tetrahydrofolate derivatives as folates. My guess is that years ago some genius must have decided that the term tetrahydrofolate was too long and complicated for the general public.

In my view lumping everything together under the term folate has turned out to be more confusing in the long run. However, I do have the advantage of hindsight. It’s easy to point out mistakes after they are made.

However, this is where all of the confusion arises. It’s because the term folate can mean so many different things. Here are a few fast facts to help clarify the confusion.

Folates in food are in the tetrahydrofolate form. Tetrahydrofolate in foods is, in fact, more natural than folic acid or folate in supplements. However, tetrahydrofolates in foods are utilized only about half as well as folic acid or folate in supplements. In addition, most of us don’t eat enough high-folate foods.

In contrast, tetrahydrofolate in a supplement is not more natural than folic acid. That’s because:

It would require one cup of lentils or two cups of spinach to provide the RDA level of tetrahydrofolate in a single vitamin tablet. That’s just one tablet. You do the math! If someone tells you that the folate in their supplement came from foods, they will lie to you about other things as well.

In fact, the tetrahydrofolate found in supplements is chemically synthesized from folic acid. It can never be more natural than folic acid.

Supplements containing tetrahydrofolate are no better utilized than supplements containing folic acid when you measure their ability to increase cellular tetrahydrofolate levels (the only measure that really matters).

The bottom line is that even if folate on the label were to refer to tetrahydrofolate, it is not from food. It is not more natural than folic acid. It is not better utilized than folic acid. If someone is charging you a higher price for that supplement, they are ripping you off.

Debunking The Methyl Folate Myths

Methyl folate has become an internet sensation. If you believe all the hype, everyone should be using supplements containing methyl folate rather than folic acid. In fact, some of the claims made by manufacturers who sell methyl folate supplements are downright deceptive.

Unfortunately, there are even medical doctors touting the wonders of methyl folate and offering all sorts of plausible sounding biochemical explanations about why it is superior to folic acid. My take on that is that I try not to practice medicine when I write my articles. I have neither the training nor the degree to do that. In turn, I would ask medical doctors to stop trying to practice biochemistry.

As I said at the beginning of this article, I have produced a video, “The Truth About Methyl Folate,” in which I debunk all the many methyl folate myths circulating on the internet. If you would like the “Cliff Notes” version, here it is:

Supplements containing methyl folate do not get their methyl folate from foods.

Methyl folate in supplements is chemically synthesized and is not more natural than folic acid.

Folic acid and methyl folate in supplements are equally well utilized by the body, even in individuals with a MTHFR deficiency.

Excess folic acid does not cause cancer.

If you would like the science and the references behind those statements, I invite you to view my video.

I hope you now understand folic acid vs. folates. If not, please feel free to reach out to me.

The Bottom Line

A reader recently asked me to clear up the confusion about why the terms folic acid vs. folate are used interchangeably on supplement labels to describe vitamin B9.

That terminology is based on simple chemistry. Folic acid and folate are two names for the same molecule. Under acidic conditions, it is called folic acid. Under neutral or alkaline conditions, it is called folate.

Since folic acid and folate are two names for the same molecule, folate is not more natural than folic acid. If someone is charging you extra because they use the term folate on their label, they are ripping you off.

In the cell folate is reduced to tetrahydrofolate and a number of metabolically active derivatives of tetrahydrofolate are formed. Unfortunately, these compounds are also referred to as folates. This terminology has a historical basis rather than a chemical basis and is confusing.

If you see the term tetrahydrofolate on your supplement label, you need to know that it is not from food. It is not more natural than folic acid. It is not better utilized than folic acid. If someone is charging you a higher price for that supplement, they are also ripping you off.

I have produced a video called “The Truth About Methyl Folate” to debunk the many methyl folate myths on the internet. In the article above, you will find the “Cliff Notes” version of the video.

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 Some Omega-3 Fish Oil Supplements Better Than Others?

September 13, 2016 by Dr. Steve Chaney

Author: Dr. Stephen Chaney

The ethyl ester form of omega-3 fatty acids from fish oil has been the industry standard for high purity omega-3 fish oil supplements for many years. It is very stable, easily purified, and well absorbed by the body. What’s not to like?

If you believe some recent advertisements, there is a lot not to like about the ethyl ester form of omega-3s. These ads each claim that their particular form of omega-3s is more natural, better absorbed, and more efficiently incorporated into cell membranes, or some combination of those features. They each cite clinical studies “proving” that their products are superior. These advertisements seem so plausible and so compelling.

However, most of these advertisements come from relatively new companies that are trying to make a name for themselves in a very profitable and competitive product niche. Are the advertisements true, or is it all just smoke and mirrors? Most of these advertisements rate at least one Pinocchio.

However, it is almost impossible to tell you why I consider these advertisements omega-3 fish oil supplements to be misleading without getting a little “techie”, so let’s start with some basic definitions. I call this section “Omega-3s 101.”

Omega-3s 101

Let’s start with some basic definitions:

Free fatty acids (FFA) are long chain hydrocarbons with a single acid group at the end. They are only slightly water soluble. They are important intermediates in metabolism, but they are almost always combined with something else in the body.
Saturated fatty acids contain no double bonds, monounsaturated fatty acids contain one double bond, and polyunsaturated fatty acids contain multiple double bonds. The number of double bonds primarily affects whether they are liquids (polyunsaturated) or solids (saturated) at room temperature.
There are two classes of polyunsaturated fatty acids that are essential because the body cannot make them. Those with a double bond 3 carbons from the end are called omega-3s(If you think about the Greek alphabet, omega is at the end). Those with a double bond 6 carbons from the end are called omega-6s.
When 3 fatty acids are combined with a single molecule of glycerol they form very water insoluble compounds commonly referred to as fats or triglycerides. The proper chemical name is triacylglycerol, which is abbreviated TAG.
If one of the fatty acids on the glycerol chain is replaced by a compound containing phosphate and other charged residues, the resulting complex is called a phospholipid (PL). Because these compounds have a hydrocarbon surface that is attracted to fats and a highly charged surface that is attracted to water, they are good at emulsifying fats and are an important part of membrane structure. One phospholipid that is a major component of membranes is called phosphatidylcholine (PC), also known as lecithin.

Next, let’s look at how omega-3 fatty acids are metabolized:

The omega-3s in fish oil are primarily in the form of triglycerides, with small amounts of phospholipids. The omega-3s in most omega-3 supplements are in the form of ethyl esters for the reasons stated above.
Before the omega-3s leave the intestine they are hydrolyzed to free fatty acids.
In the cells that line the intestine the omega-3s are reconverted back into triglycerides and phospholipids and incorporated into special lipid-protein complexes for transport through the blood.
Once these lipid-protein complexes reach our cells, their contents are delivered to the cell where they can be stored as fat (TAG), used for energy (FFA), or incorporated into membranes (PL). It is primarily the omega-3s incorporated in cellular membranes that are thought to be responsible for the beneficial effects of omega-3s.

Finally, we should ask how one measures the bioavailability of the various forms of omega-3s:

While there are some nuances that I did not cover, the basic mechanisms of absorption and metabolism of omega-3s are remarkably similar regardless of whether they start out in the ethyl ester, triglyceride, phospholipid, or free fatty acid form. The questions then become, how does one test how efficiently the various forms are utilized by the body and how much do these individual test actually tell us?

When we look at what happens in the bloodstream, we need to be aware that we are looking at a combination of two effects – how rapidly the substance enters the bloodstream and how rapidly it leaves from the bloodstream. There are three important parameters we can measure when looking at delivery of omega-3s to the bloodstream:
- The maximum concentration achieved (Cmax)
- How rapidly that maximum concentration was achieved (Tmax)
- The total amount in the bloodstream over time (AUC)
When you look at some of the ads touting specialized forms of omega-3s, they are usually based on studies looking at either the maximum levels of omega-3s in the bloodstream (Cmax) or how rapidly those maximum levels were achieved (Tmax). (One suspects the ads may have selectively featured whichever parameter made their product look best). However, the parameter that really matters is the total concentration of omega-3s achieved over time (AUC).
Finally, the most important question is how much of the omega-3 is actually incorporated into cellular membranes. Once again, there is more than one parameter that can be measured.
One can measure the level of omega-3s found in cellular membranes in a short term study (a few hours) or in a long term study following many weeks of supplementation.
The short term studies only measure the rate of incorporation. The long term studies measure the steady state levels attained over time, which is a much more relevant measure.
Once again, the ads touting specialized products are usually based on short term studies which are really measuring an initial rate of incorporation of omega-3s into cellular membranes, not on long term studies that measure the steady state level of omega-3s achieved over time.

Are Some Omega-3 Fish Oil Supplements Better Than Others?

There has been a lot of confusion in the literature about whether the form of omega-3 supplements matters. Various studies have been published supporting the superiority of one form or another of omega-3s. Most of these studies have been supported by manufacturers who have a particular form of omega-3s they want to sell, and, as I mentioned above, the parameters tested seem to have been selected to make their supplement look good. So, are some omega-3 fish oil supplements better than others?

Finally, someone has designed a comprehensive study to clear up all the confusion and provide answers that can be trusted (West et al, British Journal of Nutrition, 116: 788-797, 2016). Interestingly, this research was supported by a pharmaceutical company (Vifor Pharma) that does not appear to sell an omega-3 product currently. Perhaps they simply wanted to find out what worked best before designing their own product. What a novel concept!

The authors tested 4 different forms of omega-3 fish oil supplements:

Unmodified fish oil containing the omega-3s primarily in triglyceride form (uTAG).
An omega-3 supplement in which the omega-3s in the fish oil had been hydrolyzed to free fatty acids (FFA).
An omega-3 supplement in which the omega-3s in the fish oil had been hydrolyzed to free fatty acids and converted back to triglycerides (TAG)
An omega-3 supplement in which the omega-3s in the fish oil had been hydrolyzed to free fatty acids and converted to ethyl esters (EE)

All 4 supplements contained 1.1 grams of EPA and 0.37 grams of DHA.

The authors conducted two studies:

One was a cross-over study where healthy men consumed each of the supplements in random order on different days with 14 days between tests. Blood samples were collected over the next 6 hours and levels of EPA and DHA in the blood and cellular membranes was determined.
The other was a long term study in which a randomized group of healthy men and women consumed one of the supplements for 12-weeks and incorporation of the EPA and DHA into cellular membranes was measured.

The results were pretty clear cut:

In the short term study there were no significant differences between the various supplements in the rate of uptake, maximum concentration achieved, or the total concentration over time when uptake of omega-3s into plasma triglycerides and phospholipids was measured.
The ethyl ester form was less efficiently incorporated into plasma free fatty acids than the other forms as reported in some previous studies, but this is perhaps the least important parameter measured, and there was large variability from subject to subject.
In the long term study, no significant differences were seen between the various supplements in omega-3 incorporation into cellular membranes.

The authors concluded: “Together, these findings show that in healthy individuals neither the lipid structure nor the overall fatty acid composition of supplements influence their bioavailability during dietary supplementation, despite the apparent lower postprandial availability [in short term studies] of EPA + DHA ethyl esters compared with triglycerides or free fatty acids.”

What Do These Studies Mean For You?

You can forget all those ads hyping the newest, greatest form of omega-3 fish oil supplements. Objective research has shown there is not a dimes worth of difference between the various forms of omega-3 supplements.

A far more important question is the purity of the omega-3 supplement you are using. Purity of omega-3 supplements is a huge issue. You need to remember that the EPA + DHA supplements you purchase come from polluted fish. Unfortunately, many manufacturers have inadequate purification and quality control standards. In other words, neither you nor they know whether their omega-3 products are pure. You need to make sure that the omega-3 supplement you purchase is made by a manufacturer with stringent quality control standards.

Sustainability is also an issue, so you should choose manufacturers who source their omega-3s in a sustainable manner. There are two comments I will make about sustainability so you won’t be misled.

Krill oil is marketed as a more sustainable source of omega-3s. Krill reserves are quite large, but they are not infinite. Krill is also the very foundation of the food chain that supports a large percentage of our ocean’s fish. We need to be very cautious about depleting our krill reserves.
Omega-3s derived from algae are also marketed as a more sustainable source of omega-3s. Algae-derived omega-3s have purity issues of their own, but may become an important source of omega-3s once those issues have been resolved.

The Bottom Line

The ethyl ester form of omega-3 fatty acids from fish oil has been the industry standard for high purity fish oil supplements for many years. It is very stable, easily purified, and well absorbed by the body.
However, in recent years, some manufacturers have been claiming that their omega-3 fish oil supplements were better utilized by the body because their supplements contained the omega-3s in triglyceride or free fatty acid forms.
Unfortunately, the clinical studies supporting those claims have been supported by the manufacturers making the products. There is reason to suspect that the data has been “cherry picked” to support the conclusions that support the manufacturer’s claims.
Finally, an independent and comprehensive study has compared the various forms of omega-3 fatty acids. It found that neither the lipid structure nor the overall fatty acid composition of omega-3 supplements influenced their bioavailability during long term dietary supplementation.
A far more important question is the purity of the omega-3 supplement you are using. Purity of omega-3 supplements is a huge issue. You need to remember that the EPA + DHA supplements you purchase come from polluted fish. Unfortunately, many manufacturers have inadequate purification and quality control standards. In other words, neither you nor they know whether their omega-3 products are pure. You need to make sure that the omega-3 supplement you purchase is made by a manufacturer with stringent quality control standards.

Omega-3 And Blood Pressure: The Good News

May 24, 2016 by Dr. Steve Chaney

Will Fish Oil Lower Your Blood Pressure?

Author: Dr. Stephen Chaney

Is there a relationship between omega-3 and blood pressure we should understand to for health benefits?

High blood pressure is a killer! It can kill you by causing heart attacks, strokes, congestive heart failure, kidney failure and much more.

High blood pressure is a serial killer. It doesn’t just kill a few people. It kills lots of people. The American Heart Association estimates that high blood pressure directly or indirectly caused 363,000 deaths in 2010. That is almost 1 person every second and represents a 41% increase from 2000. It’s because high blood pressure is not a rare disease.

31% of Americans have high blood pressure, also called hypertension, (defined as a systolic blood pressure of 140 mm Hg or more or a diastolic blood pressure of 90 mm Hg or more).

Another 30% of Americans have prehypertension (systolic blood pressure of 120-139 mm Hg or diastolic blood pressure of 80-89 mm Hg).

That’s over 61% of Americans with abnormal blood pressure!

High blood pressure is a silent killer. That’s because it is a very insidious disease that sneaks up on you when you least expect it. Systolic blood pressure increases 0.6 mm Hg/year for most adults over 50. By age 75 or above 76-80% of American adults will have high blood pressure. Even worse, many people with high blood pressure have no symptoms, so they don’t even know that their blood pressure is elevated. For them the first symptom of high blood pressure is often sudden death.

Blood pressure medications can harm your quality of life. Blood pressure medications save lives. However, like most drugs, blood pressure medications have a plethora of side effects – including weakness, dizziness, fainting, shortness of breath, chest pain, nausea, diarrhea or constipation, heartburn, depression, heart palpitations, and even memory loss . The many side effects associated with blood pressure medications lead to poor compliance, which is probably why only 47% of patients with high blood pressure are adequately controlled.

You do have natural options. By now you are probably wondering whether there are natural approaches for controlling your blood pressure that are both effective and lack side effects. The answer is a resounding YES! I’ll outline a holistic natural approach for keeping your blood pressure under control in a minute, but let me start with the good news about omega-3 fatty acids.

The Good News About Omega-3 and Blood Pressure

What’s the good news about omega-3 and blood pressure? We’ve known for some time that omega-3 fatty acids helped lower blood pressure, but two recent studies have really highlighted just how strong the effect of omega-3s on lowering blood pressure is.

The first study (Miller et al, American Journal of Hypertension, 27: 885-896, 2014) was a meta-analysis of 70 randomized, placebo-controlled clinical trials of long chain omega-3 (EPA + DHA) supplementation and blood pressure.

Here are the results of this study:

In the group with normal blood pressure at the beginning of the study EPA + DHA supplementation decreased systolic blood pressure by 1.25 mm Hg.

Given that systolic blood pressure rises an average of 0.6 mm Hg/year in adults over 50, the authors estimated that omega-3 supplementation alone would delay the onset of age-related high blood pressure by 2 years.

In the group with elevated blood pressure not taking medication at the beginning of the study, EPA + DHA supplementation decreased systolic blood pressure by an impressive 4.51 mm Hg and diastolic blood pressure by 3.05 mm Hg.

The authors noted that this decrease in systolic blood pressure could “prevent an individual from requiring medication [with all its side effects] to control their hypertension” or decrease the amount of medication required.

However, the doses of omega-3s used in these studies ranged from 1 to over 4 grams/day (mean dose = 3.8 grams/day). That sparked a second study (Minihane et al, Journal of Nutrition, 146: 516-523, 2016) to see whether lower levels of omega-3s might be equally effective. This study was an 8 week double-blind, placebo-controlled study comparing the effects of 0.7 or 1.8 grams of EPA + DHA per day (versus an 8:2 ratio of palm and soybean oil as a placebo) on blood pressure.

Here are the results of this study:

In the group with normal blood pressure at the beginning of the study, EPA + DHA supplementation caused no significant decrease in blood pressure. This could be due to the smaller number of subjects or the lower doses of EPA + DHA used in this study.

In the group with elevated blood pressure not taking medication at the beginning of the study, EPA + DHA supplementation decreased systolic blood pressure by 5 mm Hg and, the effect was essentially identical at 0.7 grams/day and 1.8 grams/day.

The authors concluded “Our data suggest that increased EPA + DHA intakes of only 0.7 grams/day may be an effective strategy for blood pressure control.”

A Holistic Approach To Blood Pressure Control

The latest information about omega-3 and blood pressure is good news indeed, but that’s not the only natural approach that lowers blood pressure. You have lots of other arrows in your quiver. For example:

The DASH diet (A diet that has lots of fresh fruits and vegetables; includes whole grains, low fat dairy, poultry, fish, beans, nuts and oils; and is low in sugar and red meats) reduces systolic blood pressure by 5-6 mm Hg. [Low sodium, low sodium/high-potassium, low-sodium/low-calorie, low-calorie and Mediterranean diets also lower blood pressure, but not by as much as the DASH diet].

Reducing sodium by about 1,150 mg/day reduces systolic blood pressure by 3-4 mm Hg.

Reducing excess weight by 5% reduces systolic blood pressure by 3 points.

Doing at least 40 minutes of aerobic exercise 3-4 times/week reduces systolic blood pressure by 2-5 mm Hg.

Nitrates, whether derived from fresh fruits and vegetables or from supplements probably also reduce blood pressure , but we don’t yet know by how much.

If you’ve been keeping track, you’ve probably figured out that a holistic lifestyle that included at least 0.7 grams/day of long chain omega-3s (EPA + DHA) plus everything else in the list above could reduce your systolic blood pressure by a whopping 18-22 mm Hg.

That’s significant because,as the graphic on the right shows, the CDC estimates that reducing high systolic blood pressure by only 12-13 mm Hg could substantially decrease your risk of disease.

A Word Of Caution

While holistic approaches have the potential to keep your blood pressure under control without the side effects of medications, it is important not to blindly rely on holistic approaches alone. There are also genetic and environmental risk factors involved in determining blood pressure. You could be doing everything right and still have high blood pressure. Plus, you need to remember that high blood pressure is a silent killer that often doesn’t have any detectable symptoms prior to that first heart attack or stroke.

My recommendations are:

Monitor your blood pressure on a regular basis.

If your blood pressure starts to become elevated, consult with your doctor about starting with natural approaches to bring your blood pressure back under control. Doctors are fully aware of the side effects of blood pressure medications, and most doctors are happy to encourage you to try natural approaches first.

Continue to monitor blood pressure as directed by your doctor. If natural approaches are insufficient to bring your blood pressure under control, they will prescribe the lowest dose of blood pressure medication possible to get your blood pressure where it needs to be.

Don’t stop making holistic lifestyle choices to reduce blood pressure just because you are on medication. The more you do to keep your blood pressure under control, the less medication your doctor will need to use (That means fewer side effects).

The Bottom Line

Recent studies have shown that supplementation with as little as 0.7 grams of long chain omega-3s (EPA + DHA) per day is sufficient to decrease systolic blood pressure by ~ 5 mm Hg in people with untreated hypertension (high blood pressure). If your blood pressure is currently in the normal range, it is not yet clear how much EPA + DHA you need to keep it there. That may require a higher dose.

When you combine that with other natural approaches such as the DASH diet, reducing sodium, losing weight, and increasing exercise you can decrease blood pressure by 18-22 mm Hg.

The CDC estimates that is enough to substantially decrease your risk of stroke, coronary heart disease, memory loss, kidney disease, erectile dysfunction, death from cardiovascular disease, and death from any cause.

The authors of these recent studies concluded that holistic lifestyle changes including substantially increasing omega-3 intake have the potential to significantly delay the onset of age-related hypertension and may allow people with elevated blood pressure to eliminate or substantially reduce the use of blood pressure medications – with their many side effects.

High blood pressure is a silent killer. It is important to monitor your blood pressure regularly. If it becomes elevated, work with your doctor to find the balance of natural approaches and medication that is right for you.

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

The Benefits of Resveratrol

April 26, 2016 by Dr. Steve Chaney

Author: Dr. Stephen Chaney

Some athletes, particularly Olympic athletes, are starting to use resveratrol to improve their workouts and their performance in events. Is their belief in the benefits of resveratrol justified, or is resveratrol just another of those “mythical” sports nutrition supplements? There have only been a few small studies on the subject, and those studies have been conflicting.

The study I am featuring this week (Polley et al, Appl. Physiol. Nutr. Metab. 41: 26-32, 2016) asked a more fundamental question. It asked whether resveratrol enhanced the effect of exercise on muscle mitochondrial capacity. For those of you who aren’t scientists that statement may require some interpretation.

What Are Mitochondria and Why Are They Important?

You can think of mitochondria as the power packs of the cell. They are tiny organelles that are found in most cells in our body. The foods that we eat contain a lot of energy (calories), but that energy is not in a form that our cells can use. Our cells metabolize those foods into small molecules that donate electrons to our mitochondria, and the mitochondria use those electrons to create energy in a form that our cells can utilize.

As you might imagine, mitochondria are particularly important for cells with high energy requirements, like our muscle cells. Those muscle cells responsible for endurance and high intensity (think gymnastics or weight lifting) exercise have the highest density of mitochondria and are the most dependent on those mitochondria for optimal performance.

Why Resveratrol Might Increase Muscle Mitochondrial Capacity?

Mitochondria have a finite lifetime in our cells. As our cells age their mitochondria become less efficient and start doing bad things like releasing damaging free radicals into the cell. Exercise stress causes the mitochondria in our muscles to age more rapidly than the mitochondria in other cells. Fortunately, regular exercise also stimulates a pathway that causes production of new mitochondria and enhances their efficiency. Thus, the net effect of any exercise program is to increase both the number and efficiency of mitochondria, something referred to as mitochondrial capacity.

It turns out that resveratrol and a small group of related polyphenols also stimulate the same pathway. Animal and cell culture studies show that resveratrol can increase muscle mitochondrial capacity. However, since resveratrol and exercise increase mitochondrial capacity by the same mechanism, the question is whether resveratrol has any added benefit over exercise alone. That is the question this study was designed to answer.

The Benefits of Resveratrol on Muscle Mitochondrial Capacity?

Previous studies had suggested that one of the benefits of resveratrol might be increasing muscle mitochondrial capacity for people who have engaged in relatively little physical activity in the past. For examples, studies have shown that resveratrol activates the pathway leading to increased mitochondrial capacity in obese and diabetic populations, both groups that may not have been involved in regular exercise. In contrast, other studies found no enhancement of those same pathways compared to exercise alone in more highly trained populations involved in high intensity training.

Based on those results, the present study (Polley et al, Appl. Physiol. Nutr. Metab. 41: 26-32, 2016) was specifically designed to assess the effect of resveratrol supplementation along with low-intensity exercise in an untrained muscle group. The authors recruited healthy young adults with approximately equal numbers of men and women. To assure that the muscle group was relatively untrained, they asked the subjects to perform wrist flexor exercises in their non-dominant arm. They excluded from the study anyone whose exercise regimen involved regular use of the non-dominant forearm such as rowing, rock climbing or CrossFit.

This was a double-blind, placebo-controlled study. Half of the group received 500 mg of resveratrol and the other half received the placebo. The placebo group served as a control for the effect of exercise alone. The dominant arm was not exercised, so it served as a control for the effect of resveratrol alone. The participants took resveratrol or placebo upon wakening each morning. The wrist flexor exercises were performed 3 times per week for 4 weeks. Mitochondrial capacity measurements were made using near infrared spectroscopy on a weekly basis.

The results were pretty straight-forward.

Low-intensity training alone (placebo group) for 4 weeks resulted in a 10% increase in mitochondrial capacity.

Low-intensity training plus resveratrol for 4 weeks resulted in a 40% increase in mitochondrial capacity. This represented a highly significant difference between the resveratrol and placebo groups.

Neither the resveratrol group or the placebo group exhibited changes in the untrained arm, which suggests that resveratrol without exercise has little or no effect on mitochondrial capacity in young, healthy subjects.

The authors concluded: “Taken together, these findings indicate that [the] combination of exercise and resveratrol is needed for eliciting maximal muscle mitochondrial adaptations to low-intensity training programs.”

What Are the Strengths and Weaknesses of This Study?

Strengths:Because previous studies had suggested that the effects of resveratrol might be masked in highly trained individuals or by high intensity exercise, this study was specifically designed to look at the effects of resveratrol on mitochondrial capacity when administered along with low-intensity exercise in untrained muscles. In that sense this study breaks new ground and suggests that, under the right conditions, resveratrol can enhance exercise training.

Weaknesses:The weaknesses of this study were many:

It was a very small study. That is not unusual in this area of research, but clearly much more research is needed.

It used a higher dose of resveratrol than previous studies. However, plasma levels of resveratrol were not determined and the effect of lower doses was also not determined, so we have no idea how much resveratrol is actually needed to elicit this response.

While increased mitochondrial capacity is a probable predictor of improved exercise efficiency, no performance outcomes were actually measured. Most people probably don’t care how well their mitochondria work. They care about how well their muscles perform.

What Does This Mean For You?

We are in the very early stages of research into the benefits of resveratrol on exercise. Many more studies are needed before we will be in a position to fully understand the effects of resveratrol on exercise efficiency and performance outcomes. This and previous studies suggest that resveratrol is likely to be most effective at enhancing exercise efficiency with low intensity exercise in relatively untrained muscles.

If true, that would mean resveratrol might be helpful for the millions of Americans who are “weekend warriors” or exercise sporadically. It may even be beneficial for those of us who exercise regularly at a low to moderate intensity level.

However, because resveratrol and exercise improve mitochondrial capacity by the same mechanism, previous studies suggest that resveratrol might be a less effective addition for highly trained athletes engaged in high-intensity exercise.If true, this would put resveratrol in the same category as several other popular exercise supplements such as arginine and citrulline that also appear to be more effective for untrained individuals than they are for highly trained athletes.

However, I am aware of many Olympic athletes who use and swear by a resveratrol polyphenol blend. It could be placebo, but it could also suggest that resveratrol does enhance performance for highly trained athletes engaged in high-intensity exercise. As I said at the beginning of this section, there is much more research to do. That’s what makes science so much fun. There are always new things to learn.

The Bottom Line

We are in the very early stages of research into the benefits of resveratrol on exercise. Many studies will be needed before we will be in a position to fully understand the effects of resveratrol on exercise efficiency and performance outcomes. However, a recent study is of interest because it introduces a new perspective to our understanding of the possible effects of resveratrol on exercise efficiency.

Thisstudy reports that resveratrol significantly enhances the increase in mitochondrial capacity caused by low-intensity exercise in untrained muscles

If true, that would mean resveratrol might increase exercise efficiency for the millions of Americans who are “weekend warriors” or exercise sporadically. It may even be beneficial for those of us who exercise regularly at a low to moderate intensity level.

However, because resveratrol and exercise improve mitochondrial capacity by the same mechanism, previous studies suggest that resveratrol might be a less effective addition for highly trained athletes engaged in high-intensity exercise.

If true, this would put resveratrol in the same category as several other popular exercise supplements such as arginine and citrulline that also appear to be more effective for untrained individuals than they are for highly trained athletes.

However, I am aware of many Olympic athletes who use and swear by a resveratrol polyphenol blend. It could be placebo, but it could also suggest that resveratrol does enhance performance for highly trained athletes engaged in high-intensity exercise.

As I said before, there is much more research to do. That’s what makes science so much fun. There are always new things to learn.

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.

PAHs Contaminate Supplements?

April 12, 2016 by Dr. Steve Chaney

Do Your Supplements Contain Carcinogens?

Author: Dr. Stephen Chaney

Most of us take supplements to improve our health. We count on those supplements being pure and effective. We don’t expect the supplements we take to contain carcinogenic (cancer causing) contaminants. However, that expectation appears to be unfounded. A recent study found that 72% of supplements tested were contaminated with a particularly dangerous class of cancer causing chemicals called polycyclic aromatic hydrocarbons (PAHs)

Where Do PAHs Come From andWhy Are TheyDeadly?

Polycyclic aromatic hydrocarbons (PAHs) are produced by incomplete combustion of organic materials. Major environmental sources of PAHs are incomplete burning of gasoline, coal and other fuels. Unfortunately, automobile exhaust, coal burning power plants, and exhaust from factories are almost ubiquitous in today’s world, resulting in significant PAH contamination of our air, water, and soil. The unfortunate truth is that we all live in an increasingly dirty and toxic environment.

As you might imagine, cigarette smoke is the #1 source of PAHs in humans. However, foods are a major route for PAH exposure in humans as well. There are many food sources of PAHs. For example,

Grilling, roasting and frying foods, especially meats, at high temperatures creates PAHs.
Smoking fish or meats creates PAHs.
Barbecuing meats creates PAHs.
Even plant-based foods can contain PAHs if the soil, air or water they were grown in was contaminated.
PAHs can be introduced into supplements if any of their ingredients are dried at high temperatures as part of the processing procedure.

By now you are probably realizing that it is not just our environment that is increasingly being contaminated with PAHs. We are all becoming contaminated with PAHs as well. Our bodies are becoming toxic waste dumps.

Unfortunately, PAHs are not innocuous chemicals. Perhaps the best studied and deadliest of the PAHs is a compound called benzo[a]pyrene. It is classified as a class 1 carcinogen and mutagen by the IARC (International Agency for Research on Cancer). Perhaps some explanation is in order:

The IARC is an international organization that is charged with evaluating the scientific evidence for the carcinogenicity of various chemicals. It also sets upper limits for safe exposure to those chemicals.

Class 1 carcinogens are compounds that the IARC has classified as definitely carcinogenic to humans. Simply put, the IARC considers the scientific evidence to be overwhelming that those compounds are carcinogens.

To date only 118 compounds have been blacklisted by the IARC as class 1 carcinogens and benzo[a]pyrene is one of them. However, many of the other, less studied, PAHs are classified as probable carcinogens by the IARC.

Unfortunately, in most countries of the world (including the United States), PAH limits in food and supplements are unregulated. Because they are unregulated, many supplement companies don’t even test for them. That is unfortunate because a recent study shows that many supplements are contaminated with high levels of PAHs, and their manufacturers didn’t even know it.

Do Your Supplements Contain PAHs or Other Carcinogens?

The European Union has taken the lead in regulating PAH levels. They have used the IARC guidelines to create upper allowable limits for PAHs in food and supplements. Separate standards were set for benzo[a]pyrene and the total of the four most common PAH contaminants (benzo[a]anthracene, benzo[a]pyrene, benzo[b]fluoranthrene, and chrysene). Those new regulations just went into effect April 1^st 2016.

To gauge the impact of these new regulations on the supplement industry, the EU asked the European Union Reference Laboratory to measure the levels of PAH contamination in supplements sold in the EU prior to the implementation of the new regulations. Because vitamin and mineral supplements are seldom contaminated with PAHs, they were excluded from the study.

The EU Reference Laboratory started collecting a wide range of herbal and botanical supplements, fish and edible oil food supplements, and propolis and other bee supplements sold in the EU in 2013. The Reference Laboratory analyzed 94 different supplements for PAH contamination, and the results of these analyses were published in October 2015 (Z. Zelinkova and T. Wenzyl, Food Additives & Contaminants: Part A, 32: 1914-1926, 2015).

[In case you, like me, were wondering what propolis is, it is a resin like substance that bees use as a glue to hold their hives together. WebMD states that it may have some use as a topical agent for cold sores, genital herpes, and after mouth surgery, but that any other uses are unproven. However, if you visit websites for propolis products you find it in capsules and liquids for internal consumption. You are told that it cures bacterial and fungal infections, cures viral infections like AIDs, cures cancer, and removes warts.]

The results of their analysis were pretty scary:

72% of the supplements tested exceeded EU limits for the four most common PAH contaminants, and 52% exceeded EU limits for benzo[a]pyrene.

Propolis and spirulina were the most heavily contaminated supplements. Valerian and St. John’s Wort had moderately high levels of contamination, and some samples of bee pollen, sea buckthorn oil, barley greens, Echinacea, and Ginko far exceeded EU standards.

If consumers took the recommended dosage of the two most contaminated products (Premium Spirulina and Propolis Intense) they would more than double their daily intake of PAHs and far exceed what the IARC considers safe.

Fish oils generally had low levels of PAH contamination. The authors speculated this may be because fish have the ability to metabolize PAHs. However, other edible oils, particularly sea buckthorn oil and a mixture of garlic oil with soybean and sunflower oils did exhibit significant PAH contamination. The authors speculated that this PAH contamination may have been introduced during the processing of these oils.

Why The PAH and Contamination Problem Is Worse Than You Thought

You might be thinking what could be worse than 72% of supplements being contaminated with cancer causing PAHs? Here is some food for thought.

PAHs are just the tip of the iceberg. Many supplements are also contaminated with PCBs and heavy metals. For example:

Fish oil is often contaminated PCBs.

Rice protein and other rice-derived ingredients are often contaminated with lead and/or mercury.

The US regulates PAHs in our water supply, but does not currently regulate PAHs in our supplements. That means that manufacturers that make products primarily for consumption in the US have no incentive to test their products for PAH contamination. Most of them have no idea whether their products are safe or not.

There is no guarantee that even products labeled Certified Organic and Non-GMO are free of PAH contamination. For example:

Organic certification just means that the crop was raised using organic methods. No analysis of purity is required to assure that the crop had not been inadvertently contaminated. The same is true of non-GMO certification. No analysis of purity is required.

Organically grown, non-GMOcrops that are used as ingredients for supplements can still be contaminated if the air, soil or water is contaminated from any nearby pollution source. For example, ground water pollution is the major source of the heavy metal contamination often seen in rice-derived ingredients.

Organically grown, non-GMO crops can even become contaminated by PAHs if they are grown next to a busy highway.

Even if the ingredients are pure to begin with, PAH contamination can be introduced during processing.

What does all of this mean to us? It means that it is absolutely imperative that we do our due diligence and only choose supplement manufacturers whose quality control standards far exceed what is required of the industry. Our health just may depend on it.

The Bottom Line

A recent study has reported that 72% of herbal and botanical supplements, fish and edible oil food supplements, and supplements derived from bees sold in the EU were contaminated with high levels of cancer causing polycyclic aromatic hydrocarbons (PAHs).

The levels of PAHs in many of these products far exceeded standards recently enacted by the EU. If those supplements were taken as recommended, the daily intake of PAHs by people consuming them would also far exceed the safe limits of exposure to these toxic chemicals set in place by the International Agency for Research on Cancer.

While all of this sounds bad enough, the news is even worse for most of us living in the US.

PAHs are just the tip of the iceberg. Many supplements are also contaminated with PCBs and heavy metals.

The US regulates PAHs in our water supply, but does not currently regulate PAHs in our supplements. That means that manufacturers that make products primarily for consumption in the US have no incentive to test their products for PAH contamination. Most of them have no idea whether their products are safe or not.

There is no guarantee that even products labeled Certified Organic and Non-GMO are free of PAH contamination.

What does all of this mean to us? It means that it is absolutely imperative that we do our due diligence and only choose supplements manufacturers whose quality control standards far exceed what is required of the industry. Our health just may depend on it. Remember, PAHs are not the only potential problem.

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.

Exercise and Weight Loss

March 22, 2016 by Dr. Steve Chaney

Author: Dr. Stephen Chaney

Are you confused yet? Just as you were starting to wrap your mind around the current consensus recommendations that we engage in 30 minutes of moderate intensity exercise 5 days/week, news stories are starting to appear saying that might not be enough exercise if you want to lose weight!

So how much exercise DO you need, and why is there so much confusion with exercise and weight loss?

Let me start by reviewing a couple of studies that appeared a few years ago on weight loss in middle aged, overweight women.

Exercise and Fat Loss

The first study looked at the effect of exercise intensity on abdominal fat loss over a 16-week period(Irving et al, Medicine & Science In Sports & Exercise,40: 1863-1872, 2008).

The women in this study were divided into three groups:the control group that just continued their normal exercise pattern (little or none), a group that engaged in supervised moderate intensity exercise 5 days per week, and a group that engaged in supervised, high intensity exercise 3 days per week and moderate intensity exercise the other two days.

The diet was identical for all three groups and the calories expended by exercise were also identical (the high intensity exercise was performed for shorter periods of time so that the calories expended were the same).

The results were striking. Weight loss was similar in the two exercise groups (calories do count). However, the women in the high intensity exercise group lost a significant amount of abdominal fat while the other two groups did not! As you may know, abdominal fat appears to be much more damaging metabolically than fat stores in other parts of our bodies.

Exercise and Weight Loss

The second study looked at the effect of exercise duration on weight loss over a 24-month period (Jackcicet al, Archives of Internal Medicine, 168: 1550-1559,2008).

In this case the diet and the intensity of the exercise(moderate intensity) were the same. The difference was in the duration of the exercise. In this case the calories expended by exercise was not kept the same. The group that exercised for longer burned significantly more calories than those who exercise for a shorter time.

Again the results were striking. Only those study participants who exercised for at least 275 minutes/week (an average of almost 60 minutes a day for 5 days) were able to lose 10% or more of their weight and keep the weight off over a 24-month period.

How Much Exercise is Enough?

So what does all of this mean to you?

When most Americans decide to shed a few pounds, one of the first things they think of is getting more exercise. After all, it’s much easier to walk around the block during lunch hour than to actually change what you are eating.

The question then becomes how much exercise is enough? Is the recommended 30 minutes a day of moderate intensity exercise 5 days per week enough?

If you actually work through the math, it is pretty easy to guess that it might not be enough. For example, a recent study looked at how much moderate intensity exercise would be required for a 155-pound woman to burn off the calories in same popular fast foods. For example, to burn off the calories:

In a MacDonald’s Big Mac, she would need to cycle at a moderate pace for 1 hour.

In an Arby’s Reuben, she would need to walk at a moderate pace for 3 hours.

In a Super Sonic Double Cheeseburger with Mayo, she would need to do low impact aerobics for 3 hours.

Of course, if she had fries and a soda with any of those meals she would need to do even more exercise.

These estimates are not just hypothetical. The studies described above clearly show that if you are relying on exercise alone to shed your excess pounds and/or excess fat, you are going to need higher intensity exercise and/or longer duration moderate intensity exercise than the current consensus recommendations suggest.

In other words, the current recommendations of 30 minutes of moderate intensity exercise 5 days per week probably won’t make much of a dent in your weight unless the exercise is coupled with a very good weight loss program.

But, if you have ever relied on exercise alone for weight loss, you have probably guessed that already!

Of course, the consensus recommendations are still valid for what they were designed to accomplish. 30 minutes a day of moderate intensity exercise 5 days per week is sufficient to improve fitness and reduce cardiovascular risk factors. And fitness reduces your risk of disease even if you are still overweight.

Furthermore, since many Americans probably don’t get even 30 minutes of exercise in a week, 30 minutes 5 days per week is a great starting goal.

The Bottom Line

Recent studies show that the current recommendations of 30 minutes of moderate intensity exercise 5 days per week probably won’t make much of a dent in your weight unless the exercise is coupled with a very good weight loss program.

Don’t freak out about all of the conflicting exercise recommendations. Here’s what I suggest:

1) Consult with your physician before you start any exercise program.

2) Get active. Start slowly and start by choosing activities that are fun and accessible to you.

3) Set your goal of 30 minutes of moderate intensity exercise 5 days per week. If you want to lose weight, couple that with a well-designed weight loss program.

4) If your combination of exercise and diet isn’t putting a dent in your weight and weight loss is important to you, pick up the pace or increase the duration of exercise.

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.

Antioxidants and Aging

March 8, 2016 by Dr. Steve Chaney

Author: Dr. Stephen Chaney

Modern medicine has helped mankind greatly extend our lifespan, but what about our “healthspan”? Aging is often associated with major degenerative diseases and loss of physical and mental functioning. As the saying goes: “Aging isn’t for sissies”. But, what if you could live healthy into your 80s and 90s? What if you had the health to truly enjoy the wisdom that comes with your years of experience? In this article we will explore antioxidants and aging.

While healthy aging is a very personal issue for all of us in our golden years, it is a very important societal issue as well. The United Nations estimates that by 2050 more than 1/3 of the population of developed countries will be over 60. Unless we can find a way to preserve the health of these older adults, health care costs will bankrupt even the richest of countries.

That’s why the recently published study on the effect of antioxidant supplements on healthy aging in French adults (Assmann et al, American Journal of Epidemiology, 182: 694-704, 2015) is so interesting.

How Was The Study Designed?

This study was a follow-up to the “Supplementation With Antioxidant Vitamins and Minerals” study that was conducted in France during 1994-2002. That was a double blind, placebo controlled study in which participants were given either a placebo or a supplement containing 120 mg of vitamin C, 6 mg of beta-carotene, 30 mg of vitamin E, 100 ug of selenium, and 20 mg of zinc every day for an eight-year period. These nutrient levels were designed to be equivalent to the quantities provided by a balanced diet rich in fruits and vegetables.

The follow-up study was conducted approximately 5 years later with 3,996 of the original participants. The investigators specifically selected participants who were disease free when they entered the original study. These study participants were equally divided between men and women and had an average age of 65.3 years.

The participants were put through a battery of screens and assigned a “healthy aging score” based on:

Absence of cancer, heart disease and diabetes
Good physical and cognitive function
No limitations in activities associated with daily living
No depressive symptoms
No health-related limitations in social life
Good overall perceived health
No function-limiting pain

In short those participants with a high healthy aging score had good health and good quality of life.

Are Antioxidants the Secret to Healthy Aging?

When the investigators looked at the group as a whole, the results were pretty discouraging:

Antioxidant supplementation provided no significant benefit to the population as a whole.

Antioxidant supplementation also provided no significant benefit to the women in the group.

However, when they looked at subgroups, the results were much more encouraging:

Antioxidant supplementation increased the probability of healthy aging by 18% for the men in the study.

For those participants with low serum vitamin C levels at the beginning of the study antioxidant supplementation increased the probability of healthy aging by 28%

For those participants with low serum zinc levels at the beginning of the study antioxidant supplementation increased the probability of healthy aging by 26%

For those participants consuming very few fruits and vegetables at the beginning of the study, antioxidant supplementation increased the probability of healthy aging by 17%

The conflicting results for men and women were puzzling, but the investigators pointed out that very few women had low serum vitamin C status at the beginning of the study, while 25% of the men had low serum vitamin C levels at the beginning of the study. The investigators speculated that supplementation may have been less effective in women simply because they had better diets than the men in the study. That certainly wouldn’t surprise me.

What Are The Strengths And Weaknesses Of This Study?

Let’s start with the strengths. This is the very first double-blind, placebo-controlled study to look at the role of antioxidant nutrients in healthy aging. A number of previous studies looking at the effect of antioxidant nutrients on individual components of aging have given conflicting results. The investigators pointed out that this study may have shown more beneficial effects of antioxidants than previous studies because:

Most previous studies have been relatively short in duration. This was an 8-year study with a 5-year follow-up period (total study length = 13 years).

Most previous studies did not measure baseline intake of the nutrients. This study shows that individuals with low baseline intake or low serum levels at the beginning of the study are significantly more likely to benefit from supplementation.

Most previous studies have measured the effects of single antioxidant nutrients, or at most combinations of 2 or 3 antioxidant nutrients. This study used a combination of 5 different antioxidant nutrients. The synergy between these nutrients may have increased the magnitude of the observed benefits.

The weaknesses of the study are also pretty apparent.

Since it is the first study of its kind, it does need to be validated by additional studies.

There is no universally accepted index for healthy aging (This is a problem for aging research as a whole, not just this study).

The participants in the study were not evaluated for healthy aging criteria at the beginning of the study so we have no idea how their healthy aging score changed over time.

The beneficial effect of antioxidant nutrients, while significant, were relatively small. You are obviously not going to live healthy to 100 by consuming antioxidant supplements alone.

Antioxidants and Aging: Will Antioxidant Nutrients Help You?

This study does suggest that antioxidant supplements may help you achieve healthy aging. This study also makes three other very important points:

A holistic approach to supplementation – one involving multiple antioxidant nutrients – is much more likely to be beneficial than individual antioxidant supplements.

Supplementation is most likely to be beneficial for those individuals who are consuming a poor diet.

Supplementation is also most likely to be beneficial for those individuals who have low serum level of essential nutrients. This can be due to poor diet, but low serum levels of individual nutrients can also be caused by individual differences in metabolism or genetic make-up.

However, as noted above:

The study has some weaknesses and needs to be repeated.

The beneficial effects of antioxidant nutrients were relatively small.

That means that holistic approaches to healthy aging are more likely to be beneficial than individual supplements. Based on what we currently know a holistic approach to healthy aging includes:

Consuming a combination of a balanced diet and supplementation that provides sufficient levels of all the essential nutrients, not just the antioxidant nutrients. This would include things like omega-3 fatty acids and polyphenols.

Avoiding saturated and trans fats, excess sugar, red and processed meats, which may have bad effects on your health.

Controlling your weight.

Staying mentally and physically active.

Maintaining strong social networks.

Maintaining a positive outlook on life.

The Bottom Line

A recent study suggests that antioxidant supplements may help you achieve healthy aging. This study also makes two other very important points:

A holistic approach to supplementation – one involving multiple antioxidant nutrients – is much more likely to be beneficial than individual antioxidant supplements.

Supplementation is most likely to be beneficial for those individuals who are consuming a poor diet and/or have low serum levels of essential nutrients.

Since the beneficial effect of antioxidant nutrients on healthy aging was relatively small, this suggests the antioxidant nutrients are just one part of a holistic approach to healthy aging that includes.

Consuming a combination of a balanced diet and supplementation that provides sufficient levels of all the essential nutrients, not just the antioxidant nutrients. This would include things like omega-3 fatty acids and polyphenols.

Avoiding saturated and trans fats, excess sugar, red and processed meats, which may have bad effects on your health.

Controlling your weight.

Staying mentally and physically active.

Maintaining strong social networks.

Maintaining a positive outlook on life.

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.

8 Weight Loss Myths

March 1, 2016 by Dr. Steve Chaney

Why Your Weight Is Increasing Rather Than Decreasing

Author: Dr. Stephen Chaney

Usually I review scholarly publications of clinical studies, but occasionally I find an article in the popular press that’s so good I just have to share it with you. The lead article about weight loss by Bonnie Liebman in the April 2015 issue of Nutrition Action is just such an article. She called it “8 Weight Mistakes”, but I think “8 Weight Loss Myths” would be a better title.

There are certain weight loss myths that are repeated so often that most people believe they are true. Unfortunately, each one of these myths is a “fat trap” that can sabotage your efforts to achieve a healthy weight. If your New Year’s weight loss resolution isn’t going as well as you would like, it may be because you are still holding on to one or more of these myths.

Weight Loss Myth #1: I Can Lose It Later

It’s easy to tell yourself that you don’t need to watch your weight during the holidays or while you are on vacation. After all you can cut back a bit when those special occasions are over and lose that extra weight. What makes that belief particularly insidious is that it actually worked for you when you were in your teens or early twenties. Why doesn’t it work anymore? There are 4 reasons:

On most diets you lose muscle as well as fat. I have talked about this in a previous article, High Protein Diets and Weight Loss , but muscle is important because it burns off calories much faster than fat.

Your organs become smaller. For example, as you lose weight your heart doesn’t have to service as many miles of blood vessels, so it can become smaller as well. That’s important because your heart works so hard pumping blood that it burns off calories much faster than resting muscle.

Once you have lost a significant amount of weight exercise burns fewer calories. If you don’t believe that, try lugging an extra 10 or 20-pound weight up a flight of stairs.

Your metabolism slows down. This is particular true if you try to lose weight too fast as I have explained in my “3 Things Every Successful Diet Must Do” eBook, which is available at Health Tips From the Professor.

Just in case you are still a doubter, Ms. Liebman shared a study in her article that showed most people never lose all of the weight they gained during the holidays before the next holiday season starts. Does that sound familiar?

Weight Loss Myth #2: Once It’s Off, It’ll Stay Off

You’ve heard this one before. However, even on the most successful diets, weight loss is temporary. Most people eventually regain all the weight they’ve lost and more. Again I’ve also covered the reason for this in my “3 Things Every Successful Diet Must Do” eBook, which is available at Health Tips From the Professor. To spare you the trouble of reading the book I will share the secret with you. Simply put: “Diets never work long term. Only true lifestyle change can lead to long term weight loss.”

However, that doesn’t stop people from believing that the next “magic” diet will be their ticket to permanent weight loss. It always amazes me that people fall for this same myth time after time.

Weight Loss Myth #3: Fat Is Fat, No Matter Where It Is

Most of you probably already knew that belly fat (the so-called apple shape) is metabolically more dangerous to our health than thigh & leg fat (the so-called pear shape). However, some of the other information Ms. Liebman shared was a surprise to me.

It turns out that belly fat is actually easier to lose than thigh & leg fat. As you add fat to your lower body you create lots of new fat cells (2.6 billion new fat cells for every 3.5 pounds of fat). Once you add that extra fat to your lower body you’re pretty much stuck with it.

Of course, you can’t add new fat to your belly forever without creating new fat cells, and once you’ve created those new fat cells you may be stuck with your belly fat as well.

Weight Loss Myth #4: You Have To Go Out Of Your Way To Overeat

It’s really difficult to understand how anyone could believe in this myth. The fact is that we live in a “fat world”. There are fast food restaurants on virtually every street corner in every city and in virtually every mall in this country. Restaurant portion sizes are through the roof. Every social interaction seems to be centered around food or drink.

You don’t need to go out of your way to overeat. Overeating has become the American way. You actually need to go out of your way to avoid overeating.

Weight Loss Myth #5: All Extra Calories Are Equal

Research has confirmed what many of you probably suspected already. All calories are NOT equal. Calories from alcohol, saturated fats, trans fats and sugars make a beeline for your belly where they are converted into the most dangerous form of fat.

Weight Loss Myth #6: I Can Just Boost My Metabolism

Many Americans cling to the false hope that they can eat whatever they want as long as they take some sort of magic herb or pill to boost their metabolism. The fact is that natural metabolic boosters like green tea have a very modest effect on metabolism. They can play a role in a well-designed diet program, but they will never allow you to eat whatever you want and lose weight.

As for those magic herbs and drugs that promise to burn off fat calories without you lifting a finger, my advice is to avoid them like the plague. I’ve talked about many of them in my previous “Health Tips From the Professor” articles. For example, you might be interested in my articles “Are Dietary Supplements Safe?” or “Are Diet Pills Safe?”. The bottom line is that these metabolic boosters are dangerous – and they just might kill you.

Weight Loss Myth #7: There’s A Magic Bullet Diet

Hope springs eternal. Perhaps that’s why so many new diets appear each year. Some diets are low fat, some are low carbohydrate, some hearken back to cave man times, and others are just plain weird. Some of them actually do give better weight loss than others short term. However, when you follow people on those diets for two years or more, none of them work very well (see myth #2), and there isn’t a dimes worth of difference between them.

Weight Loss Myth #8: I Can Work Off The Extra Calories

This is perhaps the most pervasive myth of all. This is the one that sells millions of gym memberships every January.

Don’t get me wrong. Diet plus exercise can be very beneficial because it helps you retain muscle mass as you are losing weight, especially if you are consuming enough protein to support the exercise.

However, exercise alone isn’t going to help you nearly as much as you think.

You’d have to ride your bicycle for an hour and 25 minutes to offset the 500 calorie dessert you just consumed at your favorite restaurant.

Exercise helps some people more than others. Studies show that some people get hungrier when they exercise. As a result, they eat more calories and actually gain weight rather than losing it.

Finally, don’t rely on your fitness trackers. Most of them grossly overestimate the calories you burn through exercise. If you use a fitness tracker you should cut their estimates for calories burned by 50% or more.

The Bottom Line

A recent article shared the 8 most common weight loss myths. If you actually believe any of these myths, you will have a very difficult time getting your weight under control.

I can lose it later.

Once it’s off, it’ll stay off.

Fat is fat, no matter where it is.

You have to go out of your way to overeat.

All extra calories are equal (A calorie is a calorie).

I can just boost my metabolism.

There is a magic bullet diet.

I can work off the extra calories.

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

Do B Vitamins Reduce Heart Disease Risk?

February 23, 2016 by Dr. Steve Chaney

What Role Do B Vitamins Play in a Heart Healthy Lifestyle?

Author: Dr. Stephen Chaney

Two weeks ago I shared some studies that challenge the claim that vitamin E doesn’t reduce heart attack risk. To close out “Heart Health” month, I want to share some information that may change how you think about B vitamins and heart disease risk. Once again, you’ve seen the headlines: “B Vitamins Do Not Reduce the Risk of Heart Disease”. In fact, these headlines have been repeated so many times that virtually every expert thinks that it has to be true. Once again, I’m going to share some information with you that I learned from a seminar by Dr. Jeffrey Blumberg who disagrees with this commonly held belief.

Dr. Blumberg is a Professor in the Friedman School ofNutrition Science and Policy at Tufts. Dr. Blumberg has over 200 publications in peer-reviewed scientific journals. He is considered one of the world’s top experts on supplementation, and his specialty is conducting and analyzing clinical studies. He believes that the media has seriously misinterpreted the studies on B vitamins and heart disease risk. You might call this “The Rest of the Story” because you (and your doctor) definitely did not hear this part of the story in the news.

Do B Vitamins Reduce Heart Disease Risk?

The study in question is called the “Heart Outcomes Prevention Evaluation-2“. In that study a group of middle aged men and women received 2.5 mg of folate, 50 mg of vitamin B6 and 1 mg of vitamin B12 versus a placebo and were followed for an average of 5 years.

The headlines that you may have seen said “B vitamins do not reduce the risk of major cardiovascular events in patients with vascular disease”. But, the headlines did not tell the whole story.

In the first place, that was only true for heart attacks and cardiovascular death. Strokes were reduced by 25%. I don’t know about you, but I consider strokes to be fairly major.

However, even when we focus on heart attacks and cardiovascular deaths the headlines didn’t tell the whole story. You see, even the best intentioned studies sometimes contain fatal flaws that aren’t obvious until after the study has been completed.

The Flaws In The Study

There were two major flaws in this study.

Flaw #1 was that 70% of the study subjects were eating foods fortified with folate and had adequate levels of that nutrient in their bloodstream before the study started.

For those people who were already getting enough folate in their diet, B vitamin supplementation didn’t make much of a difference. However, for those people not getting adequate levels of folate in their diet, B vitamin supplementation decreased their risk of heart disease by ~15%.

Flaw #2 was that ~90% of the people in the study had a history of coronary artery disease and most of them were already on cholesterol lowering medications.

To understand why this is a problem you have to understand both the proposed mechanism by which B vitamin supplementation has been proposed to lower the risk of heart disease AND how the cholesterol lowering drugs work.

Deficiencies of folate, B6 and B12 are thought to increase the risk of heart disease because the B vitamin deficiency causes an increase in homocysteinelevels in the blood, and high homocysteine levels are thought to increase inflammation – which is a risk factor for heart disease. So supplementation with folate, B6 and B12 has been proposed to decrease heart disease risk by decreasing inflammation.

The problem is that the most commonly used cholesterol lowering medications also decrease inflammation.So you might not be surprised to learn that those people who had a history of coronary artery disease(and were taking cholesterol lowering medication that reduces inflammation) did not receive much additional benefit from B vitamin supplementation.

For those people in the study who were not taking cholesterol lowering medication, B vitamin supplementation also reduced their risk of heart attacks by ~15% – but there were too few people in that group for the results to be statistically significant.

So the headlines from this study really should have said “B vitamins do not reduce the risk of heart attacks or cardiovascular deaths in people who are already getting adequate folate from their diet or in people who are taking drugs that reduce the bad effects of B vitamin deficiency”. But that kind of headline just wouldn’t sell any newspapers.

What Does This Study Mean For You?

There are two very important take-home lessons from this study.

Lesson #1: Once again this study makes the point that supplementation makes the biggest difference when people have an increased need. The studies discussed in Vitamin E and Heart Disease two weeks ago illustrated increased need because of age, pre-existing disease, and genetic predisposition. This study illustrated increased need because of inadequate diet.

Lesson #2: This study also illustrates a problem that is becoming increasingly common in studies of supplementation. It is considered unethical to not provide participants in both groups with what is considered the standard of care for medical practice. In today’s world the standard of care includes multiple drugs with multiple side effects, and some of those drugs may have the same mechanism of action as the supplement.

I have discussed this problem in the context of omega-3 fatty acids and heart disease in a previous “Health Tips From the Professor,” Is Fish Oil Really Snake Oil? In many cases it is no longer possible to ask whether supplement X reduces the risk of a particular disease. It is now only possible to ask whether supplement X provides any additional benefit for patients who are taking multiple drugs, with multiple side effects. That’s not the question that many of my readers are interested in.

The Bottom Line

Headlines have proclaimed for years the “B Vitamins Do Not Reduce Heart Disease Risk”. Dr. Jeffrey Bloomberg of Tufts University has reviewed one of the major studies behind this claim and found the headlines to be misleading.

For example, the study showed that B vitamin supplementation reduced strokes by 25%, which is a pretty significant finding in itself.

When he analyzed the portion of the study looking at heart attacks, he found two major flaws:

#1: 70% of the people in the study were already getting adequate amounts of B vitamins from their diet and would not be expected to benefit from supplementation. For the 30% who weren’t getting adequate amounts of B vitamins from their diet, supplementation reduced their risk of heart attack by 15%.

#2: 90% of the people in the study were taking a drug that masks the beneficial effects of B vitamin supplementation. For the 10% who weren’t taking the drug, supplementation with B vitamins also reduced their risk of heart attack by 15%, but there were too few people in that group for the results to be statistically significant.

Obviously, there were only a handful of people in the study who weren’t getting enough B vitamins from their diet AND weren’t on medication, so we have no idea what the effect of B vitamin supplementation was in that group.

Once again this study makes the point that supplementation makes the biggest difference when people have an increased need. The studies discussed in “Health Tips From the Professor” two weeks ago illustrated increased need because of age, pre-existing disease, and genetic predisposition. This study illustrated increased need because of inadequate diet.

This study also illustrates a problem that is becoming increasingly common in studies of supplementation. It is considered unethical to not provide participants in both groups with what is considered the standard of care for medical practice. In today’s world the standard of care includes multiple drugs, some of which may have the same mechanism of action as the supplement.

In many cases it is no longer possible to ask whether supplement X reduces the risk of a particular disease. It is now only possible to ask whether supplement X provides any additional benefit for patients who are taking multiple drugs, with multiple side effects. That’s not the question that many of my readers are interested in.

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.

Plantar Fasciitis Causes and Treatment

February 16, 2016 by Dr. Steve Chaney

You Can Enjoy Pain Free Living From Home

Author: Julie Donnelly, LMT –The Pain Relief Expert

Editor: Dr. Steve Chaney

Recently a woman came in to see me who was suffering from severe plantar fasciitis pain, her arch hurt so much she could barely walk. She’d been to several specialists and has so far bought three pair of orthotics (at $400 each!). Plantar fasciitis is getting to be a commonplace condition in my office. I love working with athletes, but I’m finding this isn’t only a problem for athletes.

Because of driving a car for long distances her right foot was worse than her left, which makes sense since the muscles that enable you to press down on the gas and brake pedals, are the same ones that are the cause of plantar fasciitis.

Plantar Fasciitis Causes: Are Muscles The Culprit?

Muscles are seldom considered when searching for the answer to plantar fasciitis pain. Instead the foot is considered to be the problem, instead of the symptom, and orthotics are commonly recommended. In many cases, when muscles are the cause of the plantar fasciitis symptoms, the orthotics will cause more pain.

The analogy I always use is, if you pull your hair at the end, your scalp will hurt. But you don’t need to massage your scalp, you don’t need to take pain-killers for the headache, and you don’t need brain surgery — you just need to let go of your hair! It’s the same with joint pain. Muscles pull on tendons, and the tendons insert into a joint. When the muscle is tight you will feel the pain at the joint. But you don’t need to rub the joint, or take pain-killers, or have surgery—you need to release the spasms in the muscle fibers.

In the case of plantar fasciitis, the muscles are in your lower leg, and the insertion of the tendon is in your arch – so when the muscles are tight your arch will hurt.

The two muscles are the tibialis anterior and the peroneal. The tibialis anterior runs along the entire length of the shin bone and then the tendon inserts onto the first metatarsal (the long bone that is on the inside of your arch and goes up to your big toe), while the peroneal runs along the entire outside of your lower leg, goes behind your ankle, and the tendon inserts on the fifth metatarsal (the bone on the outside of your foot) and also on the first metatarsal at the same point as the insertion of your tibialis anterior. This is important to visualize so you can see how the tendons pulling on the bones will put pressure on your arch and cause the arch muscles to be strained — causing plantar fasciitis pain in the bottom of your foot.

Self-Treatment For Plantar Fasciitis Pain

There are several muscles that all impact your arch and cause the pain of plantar fasciitis. This picture is doing the treatment for the muscle that runs down the outside of your lower leg, called peroneal. The peroneal is neglected by most therapists when searching for an answer to foot pain, yet it is often one of the key muscles that needs to be treated to get relief.

Sit as shown in the picture and use either the Julstro Perfect Ball, or a new tennis ball, and press the outside of your leg directly onto the ball. You’ll find a very tender point at the same level as shown in this picture.

When you find it, hold the pressure steady, and then slightly move your leg so the ball rolls up and down the outside of your leg. Use your hand as shown to press down on your leg to increase the pressure.

You’ll be thrilled when you see how quickly you’ll feel relief! You’ll be able to go back out and enjoy your life pain-free!

Plantar fasciitis causes are often centered around muscles in the legs, therefore plantar fasciitis pain relief is also.

Wishing you well,

Julie Donnelly

About The Author

Julie Donnelly is a Deep Muscle Massage Therapist with 20 years of experience specializing in the treatment of chronic joint pain and sports injuries. She has worked extensively with elite athletes and patients who have been unsuccessful at finding relief through the more conventional therapies.

She has been widely published, both on – and off – line, in magazines, newsletters, and newspapers around the country. She is also often chosen to speak at national conventions, medical schools, and health facilities nationwide.

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

Check It Out!

If you would like easy to follow instructions on how to relieve joint pain and muscle tightness from head to toe click here (http://www.triggerpointyoga.com/product/triggerpoint-yoga-full-body-kit/?ap_id=SteveChaneyTips) to check out Julie Donnelly’s Trigger Point Yoga instruction kit today. Whenever, I have pain and stiffness I use her techniques. They work!