Diets

Is The Mediterranean Diet Healthy For Women?

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What Does This Study Mean For You? 

Author: Dr. Stephen Chaney 

There is a well-known health disparity in clinical studies related to health. For years most of the studies have been done by men for men. Women have been assumed to experience the same benefits and risks from diet choices as men. But that hasn’t always proven to be true.

The Mediterranean diet is no exception. For example, it has garnered a reputation of reducing heart disease risk for both men and women.

However, most studies on the Mediterranean diet have included primarily male participants or did not report sex specific differences in outcomes.

And the few studies that reported sex specific outcomes have been inconsistent.

  • Some studies have found that men and women benefitted equally from the Mediterranean diet.
  • Other studies have reported that men benefitted more than women.

However, these were all small studies. No meta-analyses have been reported that focused on the heart benefits of the Mediterranean diet for women.

The study (A Pant et al., Heart; 109: 1208-1215, 2023) I will describe today was designed to fill that gap.

How Was The Study Done?

clinical studyThe investigators started by screening the literature to find studies that:

  • Measured adherence to the Mediterranean diet using the original MDS (Mediterranean Diet Score) or more recent modifications of the MDS.
  • Included women ≥18 years without previous diagnosis of clinical or subclinical heart disease.
  • Performed the study with only women participants or organized their data so that the data pertaining to women could be extracted from the study.

The investigators then performed a meta-analysis on data from 722,495 women in 16 studies published between 2006 and 2021 that met these criteria. These studies followed the women for an average of 12.5 years. The studies were primarily conducted in the United States and Europe.

The individual studies divided participants into either quintiles or quartiles and compared participants with the highest adherence to the Mediterranean diet to those with the lowest adherence.

  • The primary outcomes measured were total mortality and the incidence of CVD, cardiovascular disease (defined as including CHD (coronary heart disease), myocardial infarction (heart attack), stroke, heart failure, and cardiovascular death).
  • The secondary outcomes measured were stroke and CHD, coronary heart disease (heart disease caused by atherosclerotic plaque build up in the coronary arteries).

Is The Mediterranean Diet Healthy For Women?

Mediterranean Diet FoodsWhen comparing the highest to the lowest adherence to the Mediterranean diet:

  • The incidence of CVD (cardiovascular disease) was reduced by 24%.
  • Total mortality during the ~12.5-year follow-up was reduced by 23%.
  • The incidence of CHD (coronary heart disease) was reduced by 25%.
  • The risk of stroke was reduced by 13%, but that risk reduction was not statistically significant.
    • The risk reduction for both CVD and total mortality was similar to that previously reported for men.
    • Risk reduction for CVD was slightly higher for women of European descent (24%) than for women of non-European descent (21%). The later category included women of Asian, Native-Hawaiian, and African – American descent.

The authors concluded, “This study supports a beneficial effect of the Mediterranean diet on the primary prevention of CVD and death in women and is an important step in enabling sex-specific guidelines.”

I would add that the data from women of non-European decent suggests that genetic background and/or ethnicity may influence the effectiveness of the Mediterranean diet at reducing heart disease risk, but this effect appears to be small.

What Does This Mean For You?

The results of this study are not unexpected. But that doesn’t mean that studies with women are not valuable. There have been several examples in recent years where health or medical advice based on studies with men needed to be modified for females once the studies were repeated with women.

Before covering what this study means for you, I should point out that while women often fear breast cancer most, heart disease is their number one killer, as the graph on the left shows. In fact, a woman’s risk of dying from coronary heart disease is 6 times greater than her risk of dying from breast cancer.

This study shows that following a Mediterranean–style diet lowers their risk of developing and dying from heart disease. But the Mediterranean diet is not alone in providing these health benefits. It is simply a whole food, primarily plant-based diet that reflects the food preferences of the Mediterranean region.

The DASH diet, which reflects the food preferences of Americans, and the Nordic diet, which reflects the food preferences of the Scandinavian countries, are equally heart healthy. In fact, any whole food, primarily plant-based diet will reduce the risk of heart disease. You should choose the one that best fits your food preferences and lifestyle.

Of course, diet is just part of a holistic approach for reducing heart disease risk. Other important risk reduction strategies include:

  • Don’t smoke.
  • Exercise and maintain a healthy weight.
  • Manage stress.
  • Avoid or limit alcohol.
  • Know your numbers (cholesterol, triglycerides, and blood pressure, for example).
  • Manage other health conditions that increase the risk of heart disease (high blood pressure, diabetes, and high cholesterol, for example).

The Bottom Line

Most studies on the heart health benefits of the Mediterranean diet have been done with men or have not analyzed the data from men and women separately. A recent meta-analysis combining data from 16 studies with 722,495 women showed that the Mediterranean diet was just as heart healthy for women as it was for men.

The authors concluded, “This study supports a beneficial effect of the Mediterranean diet on the primary prevention of CVD and death in women and is an important step in enabling sex-specific guidelines.”

For more details on this study and information on other diets that are heart healthy, 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 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 Personalized Diets Help Control Blood Sugar?

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What Does This Study Mean For You? 

Author: Dr. Stephen Chaney 

Personalized diets are highly advertised. We are told to forget the old “one size fits all” diets of the past. We are told we are all different, so diets should be individualized to us.

We are promised that by collecting DNA samples from our tissue or bacteria in our gut, blood samples, and personal medical history, a personalized diet can be created that “fits us like a glove”.

But are those promises true, or are they hype? Diets to control blood sugar spikes should be a perfect topic for testing those claims. Millions of Americans have trouble controlling their blood sugar levels. Specifically:

  • 1 million adults (14.7% of US adults) have diabetes, mostly type 2 diabetes.
  • 6 million adults (38.0% of US adults) have prediabetes.
    • That amounts to 52% of the US population who have trouble controlling blood sugar levels.
  • Previous studies have shown that prediabetes and type 2 diabetes are largely reversible with diet and lifestyle change.
  • Recent studies have shown tremendous inter-person variability in the blood sugar response to any given food.
  • Previous studies have shown that our gut bacteria influence our blood sugar response to foods.

In theory, blood sugar control should be the perfect candidate for personalized diets. With that in mind, the authors of this study have created an algorithm called PNP (Personal Nutrition Program) that combines continuous blood glucose monitoring, HbA1c measurement (a measure of blood sugar control), personal characteristics (physical activities, sleep times, stress, and hunger), and a DNA analysis of stool samples to identify the species of gut bacteria. They also created a PNP app to allow participants to monitor and modify the foods they ate on a continuous basis.

In this study (AY Kharmats et al, The American Journal of Clinical Nutrition, 118: 443-451, 2023) the authors compared the effectiveness of their Personalized Nutrition Program algorithm with a standard, one-size-fits-all, low fat diet for improving blood sugar control in patients with prediabetes and type 2 diabetes.

Note: They used a low fat diet because, despite what you may have heard, low fat diets are better than low carb diets for diabetics. Of course, the low fat diet they used was created by dietitians. The carbohydrates came from whole foods rather than added sugars.

How Was The Study Done? 

Clinical StudyThe investigators recruited 156 participants from the NYU Langone Health Center between January 2018 and March 2021. The participants selected were overweight with prediabetes or moderately controlled type 2 diabetes. For participants with type 2 diabetes, it was managed with lifestyle alone or lifestyle plus metformin. Other characteristic of the study participants were:

  • Gender: 33.5% male, 66.5% female.
  • Race & Ethnicity: 55.7% white, 24.1% black, 16.5% Hispanic.
  • Education: 69.5% with a college degree.
  • Baseline BMI: 33 (Obese).
  • Baseline HbA1c: 5.8% (prediabetic range) with 12% of participants ≥6.5% (diabetic range).

The participants were randomly divided into two groups that were matched with respect to weight and blood sugar control. One group was put on a diet based on the investigator’s PNP algorithm. The other group was put on a standardized low fat (< 25% of calories from fat) diet that is often used with diabetic patients.

Upon admission to the study, blood samples were drawn for HbA1c, a detailed questionnaire was filled out, and stool samples were obtained for DNA analysis to identify the species of bacteria in their gut.

Each participant was given a continuous glucose monitoring device to wear during the study. This allowed the investigators to monitor the participants blood sugar control throughout the study.

All this information was used to provide individual diet recommendations for the personalized diet group using the PNP algorithm developed by the investigators.

The study lasted 6 months and measured improvements in blood sugar control as assessed by a decrease in blood sugar spikes and a reduction in HbA1c.

Both Groups were put on a registered dietitian-led behavioral intervention program targeting 7% weight loss and a calorie deficit goal of 500 calories per day. The 1-hour sessions were conducted by Webex weekly for 4 weeks and then every other week for the remaining 5 months. The sessions included:

  • Education (e.g., obesity risks, benefits of weight loss, strategies for restricting calories, protocols for aerobic exercise and strength training, and dealing with weight loss plateaus)
  • Behavioral change (e.g., importance of behavioral change, goal setting, self-reward, and problem-solving around common barriers to weight loss success)

The participants were advised to gradually build up to 150 min/week of moderate intensity exercise.

Each participant was given access to the PNP mobile app designed by the investigators. The app provided real-time feedback regarding their dietary intake relative to the target specific to their group (low fat diet or personalized diet). Participants were asked to use the app to:

  • Enter their dietary intake and self-monitor their meals (If the meal did not match the target specific to their group, the participants were trained how to substitute other foods, so their meal better matched their target.)
  • For the Standardized Low Fat Group, the PNP app provided real-time feedback regarding calorie intake and macronutrient distribution for meals and snacks logged in by the participants.
  • For the Personalized Group the PNP app scored meals as excellent, very good, good, bad, or very bad based on the PNP algorithm developed by the investigators.

Can Personalized Diets Help Control Blood Sugar? 

The results were clear-cut:

  • Weight loss was identical on both diets. This is no surprise. The study design included an exceptionally well-designed weight loss protocol for both groups.
  • The decrease in HbA1c was identical on both diets.
  • The improvement in blood sugar control was identical on both diets.

The investigators concluded, “[The] personalized diet did not result in an increased reduction in GV [blood sugar control] or HbA1c in patients with prediabetes or moderately controlled type 2 diabetes compared to a standardized diet.”

Since the investigators had designed the algorithm used to create personalized diets for this study, this was probably not the result they wanted.

So, they added, “Additional subgroup analyses may help to identify patients who are more likely to benefit from this personalized intervention.”

What Does This Study Mean For You? 

QuestionsThis first takeaway from this study was obvious:

  • The personally designed diet did not perform any better than a standard, one size fits all, diet at improving blood sugar control.

Of course, this was not any standard diet. It was a diet that has been used successfully with diabetics for years. However, a lot of research had gone into developing the personalized diet. One might have expected it to perform better.

This is not the first study in which a personalized diet has performed no better than a standard diet. It doesn’t mean that the concept behind personalized diets is faulty. It just means we don’t yet know enough to design a personalized diet that really works.

The second takeaway from this study might be less obvious:

  • Weight loss is the most important factor for improving blood sugar control. Any diet that reduces weight will improve blood sugar control. This is also true for many other health issues such as high cholesterol, high blood pressure, high triglycerides, and osteoarthritis.
  • However, this should not come as a surprise either.
    • Vegan and keto diets are polar opposites. Yet both give similar short-term weight loss and provide similar short-term health benefits.
    • Studies have shown that intermittent fasting gives no better weight loss and health benefits than any diet that cuts calories to a similar extent.
    • In other words, the diet you choose or the way you choose to restrict calories doesn’t matter. It is weight loss that provides the health benefits.
  • However, diet does appear to matter in the long term. If you look at studies ranging from 10 to 30 years, primarily plant-based diets provide better health benefits than primarily meat-based diets. And diets consisting primarily of whole, unprocessed foods provide better health benefits than diets high in processed foods.

Finally, there is an important corollary to this study showing that a personalized diet performed no better than a standardized diet at controlling blood sugar.

  • Some companies are trying to sell you expensive personalized diets with extravagant claims about the health benefits of their diet. Be wary of those diets. The science supporting their diets is premature. Their claims may be misleading.
  • And if the companies claim their diet is supported by published clinical studies, you should evaluate those studies carefully. The study I reviewed in this article was an exceptionally well-designed study. Any study that does not control for weight loss is likely to provide misleading results.

The Bottom Line 

A recent study compared the effectiveness of a personalized diet and a standardized diet in improving blood sugar control for patients with prediabetes or type 2 diabetes. The results were clear-cut:

  • Weight loss was identical on both diets. This is no surprise. The study design included an exceptionally well-designed weight loss protocol for both groups.
  • The decrease in HbA1c was identical on both diets.
  • The improvement in blood sugar control was identical on both diets.

This doesn’t mean that the concept behind personalized diets is faulty. It just means we don’t yet know enough to design a personalized diet that really works.

For more information on this 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.

Is Time-Restricted Eating Better Than Other Diets?

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Is Time-Restricted Eating Right For You?

Author: Dr. Stephen Chaney 

Time-restricted eating is the latest fad. If you read Dr. Strangeloves’ blogs, he or she will tell you that eating for 8-10 hours and fasting the rest of the day will change your metabolism. They tell you that:

  • You don’t need to change what you eat.
  • You don’t have to restrict calories.
  • You don’t have to restrict fats or carbs.
  • You will feel fuller and naturally eat less.
  • The pounds will just drop away magically.

And you will have benefits like:

  • Better blood sugar control.
  • Lower levels of heart-unhealthy lipids like LDL and triglycerides.
  • Enhanced cellular repair, which might help you live longer.

Are these claims true? Is there something special about time-restricted eating, or is it simply another way to cut calories?

Two recent studies (EA Thomas et al, Obesity; 30: 1027-1038, 2022) and (D Liu et al, New England Journal of Medicine, 386: 1495-1505, 2023) answered these questions by cutting calories to the same extent for people following a time-restricted eating pattern and people who had no restrictions on when they ate.

How Were These Studies Done?

clinical studyStudy 1: The authors enrolled 81 adults aged 18 to 50 years (average = 38 years, 69% female) with BMIs of 27 to 45 (overweight to morbidly obese).

The study lasted 39 weeks with measurements taken at baseline, 12 weeks, and 39 weeks.

The participants were divided into two groups:

  • A time-restricted eating group that was advised to restrict their eating to start eating within 3 hours of waking and restrict their eating to 10 hours.
  • A calorie restricted group that was given no time limitations on when they could eat.

Both groups were:

  • given a personalized calorie goal which represented a 35% caloric restriction based on measurements of their resting energy expenditure.
  • enrolled in a 39-week, group-based, comprehensive weight-loss program. Groups were taught by registered dietitians and met weekly through the first 12 weeks, and monthly between weeks 13 and 39.

Study 2: The authors enrolled 139 adults 18 to 75 years (average age = 32, 64% female) with BMIs of 28 to 45. The study lasted 12 months.

The participants were divided into two groups:

  • A time-restricted eating group that was advised to restrict their eating to between 8 AM and 4 PM (an 8-hour window) each day.
  • A calorie restricted group that was given no time limitations on when they could eat.

Both groups:

  • Were told to reduce calories by 25% which represented a 1500-1800 calorie/day diet for men and a 1200-1500 calorie/day diet for women.
  • Received dietary information booklets that provided portion advice and sample menus.
  • Were required to write in a daily dietary log, photograph the food they ate, and note the time they ate it using a mobile app.
  • Received follow up phone calls or app messages twice per week and met with trained health coaches every two weeks.

Is Time Restricted Eating Better Than Other Diets?

Here are the results of the two studies.

Study 1: There was no difference between the time-restricted group and the group who were just told to cut calories at either 12 or 39 weeks for:

  • Weight loss.
  • Body composition (fat loss and lean muscle mass loss).
  • Appetite and eating behaviors.
  • HDL cholesterol, LDL cholesterol, total cholesterol, and HbA1c (a measure of blood sugar control).

The authors concluded two things:

  1. “Time-restricted eating with caloric restriction was found to be an acceptable dietary strategy, resulting in similar levels of adherence and weight loss compared to caloric restriction alone.”

2) “The addition of behavioral support and caloric restriction to a time-restricted eating intervention results in a clinically significant weight loss, a reduction in caloric input, and an improvement in diet quality.”

Study 2: There was no difference between the time-restricted group and the group who were just told to cut calories at 12 months for:

  • Weight loss, BMI, and waist circumference.
  • Body composition (fat loss and lean muscle mass loss).
  • Appetite and eating behaviors.
  • Blood pressure, HDL cholesterol, LDL cholesterol, total cholesterol, fasting blood sugar levels, and several measures of blood sugar control.

The authors concluded, “Among patients with obesity, a regimen of time-restricted eating was not more beneficial with regard to reduction in body weight, body fat, or metabolic risk factors than daily caloric restriction.”

Is Time-Restricted Eating Right For You?

Questioning WomanThe take-home lessons are the same for both studies.

  1. You can forget the metabolic mumbo-jumbo of the Dr. Strangeloves of our world. When you restrict calories to the same extent, time-restricted eating is no more successful and no healthier than any other diet.”

2) Like any other diet, time-restricted eating works best when you focus on eating healthy foods and reducing your caloric intake.

So, what does this mean for you? I have two thoughts:

1) If you find it easier to cut calories by restricting the time you eat, then time-restricted eating is right for you. If not, choose a healthy, reduced calorie diet that best fits your food preferences and lifestyle.

2) Time-restricted eating works best when you are in complete control of when and what you eat. They don’t work as well for travel, holidays with friends and family, and other social occasions. If your lifestyle is such that you are often not in control of when and what you eat, you might want to choose a more flexible diet.

The Bottom Line 

Time-restricted eating is the latest fad. If you read Dr. Strangeloves’ blogs, he or she will tell you that eating for 8-10 hours and fasting the rest of the day will change your metabolism, the weight will fall away effortlessly, and your health will be better.

But is this true? Two recent studies tested the hypothesis that time-restricted eating offers a special advantage by cutting calories to the same extent for people following a time-restricted eating pattern and people who had no restrictions on when they ate.

Both studies found there was no difference between the time-restricted group and the group who were just told to cut calories for:

  • Weight loss.
  • Body composition (fat loss and lean muscle mass loss).
  • Appetite and eating behaviors.
  • HDL cholesterol, LDL cholesterol, total cholesterol, and HbA1c (a measure of blood sugar control).

The take-home lessons are the same for both studies.

  1. You can forget the metabolic mumbo-jumbo of the Dr. Strangeloves of our world. When you restrict calories to the same extent, time-restricted eating is no more successful and no healthier than any other diet.”

2) Like any other diet, time-restricted eating works best when you focus on eating healthy foods and reducing your caloric intake.

For more information on this study and a discussion of whether time-restricted eating might be right 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

Which Diets Are Heart Healthy?

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What Does A Heart Healthy Diet Look Like?

Author: Dr. Stephen Chaney 

heart attacksHeart disease is a big deal. According to the CDC, “Heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups in the United States. One person dies every 33 seconds in the United States from cardiovascular disease. About 695,000 people in the United States died from heart disease in 2021 – that’s 1 in every 5 deaths”.

This doesn’t have to happen. According to the Cleveland Clinic, “90 percent of heart disease is preventable through healthier diet, regular exercise, and not smoking”. For this issue of “Health Tips From the Professor”, I will focus on the role of diet on heart health.

The problem is many Americans are confused. They don’t know what a heart-healthy diet is. There is so much conflicting information on the internet.

Fortunately, the American Heart Association has stepped in to clear up the confusion.

In 2021 they reviewed hundreds of clinical studies and published “Evidence-Based Dietary Guidance to Promote Cardiovascular Health”.

And recently they have published a comprehensive review (CD Gardner et al, Circulation, 147: 1715-1730, 2023) of how well popular diets align with their 2021 dietary guidelines.

I will cover both publications below. But first I want to address why Americans are so confused about which diets reduce heart disease risk.

Why Are Americans Confused About Diet And Heart Disease Risk?

I should start by addressing the “elephant in the room”.

  • As I discussed in last week’s “Health Tips From the Professor” article, Big Food Inc has seduced us. They have developed an unending supply of highly processed foods that are cheap, convenient, easy to prepare, and fulfill all our cravings. These foods are not heart-healthy, but they make up 73% of our food supply.

The Institute of Medicine, the scientific body that sets dietary standards, states that a wide range of macronutrient intakes are consistent with healthy diets. Specifically, they recommend carbohydrate intake at 45% to 65%, fat intake at 20% to 35%, and protein intake at 10% to 35% of total calories. (Of course, they are referring to healthy carbohydrates, fats, and proteins.)

The authors of this article pointed to several reasons why Americans have been misled about heart-healthy diets.

  • Many of the most popular diets fall outside of the “Acceptable Macronutrient Range”.
  • Many popular diets exclude heart-healthy food groups.

And, the words of the authors,

  • “Further contributing to consumer misunderstanding is the proliferation of diet books, [and] blogs [by] clinicians with limited understanding of what the dietary patterns entail and the evidence base for promoting cardiometabolic health.” I call these the Dr. Strangeloves of our world.

What Does A Heart Healthy Diet Look Like?

Let me start by sharing the American Heart Association’s 10 “Evidence-Based Dietary Guidelines to Promote Cardiovascular Health.

#1: Adjust energy intake and expenditure to achieve and maintain a healthy body weight
#2: Eat plenty of vegetables and fruits; choose a wide variety
#3: Choose foods made mostly with whole grains rather than refined grains
#4: Choose healthy sources of protein
Mostly from plants (beans, other legumes, and nuts)
Fish and seafood
Low-fat or fat-free dairy products instead of full-fat dairy products
If meat or poultry are desired, choose lean cuts and avoid processed forms
#5. Use liquid plant oils (olive, safflower, corn) rather than animal fats (butter and lard) and tropical oils (coconut and palm kernel)
#6. Use minimally processed foods instead of highly processed foods
#7: Minimize intake of beverages and foods with added sugars
#8: Choose and prepare foods with little or no salt
#9: If you do not drink alcohol, do not start; if you choose to drink alcohol, limit intake
#10: Adhere to this guidance regardless of where food is prepared or consumed

Here are my comments on these guidelines:

  • If you have been reading my “Health Tips From the Professor” blog for a while, you probably realize that these aren’t just guidelines to promote heart health. These guidelines also reduce the risk of diabetes, cancer, inflammatory diseases, and much more.
  • If you have read my post on coconut oil, you will know that I have a minor disagreement with the AHA recommendation to avoid it. There is no long-term evidence that coconut oil is bad for the heart. But there is also no long-term evidence that it is good for the heart. My recommendation is to use it sparingly.
  • And you probably know there has been considerable discussion recently about whether full fat dairy is actually bad for the heart. In my most recent review of the topic, I concluded that if full fat dairy is heart healthy, it is only in the context of a primarily plant-based diet and may only be true for fermented dairy foods like unpasteurized yogurt and kefir.
  • Finally, guideline 10 may need some translation. Basically, this guideline is just asking how easy it is to follow the diet when you are away from home.

Which Diets Are Heart Healthy?

confusionIn evaluating how well diets adhered to the American Heart Association guidelines the authors ignored item 1 (energy intake) because most of the diets they evaluated did not provide any guidelines on how many calories should be consumed.

Each diet was given a score between 0 (Fail) and 1 (A+) for each of the other 9 guidelines by a panel of experts. The points for all 9 guidelines were added up, giving each diet a rating of 0 (worst) to 9 (best). Finally, a score of 9 was assigned 100%, so each diet could be given a percentage score for adherence to heart-healthy guidelines.

Here are the results:

Tier 1 diets (the most heart healthy diets) received scores of 86% to 100%. Going from highest (100%) to lowest (86%), these diets were:

  • DASH, Nordic, Mediterranean, Pescetarian (vegetarian diets that allow fish), and Ovo-Lacto Vegetarian (vegetarian diets that allow dairy, eggs, or both).
  • You will notice that these are all primarily plant-based diets.

Tier 2 diets were Vegan and other low-fat diets (TLC, Volumetrics). They both received scores of 78%.

  • The Vegan diet received 0 points for category 10 (ease of following the diet when eating out). It was also downgraded in category 7 for not having clear guidance for the use of salt when preparing foods.
  • The other low-fat diets were downgraded in categories 7, 10, and 5 (use of tropical oils).

Tier 3 diets received scores of 64% to 72%. They included very-low fat diets (<10% fat, very strict vegan diets) and low-carb diets (Zone, South Beach, Low-Glycemic Index).

  • They received 0 points for category 10 and were downgraded for eliminating heart-healthy food groups (liquid plant oils for the very low-fat diets, and fruits, vegetables, whole grains, and plant proteins for the low-carb diets).

Tier 4 diets (the least heart healthy diets) were the Paleo diet with a score of 53% and very low-carb diets (Atkins and Ketogenic) with a score of 31%.

  • The Paleo diet received 0 points for categories 10, 3 (choose whole grains), and 5 (using liquid plant oils rather than animal fats or tropical oils). It was also downgraded for lack of healthy plant-based protein sources.
  • The very low-carb diets were the least heart healthy. They received 0 points for categories 2 (eat plenty of fruits and vegetables), 3 (choose whole grains), 3 (healthy protein sources), 5 (use liquid plant oils instead of animal fats), 7 (minimize salt consumption), and 10 (ease of following the diet away from home).

The authors concluded, “Numerous [dietary] patterns [are] strongly aligned with 2021 American Heart Association Dietary Guidance (ie, Mediterranean, DASH, pescetarian, vegetarian) [and] can be adopted to reflect personal and cultural preferences and budgetary constraints.

Thus, optimal cardiovascular health would be best supported by developing a food environment that supports adherence to these patterns wherever food is prepared or consumed.”

Given our current food environment that last statement is wildly optimistic. But at least you have the information needed to make the best food choices for you and your family

The Bottom Line 

In 2021 the American Heart Association published 10 guidelines for evaluating heart-healthy diets. A recent study looked at how well popular diets adhered to those guidelines. The authors separated the diets into four categories (tiers) based on how heart-healthy they were. The results were not surprising:

  • Tier 1 diets (the most heart healthy diets) were DASH, Nordic, Mediterranean, Pescetarian (vegetarian diets that allow fish), and Ovo-Lacto Vegetarian (vegetarian diets that allow dairy, eggs, or both).
  • Tier 2 diets were Vegan and other low-fat diets (TLC, Volumetrics).
  • Tier 3 diets included very-low fat diets (<10% fat, very strict vegan diets) and low-carb diets (Zone, South Beach, Low-Glycemic Index).
  • Tier 4 diets (the least heart healthy diets) were the Paleo diet and very low-carb diets (Atkins and Ketogenic).

The authors concluded, “Numerous [dietary] patterns [are] strongly aligned with 2021 American Heart Association Dietary Guidance (ie, Mediterranean, DASH, pescetarian, vegetarian) [and] can be adopted to reflect personal and cultural preferences and budgetary constraints.

Thus, optimal cardiovascular health would be best supported by developing a food environment that supports adherence to these patterns wherever food is prepared or consumed.”

Given our current food environment that last statement is wildly optimistic. But at least you have the information needed to make the best food choices for you and your family.

For more information on this study, 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

What Role Should DNA Testing Play In Nutritional Recommendations?

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The Promise And Problems Of Nutrigenomics

Author: Dr. Stephen Chaney 

nutrigenomicsWhen the human genome was sequenced in 2003, many of us in the scientific community thought we were on the verge of a revolution in human health and longevity. We would soon be able to tell individuals their risk of developing various diseases.

Even better, we would be able to tell them the kind of diet and supplementation they needed to avoid those diseases. We would be able to personalize our nutritional recommendation for every individual based on their genome – something called nutrigenomics.

How naive we were! It has turned out to be much more complicated to design personalized nutrition recommendations based on someone’s genome than we ever imagined.

What Is Nutrigenomics?

professor owlAs a Professor at the University of North Carolina I specialized in cancer drug development for over 30 years. Over the last decade of my career a field called pharmacogenomics became widely accepted in the field of cancer drug development. In simple terms, pharmacogenomics looks at how an individual’s genes influence the effectiveness and side effects of drugs.

Because of pharmacogenomics, drugs today are being approved to target cancers for people whose cancer cells have a particular genetic makeup. These drugs would not have been approved a decades ago because if you test them on cancer in the general population, they have little or no effectiveness. They only work on a subset of people who have a form of cancer with a specific genetic makeup.

In principle, nutrigenomics is the same principle. You’ve heard for years that we all have unique nutritional needs. Now we are starting to learn why. It’s because we all have unique variations in our genetic makeup. These genetic mutations increase our risk of certain diseases, and they increase our needs for certain nutrients.

For example, mutations in the MTHFR gene increase the risk of certain birth defects, and supplementation with folic acid is particularly important for reducing birth defects in that population group.

Similarly, mutations in the vitamin D receptor, the VDR gene, interfere with vitamin D absorption from foods and are associated with a condition known as “vitamin D-resistant rickets”. Babies born with this genetic defect require mega doses of vitamin D for normal bone formation.

These are the best-established examples of gene mutations that affect nutritional needs. Many more gene-nutrient interactions have been proposed, but they have not been validated by follow-up experiments.

The situation is similar when we look at gene mutations associated with metabolic responses such as fat and carbohydrate metabolism, obesity, insulin resistance and type 2 diabetes. There are a few gene mutations that have strong associations with obesity and diabetes. Many more gene-metabolism interactions have been proposed, but the data are weak and inconsistent.

The Promise And Problems Of Nutrigenomics

The Promise Of Nutrigenomics.

thumbs upNow that you understand what nutrigenomics is and have some background information about it, let’s look at the promise of nutrigenomics. One promise of nutrigenomics is personalized supplement programs.

We all have different nutritional needs. Wouldn’t it be wonderful if someone could analyze your genome and provide you with a personalized supplement program that precisely fits your genetically determined nutritional requirements?

There are companies that offer such personalized supplement programs. Are they providing you with something of value or is their testing bogus? Are their supplements worthless?

Another promise of nutrigenomics is personalized diet advice. Some people seem to do better on low-fat diets. Other people do better on low-carb diets. Saturated fats and red meats may be more problematic for some individuals than for others. Wouldn’t it be wonderful if someone could analyze your genome and provide you with a personalized diet program – one that allows you to lose weight easily and gain vibrant health.

There are companies that will analyze your genome and tell you whether you are more likely to lose weight and be healthier on a low-fat or low-carbohydrate diet. Is their testing accurate or is it bogus? Are they providing you with useful information, or is their diet advice worthless?

The Problem With Nutrigenomics

thumbs down symbolThe short answer to the questions I posed in the previous section is that personalized supplement and diet programs are on the horizon, but we are not there yet. Companies promising you personalized nutrition programs based only on DNA tests are misleading you. They quote a few studies supporting the tests they run and ignore the many studies showing their tests are worthless.

In case you think that is just my opinion, let me quote from some recent reviews on the current status of nutrigenomics.

For example, a review (C Murgia and MM Adamski, Nutrients, 366, 2017) published in 2017 concluded: “The potential applications to nutrition of this invaluable tool were apparent since the genome was mapped. The first articles discussing nutrigenomics and nutrigenetics were published less than a year after the first draft of the human DNA sequence was made available…However, fifteen years and hundreds of publications later, the gap between the experimental and epidemiologic evidence and health practice is not yet closed.”

“The [complexity] of the genotype information is not the only factor that complicates this translation into practice. The discovery of other levels of control, including epigenetics [modifications of DNA that affect gene expression] and the intestinal microbiome, are other complicating factors. While the science of nutritional genomics continues to demonstrate potential individual responses to nutrition, the complex nature of gene, nutrition and health interactions continues to provide a challenge for healthcare professionals to analyze, interpret and apply to patient recommendations.”

Another review (M Gaussch-Ferre et al, Advances in Nutrition, 9: 128-135, 2018) published in 2018 concluded: “Overall, the scientific evidence supporting the dissemination of genomic information for nutrigenomic purposes remains sparse. Therefore, additional knowledge needs to be generated…”

In short, the experts are saying we still don’t know enough to predict the best diets, or the best supplements based on genetic information alone. Why is that? Why is it so complicated? In part, it can be explained by a term called penetrance. Penetrance simply means that the same gene mutation can have different effects in different people. In some people, its effects may be barely noticeable. In other people its effects may be debilitating.

The Truth About DNA Testing And Personalized Nutrition

The TruthPenetrance is just a word. It’s a concept. The important question is, “What causes differences in genetic penetrance?” Here are the most likely explanations.

1) Human genetics is very complex. There are some gene mutations, such as those causing cystic fibrosis and sickle cell anemia, that can cause a disease by themselves. Most gene mutations, however, simply predispose to a disease or metabolic disturbance and are highly influenced by the activity of other genes. That’s because the products of gene expression form intricate regulatory and metabolic networks. When a single gene is mutated, it interacts with many other genes in the network. And, that network is different for each of us.

2) Many common diseases are polygenic. That includes diseases like heart disease, diabetes, and most cancers. Simply put, that means that they are not caused by a single gene mutation. They are caused by the cumulative effect of many mutations, each of which has a small effect on disease risk. The same appears to be true for mutations that influence carbohydrate and fat metabolism and affect nutrient requirements.

3) The outcome of gene mutations is strongly influenced by our diet, lifestyle, and environment. For example, a common mutation in a gene called FTO predisposes to obesity. However, the effect of this mutation on obesity is strongest when it is coupled with inactivity and foods of high caloric density (translation: junk foods and fast foods instead of fresh fruits and vegetables). Simply put, that means most of us are genetically predisposed to obesity if we follow the American lifestyle, but obesity is not inevitable.

4) Epigenetics has an important influence on gene expression. When I was a graduate student, we believed our genetic destiny was solely determined by our DNA sequence. That was still the prevailing viewpoint when the human genome project was initiated. We thought that once we had our complete DNA sequence, we would know everything we needed to know about our genetic destiny.

How short sighted we were! It turns out that our DNA can be modified in multiple ways. These modifications do not change the DNA sequence, but they can have major effects on gene expression. They can turn genes on or turn them off. More importantly, we have come to learn that these DNA modifications can be influenced by our diet, lifestyle, and exposure to environmental pollutants.

This is the science we call epigenetics. We have gone from believing we have a genome (DNA sequence) that is invariant and controls our genetic destiny to understanding that we also have an “epigenome” (modifications to our DNA) that is strongly influenced by our diet, lifestyle, and environment and can change day-to-day.

microbiome5) Our microbiome has an important influence on our health and nutritional status. Simply put, the term microbiome refers to our intestinal microbes. Our intestinal bacteria are incredibly diverse. Each of us has about 1,000 distinct species of bacteria in our intestines. 

Current evidence suggests these intestinal bacteria influence our immune system, inflammation and auto-immune diseases, brain function and mood, and our predisposition to weight gain – and this may just be the tip of the iceberg.

More importantly, our microbiome is influenced by our diet. For example, vegetarians and meat eaters have entirely different microbiomes. Furthermore, the effect of diet on our microbiome is transitory. If you change your diet, the species of bacteria in your microbiome will completely change in a few weeks.

Finally, our microbiome also influences our nutritional requirements. For example, some species of intestinal bacteria are the major source of biotin and vitamin K2 for all of us and the major source of vitamin B12 for vegans. Intestinal bacteria may also contribute to our supply of folic acid and thiamine. Other intestinal bacteria inactivate and/or remove some vitamins from the intestine for their own use. Thus, the species of bacteria that populate our intestines can influence our nutritional requirements.

Now that you know the complexity of gene interactions you understand why we are not ready to rely on DNA tests yet. We don’t yet know enough to design a simple DNA test to predict our unique nutritional needs. That science is at least 10-20 years in the future. Companies that tell you otherwise are lying to you.

What Role Should DNA Testing Play In Nutritional Recommendations? 

Questioning WomanThe algorithms that are most successful in creating personalized diet and/or supplement recommendations:

1) Start with an analysis of your diet and lifestyle. They powerfully affect both gene expression and your microbiome.

2) Add in health parameters such as blood pressure, LDL cholesterol, HDL cholesterol, triglycerides, and hemoglobin A1c (a measure of blood sugar control). For example, a DNA analysis may suggest you are at risk for having elevated cholesterol, but whether you do or not is influenced by many other factors. A simple blood test indicates whether that risk is real for you.

3) Consider your personal health goals. If nutritional recommendations are to be personalized to you, they should emphasize the health goals you value most.

4) Include any diseases you have and recommendations of your doctor. If your doctor has recommended you lower your blood pressure, your cholesterol, or blood sugar levels, that is valuable information to include in the mix.

5) Now you are ready to include DNA testing in the mix. It can provide some valuable insights, but those insights need to be filtered through the lens of all the critical information collected in the first four steps. Genetics gives you possibilities. The information collected in the first four steps represents your realities.

The Bottom Line 

Nutrigenomics is defined as the interaction between our genetic makeup and our diet. How far have we advanced in the science of nutrigenomics? Can a simple DNA test provide us with useful information?

For example, we all have different nutritional needs. Wouldn’t it be wonderful if someone could analyze your genome and provide you with a personalized supplement program that precisely fits your genetically determined nutritional requirements?

There are companies that will analyze your genome and offer personalized supplement programs. Are they providing you with something of value or is their testing bogus? Are their supplements worthless?

There are companies that will analyze your genome and tell you whether you are more likely to lose weight and be healthier on a low-fat or low-carbohydrate diet. Is their testing accurate or is it bogus? Are they providing you with useful information, or is their diet advice worthless?

Two recent reviews have surveyed the nutrigenomic literature (all published clinical studies) and have concluded that we still don’t know enough to predict the best diets, or the best supplements based on genetic information alone. Why is that? It is because:

1) Human genetics is very complex.

2) Many common diseases are polygenic (caused by the cumulative effect of many mutations).

3) The effect of gene mutations on our health and wellbeing is strongly influenced by our diet, lifestyle, and environment.

4) Epigenetics has an important influence on gene expression.

5) Our microbiome has an important influence on our health and nutritional status.

For more details on these studies and the kind of testing that best determines the right diet and/or supplement program 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.

Which Diets Are Best In 2023?

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Which Diet Should You Choose?

Author: Dr. Stephen Chaney

Emoticon-BadMany of you started 2023 with goals of losing weight and/or improving your health. In many cases, that involved choosing a new diet. That was only 6 weeks ago, but it probably feels like an eternity.

For many of you the “bloom” has gone off the new diet you started so enthusiastically in January.

  • Perhaps the diet isn’t working as well as advertised…
  • Perhaps the diet is too restrictive. You are finding it hard to stick with…
  • Perhaps you are always hungry or constantly fighting food cravings…
  • Perhaps you are starting to wonder whether there is a better diet than the one you chose in January…
  • Perhaps you are wondering whether the diet you chose is the wrong one for you…

If you are rethinking your diet, you might want to know which diets the experts recommend. Unfortunately, that’s not as easy as it sounds. The diet world has become just as divided as the political world.

Fortunately, you have an impartial resource. Each year US News & World Report invites a panel of experts with different points of view to evaluate popular diets. They then combine the input from all the experts into rankings of the diets in various categories.

If you are still searching for your ideal diet, I will summarize the US News & World Report’s “Best Diets In 2023”. For the full report, click on this link.

How Was This Report Created?

Expert PanelUS News & World Report recruited a panel of 30 nationally recognized experts in diet, nutrition, obesity, food psychology, diabetes, and heart disease to review the 24 most popular diets.

The diets evaluated are not the same each year. Last year they evaluated the top 40 most popular diets. This year they only reviewed the top 24.

That means some good diets were left off the list. For example, the vegan diet is very healthy, but it is also very restrictive. Very few people follow a pure vegan diet, so it didn’t make the top 24 most popular. However, this year’s list did include several primarily plant-based diets that are more popular with the general public.

The panel is also not the same each year. Some experts are rotated off the panel, and others are added. The experts rate each diet in seven categories:

  • How easy it is to follow.
  • Its ability to produce short-term weight loss.
  • Its ability to produce long-term weight loss.
  • its nutritional completeness.
  • Its safety.
  • Its potential for preventing and managing diabetes.
  • Its potential for preventing and managing heart disease.

They converted the experts’ ratings to scores 5 (highest) to 1 (lowest). They then used these scores to construct eleven sets of Best Diets rankings:

  • Best Diets Overall ranks diets on several different parameters, including whether all food groups are included in the diet, the availability of the foods needed to be on the diet and the use of additional vitamins or supplements. They considered if the diet was evidence-based and adaptable to meet cultural, religious, or other personal preferences. In addition, the criteria also included evaluation of the prep and planning time required for the diet and the effectiveness of the diet for someone who wants to get and stay healthy.
  • Best Plant-Based Diets used the same approach as Best Diets Overall to rank the eight plans emphasizing minimally processed foods from plants that were included in this year’s ratings.
  • Best Commercial Diet ratings used the same approach to rank 15 commercial diet programs that require a participation fee or promote the use of branded food or nutritional products.
  • Best Long-Term Weight-Loss Diet ratings were generated by combining the safety of the rate of weight loss promoted and the likelihood of the plan to result in successful long-term weight loss and maintenance of weight loss.
  • Best Fast Weight-Loss Diets were scored on their effectiveness for someone who wants to lose weight in three months or less.
  • Best Diabetes Diet ratings were calculated equally from the effectiveness of the diet for someone who wants to lower risk factors for diabetes, the nutritional quality of the diet, and research evidence-based support for the diet.
  • Best Heart-Healthy Diet ratings were calculated equally from the effectiveness of the diet for someone who wants to lower risk factors for hypertension and other forms of heart disease, the nutritional quality of the diet, and evidence-based support for the diet.
  • Best Diets for Bone and Joint Health were calculated equally on the effectiveness of the diet for someone who wants to lower their risk factors for inflammation and improve bone and joint health, as well as the nutritional quality and research evidence-based support for the diet.
  • Best Diets for Healthy Eating combines nutritional completeness and safety ratings, giving twice the weight to safety. A healthy diet should provide sufficient calories and not fall seriously short on important nutrients or entire food groups.
  • Easiest Diets to Follow represents panelists’ averaged scores for the relevant lifestyle questions, including whether all food groups are included and if the recommended foods are readily available at the average supermarket.
  • Best Family-Friendly Diets were calculated equally on their adaptability for the whole family, including cultural, religious, and personal preferences, the time required to plan and prep, nutritional value and access to food at any supermarket.

Which Diets Are Best In 2023?

Are you ready? If this were an awards program, I would be saying “Envelop please” and would open the envelop slowly to build suspense.

However, I am not going to do that. Here are the top 3 and bottom 3 diets in each category (If you would like to see where your favorite diet ranked, click on this link.

[Note: I excluded commercial diets from this review. (I have a brief discussion of commercial diets below). If you notice a number missing in my summaries, it is because I eliminated one or more commercial diet from my summary.]

Best Diets Overall 

The Top 3: 

#1: Mediterranean Diet. The Mediterranean diet has been ranked #1 for 6 consecutive years.

#2 (tie): DASH Diet (This diet was designed to keep blood pressure under control, but you can also think of it as an Americanized version of the Mediterranean diet.)

#2 (tie): Flexitarian Diet (A flexible semi-vegetarian diet).

The Bottom 3: 

#20: Keto Diet (A high protein, high fat, very low carb diet designed to achieve ketosis).

#21: Atkins Diet (The granddaddy of the high animal protein, low carb, high fat diets).

#24: Raw Food Diet (A diet based on eating foods that have not been cooked or processed).

Best Plant-Based Diets Overall 

The Top 3: 

#1: Mediterranean Diet.

#2: Flexitarian Diet.

#3: MIND Diet (This diet is a combination of Mediterranean and DASH but is specifically designed to reduce cognitive decline as we age.)

The Bottom 3: 

Since only 8 diets were included in this category, even the bottom 3 are pretty good diets, so I did not include a “list of shame” in this category.

Best Long-Term Weight-Loss DietsWeight Loss

The Top 3: 

#1: DASH Diet

#2 (tie): Volumetrics Diet (A diet based on the caloric density of foods).

#2 (tie): Mayo Clinic Diet (A diet designed to establish lifelong healthy eating habits).

The Bottom 3: 

#22 (tie): Keto Diet.

#22 (tie): Atkins Diet.

#24: Raw Food Diet.

Best Fast Weight-Loss Diets

The Top 3: 

#1: Keto Diet

#2: Atkins Diet

#7 (tie): Mayo Clinic Diet

#7 (tie): South Beach Diet

#7 (tie): Volumetrics Diet

The Bottom 3: 

The diets at the bottom of this list were designed for health and weight maintenance rather than rapid weight loss, so I did not include a “list of shame” in this category.

Best Diabetes Diets

The Top 3: 

#1: DASH Diet

#2: Mediterranean Diet

#3: Flexitarian Diet

The Bottom 3: 

#20: Atkins Diet

#21: Paleo Diet (A diet based on what our paleolithic ancestors presumably ate. It restricts grains and dairy and is heavily meat-based).

#22: Raw Food Diet.

Best Heart-Healthy Diets

Healthy HeartThe Top 3: 

#1: DASH Diet

#2: Mediterranean Diet

#3 (tie): Ornish Diet (A whole food, semi-vegetarian diet designed to promote heart health).

#3 (tie): Flexitarian Diet

The Bottom 3: 

#22 (tie): Raw Foods Diet

#22 (tie): Paleo Diet

#24: Keto Diet

Best Diets for Bone and Joint Health 

The Top 3: 

#1 (tie): DASH Diet

#1 (tie): Mediterranean Diet

#3: Flexitarian Diet

The Bottom 3: 

#21 (tie): Raw Foods Diet

#21 (tie): Paleo Diet

#22: Atkins Diet 

#23: Keto Diet 

Best Diets for Healthy Eating

The Top 3: 

#1: Mediterranean Diet

#2: DASH Diet

#3: Flexitarian Diet

The Bottom 3: 

#22: Keto Diet

#23: Atkins Diet

#24: Raw Foods Diet

Easiest Diets to FollowEasy

The Top 3: 

#1 (tie): Flexitarian Diet

#1 (tie): TLC Diet (This diet was designed by the NIH to reduce cholesterol levels and promote heart health.)

#3 (tie): Mediterranean Diet

#3 (tie): DASH Diet

The Bottom 3: 

#19: Atkins Diet

#20: Keto Diet

#22: Raw Foods Diet

Which Diets Are Best For Rapid Weight Loss?

Happy woman on scaleThere are 2 take-home lessons from the rapid weight loss category:

  1. If you are looking for rapid weight loss, any whole food restrictive diet will do.
    • Last year’s diet analysis included the vegan diet, and both vegan and keto diets ranked near the top of the rapid weight loss category. Keto and vegan diets are both very restrictive, but they are polar opposites in terms of the foods they allow and restrict.
      • The keto diet is a meat heavy, very low carb diet. It restricts fruits, some vegetables, grains, and most legumes.
      • The vegan diet is a very low-fat diet that eliminates meat, dairy, eggs, and animal fats.
    • The Atkins and keto diets toppled this year’s rapid weight loss list, but they were joined by the Mayo Clinic, South Beach, and volumetrics diets. Those diets are also restrictive, but, like the vegan diet, they are very different from the Atkins and keto diets.
    • I did not include commercial diets that rated high on this list, but they are all restrictive in one way or another.

2) Whole food, very low carb diets like Atkins and keto are good for rapid weight loss, but they rank near the bottom of the list for every healthy diet category.

    • If you choose to lose weight on the Atkins or keto diets, switch to a healthier diet once you reach your desired weight loss.

Which Diet Should You Choose?

Food ChoicesWith rapid weight loss out of the way, let’s get back to the question, “Which Diet Should You Choose?” My recommendations are:

1) Choose a diet that fits your needs. That is one of the things I like best about the US News & World Report ratings. The diets are categorized. If your main concern is diabetes, choose one of the top diets in that category. If your main concern is heart health… You get the point.

2) Choose diets that are healthy and associated with long term weight loss. If that is your goal, you will notice that primarily plant-based diets top these lists. Meat-based, low carb diets like Atkins and keto are near the bottom of the lists.

  • “Why is that?”, you might ask? The answer is simple. And it’s not that all 30 experts were prejudiced against low carb diets. It’s that the major primarily plant-based diets like Mediterranean, DASH, and flexitarian are backed by long-term clinical studies showing they are healthy and significantly reduce the risk of diabetes, heart disease, and other chronic diseases.
  • On the other hand, there are no long-term studies showing the Atkins and keto diets are healthy long term. And since the Atkins diet has been around for more than 50 years, the lack of clinical evidence that it is healthy long term is damming.

3) Choose diets that are easy to follow. The less-restrictive primarily plant-based diets top this list – diets like Mediterranean, DASH, MIND, and flexitarian. They are also at or near the top of almost every diet category.

4) Choose diets that fit your lifestyle and dietary preferences. For example, if you don’t like fish and olive oil, you will probably do much better with the DASH or flexitarian diet than with the Mediterranean diet.

5) Finally, focus on what you have to gain, rather than on foods you have to give up.

  • On the minus side, none of the diets include sodas, junk foods, and highly processed foods. These foods should go on your “No-No” list. Sweets should be occasional treats and only as part of a healthy meal. Meat, especially red meat, should become a garnish rather than a main course.
  • On the plus side, primarily plant-based diets offer a cornucopia of delicious plant foods you probably didn’t even know existed. Plus, for any of the top-rated plant-based diets, there are websites and books full of mouth-watering recipes. Be adventurous.

What About Commercial Diets?

I chose not to review commercial diets by name, but let me make a few observations.

  • If you look at the gaps in my lists, it should be apparent that several commercial diets rank near the top for fast weight loss, but near the bottom on most healthy diet lists.
  • I do not recommend commercial diets that rely on ready-to-eat, low-calorie, highly processed versions “of your favorite foods”.
    • These pre-packaged meals are expensive. Unless you are a millionaire, you won’t be able to afford these meals for the rest of your life.
    • These pre-packaged meals are not teaching you healthy eating habits that will allow you to keep the weight off.
  • If you wish to spend your hard-earned dollars on a commercial diet, choose a diet that:
    • Relies on whole foods from all 5 food groups.
    • Teaches and provides support for the type of lifestyle change that leads to permanent weight loss.
  • Meal replacement shakes can play a role in healthy weight loss if:
    • They are high quality and use natural ingredients as much as possible.
    • They are part of a holistic lifestyle change program.

The Bottom Line 

For many of you the “bloom” has gone off the new diet you started so enthusiastically in January. If you are rethinking your diet, you might want to know which diets the experts recommend. Unfortunately, that’s not as easy as it sounds. The diet world has become just as divided as the political world.

Fortunately, you have an impartial resource. Each year US News & World Report invites a panel of experts with different points of view to evaluate popular diets. They then combine the input from all the experts into rankings of the diets in various categories. In the article above I summarize the US News & World Report’s “Best Diets In 2023”.

There are probably two questions at the top of your list.

#1: Which diets are best for rapid weight loss? Here are 2 general principles:

  1. If you are looking for rapid weight loss, any whole food restrictive diet will do.

2) If you choose to lose weight on the Atkins or keto diets, switch to a healthier diet once you reach your desired weight loss. Atkins and keto diets are good for rapid weight loss, but they rank near the bottom of the list for every healthy diet category.

#2: Which diet should you choose? Here the principles are:

  1. Choose a diet that fits your needs.

2) Choose diets that are healthy and associated with long term weight loss.

3) Choose diets that are easy to follow.

4) Choose diets that fit your lifestyle and dietary preferences.

5) Finally, focus on what you have to gain, rather than on foods you have to give up.

For more details on the diet that is best for you and my thoughts on commercial diets, read the article above.

Tips For Successful Weight Loss

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Which Diet Is Best?

Author: Dr. Stephen Chaney

It’s the beginning of January. Weight loss season has just launched again. Like millions of Americans, you have probably set a goal to eat healthier, lose weight, or both. But which diet is best? Vegan, Paleo, Keto, 360, Intermittent Fasting, low-carb, low fat – the list is endless.

And then there are the commercial diets: Meal replacements, low calorie processed foods, prepared meals delivered to your door – just to name a few of the categories.

You can choose to count calories, focus on portion sizes, or keep a food journal.

And, if you really want to live dangerously, you can try the latest diet pills that claim to curb your appetite and rev up your metabolism.

The advertisements for all these diets sound so convincing. They give you scientific-sounding mumbo jumbo to explain why they work. Then they talk about clinical studies they say prove their diet works.

If you are like most Americans, you have already tried several of these diets. They worked for a while, but the pounds came back – and brought their friends with them.

But, as the saying goes, “Hope springs eternal in the human breast”. Surely some diet you haven’t tried yet will work for you.

There are such diets. But they will require effort. They will require a change of mindset. There is no magic wand that will chase the extra pounds away forever.

If you are searching for the perfect diet to start the new year, let me be your guide. Here are:

  • 4 tips on mistakes to avoid and…
  • 6 tips on what to look for…
  • 7 tips for making weight loss permanent…

…when you are choosing the best diet for you.

Mistakes To Avoid When Choosing The Best Diet

Avoid1. Endorsements

Endorsements by your favorite athlete or public person are paid for. They don’t necessarily represent their opinion. Nor do they assure you that they follow that diet or use that diet supplement.

Endorsements by Dr. Strangelove and his buddies can be equally misleading. They usually tell you that the medical establishment has been lying to you, and they have discovered the “secret” to permanent weight loss and the “Fountain of Youth”.

Recommendations of the medical and scientific communities usually represent a consensus statement by the top experts in their field. I would choose their advice over Dr. Strangelove’s opinion any day.

2) Testimonials

Most of the testimonials you see online or in print are either paid for or are fake.

Testimonials by your friends can be equally misleading. We are all different. What works for your friend or for your trainer may not work for you.

For example, some of us do better on low-carb diets, and others do better on low fat diets.

[Note: Some DNA testing companies claim they can sequence your DNA and tell you which diet is best. However, as I reported in a recent article in “Health Tips From The Professor”, independent studies show that DNA testing is of no use in predicting whether low-carb or low-fat diets are better for you.]

3) Diets Based on “Magic” Or “Forbidden” Foods or Food Groups.

I have often said we have 5 food groups for a reason. Each food group provides a unique blend of nutrients and phytonutrients. And each plant food group provides a unique blend of fibers that support the growth of different types of friendly gut bacteria.

The bottom line is that each of us does better with some foods than others, but there are no “magic” or “forbidden” foods that apply to everyone.

Magic4) “Magic” Diets.

I have written perhaps the first diet book, “Slaying The Food Myths”, that doesn’t feature a “magic” diet that is going to make the pounds melt away and allow you to live to 100. Instead, I recommend a variety of healthy diets and suggest you choose the one that fits you best.

However, I understand the allure of “magic” diets. Dr. Strangelove claims the diet will be effortless. He gives you some scientific-sounding mumbo-jumbo to convince you the diet is scientifically sound. Then he cites some clinical studies showing the diet will cause you to lose weight and will improve your health parameters (things like cholesterol, triglycerides, blood sugar, and blood pressure). It sounds so convincing.

Before you fall for Dr. Strangelove’s latest “magic” diet, let me share two things that may blow your mind:

  • The studies are all short-term (usually 3 months or less).
  • When you rely on short-term studies, the very low-fat Vegan diet and very low-carb Keto diet give you virtually identical weight loss and improvement in health parameters!

Those two diets are as different as any two diets could be. That means we can forget all the scientific-sounding mumbo-jumbo as to why each of those diets work. Instead, we should ask what these two diets have in common.

The answer is simple:

#1: The clinical studies are comparing “magic” diets to the typical American diet. Anything is better than the typical American diet! It is high in sugar, refined carbohydrates, saturated fat, and highly processed foods. No wonder the “magic” diets look so good.

#2: The diets are whole food diets. Anytime you eliminate sodas, fast foods, and highly processed foods, you will lose weight.

#3: The diets eliminate one or more food groups. Whenever you eliminate some of your favorite foods from your diet, you tend to lose weight without thinking about it. I call this the cream cheese and bagel phenomenon.

  • If you are following a low-fat diet, it sounds great to say you can eat all the bagels you want. But without cream cheese to go with the bagels, you tend to eat fewer bagels.
  • If you are following a low-carb diet, it sounds great to say you can eat as much cream cheese as you want, but without bagels to go with your cream cheese, you tend to eat less cream cheese.

#4: Because they eliminate many of your favorite foods, “magic” diets make you focus on what you eat. Whenever you focus on what you eat, you tend to lose weight. That is why food journals and calorie counters are effective.

#5: Finally, whenever you lose weight, your health parameters (cholesterol, triglycerides, blood sugar, and blood pressure) improve.

Tips For Successful Weight Loss

SkepticWhat should you look for in choosing a healthy weight loss diet? Here are my top 6 tips.

1. Choose whole food diets. Avoid sodas, fast foods, and highly processed foods.

2) Choose primarily plant-based diets. These can range from Vegan through semi-vegetarian, Mediterranean, DASH, and Nordic. All are healthy diets. I have discussed the evidence for this recommendation in my book “Slaying The Food Myths”. Here is a brief summary.

When we look at long term (10-20 year) studies:

  • Vegetarians weigh less and are healthier than people consuming the typical American diet.
  • People consuming semi-vegetarian, Mediterranean, and DASH diets are healthier than people consuming the typical American diet.

When we look at low-carb diets:

  • People consuming plant-based low-carb diets weigh less and are healthier than people consuming the typical American diet.
  • People consuming meat-based low-carb diets are just as fat and unhealthy as people consuming the typical American diet.
  • The Atkins low-carb diet has been around for more than 50 years, and there is no evidence it is healthy long-term.

3) Choose diets that include a variety of foods from all 5 food groups. I have discussed the rationale for that recommendation above.

4) Choose diets that consider meat as a garnish, not a main course.

5) Choose diets that feature healthy carbs and healthy fats rather than low-carb or low-fat diets.

6) Think lifestyle, not diet. If you choose a restrictive diet so you can achieve quick weight loss, you will probably be just as fat and unhealthy next December 31st as you are this year. Instead, choose diets that teach healthy eating and lifestyle changes that you can make a permanent part of your life.

Tips For Keeping The Weight Off

You know the brutal truth. Around 95% of dieters regain everything they lost and then some within a few years. You have probably gone through one or more cycles of weight loss and regain yourself – something called “yo-yo dieting”. You may even be asking yourself if it is worth bothering to try to lose weight this year.

Rather focusing on the negative statistics of weight loss, let’s look at the good news. There are people who lose the weight and keep it off. What do they do?

There is an organization called the National Weight Control Registry that has enrolled more than 10,000 people who have lost weight and kept it off. The people in this group lost weight on almost every diet imaginable. However, here is the important statistic: On average people in this group have lost 66 pounds and kept it off for at least 5 years.

The National Weight Control Registry has kept track of what they have done to keep the weight off. Here is what they do that you may not be doing:

1. They consume a reduced calorie, whole food diet.

2) They get lots of exercise (around 1 hour/day).

3) They have internalized their eating patterns. In short, this is no longer a diet. It has become a permanent part of their lifestyle. This is the way they eat without even thinking about it.

4) They monitor their weight regularly. When they gain a few pounds, they modify their diet until they are back at their target weight.

5) They eat breakfast on a regular basis.

6) They watch less than 10 hours of TV/week.

7) They are consistent (no planned cheat days).

Which Diet Is Best?

Now it is time to get back to the question you are asking right now, “Which diet is best?” I have covered a lot of ground in this article. Let me summarize it for you.

If you are thinking about popular diets:

  • Primarily plant-based diets ranging from Vegan to Mediterranean and Dash are associated with a healthier weight and better health long term.
    • If want to lose weight quickly, you may want to start with the more restrictive plant-based diets, like Vegan, Ornish, Pritikin or semi-vegetarian.
    • If you do better with a low-carb diet, my recommendation is the lower-carb version of the Mediterranean diet called Med-Plus. It is a whole food version of the Mediterranean diet that minimizes added sugar and refined grains (I will be talking more about it in next week’s “Health Tips From the Professor”).
    • If your primary goal is rapid weight loss, you could also start with one of the healthier of the restrictive low-carb diets, like the Paleo or the 360 diet. I do not recommend the Keto diet.
  • No matter what diet you start with, plan to transition to the primarily plant-based diet that best fits your lifestyle and food preferences. This is the diet you will want to stick with to maintain your weight loss and achieve better health long term.
  • Plan on permanent lifestyle change rather than a short-term diet. Otherwise, you are just wasting your time.
  • Eat whole foods. Big Food keeps up with America’s favorite diets and is only too happy to sell you highly processed foods that match your favorite diet. Avoid those like the plague.

If you are thinking about commercial diets featuring meal replacement products:

  • Look for meal replacement products that:
    • Do not contain artificial sweeteners, flavors, or preservatives.
    • Use non-GMO protein. A non-GMO certification for the other ingredients is not necessary. For a more detailed explanation of when non-GMO certification is important and when it is unnecessary, see my article in “Health Tips From the Professor”.
    • Have stringent quality controls in place to assure purity. “Organic” and/or “non-GMO” on the label do not assure purity.
  • Look for programs that can provide clinical studies showing their diet plan is effective for weight loss and for keeping the weight off. Many programs have short-term clinical studies showing they are effective for weight loss, but very few have longer-term studies showing the weight stays off.
  • Finally, look for programs that teach permanent lifestyle change. This should include guidance on exercise and healthy eating.

I do not recommend most commercial diets that feature prepared low-calorie foods “shipped right to your door” as a major part of their program. The foods are highly processed. Plus, they include all your favorite unhealthy foods as part of the program. Even if they include lifestyle change as part of their program, they are undermining their message with the foods they are providing you.

I would be remiss if I didn’t mention that Weight Watchers is highly recommended by most experts in the field. Weight Watchers emphasizes journaling and counting calories, which is a plus because it makes you focus on what you are eating. They also have a good lifestyle program and support that can help you transition to permanent lifestyle change if you are willing to put in the effort. However, I don’t recommend their prepared low-calorie foods. They are no better than foods provided by the other commercial diet programs.

The Bottom Line 

Weight loss season is upon us. If you plan to lose weight and/or adopt a healthier diet this year, you are probably asking, “Which Diet Is Best?” In this issue of “Health Tips From The Professor” I give you:

  • 4 tips on mistakes to avoid when selecting the diet that is best for you.
  • 6 tips on how to choose the best diet.
  • 5 tips on what to look for when selecting a diet featuring meal replacement products.
  • 7 tips on how to keep the weight off.

Then I put all this information together to help you choose the best diet, the best meal replacement product, and/or the best commercial diet program.

For more details read the article above.

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

Can Healthy Eating Help You Lose Weight?

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Who Benefits Most From A Healthy Diet?

Author: Dr. Stephen Chaney 

fad dietsFad diets abound. High protein, low carb, low fat, vegan, keto, paleo – the list is endless. They all claim to be backed by scientific studies showing that you lose weight, lower your cholesterol and triglycerides, lower your blood pressure, and smooth out your blood sugar swings.

They all claim to be the best. But any reasonable person knows they can’t all be the best. Someone must be lying.

My take on this is that fad diet proponents are relying on “smoke and mirrors” to make their diet look like the best. I have written about this before, but here is a brief synopsis:

  • They compare their diet with the typical American diet.
    • Anything looks good compared to the typical American diet.
    • Instead, they should be comparing their diet with other weight loss diets. That is the only way we can learn which diet is best.
  • They are all restrictive diets.
    • Any restrictive diet will cause you to eat fewer calories and to lose weight.
    • As little as 5% weight loss results in lower cholesterol & triglycerides, lower blood pressure, and better control of blood sugar levels.

Simply put, any restrictive diet will give you short-term weight loss and improvement in blood parameters linked to heart disease, stroke, and diabetes. But are these diets healthy long term? For some of them, the answer is a clear no. Others are unlikely to be healthy but have not been studied long term. So, we don’t know whether they are healthy or not.

What if you started from the opposite perspective? Instead of asking, “Is a diet that helps you lose weight healthy long term?”, what if you asked, “Can healthy eating help you lose weight?” The study (S Schutte et al, American Journal of Clinical Nutrition, 115: 1-18, 2022) I will review this week asked that question.

More importantly, it was an excellent study. It compared a healthy diet to an unhealthy diet with exactly the same degree of caloric restriction. And it compared both diets to the habitual diet of people in that area. This study was performed in the Netherlands, so both weight loss diets were compared to the habitual Dutch diet.

How Was The Study Done?

clinical studyThis was a randomized controlled trial, the gold standard of clinical studies. The investigators recruited 100 healthy, abdominally obese men and women aged 40-70. At the time of entry into the study none of the participants:

  • Had diabetes.
  • Smoked
  • Had a diagnosed medical condition.
  • Were on a medication that interfered with blood sugar control.
  • Were on a vegetarian diet.

The participants were randomly assigned to:

  • A high-nutrient quality diet that restricted calories by 25%.
  • A low-nutrient-quality diet that restricted calories by 25%.
  • Continue with their habitual diet.

The study lasted 12 weeks. The participants met with a dietitian on a weekly basis. The dietitian gave them the foods for the next week and monitored their adherence to their assigned diet. They were advised not to change their exercise regimen during the study.

At the beginning and end of the study the participants were weighed, and cholesterol, triglycerides, and blood pressure were measured.

Can Healthy Eating Help You Lose Weight?

Vegetarian DietTo put this study into context, these were not healthy and unhealthy diets in the traditional sense.

  • Both were whole food diets.
  • Both included fruits, vegetables, low-fat dairy, and lean meats.
  • Both restricted calories by 25%.

The diets were designed so that the “high-nutrient quality” diet had significantly more plant protein (in the form of soy protein), fiber, healthy fats (monounsaturated and omega-3 fats), and significantly less fructose and other simple sugars than the “low-nutrient-quality” diet.

At the end of 12 weeks:

  • Participants lost significant weight on both calorie-restricted diets compared to the group that continued to eat their habitual diet.
    • That is not surprising. Any diet that successfully restricts calories will result in weight loss.
  • Participants on the high-nutrient quality diet lost 33% more weight than participants on the low-nutrient-quality diet (18.5 pounds compared to 13.9 pounds).
  • Participants on the high-nutrient quality diet lost 50% more inches in waist circumference than participants on the low-nutrient-quality diet (1.8 inches compared to 1.2 inches).
    • This is a direct measure of abdominal obesity.

When the investigators measured blood pressure, fasting total cholesterol levels, and triglyceride levels:Heart Healthy Diet

  • These cardiovascular risk factors were significantly improved on both diets.
    • Again, this would be expected. Any diet that causes weight loss results in an improvement in these parameters.
  • The reduction in total serum cholesterol was 2.5-fold greater and the reduction in triglycerides was 2-fold greater in the high-nutrient quality diet group than in the low-nutrient-quality diet group.
  • The reduction in systolic blood pressure was 2-fold greater and the reduction in diastolic blood pressure was 1.67-fold greater in the high-nutrient quality diet group than in the low-nutrient-quality diet group.

The authors concluded, “Our results demonstrate that the nutrient composition of an energy-restricted diet is of great importance for improvements of metabolic health in an overweight, middle-aged population. A high-nutrient quality energy-restricted diet enriched with soy protein, fiber, monounsaturated fats, omega-3 fats, and reduced in fructose provided additional health benefits over a low-nutrient quality energy-restricted diet, resulting in greater weight loss…and promoting an antiatherogenic blood lipid profile.”

In short, participants in this study lost more weight and had a better improvement in risk factors for heart disease on a high-nutrient-quality diet than on a low-nutrient-quality diet. Put another way, healthy eating helped them lose weight and improved their health.

Who Benefits Most From A Healthy Diet?

None of the participants in this study had been diagnosed with diabetes when the study began. However, all of them were middle-aged, overweight, and had abdominal obesity. That means many of them likely had some degree of insulin resistance.

Because of some complex metabolic studies that I did not describe, the investigators suspected that insulin resistance might influence the relative effectiveness of the two energy-restricted diets.

To test this hypothesis, they used an assay called HOMA-IR (homeostatic model assessment of insulin resistance). Simply put, this assay measures how much insulin is required to keep your blood sugar under control.

They used a HOMA-IR score of 2.5 to categorize insulin resistance among the participants.

  • Participants with a HOMA-IR score >2.5 were categorized as insulin-resistant. This was 55% of the participants.
  • Participants with a HOMA-IR score ≤2.5 were categorized as insulin-sensitive. This was 45% of the participants.

When they used this method to categorize participants they found:

  • Insulin-resistant individual lost about the same amount of weight on both diets.
  • Insulin-sensitive individuals lost 66% more weight on the high-nutrient-quality diet than the low-nutrient-quality diet (21.6 pounds compared to 13.0 pounds).

The investigators concluded, “Overweight, insulin-sensitive subjects may benefit more from a high- than a low-nutrient-quality energy-restricted diet with respect to weight loss…”

What Does This Study Mean For You?

Questioning WomanSimply put this study confirms that:

  • Caloric restriction leads to weight loss, and…
  • Weight loss leads to improvement in cardiovascular risk factors like total cholesterol, triglycerides, and blood pressure.
    • This is not new.
    • This is true for any diet that results in caloric restriction.

This study breaks new ground in that a high-nutrient quality diet results in significantly better:

  • Weight loss and…
  • Reduction in cardiovascular risk factors…

…than a low-nutrient quality diet. As I said above, the distinction between a “high-nutrient-quality” diet and a “low-nutrient-quality” diet may not be what you might have expected.

  • Both diets were whole food diets. Neither diet allowed sodas, sweets, and highly processed foods.
  • Both included fruits, vegetables, grains, and lean meats.
  • Both reduced caloric intake by 25%.
    • If you want to get the most out of your weight loss diet, this is a good place to start.

In this study the investigators designed their “high-nutrient-quality” diet so that it contained:

  • More plant protein in the form of soy protein.
    • In this study they did not reduce the amount of animal protein in the “high-nutrient-quality” diet. They simply added soy protein foods to the diet. I would recommend substituting soy protein for some of the animal protein in the diet.
  • More fiber.
    • The additional fiber came from substituting whole grain breads and brown rice for refined grain breads and white rice, adding soy protein foods, and adding an additional serving of fruit.
  • More healthy fats (monounsaturated and omega-3 fats).
    • The additional omega-3s came from adding a fish oil capsule providing 700mg of EPA and DHA.
  • Less simple sugars. While this study focused on fructose, their high-nutrient-quality diet was lower in all simple sugars.

ProfessorAll these changes make great sense if you are trying to lose weight. I would distill them into these 7 recommendations.

  • Follow a whole food diet. Avoid sodas, sweets, and highly processed foods.
  • Include all 5 food groups in your weight loss diet. Fruits, vegetables, whole grains, dairy, and lean proteins all play an important role in your long-term health.
  • Eat a primarily plant-based diet. My recommendation is to substitute plant proteins for at least half of your high-fat animal proteins. And this study reminds us that soy protein foods are a convenient and effective way to achieve this goal.
  • Eat a diet high in natural fibers. Including fruits, vegetables, whole grains, beans, nuts, seeds, and soy foods in your diet is the best way to achieve this goal.
  • Substitute healthy fats (monounsaturated and omega-3 fats) for unhealthy fats (saturated and trans fats) in your diet. And this study reminds us that it is hard to get enough omega-3s in your diet without an omega-3 supplement.
  • Reduce the amount of added sugar, especially fructose, from your diet. That is best achieved by eliminating sodas, sweets, and highly processed foods from the diet. I should add that fructose in fruits and some healthy foods is not a problem. For more information on that topic, I refer you to a previous “Health Tips” article .
  • Finally, I would like to remind you of the obvious. No diet, no matter how healthy, will help you lose weight unless you cut back on calories. Fad diets achieve that by restricting the foods you can eat. In the case of a healthy diet, the best way to do it is to cut back on portion sizes and choose foods with low caloric density.

I should touch briefly on the third major conclusion of this study, namely that the “high-nutrient quality diet” was not more effective than the “low-nutrient-quality” diet for people who were insulin resistant. In one sense, this was not news. Previous studies have suggested that insulin-resistant individuals have more difficulty losing weight. That’s the bad news.

However, there was a silver lining to this finding as well:

  • Only around half of the overweight, abdominally obese adults in this study were highly insulin resistant.
    • That means there is a ~50% chance that you will lose more weight on a healthy diet.
  • Because both diets restricted calories by 25%, insulin-resistant individuals lost weight on both diets.
    • That means you can lose weight on any diet that successfully reduces your caloric intake. That’s the good news.
    • However, my recommendation would still be to choose a high-nutrient quality diet that is designed to reduce caloric intake, because that diet is more likely to be healthy long term.

The Bottom Line 

A recent study asked, “Can healthy eating help you lose weight?” This study was a randomized controlled study, the gold standard of clinical studies. The participants were randomly assigned to:

  • A high-nutrient quality diet that restricted calories by 25%.
  • A low-nutrient-quality diet that restricted calories by 25%.
  • Continue with their habitual diet.

These were not healthy and unhealthy diets in the traditional sense.

  • Both were whole food diets.
  • Both included fruits, vegetables, low-fat dairy, and lean meats.
  • Both restricted calories by 25%.

The diets were designed so that the “high-nutrient quality” diet had significantly more plant protein (in the form of soy protein), fiber, healthy fats (monounsaturated and omega-3 fats), and significantly less fructose and other simple sugars than the “low-nutrient-quality” diet.

At the end of 12 weeks:

  • Participants on the high-nutrient quality diet lost 33% more weight than participants on the low-nutrient-quality diet (18.5 pounds compared to 13.9 pounds).

When the investigators measured cardiovascular risk factors at the end of 12 weeks:

  • The reduction in total serum cholesterol was 2.5-fold greater and the reduction in triglycerides was 2-fold greater in the high-nutrient quality diet group than in the low-nutrient-quality diet group.
  • The reduction in systolic blood pressure was 2-fold greater and the reduction in diastolic blood pressure was 1.67-fold greater in the high-nutrient quality diet group than in the low-nutrient-quality diet group.

The authors concluded, “Our results demonstrate that the nutrient composition of an energy-restricted diet is of great importance for improvements of metabolic health in an overweight, middle-aged population. A high-nutrient quality energy-restricted diet enriched with soy protein, fiber, monounsaturated fats, omega-3 fats, and reduced in fructose provided additional health benefits over a low-nutrient quality energy-restricted diet, resulting in greater weight loss…and promoting an antiatherogenic blood lipid profile.”

In short, participants in this study lost more weight and had a better improvement in risk factors for heart disease on a high-nutrient-quality diet than on a low-nutrient-quality diet. Put another way, healthy eating helped them lose weight and improved their health.

For more details on this study, what this study means for you, and my 7 recommendations for a healthy weight loss diet, 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.

Which Diets Are Best In 2022?

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Which Diet Should You Choose?

Author: Dr. Stephen Chaney

Emoticon-BadMany of you started 2022 with goals of losing weight and/or improving your health. In many cases, that involved choosing a new diet. That was only a month ago, but it probably feels like an eternity.

For many of you the “bloom” has gone off the new diet you started so enthusiastically in January.

  • Perhaps the diet isn’t working as well as advertised…
  • Perhaps the diet is too restrictive. You are finding it hard to stick with…
  • Perhaps you are always hungry or constantly fighting food cravings…
  • Perhaps you are starting to wonder whether there is a better diet than the one you chose in January…
  • Perhaps you are wondering whether the diet you chose is the wrong one for you…

If you are rethinking your diet, you might want to know which diets the experts recommend. Unfortunately, that’s not as easy as it sounds. The diet world has become just as divided as the political world.

Fortunately, you have an impartial resource. Each year US News & World Report invites a panel of experts with different points of view to evaluate popular diets. They then combine the input from all the experts into rankings of the diets in various categories.

If you are still searching for your ideal diet, I will summarize the US News & World Report’s “Best Diets In 2022”. For the full report, click on this link.

How Was This Report Created?

Expert PanelUS News & World Report recruited panel of 27 nationally recognized experts in diet, nutrition, obesity, food psychology, diabetes, and heart disease to review the 40 most popular diets.  The panel is not the same each year. Some experts are rotated off the panel, and others are added. The experts rate each diet in seven categories:

  • How easy it is to follow.
  • Its ability to produce short-term weight loss.
  • Its ability to produce long-term weight loss.
  • its nutritional completeness.
  • Its safety.
  • Its potential for preventing and managing diabetes.

 

  • Its potential for preventing and managing heart disease.

They converted the experts’ ratings to scores 5 (highest) to 1 (lowest). They then used these scores to construct nine sets of Best Diets rankings:

  • Best Diets Overall combines panelists’ ratings in all seven categories. However, all categories were not equally weighted. Short-term and long-term weight loss were combined, with long-term ratings getting twice the weight. Why? A diet’s true test is whether it can be sustained for years. And safety was double counted because no diet should be dangerous.
  • Best Commercial Diets uses the same approach to rank 15 structured diet programs that require a participation fee or promote the use of branded food or nutritional products.
  • Best Weight-Loss Diets was generated by combining short-term and long-term weight-loss ratings, weighting both equally. Some dieters want to drop pounds fast, while others, looking years ahead, are aiming for slow and steady. Equal weighting accepts both goals as worthy.
  • Best Diabetes Diets is based on averaged diabetes ratings.
  • Best Heart-Healthy Diets uses averaged heart-health ratings.
  • Best Diets for Healthy Eating combines nutritional completeness and safety ratings, giving twice the weight to safety. A healthy diet should provide sufficient calories and not fall seriously short on important nutrients or entire food groups.
  • Easiest Diets to Follow represents panelists’ averaged judgments about each diet’s taste appeal, ease of initial adjustment, ability to keep dieters from feeling hungry and imposition of special requirements.
  • Best Plant-Based Diets uses the same approach as Best Diets Overall to rank 12 plans that emphasize minimally processed foods from plants.
  • Best Fast Weight-Loss Diets is based on short-term weight-loss ratings.

Which Diets Are Best In 2022?

Are you ready? If this were an awards program I would be saying “Envelop please” and would open the envelop slowly to build suspense.

However, I am not going to do that. Here are the top 5 and bottom 5 diets in each category (If you would like to see where your favorite diet ranked, click on this link). [Note: I excluded commercial diets from this review.]

Best Diets Overall 

The Top 5: 

#1: Mediterranean Diet. The Mediterranean diet has been ranked #1 for 5 consecutive years.

#2: DASH Diet (This diet was designed to keep blood pressure under control, but you can also think of it as an Americanized version of the Mediterranean diet.)

#3: Flexitarian Diet (A flexible semi-vegetarian diet).

#4: MIND Diet (This diet is a combination of Mediterranean and DASH but is specifically designed to reduce cognitive decline as we age.)

#5: The TLC Diet (This diet was designed by the NIH to promote heart health.)

The Bottom 5: 

#36: Whole 30 Diet (A whole food, restrictive diet, designed for a 30-day jump start to weight loss. It was not designed for long-term use).

#37: Modified Keto Diet (A slightly less restrictive version of the Keto Diet).

#38: Keto Diet (A high protein, high fat, very low carb diet designed to achieve ketosis).

#39: Dukan Diet (High protein, low carb, low fat diet).

#40: GAPS Diet (A diet designed to improve gut health).

Best Weight-Loss Diets

The Top 5: Weight Loss

#1: Flexitarian Diet

#2: Volumetrics Diet (A diet based on the caloric density of foods).

#3: Vegan Diet (A diet that only allows plant foods).

#4: Mayo Clinic Diet (A diet designed to establish lifelong healthy eating habits).

#5: Ornish Diet (A whole food, semi-vegetarian diet designed to promote heart health).

The Bottom 5: 

#36: Fertility Diet (A diet designed to improve fertility, but the experts were skeptical that it would increase your chances of becoming pregnant)

#37: Whole 30 Diet

#38: Alkaline Diet (A diet designed to make your blood more alkaline, but the experts were skeptical about that claim)

#39: AIP Diet (A diet designed for people with autoimmune diseases)

#40: GAPS Diet

Best Diabetes Diets

The Top 5: 

#1: Mediterranean Diet

#2: Flexitarian Diet

#3: Vegan Diet

#4: Mayo Clinic Diet

#5: DASH Diet

The Bottom 5: 

#36: Alkaline Diet

#37: Dukan Diet

#38: GAPS Diet

#39: Sirtfood Diet (a very low calorie, fad diet that emphasizes plant foods rich in sirtuins)

#40: Whole 30 Diet

Best Heart-Healthy Diets 

strong heartThe Top 5: 

#1: Mediterranean Diet

#2: Ornish Diet

#3: DASH Diet

#4: Flexitarian Diet

#5: TLC Diet

#6: Vegan Diet

The Bottom 5: 

#36: Keto Diet

#37: AIP Diet

#38: Whole 30 Diet

#39: Modified Keto Diet

#40: Dukan Diet

Best Diets for Healthy Eating

The Top 5: 

#1: Mediterranean Diet

#2: DASH Diet

#3: Flexitarian Diet

#4: MIND Diet

#5: TLC Diet

The Bottom 5: 

#36: Raw Food Diet

#37: Atkins Diet

#38: Dukan Diet

#39: Modified Keto Diet

#40: Keto Diet 

Easiest Diets to Follow

The Top 5: Easy

#1: Mediterranean Diet

#2: Flexitarian Diet

#3: Fertility Diet

#4: MIND Diet

#5: DASH Diet

The Bottom 5: 

#36: Modified Keto Diet

#37: Keto Diet

#38: Whole 30 Diet

#39: GAPS Diet

#40: Raw Foods Diet 

Best Fast Weight-Loss Diets

The Top 5 (Excluding Commercial Diets): 

#1: Atkins Diet

#2: Biggest Loser Diet

#3: Keto Diet

#4: Raw Food Diet

#5: Vegan Diet

The Bottom 5 

#36: Dr. Weil’s Anti-Inflammatory Diet

#37: The Fertility Diet

#38: AIP Diet

#39: Alkaline Diet

#40: Gaps Diet

Which Diets Are Best For Rapid Weight Loss?

Happy woman on scaleThere are 3 take-home lessons from the rapid weight loss category:

1) If you are looking for rapid weight loss, any whole food restrictive diet will do. The top 5 diets are very different. For example, the keto and vegan diets are polar opposites, yet they both are in the top 5 for rapid weight loss.

  • The Atkins and keto diets are meat heavy, low carb diets. They restrict fruits, some vegetables, grains, and most legumes.
  • The Biggest Loser diet relies on restrictive meal plan and exercise programs.
  • The restrictions of the raw food diet are obvious.
  • The vegan diet is a very low-fat diet that eliminates meat, dairy, eggs, and animal fats.
  • I did not include commercial diets that rated high on this list, but they are all restrictive in one way or another.

2) We should ask what happens when we get tired of restrictive diets and add back some of your favorite foods.

  • If you lose weight on a vegan diet and add back some of your favorite foods, you might end up with a semi-vegetarian diet. This is a healthy diet that can help you maintain your weight loss.
  • If you lose weight on the Atkins or keto diets and add back some of your favorite foods, you end up with the typical American diet – one that is high in both fat and carbs. This is not a recipe for long-term success.

3) Don’t pay too much attention to the bottom 5 diets. None of them were designed with weight loss in mind.

Which Diet Should You Choose?

Food ChoicesWith rapid weight loss out of the way, let’s get back to the question, “Which Diet Should You Choose?” My recommendations are:

1) Choose a diet that fits your needs. That is one of the things I like best about the US News & World Report ratings. The diets are categorized. If your main concern is diabetes, choose one of the top diets in that category. If your main concern is heart health… You get the point.

2) Choose diets that are healthy and associated with long term weight loss. If that is your goal, you will notice that primarily plant-based diets top these lists. Meat-based, low carb diets like Atkins and keto are near the bottom of the lists.

3) Choose diets that are easy to follow. The less-restrictive primarily plant-based diets top this list – diets like Mediterranean, DASH, MIND, and flexitarian.

4) Choose diets that fit your lifestyle and dietary preferences. For example, if you don’t like fish and olive oil, you will probably do much better with the DASH or flexitarian diet than with the Mediterranean diet.

5) In case you were wondering, intermittent fasting ranked 26-30 and the Paleo diet ranked 26-33 on most of the list – not the worst diets, but a long way from the best. If you have a favorite diet I didn’t mention, check the US News website to find where it is ranked.

6) Finally, focus on what you have to gain, rather than on foods you have to give up.

  • On the minus side, none of the diets include sodas, junk foods, and highly processed foods. These foods should go on your “No-No” list. Sweets should be occasional treats and only as part of a healthy meal. Meat, especially red meat, should become a garnish rather than a main course.
  • On the plus side, primarily plant-based diets offer a cornucopia of delicious plant foods you probably didn’t even know existed. Plus, for any of the top-rated plant-based diets, there are websites and books full of mouth-watering recipes. Be adventurous.

The Bottom Line 

For many of you the “bloom” has gone off the new diet you started so enthusiastically in January. If you are rethinking your diet, you might want to know which diets the experts recommend. Unfortunately, that’s not as easy as it sounds. The diet world has become just as divided as the political world.

Fortunately, you have an impartial resource. Each year US News & World Report invites a panel of experts with different points of view to evaluate popular diets. They then combine the input from all the experts into rankings of the diets in various categories. In the article above I summarize the US News & World Report’s “Best Diets In 2022”.

There are probably two questions at the top of your list.

#1: Which diets are best for rapid weight loss? Here are some general principles:

  • If you are looking for rapid weight loss, any whole food restrictive diet will do.
  • We should ask what happens when we get tired of restrictive diets and add back some of our favorite foods.
  • Long term weight loss is possible if you transition to a healthy diet after you have lost the weight.

#2: Which diet should you choose? Here the principles are:

  • Choose a diet that fits your needs.
  • Choose diets that are healthy and associated with long term weight loss.
  • Choose diets that are easy to follow.
  • Choose diets that fit your lifestyle and dietary preferences.
  • Finally, focus on what you have to gain, rather than on foods you have to give up.

For more details on the diet that is best 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.

Who Benefits Most From Supplementation?

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Supplements Are Part of a Holistic Lifestyle

Author: Dr. Stephen Chaney

need for supplementsThe headlines about supplementation are so confusing. Are they useful, or are they a waste of money? Will they cure you, or will they kill you? I feel your pain.

I have covered these questions in depth in my book, “Slaying The Supplement Myths”, but let me give you a quick overview today. I call it: “Who Benefits Most From Supplementation?” I created the graphic on the left to illustrate why I feel responsible supplementation is an important part of a holistic lifestyle for most Americans. Let me give you specific examples for each of these categories.

 

Examples of Poor Diet

No Fast FoodYou have heard the saying that supplementation fills in the nutritional gaps in our diets, so what are the nutritional gaps? According to the USDA’s 2020-2025 Dietary Guidelines for Americans, many Americans are consuming too much fast and convenience foods. Consequently, we are getting inadequate amounts of calcium, magnesium, and vitamins A, D, E and C. Iron is considered a nutrient of concern for young children and pregnant women. In addition, folic acid, vitamin B6, and iodine are nutrients of concern for adolescent girls and pregnant women.

According to a recent study, regular use of a multivitamin is sufficient to eliminate all these deficiencies except for calcium, magnesium and vitamin D (J.B. Blumberg et al, Nutrients, 9(8): doi: 10.3390/nu9080849, 2017). 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 (K.D. Stark et al, Progress In Lipid Research, 63: 132-152, 2016; S.V. Thuppal et al, Nutrients, 9, 930, 2017; M Thompson et al, Nutrients, 11: 177, 2019). Therefore, omega-3 supplementation is often a good idea.

In previous editions of “Health Tips From the Professor” I have talked about our “mighty microbiome”, the bacteria and other microorganisms in our intestine. These intestinal bacteria can affect our tendency to gain weight, our immune system, inflammatory diseases, chronic diseases such as diabetes, cancer, and heart diseases, our mood—the list goes on and on. This is an emerging science. We are learning more every day, but for now it appears our best chances for creating a health-enhancing microbiome are to consume a primarily plant-based diet and take a probiotic supplement.

Finally, diets that eliminate whole food groups create nutritional deficiencies. For example, vegan diets increase the risk of deficiencies in vitamin B12, vitamin D, calcium, iron, zinc and long chain omega-3 fatty acids. A recent study reported that the Paleo diet increased the risk of calcium, magnesium, iodine, thiamin, riboflavin, folate and vitamin D deficiency (A. Genomi et al, Nutrients, 8, 314, 2016). The Keto diet is even more restrictive and is likely to create additional deficiencies.

Examples of Increased Need

pregnant women taking omega-3We have known for years that pregnancy and lactation increase nutritional requirements. In addition, seniors have increased needs for protein, calcium, vitamin D and vitamin B12. In previous issues of “Health Tips From the Professor” I have also shared recent studies showing that protein requirements are increased with exercise.

Common medications also increase our need for specific nutrients. For example, seizure medications can increase your need for vitamin D and calcium. Drugs to treat diabetes and acid reflux can increase your need for vitamin B12. Other drugs increase your need for vitamin B6, folic acid, and vitamin K. Excess alcohol consumption increases your need for thiamin, folic acid, and vitamin B6. These are just a few examples.

Vitamin D is a special case. Many people with apparently adequate intake of vitamin D have low blood levels of 25-hydroxy vitamin D. It is a good idea to have your blood 25-hydroxy vitamin D levels measured on an annual basis and supplement with vitamin D if they are low.

More worrisome is the fact that we live in an increasing polluted world and some of these pollutants may increase our needs for certain nutrients. For example, in a recent edition of “Health Tips From the Professor” I shared a study reporting that exposure to pesticides during pregnancy increases the risk of giving birth to children who will develop autism, and that supplementation with folic acid during pregnancy reduces the effect of pesticides on autism risk. I do wish to acknowledge that this is a developing area of research. This and similar studies require confirmation. It is, however, a reminder that there may be factors beyond our control that have the potential to increase our nutritional needs.

Examples of Genetics Influencing Nutritional Needs

nutrigenomicsThe effect of genetic variation on nutritional needs is known as nutrigenomics. One of the best-known examples of nutrigenomics is genetic variation in the methylenetetrahydrofolate reductase (MTHFR) gene.  MTHFR gene mutations increase the risk of certain birth defects, such as neural tube defects. MTHFR mutations also slightly increase the requirement for folic acid. A combination of food fortification and supplementation with folic acid have substantially decreased the prevalence of neural tube defects in the US population. This is one of the great success stories of nutrigenomics. Parenthetically, there is no evidence that methylfolate is needed to decrease the risk of neural tube defects in women with MTHFR mutations.

Let me give you a couple of additional examples:

One of them has to do with vitamin E and heart disease (A.P. Levy et al, Diabetes Care, 27: 2767, 2004). Like a lot of other studies there was no significant effect of vitamin E on cardiovascular risk in the general population. But there is a genetic variation in the haptoglobin gene that influences cardiovascular risk. The haptoglobin 2-2 genotype increases oxidative damage to the arterial wall, which significantly increases the risk of cardiovascular disease. When the authors of this study looked at the effect of vitamin E in people with this genotype, they found that it significantly decreased heart attacks and cardiovascular deaths.

This has been confirmed by a second study specifically designed to look at vitamin E supplementation in that population group (F. Micheletta et al, Arteriosclerosis, Thrombosis and Vascular Biology, 24: 136, 2008). This is an example of a high-risk group benefiting from supplementation, but in this case the high risk is based on genetic variation.

Let’s look at soy and heart disease as a final example. There was a study called the ISOHEART study (W.L. Hall et al, American Journal of Clinical Nutrition, 82: 1260-1268, 2005 (http://ajcn.nutrition.org/content/82/6/1260.abstract); W.L. Hall et al, American Journal of Clinical Nutrition, 83: 592-600, 2006) that looked at a genetic variation in the estrogen receptor which increases inflammation and decreases levels of HDL. As you might expect, this genotype significantly increases cardiovascular risk.

Soy isoflavones significantly decrease inflammation and increase HDL levels in this population group. But they have no effect on inflammation or HDL levels in people with other genotypes affecting the estrogen reception. So, it turns out that soy has beneficial effects, but only in the population that’s at greatest risk of cardiovascular disease, and that increased risk is based on genetic variation.

These examples are just the “tip of the iceberg”. Nutrigenomics is an emerging science. New examples of genetic variations that affect the need for specific nutrients are being reported on a regular basis. We are not ready to start genotyping people yet. We don’t yet know enough to design a simple genetic test to predict our unique nutritional needs. That science is 10-20 years in the future, but this is something that’s coming down the road.

What the current studies tell us is that some people are high-risk because of their genetic makeup, and these are people for whom supplementation is going to make a significant difference. However, because genetic testing is not yet routine, most people are completely unaware that they might be at increased risk of disease or have increased nutritional requirements because of their genetic makeup.

Examples of Disease Influencing Nutritional Needs

Finally, let’s consider the effect of disease on our nutritional needs. If you look at the popular literature, much has been written about the effect of stress on our nutritional needs. In most case, the authors are referring to psychological stress. In fact, psychological stress has relatively minor effect on our nutritional needs.

Metabolic stress, on the other hand, has major effects on our nutritional needs. Metabolic stress occurs when our body is struggling to overcome disease, recover from surgery, or recover from trauma. When your body is under metabolic stress, it is important to make sure your nutritional status is optimal.

The effects of surgery and trauma on nutritional needs are well documented. In my book, “Slaying The Supplement Myths”, I discussed the effects of disease on nutritional needs in some detail. Let me give you a brief overview here. It is very difficult to show beneficial effects of supplementation in a healthy population (primary prevention). However, when you look at populations that already have a disease, or are at high risk for disease, (secondary prevention), the benefits of supplementation are often evident.

For example, studies suggest that vitamin E, B vitamins, and omega-3s each may reduce heart disease risk, but only in high-risk populations. Similarly, B vitamins (folic acid, B6 and B12) appear to reduce breast cancer risk in high risk populations.

Who Benefits Most From Supplementation?

Question MarkWith this information in mind, let’s return to the question: “Who benefits most from supplementation? Here is my perspective.

1) The need for supplementation is greatest when these circles overlap, as they do for most Americans.

2) The problem is that while most of us are aware that our diets are not what they should be, we are unaware of our increased needs and/or genetic predisposition. We are also often unaware that we are at high risk of disease. For too many Americans the first indication they have heart disease is sudden death, the first indication of high blood pressure is a stroke, or the first indication of cancer is a diagnosis of stage 3 or 4 cancer.

So, let’s step back and view the whole picture. The overlapping circles are drawn that way to make a point. A poor diet doesn’t necessarily mean you have to supplement. However, when a poor diet overlaps with increased need, genetic predisposition, disease, or metabolic stress, supplementation is likely to be beneficial. The more overlapping circles you have, the greater the likely benefit you will derive from supplementation.

That is why I feel supplementation should be included along with diet, exercise, and weight control as part of a holistic approach to better health.

The Bottom Line

In this article I provide a perspective on who benefits most from supplementation and why. There are four reasons to supplement.

  1. Fill Nutritional gaps in our diet

2) Meet increased nutritional needs due to pregnancy, lactation, age, exercise, many common medications, and environmental pollutants.

3) Compensate for genetic variations that affect nutritional needs.

4) Overcome needs imposed by metabolic stress due to trauma, surgery, or disease.

With this information in mind, let’s return to the question: “Who benefits most from supplementation? Here is my perspective.

  1. A poor diet alone doesn’t necessarily mean you have to supplement. However, when a poor diet overlaps with increased need, genetic predisposition, or metabolic stress, supplementation is likely to be beneficial. The more overlap you have, the greater the likely benefit you will derive from supplementation.

2) The problem is that while most of us are aware that our diets are not what they should be, we are unaware of our increased needs and/or genetic predisposition. We are also often unaware that we are at high risk of disease. For too many Americans the first indication they have heart disease is sudden death, the first indication of high blood pressure is a stroke, or the first indication of cancer is a diagnosis of stage 3 or 4 cancer.

For more details, read the article above.

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

Health Tips From The Professor