Health Current Events

Do Statins Cause Memory Loss?

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Is the Cure Worse Than the Disease?

Author: Dr. Steve Chaney

 

statins and diabetesDo statins cause memory loss?  They are at it again. The medical profession is telling us that yet another study shows that statins are safe, so almost everyone should be taking a statin drug. There is only one problem. That’s not what the study really showed.

Let’s start at the beginning. For people who have already had a heart attack it is pretty clear that statin drugs save lives. If stain drugs were only prescribed for people who have had a heart attack or were at high risk of having a heart attack, I would be a proponent of their use.

However, the guidelines developed by the pharmaceutical and medical industry recommend statin use for millions of Americans who have never had a heart attack and who are at low to moderate risk of ever having a heart attack. That is problematic.

As I documented in a recent “Health Tips From the Professor”  the benefits of statins are marginal at best in healthy people who have not yet had a heart attack.

In addition, statins have some significant side effects. For example, up to 5% of people taking statins develop muscle pain and weakness. For most people the muscle pain is merely an inconvenience, but in a small percentage of cases it can lead to serious complications.

More concerning are the required label warnings that statins can lead to memory loss, mental confusion, high blood sugar and type 2 diabetes. In fact, a recent study described in “Health Tips From the Professor” suggests that statins may increase diabetes risk by as much as 46%.

In other words, statins may not kill you, but they sure can make life miserable. For many people, the most troubling aspect of statin use is memory loss. One of the most terrifying aspects of aging is the thought that you might be able to keep your body healthy but lose your mind.

However, recent headlines have proclaimed that we can “forget” about statins causing memory loss (Pardon the pun. I couldn’t resist it). They claim that a recent study has shown that statins don’t actually cause memory loss. The problem is that is not exactly what the study showed. It is only the medical profession’s interpretation of what the study showed.

Why Might Statins Cause Memory Loss?

iron and brain developmentStatin drugs block cholesterol synthesis, and cholesterol is an integral part of the myelin sheath that coats our neurons. You can think of myelin as being like the plastic coating on an electrical wire. It is that plastic coating that allows the electrical current to travel from one end of the wire to the other without shorting out. Myelin plays essentially the same role for our neurons.

Because of the importance of cholesterol in maintaining the integrity of myelin, there was concern from the earliest days of statin development that it might adversely affect memory. Thus, multiple clinical studies have been performed to determine whether statin use adversely affects memory.

Unfortunately, the previous clinical studies have been inclusive. Some suggested that statins cause memory loss. Others found no correlation between statin use and memory loss. A few actually suggested that statins improved memory. There are a number of reasons why the previous studies came to different conclusions including use of different statin drugs, different duration of the studies, and differences in how memory was measured.

Do Statins Cause Memory Loss?

blood pressure medicationsThis study (Strom et al, JAMA Internal Medicine, doi: 10.1001/jamainternmed.2015.2092) differed from previous studies in that:

  • It focused on short term memory loss, and
  • It also included a group of patients who were using non-statin cholesterol lowering drugs.

The study drew on patient data from the online Health Improvement Network database collected from general practitioners offices throughout England between July 7, 2013 and January 15, 2015. The study compared 482,543 statin users with 482,543 matched controls using no cholesterol lowering medication and 26,484 patients using non-statin cholesterol lowering medications. The average age of the participants in this study was 63. Memory loss within the first 30 days after initiation of drug therapy was assessed by scanning the medical records in the database for codes related to memory loss.

The results were stunning!

  • Stain drug users were 4-fold more likely to experience short term memory loss within the first 30 days than non-users, and the likelihood of memory loss was dose dependent.
  • The users of non-statin cholesterol lowering drugs were also 4-fold more likely to experience short term memory loss within the first 30 days than non-users.
  • As you might expect there was no significant difference in memory loss between users of the statin and non-statin cholesterol lowering drugs.

How Were The Results Interpreted?

The results seemed to be pretty clear cut, but it was a somewhat misleading interpretation of the results that was widely publicized. The authors of the article correctly pointed out that there are two possible interpretations of these results. Either…

  • All cholesterol lowering drugs cause acute memory loss….or
  • The association of memory loss with cholesterol lowering drugs is the result of something called “detection bias”.

Let me explain. Some memory loss is fairly common for people in their 60s and beyond. The term “detection bias” simply means that the patients might have been more acutely aware of memory loss because they were monitoring themselves for side effects to the drug they just started taking.

Of course, the medical profession is so confident in the benefits of statins that they focused on the second interpretation, and that is the one that you heard about in all of the press releases about this study. If you believe that the self-reported memory loss in this study was entirely due to detection bias, then the most logical interpretation of the study is that statin drugs really don’t cause memory loss.

However, I consider the first interpretation to be the most likely of the two. If use of cholesterol lowering drugs were associated with a 25% or 50% increase in memory loss, detection bias could have been a credible interpretation of the data. However, a 4-fold increase in memory loss is hard to ascribe to detection bias alone.

Furthermore, the first explanation is fully consistent with what we know about myelin. Because of the importance of cholesterol in maintaining the integrity of the myelin sheath, it is logical that any drug that dramatically lowers cholesterol levels could have an adverse effect on cognitive function.

Are There Other Options Besides Statin Drugs?

Because of the marginal benefits in healthy people and the multiple side effects, some experts are starting to step up and say that statins may be overprescribed. For example, Dr. Roger Blumenthal, MD, a professor and director of the Ciccarone Preventive Cardiology Center at Johns Hopkins recently said: “Statin therapy should not be approached like diet and exercise as a broadly based solution for preventing coronary heart disease. These are lifelong medications with potential, although rare, side effects, and physicians should only consider their use for those patients at greatest risk…”

So, what are the alternatives?

#1: Lower Cholesterol Naturally With Some TLC

healthy livingsThe National Heart Lung & Blood Institute recommends that something called Therapeutic Lifestyle Change or TLC should always be tried first for patients with elevated cholesterol, and that statins only be used if the lifestyle approach fails – a message that seems to have gotten lost in the translation in many doctor’s offices. The TLC recommendations are:

  • Add 2 grams per day of plant stanols and sterols to your diet. In most cases some that will require some degree of supplementation.
  • Eat less than 7 percent of your daily calories from saturated fat
  • Eat less than 200 mg a day of cholesterol
  • Make sure that you get 10-25 grams per day of soluble fiber.
  • Get only 25–35 percent of daily calories from total fat (this includes saturated fat calories)
  • Consume only enough calories to reach or maintain a healthy weight
  • In addition, you should get at least 30 minutes of a moderate intensity physical activity, such as brisk walking, on most, and preferably all, days of the week.

There is ample evidence that implementation of these lifestyle changes will reduce cholesterol levels and reduce the risk of heart attack and stroke without any side effects. The reduction in cholesterol levels is more modest than what can be achieved with cholesterol lowering medications, but perhaps that is the point. Perhaps the medical profession is being too aggressive in reducing cholesterol levels with drug therapy.

If you are a bit overwhelmed by the TLC recommendations, there is good news. Even one or two of the lifestyle changes mentioned above can substantially reduce your risk of heart attack or stroke. For example, in a previous “Health Tips From the Professor,” apple a day keeps statins away, I reported on a study claiming that simply eating one apple a day would be just as effective as statins at reducing cardiovascular deaths.

#2: Reduce Other Risk Factors Associated with Heart Disease

Elevated cholesterol is not the only risk factor associated with heart disease. In fact, many experts feel that it isn’t even the most important risk factor. High blood pressure, high triglycerides, inflammation and damage to the endothelial lining of our arteries are other important risk factors for heart disease. If you are leery about using statins to reduce your cholesterol levels, you might want to explore other natural approaches to reducing heart disease risk. For example:

  • Nitrate from foods such as beetroot and spinach reduce blood pressure and improve endothelial health. This is also a topic I have covered in a previous “Health Tips From the Professor” Nitric Oxide Benefits Side Effects.
  • Resveratrol and related polyphenols reduce inflammation and improve endothelial health.

I could go on, but you get the point. There are other natural approaches for reducing heart attack risk. Statins and other cholesterol lowering drugs are not the only game in town.

     Red Yeast Rice Yeast Rice Side Effects?

red yeast rice side effectsHowever, just because a supplement is natural doesn’t necessarily mean that it is either safe or effective. Red yeast rice is a perfect example. Many people think of red yeast rice as a natural way to reduce cholesterol levels. They believe red yeast rice side effects are non-existent. Nothing could be further from the truth!

The active ingredients in red yeast rice are a class of compounds called monacolins, which are close analogs of the statin drugs. In fact, the most abundant monacolin, monacolin K, is identical to the statin drug lovastatin.

That destroys one myth. If a red yeast rice product contains as much monacolin K as a lovastatin pill, it would have the same benefits and the same side effects.

It only gets worse! In fact, you have no way of knowing how much monacolin K is in your red yeast rice supplement. Because lovastatin is a drug the manufacturers are caught in a Catch-22 situation. If the manufacturers were to actually standardize or disclose the levels of monacolin K in their product, the FDA would consider it an unapproved drug.

When manufacturers don’t standardize their active ingredients bad things happen. How bad, you might ask? A recent study analyzed the concentration of active ingredients in 12 commercially available red yeast rice supplements (R. Y. Gordon et al, Archives of Internal Medicine, 170: 1722-1727, 2015). The results were appalling:

  • Total monacolins in the supplements ranged from 0.31 to 11.15 mg/capsule.
  • Monacolin K (lovastatin) ranged from 0.10 to 10.09 mg/capsule.
  • To put that into perspective therapeutic doses of lovastatin range from 10 to 80 mg/day.

It gets even worse! The study also measured levels of a toxin called citrinin that is produced by a fungus and is potentially toxic to the kidneys. This is not a toxin that you would find in a pharmaceutical product like lovastatin, but it was present in high levels in one third of the red yeast rice formulations tested.

To sum it all up, if you were to go out and purchase a red yeast rice supplement.

  • You might get a batch with no active ingredients. It wouldn’t have any of the side effects of a statin drug, but it wouldn’t have any efficacy either.
  • You might get a batch that would have the same efficacy and the same side effects as a low dose statin drug.
  • You would have a 33% chance of getting a batch that was contaminated with a toxin that you would never find in a statin drug.

I don’t know about you, but after reading that study I have no desire to ever try a red yeast rice supplement.

Do statins cause memory loss?

 

 

The Bottom Line

  • For people who have already had a heart attack statin drugs are clearly beneficial. They save lives.
  • If you haven’t already had a heart attack and your doctor prescribes a statin, you may want to have a serious discussion with your doctor about alternative approaches for reducing heart attack risk. You may even want to seek a second opinion from a doctor with a more holistic orientation. Recent research suggests that statin drugs:
  • Are of marginal efficacy in low to moderate risk individuals who have not suffered a heart attack.
  • Can cause muscle pain and weakness, which can lead to serious illness in a small percentage of the cases.
  • May increase the risk of developing type 2 diabetes by up to 46%.
  • May cause memory loss and mental confusion.
  • A recent study showed that both statin and non-statin cholesterol lowering drugs caused 4-fold greater short term memory loss in older adults compared to matched patients who were not taking statin medications.
  • The medical profession has chosen to interpret this study as showing that statin drugs don’t cause short term memory loss, and that is the interpretation that has been widely reported in the press. I feel that the more logical interpretation of the data is that both statin and non-statin cholesterol lowering drugs cause short term memory loss.
  • Fortunately, there are natural approaches for reducing cholesterol levels and heart disease risk without any side effects. For example, the National Heart Lung and Blood Institute recommends a natural approach called Therapeutic Lifestyle Change or TLC .
  • There are also natural approaches for reducing other risk factors for heart disease such as high blood pressure, high triglycerides, and inflammation. These include things like omega-3 fatty acids, nitrate from vegetables like beetroots and spinach, and polyphenols like resveratrol just to name a few.
  • However, natural is not always better. Red yeast rice, for example, is neither safe nor effective. 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.

Restaurant Chains Beginning To Serve Healthy Fast Food?

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Would You Like Hydrocolloids In Your “Healthy Fast Food?”

Author: Dr. Stephen Chaney

 

The fast food industry is changing. Some of the changes are good. Some of the changes are bad. Some of the changes are downright ugly. Let’s start with the good.

healthy fast foodIn recent months Panera, MacDonald’s and Subway have all announced that they are switching to ingredients that people can recognize – ingredients that you might actually use in your own kitchen. Chipotle has recently announced that they have removed all genetically modified organisms from their foods.

This week Pizza Hut said that it will remove artificial colors and preservatives from its food. Taco Bell pledged to remove artificial colors, artificial flavors, high-fructose corn syrup and palm oil from its foods.

For example, Taco Bell will start using real pepper instead of “black pepper flavor” in its food (I didn’t even realize that there was an artificial pepper flavor. Come on! Real pepper can’t be that expensive!). They also plan to remove Yellow No. 6 from their nacho cheese, Blue No. 2 from their avocado ranch dressing, and carmine from their red tortilla strips.

Are restaurants making healthy fast food? Or is this all for show?

Will Healthy Fast Food Be Available At  Ordinary Fast Food Chains?

Now let’s look at the bad. Perhaps the first question to ask is: “Why is the fast food industry making these changes? Have they suddenly decided that they want to become part of the health food industry?”

One clue to those questions is the name of the parent company that owns both Pizza Hut and Taco Bell. They call themselves Yum Foods. You will notice that they don’t call themselves Health Foods. Their name alone speaks volumes about their priorities.

When the CEO of Yum Foods was describing these changes, he didn’t speak about any desire to make healthy fast food. He spoke about responding to shifting consumer attitudes and the desire of consumers for “real food” as driving these kinds of changes. The bottom line is that fast food companies are realizing that consumers are becoming more aware of the dangers of artificial ingredients and are making their buying choices accordingly. The companies simply don’t want to lose market share.

The second question to ask is: “Are these foods actually healthier?” The answer is: “Not really”. None of these companies are talking about removing fat, sugar, salt or calories from their foods. They are more concerned with retaining the “yum” factor than they are in actually making healthy fast food.

Do You Want Hydrocolloids With That Pizza?

hydrocolloidsNow let’s talk about the ugly. Perhaps the most important questions you should be asking are: “What is behind the curtain?” “What aren’t they telling us about?” The answer is: “You probably don’t want to know.”

For example, I came across an interesting article in a food industry journal. A Spanish company called Premium Ingredients was announcing that they had developed a new “food” product from hydrocolloids and melting salts that could be used to replace casein in pizza toppings.

But, first a bit of background:

You’ve heard nutritionists claim that pizza is a perfect food because it contains foods from all four food groups. Of course, that’s ignoring the fact that pizza is generally made with white flour and contains lots of fat – mostly saturated, calories and sodium.

But, when you look at many of the frozen and fast food pizzas on the market it gets even worse.

You noticed that Premium Ingredients didn’t say that their hydrocolloids/melting salts mixture could be used to replace cheese. They said that it could be used to replace casein. That’s because many pizza manufacturers haven’t used real cheese in years.

Instead they are using casein (milk protein) and a chemical smorgasbord to manufacture a cheese “food” with the taste and consistency of cheese.

Cheese is a good source of protein and calcium, and it supplies a lot of other essential nutrients as well – such as vitamin D, vitamin A, vitamin B12, riboflavin, folic acid, magnesium & zinc. Some of the artificial cheeses on the market do supply the calcium found in real cheese, but almost none of them provide the other essential micro-nutrients. But, because the artificial cheeses have been made with casein up to now, we could at least count on them to supply the protein found in real cheese.

Now, thanks to Premium Ingredients, the manufacturers of frozen and fast food pizzas won’t even have to use casein-containing artificial cheeses. In their trade journal article Premium Ingredients boasted that their product will help manufacturers cut costs (and cut protein and essential nutrients in the process).  Is this creating healthy fast food?

Lucky us?

 

The Bottom Line

  • A number of fast food chains have recently announced that they are removing some artificial ingredients from their foods.
  • These changes appear to arise from a desire to respond to changes in consumer preferences rather than to actually make healthy fast food.
  • For example, most of the fast food chains that are removing artificial ingredients from their foods are making no effect to reduce fat, sugar, salt and calories. Fast foods are not becoming health foods.
  • Even worse are the hidden ingredients you don’t know about. For example, a fast food supplier recently announced that it had developed a mixture of hydrocolloids and melting salts that could be used in place of casein (milk protein) for the “cheese food” that fast food chains for their pizza topping.
  • That saves the fast food chains money, but it leaves you with a pizza that gives you no milk, no calcium, no vitamin D and less of many other essential nutrients.
  • Pizzas are just the tip of the iceberg. Most of us no longer make complex foods like pizza from scratch. We count on manufacturers to use the same natural ingredients that we would use. But, in fact we have no idea of what they are putting in the foods that we are eating. That is why our food supply is becoming depleted of essential nutrients in ways that we don’t even know about. That’s one reason why I use food supplements and why I recommend food supplements for others.

 

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.

Food Ingredients To Avoid List

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Food Ingredients to Avoid Part 2: The Good, The Bad & The Ugly

Author: Dr. Stephen Chaney

 

food additivesIt is getting really hard to find a food or food supplement that doesn’t have any ingredients on the internet “naughty list”. The problem is that many of the internet warnings about food ingredients are what I call “urban nutrition myths”.  Want to know the truth about which additives should be on the  food ingredients to avoid list?

Last week I identified the top 25 food ingredients on the internet “naughty list” and told you which ones were actually “good” – OK for most people most of the time. This week I’m going to tell which ones are “bad” and which ones are truly “ugly”.

Food Ingredients to Avoid List?  The Bad

food ingredients to avoid badThe term “bad” for the food ingredients in this list is a bit of a misnomer. These are food ingredients that some people will want to avoid, but are perfectly OK for many people. In some cases, the type of food the ingredients are added to determines whether the ingredient is OK or should be avoided.  So, the following could possibly be on your food ingredients to avoid list.

Sodium Nitrate and Nitrite: This is a topic I have covered in a previous article titled “Nitric Oxide Benefits and Side Effects” . It is a perfect example of a food ingredient that can be “bad” in certain foods and “good” in others. Briefly:

  • When sodium nitrate and/or sodium nitrate are added to processed meats, they can combine with the amino acids from the meat in the intestine to form cancer-causing nitrosamines. As you might suspect, this is not a good thing.
  • On the other hand, when sodium nitrate or sodium nitrite are found in fruits are vegetables or combined with natural antioxidants such as vitamin C, they are converted to nitric oxide, which has a number of beneficial effects in the body. So when they are present in these foods or food supplements, they are actually beneficial.

Sugar & High Fructose Corn Syrup: As I said in my video “The Truth About Sugar” , there are no sugar villains and there are no sugar heroes. For example, high fructose corn syrup has been particularly vilified in recent years, but its chemical composition is not significantly different from honey and agave nectar, which are considered to be “good” sugars.

The problems associated with sugars of all types in the American diet are related to the amount of sugar in our diet (too much) and the kinds of foods they are found in. Let’s focus on that last one for a minute.

  • When sugars are consumed as a part of foods that are rich in fiber and/or protein they have much less of an effect on blood sugar levels (a lower glycemic index) than when they are consumed in sodas, juices and highly processed foods. That’s important because the bad health consequences of sugars are primarily caused by foods that lead to high blood sugar levels. See, for example, my article “Can Soft Drinks Cause Heart Disease?” .
  • Consequently, we should be focusing on the glycemic index (the effect on blood sugar levels) of the foods we eat rather than obsessing about the amount or kinds of sugar on the label.

MSG: MSG, or monosodium glutamate, is a particularly interesting case. MSG is the sodium salt of the amino acid glutamate.

Glutamate is a neurotransmitter.

  • When MSG is used as a flavor enhancer in foods with a low protein content, the glutamate is very rapidly taken up by the brain and can overstimulate some neurons.
  • For most people this is no problem, but a small number of people experience what used to be called “Chinese Restaurant Syndrome” due to the large amounts of MSG used in some Chinese foods.
  • The common symptoms associated with “Chinese Restaurant Syndrome” are headache, sweating, skin flushing, nausea & fatigue. Allergic reactions to MSG can even be life threatening in some individuals.

Glutamate is also found in every protein we eat. Consequently, we create lots of MSG in our intestine every time we eat and digest protein. In this situation it is no more harmful than any other amino acid in the proteins we eat.

  • The most logical explanation for this phenomenon is that when all of the amino acids are in our bloodstream simultaneously they compete with glutamate for uptake into the brain. This slows the entry of glutamate into the brain and prevents overstimulation of neurons.

The bottom line is that MSG as a flavor enhancer is harmless for most people, but problematic for some. MSG as a component of hydrolyzed vegetable protein or sodium caseinate is harmless because it is in balance with the other naturally occurring amino acids. Some websites claim that MSG is found in maltodextrin and citric acid. It is not.

Salt (Sodium): I could, and probably should, write a whole article on sodium intake. Suffice it to say that 1) most of us consume too much sodium, 2) most of that sodium is hidden in the foods we eat rather than added at the table, and 3) some people are more sensitive to the bad effects of sodium than others.

Refined Grains: Again, this could be a whole article. Suffice it to say that 1) whole grains are better than refined grains and 2) most of us would benefit from eating fewer grains in any form and more fruits and vegetables in their place.

Food Ingredients to Avoid List: The Ugly

Finally, there are some food ingredients that most experts (except for those in the food industry) agree should be avoided. I call them the dirty dozen. All should be on everyone’s food ingredients to avoid list.  They are:

food ingredients to avoid ugly

  • Trans fats (also known as partially hydrogenated vegetable oils).
  • Aspartame
  • Acesulfame-K
  • Sucralose
  • Artificial colors
  • Artificial flavors
  • BHA & BHT
  • Propyl gallate
  • Sodium and potassium benzoate
  • Potassium bromate
  • Potassium sorbate
  • Polysorbate 80

 

The Bottom Line

If you were to believe everything you read on the internet about food ingredients that you should avoid, you could end up spending most of your day reading food labels and still find very few foods that you could eat. Some of those warnings are true, some are partially true, and some are mostly myths.

To help you determine which to place on your food ingredients to avoid list,  I have identified the top 25 food ingredient warnings and have divided them into the good, the bad and the ugly.

  • The “good” are those food ingredients that are perfectly OK for most people, most of the time. Here are some examples (see the article above for a full explanation).
  • Soy: The supposed dangers of soy have been disproven by numerous clinical studies, but the myths persist. I do recommend that you choose non-GMO soy protein.
  • GMO: GMO foods and proteins are a concern but purified food ingredients obtained from GMO foods pose no health risks. There are, however, possible environmental concerns due to the overuse of Roundup.
  • Carrageenan and Caramel Color: In this case it is contaminants rather than the food ingredients themselves that are the problem. As long as you choose a manufacturer who performs rigorous quality control tests on their ingredients, you need not be concerned about these ingredients.
  • Canola Oil, Maltodextrin and Soy lecithin: The supposed dangers of these food ingredients are myths. They are not backed up by credible clinical studies. However, they are generally derived from GMO foods, so there is a possible environmental concern.
  • The “bad” are the food ingredients that do pose a problem for some people, particularly when those ingredients are found in the wrong kinds of foods. However, those same ingredients are OK for many people when they are in the right foods.
  • Sodium nitrate and nitrite: Those ingredients are a concern when added to processed meats, but are actually healthy when found in fresh fruits and vegetables or combined with antioxidants such as vitamin C.
  • Sugar and High Fructose Corn Syrup: We definitely need to reduce the amount of sugar in our diet. However, when looking at individual foods we should focus more on glycemic index than on the amount or kind of sugar.
  • MSG: MSG is a concern for some individuals when used as a flavor enhancer in low protein foods. However, it poses no risk when it is present as a component of partially digested proteins such as hydrolyzed vegetable protein or sodium casseinate.
  • The “ugly” are those ingredients that most experts agree we should avoid. They include trans fats, artificial sweeteners, artificial colors, artificial flavors, artificial preservatives and a few others listed 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.

Risk Factors for Diabetes

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Are Statins Dangerous?

Author:  Dr. Stephen Chaney

 

statins side effectsSeveral years ago I recall a cardiologist telling my class of first year medical students that statins were so beneficial that we should just put them in the water supply. He said it in a lighthearted manner, but I think he really believed it. [In actuality, statin drugs are so widely prescribed that they already are in the water supply of some major US cities (http://usatoday30.usatoday.com/news/nation/2008-03-10-drugs-tap-water_N.htm).]

The Pros And Cons of Statins

When taken by people who have already had a heart attack, statins clearly save lives. However, as I documented in my eBook “The Myths of the Naysayers” (scroll down to Check It Out if you would like to learn how you can get that eBook for FREE) the benefits of statins are marginal at best in healthy people who have not yet had a heart attack.  So are statins one of the risk factors for diabetes?

Statin Side Effects

In addition, statins have some significant side effects. For example, up to 5% of people taking statins develop muscle pain. For most people the muscle pain is merely an inconvenience, but in a small percentage of cases it can lead to fatal complications.

More concerning are the required label warnings that statins can lead to memory loss, mental confusion, high blood sugar and type 2 diabetes. In other words, they may not kill you, but they sure can make life miserable.

Because of the marginal benefits in healthy people and the multiple side effects, some experts are starting to step up and say that statins may be overprescribed. For example, Dr. Roger Blumenthal, MD, a professor and director of the Ciccarone Preventive Cardiology Center at Johns Hopkins recently said: “Statin therapy should not be approached like diet and exercise as a broadly based solution for preventing coronary heart disease. These are lifelong medications with potential, although rare, side effects, and physicians should only consider their use for those patients at greatest risk…”

Dr. Blumenthal made that statement a few years ago when we thought that statins only increased diabetes risk by 9-22%. The latest study suggests that statins may increase diabetes risk by as much as 46%. That, in my opinion, is a game changer.

Statins And Diabetes Risk?

statins and diabetes riskThe idea that statins increase the risk of type 2 diabetes is not new. Previous studies have reported that statins increase the risk of diabetes anywhere from 9% to 22%. As a consequence, the FDA required that “increased risk of elevated blood sugar and developing type 2 diabetes” be added to the warning label on statin drugs starting in 2012.

The authors of the current study (Cederberg et al., Diabetologia, DOI 10.1007/s00125-015-3528-5) felt that previous studies may have underestimated the true risk of developing diabetes because:

  • Previous studies were often done with patient populations at very high risk of cardiovascular disease. In today’s world statin drugs are often prescribed for patients at moderate or low risk of cardiovascular disease. The authors felt that the effect of statins on diabetes risk might not be the same in these two populations.
  • Previous studies relied on self-reported diabetes or fasting blood glucose levels as the criteria for classifying the study subjects as diabetic. In today’s world there are a wider array of diagnostic tests that are used to confirm a diagnosis of diabetes.

This study looked at the risk of developing type 2 diabetes associated with statin treatment over a 6-year period in a group of 8,749 Finnish men (aged 45-73 years) who were enrolled in the Metabolic Syndrome in Men (METSIM) study. That means that the men had metabolic syndrome (they were pre-diabetic), but none of them were yet diabetic at the beginning of the study. Other important characteristics of the study were:

  • This was a healthy cross-section of the Finnish population. Only 24.5% of the study participants were using statin drugs.
  • The diagnosis of diabetes was based on multiple criteria: fasting blood glucose levels, an oral glucose tolerance test, and hemoglobin A1c (a measure of blood sugar control over the last 6 weeks).

As you might suspect, the increased risk of developing diabetes during the 6-year trial was greatest for those who were older, more obese, less physically active and had more advanced metabolic syndrome at the beginning of the study. What was surprising, however, were the other conclusions of the study.

  • Statin treatment increased the risk of developing type 2 diabetes by 46%, and the increased risk of developing diabetes directly correlated with the dose of the statin drug.
  • Insulin sensitivity was decreased by 24% and insulin secretion was decreased by 12% in individuals on statin treatment. In layman’s terms that means the pancreas was 12% less able to release insulin and tissues in the body were 24% less able to respond to insulin. That’s a double whammy!

Even though this study is a significant improvement over previous studies, it does have some limitations of its own.

  • The study population was exclusively white, Finnish men. The conclusions may not apply to other population groups.
  • Simvastin (Zocor) and atorvastatin (Lipitor) were the most widely used statin drugs in this study (84% of the study participants taking statins were on one of these two drugs). These two statins clearly increased the risk of developing diabetes in a dose-dependent manner. There were not enough subjects on the other statin drugs to evaluate their effect on diabetes risk, but previous studies have suggested that other statins may be less prone to increase diabetes risk.

Should You Take Statins If you are Diabetic or Pre-Diabetic?

statins and diabetesLet’s start by identifying the symptoms of metabolic syndrome or pre-diabetes. They are:

 

  • Abdominal obesity (waist size of greater than 35” for women & 40” for men)
  • Slightly elevated triglycerides (greater than 150 mg/dl)
  • Low HDL cholesterol (less than 50 mg/dl for women and 40 mg/dl for men)
  • Slightly elevated blood pressure (greater than 130/85
  • Slightly elevated blood sugar (greater than 100 mg/dl fasting blood glucose)

If you have three or more of these symptoms, you likely have metabolic syndrome or pre-diabetes.

The medical profession and the pharmaceutical industry are circling their wagons and assuring us that the benefits of taking statins clearly outweigh the risks – even if you are diabetic or pre-diabetic. I’m not so sure

The problem is that the benefits of statin therapy in healthy individuals who have not had a heart attack are modest at best. This sets up a real “Catch 22” situation. Diabetes and pre-diabetes increase the risk of heart disease, so current guidelines recommend that statin drugs should be prescribed for individuals who are pre-diabetic or diabetic. However, we now know that those very same statin drugs increase the risk of you becoming diabetic if you are already pre-diabetic. Because they decrease insulin production and increase insulin resistance they may also make your diabetes worse if you are already diabetic, but that has not been directly tested.

That is concerning because diabetes can lead to very serious complications such as neuropathy (numbness in the extremities), kidney disease & kidney failure, high blood pressure and stroke, and cataracts & glaucoma. Of course, you can always use diabetes medications to counteract the diabetes-enhancing effect of the statins, but those medications also have serious side effects. The pharmaceutical merry-go-round continues!

Are There Alternatives For Reducing the Risk Of Heart Disease?

alternative is eat healthyIf statins are only modestly effective at reducing the risk of heart disease in otherwise healthy individuals and they significantly increase the risk of developing diabetes, it is perhaps prudent to ask whether there are alternative, non-drug approaches that can significantly reduce your cholesterol levels and allow you to avoid statins altogether?

According to the National Heart Lung & Blood Institute the answer to that question is a resounding yes! They call it Therapeutic Lifestyle Change or TLC (http://www.nhlbi.nih.gov/health/resources/heart/cholesterol-tlc). The TLC recommendations are:

  • Eat less than 7 percent of your daily calories from saturated fat
  • Eat less than 200 mg a day of cholesterol
  • Get only 25–35 percent of daily calories from total fat (this includes saturated fat calories)
  • Other diet options you can use for more LDL lowering are:
    • Add 2 grams per day of plant stanols or sterols
    • Add 10–25 grams per day of soluble fiber
  • Consume only enough calories to reach or maintain a healthy weight
  • In addition, you should get at least 30 minutes of a moderate intensity physical activity, such as brisk walking, on most, and preferably all, days of the week.

The NHLB Institute recommends that the TLC approach always be tried first, and that statins only be used if the lifestyle approach fails – a message that seems to have gotten lost in the translation in many doctor’s offices.

I have also discussed some natural alternatives in my previous articles such as “Does An Apple A Day Keep Statins Away?” (https://www.chaneyhealth.com/healthtips/apple-day-keep-statins-away/) and “Is Fish Oil Really Snake Oil?” (https://www.chaneyhealth.com/healthtips/fish-oil-really-snake-oil/).

What Should You Do?

Perhaps it is time to have a serious discussion with your doctor about following the National, Heart Blood & Ling Institute’s TLC recommendations – either as an alternative to statins or as something that will allow your doctor to reduce the amount of statins that your need to take.

I also recommend that you make lots of fresh fruits and vegetables and either oily fish or fish oil supplements part of your regular diet.

The old professor is just like the rest of you. My cholesterol gets a bit high from time to time and my doctor suggests going on a statin. Instead I ramp up my exercise, watch what I eat a bit more carefully, and use a supplementation program that includes stanols, sterols and omega-3 fatty acids.

My cholesterol gets back to where it is supposed to be. My doctor is happy, and I am happy.

 

The Bottom Line

  • The news about statin drugs keeps getting worse. Not only are they only marginally effective in healthy people who have not yet had a heart attack, but the latest study suggests that they may increase the risk of developing diabetes by up to 46%.
  • That is concerning because the complications of diabetes can be quite serious, and diabetes drugs have side effects of their own.
  • In addition to the TLC program I recommend lots of fresh fruits and vegetables, oily fish or fish oil supplements, and a supplement that provides the TLC-recommended 2,000 mg of plant stanols and sterols.

If you have been prescribed statin drugs, it may be time to make a serious commitment to the TLC lifestyle change and have a discussion with your physician about reducing or eliminating your statins. This is especially true if you are already pre-diabetic or diabetic.

 

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.

Vitamin D Deficiency

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What Is The Real Vitamin D Story?

Author: Dr. Stephen Chaney

 

Vitamin DIf you are like most people, you probably don’t know what to believe about vitamin D deficiency. Some experts tout vitamin D as a miracle nutrient that will help you lead a longer, healthier life. They leave you with the impression that everyone should be supplementing with vitamin D.

Other experts tell you that the supposed benefits of vitamin D are all hype. They tell you not to waste your money on vitamin D supplements.

When you pull back the curtain and look at the clinical studies behind the headlines, a pattern begins to emerge.

Most of the studies that support a role for vitamin D in preventing heart disease, preventing cancer and extending life have been population studies. They have compared populations with low vitamin D intake with populations with adequate vitamin D intake. While population studies are good for suggesting associations, they have their limitations:

  • Population studies are good at suggesting associations, but they do not prove cause and effect.
  • With population studies it is also very difficult to eliminate what scientists call “confounding variables”. Let me give you an example. Suppose someone had low 25-hydroxyvitamin D levels in their blood because they sat around all day watching TV and never got out in the sun. If they got sick you wouldn’t really know whether it was due to low 25-hydroxyvitamin D levels or due to inactivity. In this case, inactivity would be a confounding variable.

On the other hand, most of the studies that fail to find any benefit of vitamin D are double blind, placebo-controlled intervention studies in which one group was given supplemental vitamin D and the other group was given a placebo. While these studies are considered the most reliable clinical studies, they have their limitations as well.

  • In the case of vitamin D many of these studies were done with a cross section of the population in which most of the participants already had adequate blood levels of 25-hydroxyvitamin D at the start of the study. Those studies are incapable of telling us whether correcting a vitamin D deficiency would have been beneficial.
  • Even when the intervention studies focus on participants with low vitamin D status at the start of the trial they have another significant limitation. They are all short term studies. Typically, the best of these studies last no more than a couple of years. Longer term studies are far too expensive. In contrast, diseases such as heart disease and cancer take decades to develop. A one or two year intervention with vitamin D simply may not be sufficient to correct the damage caused by decades of vitamin D deficiency

This is the current dilemma that is creating all of the confusion in the vitamin D story. For the most part, population studies and intervention studies are coming to very different conclusions. And both kinds of studies have inherent limitations that are difficult to overcome.

Fortunately, a new kind of clinical study has been developed in recent years that overcomes the limitations of both population studies and intervention studies.

A New Kind of Clinical Study

Bad GenesThe new approach is something called mendelian randomization. I apologize for the scientific jargon, but let me explain. In this case you are separating your population based on genetic variation rather than on the basis of biochemical or behavioral differences.

 

For example, in the clinical study I will describe in a minute the population was separated into groups based on genetic variations in the DHCR7 and CYP2R1 genes. The first gene is involved in the biosynthesis of cholesterol, which is a precursor of vitamin D, and the second gene converts vitamin D to 25-hydroxyvitamin D. Both genes affect blood levels of 25-hydroxyvitamin D.

This kind of study has several unique strengths:

  • Genetic variations are unaffected by confounding variables such as sun exposure, obesity, smoking, inactivity, and poor diet. If the study population is large enough, those confounding variables will be equally distributed among groups that are selected solely on the basis of genetic variations.
  • These studies are long term by definition. If someone has a genetic variant that lowers their 25-hydroxyvitamin D level, it will do so for their entire lifetime. They can increase their vitamin D status by sun exposure, for example, but their blood levels of 25 hydroxyvitamin D will always be less than someone with equal sun exposure who does not have that genetic variant.
  • Because these studies reflect lifelong exposure to 25-hydroxyvitamin D they are ideally suited for measuring the effect of vitamin D status on mortality and diseases that take decades to develop.

Do Vitamin D Genes Affect Mortality?

This study (S. Afzal et al, The British Medical Journal, 2014;p 349:g6330 doi: 10.1136/bmj.g6330) combined the data from three clinical studies conducted in Copenhagen between 1976 and 2013. The age of the participants ranged from 20 to 100 years and the follow-up was 6-19 years. 95,766 participants in these studies were genotyped for variants in the DHCR7 and CYP2R1 genes which were known to affect 25-hydroxyvitamin D levels. 35,334 of those participants also had blood 25-hydroxyvitamin D levels determined. By the end of the study 10,349 of the participants had died.

  • The individual genetic variants included in this study caused a relatively small (1.9 nmol/L) decrease in blood levels of 25-hydroxyvitamin D. However, because this was a very large study and the participants with those genetic variants were exposed to lower 25-hydroxyvitamin D levels for their entire lifespan, the decreased 25-vitamin D levels were associated with significant increases in all cause mortality and cancer mortality, but not with increased cardiovascular mortality.
  • When they extrapolated to a genetically caused 20 nmol/L decrease in 25-hydroxyvitamin D, the decrease in 25-hdroxyvitamin D was associated with a 30% increase in all cause mortality and a 30% increase in cancer mortality.

What Kind Of Studies Are Needed Next?

The authors noted that this is the first study of its kind, so it obviously needs to be confirmed by other large mendelian randomization studies that test the link between vitamin D status and mortality.

Ideally, it should also be verified by double blind, placebo controlled intervention studies, but that may not be possible. If one really wanted to verify this study, the intervention study should start with a population group with 25-hydroxyvitamin D levels at least 20 nmol/L below what is considered adequate and provide them with enough supplemental vitamin D to increase their 25-hydroxyvitamin D to the adequate range. That is difficult, but doable.

However, the intervention study would also need to be long enough (decades perhaps) to prevent cancer from developing. That kind of study will probably never be done.

 

The Bottom Line

  • The relationship between vitamin D status and mortality has been investigated with a new type of clinical study based on what is called mendelian randomization. Population groups were segregated based on genetic variations in two genes that affect blood 25-hydroxyvitamin D levels (a measure of vitamin D status).
  • This study concluded that a genetically determined decrease of 20 nmol/L in blood 25-hydroxyvitamin D was associated with a 30% increase in all cause mortality and a 30% increase in cancer mortality, but had no significant effect on cardiovascular mortality.
  • This kind of study is particularly strong because it measures the affect of lifelong exposure to 25-hydroxyvitamin D. This is important when assessing the effect of vitamin D status on mortality and diseases such as cancer that take decades to develop. In contrast, the double blind, placebo controlled intervention studies that are consider the “Gold Standard” for clinical studies may be too short term to adequately assess the effect of vitamin D status on cancer or all cause mortality.
  • This study supports the benefit of maintaining optimal vitamin D status, but it is the first clinical study of its kind and needs to be confirmed by other studies.
  • In the meantime, there is no harm to in maintaining your blood levels of 25-hydroxyvitamin D in the optimal range through diet, sun exposure and supplementation. This study suggests it just may help you live a longer, healthier life.

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

Can Resveratrol Improve Memory Performance In The Elderly ?

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red wine benefitsWill Red Wine Make You Smarter?

Author: Dr. Stephen Chaney

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

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

What is Resveratrol?

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

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

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

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

Can Resveratrol Improve Memory In Healthy Older Adults?

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

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

Here are the results:

  • There was a significant effect of resveratrol on retention of words over 30 minutes compared to placebo. Memory improved significantly in the resveratrol group, while it declined slightly in the placebo group.
  • There was no effect of resveratrol on brain volume compared to the placebo (most interventions showing significant effects on brain volume required 2-3 years to demonstrate a significant effect).
  • Subjects in the resveratrol group showed significant increases in functional connectivity of the hippocampus to other brain regions involved learning and memory compared to the placebo group.
  • Subjects in the resveratrol group had lower hemoglobin A1c (better long term blood sugar control) compared to the placebo group.
  • When they statistically evaluated individual patients, the degree of improvement in the word memory test correlated with the increase in functional connectivity of the hippocampus and both of those measures correlated with decreased hemoglobin A1c.

What Does This Study Mean?

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

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

Can resveratrol improve memory?

The Bottom Line:

  • A recent study suggests that resveratrol, a polyphenol from red wine, improves memory (measured by a word recall test) and functional connectivity of the hippocampus, a region of the brain involved in memory function.
  • This is the very first study of its kind. It was small (46 subjects) and short (6 months). However, it was well designed and consistent with previous animal results. Thus, it should be considered preliminary, but promising. More studies are clearly needed to test this hypothesis.
  • If the results of this study are substantiated, it will not necessary mean that other polyphenols will exert similar effects on memory. The action mechanism of resveratrol is different than most other polyphenols.
  • It also does not necessarily mean that red wine will make you smarter. The 100 glasses of red wine a day that you would need to drink to get the amount of resveratrol used in this study would probably kill more brain cells than the resveratrol could help.
  • Finally, as I said in a recent “Health Tips From the Professor” , there are no “magic bullets” when it comes to preventing cognitive decline. Your chances of reducing cognitive decline are best with a holistic approach that includes healthy diet, exercise, socialization, mental exercises, maintaining a healthy weight, B vitamins and omega-3 fatty acids. If this study is confirmed by future studies, you may be able to add resveratrol supplements to the list.

 

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

Is Soda One of The Causes of Arthritis?

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is soda one of the causes of arthritis

Author: Dr. Stephen Chaney

 

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

Do Sodas Cause Arthritis?

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

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

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

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

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

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

 

What Are The Strengths and Weaknesses Of The Study?

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

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

Weaknesses of The Study:

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

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

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

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

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

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

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

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

Is It Enough To Just Stop Drinking Sodas?

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

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

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

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

Is soda one of the causes of arthritis?

The Bottom Line:

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

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

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

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

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

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

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

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

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

Should I Get a Flu Shot?

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

Author: Dr. Stephen Chaney

 should I get flu shot

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

When you examine the scientific literature it is clear that:

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

Flu Shot Side Effects

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

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

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

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

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

Let’s Talk Science

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

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

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

 

Is The Flu Shot Effective?

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

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

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

 

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

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

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

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

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

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

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

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

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

 

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

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

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

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

 

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

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

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

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

 

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

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

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

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

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

 

Who Has Most To Fear From The Flu?

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

 

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

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

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

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

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

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

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

 

Should I Get A Flu Shot?

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

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

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

 

The Bottom Line:

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

 

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

Is Alkaline Water Better For You?

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Facts About Water

Author: Dr. Stephen Chaney

 

is alkaline water better for youIs alkaline water better for you?  It’s bad enough that some people are paying a premium price for bottled water that isn’t required to be any better than tap water, but the latest fads appear to be things like “alkaline” water and “ionized” water. And these “super” waters come with a really hefty price tag.

If you believed the hype behind these products, you would think that they are revolutionary advances that will cure all sorts of ills. But the truth is these enticing claims are completely bogus. They contradict the basic laws of chemistry and biochemistry.

More importantly, there are no good quality clinical studies showing that they work!

What Is Alkaline Water?

Let’s start with alkaline water – but first a bit of background information.

Pure water has a pH of around 7, which is neutral. However, if the water is exposed to air for any length of time it picks up CO2 from the atmosphere. The CO2 dissolves in the water and is converted to carbonic acid making most sources of pure water slightly acidic.

On the other hand, if metal salts are dissolved in the water it generally becomes slightly alkaline.

Is Alkaline Water Better For You?

Here are some questions you might ask when deciphering if alkaline water is better for you than plain water:

1) What Are the Benefits of Drinking Alkaline Water?

In the 1930s Otto Warburg, one of the founders of modern biochemistry, showed that cancer cells were much more dependent on glucose (blood sugar) as an energy source than were most other cells in the body and that cancer cells metabolized glucose in a way that made the cancer cells very acidic.

That information languished for many years, but interest in the “Warburg Hypothesis” has been revived in recent years by studies showing that cancer cells can be selectively killed by limiting their source of glucose.

So, what are the benefits of drinking alkaline water?  In theory, making the body more alkaline would also slow the growth of the cancer cells. There is some evidence to support that hypothesis, but the evidence is still relatively weak.

It is the same with the other proposed health benefits of alkalinizing the body. There is some evidence in the literature, but it is not yet convincing. As a scientist I’m keeping an open mind, but I’m not ready to when-pigs-fly“bet the farm” on it.

2) Can Alkaline Water Alkalinize the Body?

Here the answer is a clear cut NO! In fact, this hypothesis wins my “Flying Pig” award for the month!

The body has a very strong buffer system and some elaborate metabolic controls to maintain a near-constant neutral pH. More importantly, water is such a weak buffer that it has almost no effect on body pH!

Alkaline Foods

If you really want to alkalinize your body you can do that by eating more of the alkaline foods (most fruits, including citrus fruits, and most vegetables, peas, beans, lentils, seeds & nuts) and less of the acidic foods (grains, especially refined grains, meat, especially red meat, fish, poultry and eggs).

I’ve seen some experts recommend 60% alkaline foods and 40% acidic foods. I can’t vouch for the validity of that recommendation in terms of the benefits of alkalinizing the body, but there are lots of other good reasons to eat more fresh fruits and vegetables and less red meat and refined carbohydrates.

Is Ionized Water Beneficial?

Ionized water is an even sillier concept from a chemical point of view.

It is very difficult to ionize pure water and the ions that you do create quickly recombine to give you pure water again without any change in pH or physical properties.

If you add sodium chloride (table salt) to the water you can get electrolysis that creates a slightly alkaline pH at one electrode and a slightly acidic pH at the other electrode.

However, as soon as you turn off the current, these pH changes rapidly disappear. Even if you were somehow able to capture some of the alkaline or acidic water remember that water alone has almost no effect on body pH.

Never Underestimate The Placebo Effect

But, what about all of those glowing testimonials that you have heard?

You need to remember that the placebo effect is near 50% when it comes to pain or a feeling of well being.

You can’t repeal the laws of chemistry and biochemistry. Water is, after all, just water!

Good science trumps good testimonials any day.  Never, never underestimate the placebo effect.

The Bottom Line

Don’t waste your money on alkaline water or ionized water. Water is a very poor buffer and has almost no effect on the pH of our bodies.

There may be some health benefits to keeping our bodies in a more alkaline state, but the best way to do that is to eat more alkaline foods and less acid foods (http://www.webmd.com/diet/alkaline-diets).

 

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

Is There Hope for Alzheimer’s

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Preventing Cognitive Decline As We Age

Author: Dr. Stephen Chaney

 alzheimer's

As we age nothing is more terrifying than the word Alzheimer’s. For most of us the ultimate irony would be to spend a lifetime taking good care of our body, only to lose our mind. From time to time there are encouraging reports about the potential of low fat diets, diets rich in fruits and vegetables, B vitamins, omega-3 fatty acids, various herbs, and other natural approaches that might slow cognitive decline as we age.

Inevitably, it seems, those hopes are dashed by subsequent meta-analyses supposedly showing that each of those approaches is worthless. That wouldn’t be so bad if there were effective medications to slow cognitive decline and prevent Alzheimer’s, but there aren’t. The Alzheimer’s drugs on the market today simply have not been shown to be effective.

But, what if all of these studies were missing the mark by focusing on individual interventions? Perhaps we should be focusing a holistic approach instead.

 

The Power of Holistic Approaches

One of the examples of the power of a holistic approach that I love to use, because it really made an impression on me as a young scientist, occurred at an International Cancer Symposium I attended more than 30 years ago.

I attended a session in which an internally renowned expert was giving his talk on colon cancer. He said, “I can show you, unequivocally, that colon cancer risk is significantly decreased by a lifestyle that includes a high-fiber diet, a low-fat diet, adequate calcium, adequate B-vitamins, exercise and weight control. But I can’t show you that any one of them, by themselves, is effective.”

The question that came to me as I heard him speak was: “What’s the message that a responsible scientist or responsible health professional should be giving to their patients or the people that they’re advising?” You’ve heard experts saying: “Don’t worry about the fat” “Don’t worry about calcium.” “Don’t worry about B-vitamins.” “Don’t worry about fiber.” “None of them can be shown to decrease the risk of colon cancer.”

Is that the message that we should be giving people? Or should we really be saying what that doctor said many years ago – a lifestyle that includes all of those things significantly decreases the risk of colon cancer?

What about Alzheimer’s and cognitive decline? Could a holistic approach have an impact here as well?

 

Is There Hope For Alzheimer’s?

preventing-cognitive-declineA study performed by Dr. Miia Kivipelto and colleagues at the Karolinska Insitute in Sweden and the National Institute for Health and Welfare in Helsinki, Finland suggests that a holistic approach may, in fact, be able to slow cognitive decline in older people.

Previous studies had suggested that exercise, a good diet, socialization and memory training might slow cognitive decline in the elderly, but, like all other individual interventions, the benefits of these interventions were not reproducible. Dr. Kivipelto and colleagues designed a clinical study that combined all of these interventions into a single holistic approach.

They started with 1,260 healthy adults aged 60-77 from Sweden and Finland and divided them into two groups. One group was enrolled in a holistic program involving exercise, a healthy diet, socialization and memory training. This group was closely monitored for compliance. The other group was just given general health advice – not unlike the advice you might expect to receive from your doctor.

Each group was given a memory test at the beginning of the study and a second memory test two years later. Both groups scored about the same on the first memory test. However, the group enrolled in the holistic program did considerably better on the second memory test than the control group who had just been given general health advice.

One of the lead investigators was quoted as saying: “These findings show that prevention is possible, and it may be good to start early [before the signs of cognitive decline become evident]. With so many negative trials of Alzheimer’s drugs reportedly lately, it’s good that we may have something that everyone can do now to lower their risk [of cognitive decline].”

 

Limitations of the Study

There are two big caveats for this study.

1)     The study was too short to assess the effectiveness of this approach at reducing Alzheimer’s. The investigators plan to continue the study for 7 years. They hope that enough participants will have developed Alzheimer’s by then so they can accurately assess whether this approach is as effective at preventing Alzheimer’s as it is at preventing cognitive decline.

2)     This study was recently presented at an Alzheimer’s Association International Conference. It has not yet undergone the rigorous peer review required for publication. Once the study has been published I will give you an update.

 

The Bottom Line

1)     It has been very difficult to prove that individual interventions, whether they are natural or pharmaceutical, are effective at preventing cognitive decline and the onset of Alzheimer’s as we age.

2)    However, a recent study suggests that a holistic approach that includes exercise, optimal nutrition, socialization and memory training may be effective at preventing cognitive decline in older adults.

3)     Based on previously published individual studies, optimal nutrition probably includes:

  • A diet low in fat, especially saturated fat and trans fats
  • A diet with lots of fresh fruits and vegetables
  • Extra B vitamins, especially with high risk populations
  • Extra omega-3 fatty acids

4)     Although not mentioned in this study, maintaining proper body weight is also an important part of a holistic approach to reducing the risk of cognitive decline. In a previous “Health Tips From the Professor” I shared data showing that obesity alone can cause a 3-fold increase in the risk of developing dementia.

5)    The take home message should not be that each of the natural interventions is ineffective at preventing cognitive decline as we age. Rather, the message should be that a holistic approach that combines all of the natural interventions may be effective at preventing cognitive decline.

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