Healthy Lifestyle

Can You Improve Your Healthspan?

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Can You Live Healthier, Longer?

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

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

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

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

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

How Were The Studies Done?

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

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

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

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

Can You Live Healthier Longer?

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

The results of the first study were:

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

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

The results of the second study were:

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

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

Can You Improve Your Healthspan?

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

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

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

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

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

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

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

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

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

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

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

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

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

How To Calculate Your Alternative Healthy Eating Index

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

Vegetables

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

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

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

Fruits

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

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

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

Whole Grains

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

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

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

Sugary Drinks and Fruit Juice

Count 10 points if you drink 0 servings per week.

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

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

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

Nuts, Seeds and Beans

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

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

Count 0 points for 0 servings per week.

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

Red and Processed Meat

Count 10 points if you eat 0 servings per week.

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

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

Count 0 points for ≥1½ servings per day.

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

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

Seafood

Count 10 points if you eat 2 servings per week.

Count 5 points for 1 serving per week.

Count 0 points for 0 servings per week.

1 serving = 4 oz.

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

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

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

The Bottom Line

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

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

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

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

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

Which Foods Should I Avoid?

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What Is Nutritionism?

In Defense Of FoodRecently, I have been reading Michael Pollan’s book “In Defense of Food”. Yes, I know the book has been around for a long time. Normally I read the scientific literature rather than popular health books. However, in the past few weeks I have had a lot more time to read books, so I decided to read this one.

Some of the things he says are “off the wall”. As he readily admits, he isn’t a scientist or a medical doctor. However, a lot of what he says is “right on”. He echoes many of the things I have been talking about for years. But he does a masterful job of pulling everything together into a framework he calls “nutritionism”.

If you have a chance, I highly recommend that you read his book.

I will briefly summarize his discussion of nutritionism below. I will also share some scientific support for what he is saying. Finally, I will close by sharing what the Bible says on the subject.

What Is Nutritionism?

Low Fat LabelSimply put, nutritionism is the belief that we can understand food solely in terms of its nutritional and chemical constituents and our requirements for them. I use the term “belief” purposely. As Michael Pollan puts it: “As the ‘-ism’ suggests, nutritionism is not a scientific subject, but an ideology.”

What Michael Pollan is referring to is taking food constituents like saturated fats, cholesterol, sugar, carbohydrates, polyunsaturated fats, monounsaturated fats, fiber, antioxidants, and probiotics and labeling them as either “good” or “bad”.

As he points out, that leads to debacles like the creation of margarine as a substitute for butter. Of course, everyone reading this article knows that we subsequently found out that the trans fat in margarine was worse for us than the saturated fat in butter. He offers many other examples like this.

He also points out that the nutritionism concept has given free rein to the food industry to replace whole foods with processed foods that are cholesterol-free, sugar-free, low-fat, low-carb, or high in fiber, omega-3s, etc. He says that these foods are seldom healthier than the foods they replace. I agree.

Finally, he points out that the scientific support for the classification of individual ingredients or foods as “good” or “bad” is weak. That’s because when scientists design a study that removes a chemical constituent or a food from the diet, they have to replace it with something. And what they replace it with determines the outcome of the study. I give some examples of this in the next section.

The essence of Michael Pollan’s message is:

  • The effect of an individual nutrient or chemical constituent on your health depends on the food it is found in. Forget the fancy nutrition labels. Whole foods are almost always healthier than processed foods.
  • The effect of a food or food constituent on your health also depends on your overall diet. We should be thinking about healthy diets rather than the latest “magical” or “forbidden” food.

I will discuss these points below.

Which Foods Should I Avoid?

Question MarkNow, let’s get to the question, “Which Foods Should I Avoid?” If we are talking about whole foods, the short answer is “None”. As I said in my book, “Slaying The Food Myths”, “We have 5 food groups for a reason”.

For example, if we are talking about plant foods, each plant food group:

  • Has a unique blend of vitamins and minerals.
  • Has a unique blend of phytonutrients.
  • Has a unique blend of fiber.
  • Supports the growth of a unique combination of beneficial gut bacteria.
  • Dr Strangelove and his friends are telling you to eliminate whole grains, fruits, and legumes (beans) from your diet. Recent studies suggest that might not be a good idea. Here is one example.

If we are talking about animal foods, each animal food group:

  • Has a unique blend of vitamins and minerals.
  • May have unique components that are important for our health. [Note: This is an active area of research. Theories have been proposed for which components in animal foods may be important for our health, but they have not been confirmed.]
  • Vegan purists will tell you that you have no need for meat and dairy foods. Recent studies suggest otherwise. Here is one example.

With that as background, let’s turn our attention to nutritionism and look at some of science behind claims that certain food components are either good for us or bad for us.

Saturated Fat. Saturated fat is the poster child for nutritionism.lowfat

First, we were told by the American Heart Association and other health organizations that saturated fat was bad for us. Recently Dr. Strangelove and his friends are telling us that saturated fat is good for us. Instead of limiting saturated fat, we should be limiting carbs by cutting out fruits, whole grains, and legumes. Both cite clinical studies to support their claims. How can this be?

Perhaps a little history is in order. When the American Heart Association recommended that we decrease intake of saturated fat, they were envisioning that we would replace it with monounsaturated and polyunsaturated fat in the context of a healthy diet of fruits, vegetables, whole grains, and legumes. That never happened.

Big Food quickly realized that if the American public were to follow the AHA guidelines, it would be disastrous for their bottom line. So, they sprang into action. They mixed sugar, white flour, and a witch’s brew of chemicals to create highly processed, low fat “foods”. Then they told the American public, “Don’t worry. You don’t have to give up your favorite foods. We have created low fat alternatives.”

This is the essence of what Michael Pollan refers to as nutritionism. By marketing their fake foods as low fat Big Food created the halo of health. In fact, Big Food’s fake foods were less healthy than the foods they replaced. Americans got fatter and sicker.

Now let’s look at the conflicting claims that saturated fat is bad for us or good for us. How can clinical studies disagree on such an important question? The answer is simple. It depends on what you replace it with. You need to consider saturated fat intake in the context of the overall diet.

I discussed this in a previous issue of “Health Tips From the Professor”, but let me summarize it briefly here. The American Heart Association tells us that replacing half of the saturated fat in a typical American diet with:

  • Trans fats, increases heart disease risk by 5%.
  • Refined carbohydrates and sugars (the kind of carbohydrates in the typical American Diet), slightly increases heart disease risk.
  • Complex carbohydrates (whole grains, fruits & vegetables), decreases heart disease risk by 9%.
  • Monounsaturated fats (olive oil & peanut oil), decreases heart disease risk by 15%.
  • Polyunsaturated fats (vegetable oils and fish oil), decreases heart disease risk by 25%.
  • Unsaturated fats in the context of a Mediterranean diet, decreases heart disease risk by 45%.

My advice: Saturated fat is neither good for you nor bad for you. A little bit of saturated fat in the context of a healthy diet is fine. A lot of saturated fat in the context of an unhealthy diet is problematic.

fatty steakRed Meat. Is red meat bad for you? Like saturated fat, it depends on the amount of red meat and the overall diet. I covered this in detail in “Slaying The Food Myths”, but let me summarize briefly here:

According to the World Health Organization, red meat is a probable carcinogen. If we look at the postulated mechanisms by which it causes cancer, they can be mostly neutralized by components of various plant foods.

My advice: An 8-ounce steak with fries and a soda is probably bad for you. Three ounces of that same steak in a green salad or stir fry may be good for you.

I should make one other point while I am on the topic. Dr. Strangelove and his friends have been telling you that grass-fed beef is better for you than conventionally raised beef. Once again, that is nutritionism.  Grass-fed beef is lower in saturated fat and high in omega-3s than conventionally raised beef. That may be better for your heart, but it has no effect on the cancer-causing potential of red meat. It doesn’t give the license to eat 8-ounce steaks on a regular basis. You still want to aim for 3-ounces of that grass-fed beef in a green salad or stir fry. 

High-Fructose Corn Syrup. This one seems to be on everyone’s “naughty list”. You are being told to read labels, and if the food has high-fructose corn syrup on the label, put it back on the shelf. But is that good advice?

It turns out that all the studies on the bad effects of high-fructose corn syrup have been done with sodas and highly processed foods. This should be your first clue.

Of course, as soon as high-fructose corn syrup gained its “bad” reputation, Big Food started replacing it with Sugar Comparisons“heathier” sugars. Does that make those foods healthier?

The answer is a clear “No”. Both chemically and biologically, high-fructose corn syrup is identical to sucrose (table sugar), honey, molasses, maple syrup, coconut sugar, date sugar, or grape juice concentrate. Agave sugar is even higher in fructose than high-fructose corn syrup. This is your second clue.

Substituting these sugars for high-fructose corn syrup doesn’t turn sodas and processed foods into health foods. This is nutritionism at its worst.

My advice: Forget reading the label. Forget trying to avoid foods with high-fructose corn syrup. Avoid sodas and processed foods instead.

Sugar. Once the public started to realize that natural sugars in processed foods were just as bad for us as high-fructose corn syrup, sugars became “bad”. We were told to avoid all foods containing sugar in any form. In fact, we were told we needed to become “label detectives” and recognize all the deceptive ways that sugar could be hidden on the label.

Apple With Nutrition LabelI have discussed this in detail in a previous issue of “Health Tips From The Professor”.

Let me just summarize that article with one quote, “It’s not the sugar. It’s the food. There is the same amount and same types of sugar in an 8-ounce soda and a medium apple. Sodas are bad for you, and apples are good for you.” If you are wondering why that is, I have covered it in another issue of “Health Tips From the Professor”.

Before leaving this subject, I should mention that nutritionism has risen its ugly head here as well. Big Food has struck again. They have replaced sugar with a variety of artificial sweeteners.

Once again, nutritionism has failed. Those artificially sweetened sodas and processed foods are no healthier and no more likely to help you keep the weight off than the sugar-sweetened foods they replace. I have covered the science behind that statement in several previous issues of “Health Tips From the Professor”. Here is one example.

My advice: Forget about sugar phobia. You don’t need to become a label detective. Just avoid sodas, sugar-sweetened beverages, and sweet processed foods. Get your sugar in its natural form in fruits and other whole foods.

low carb dietCarbs. Dr. Strangelove and his friends are now telling you that you need to avoid all carbs. That is pure nutritionism. Carbs are neither good nor bad. It depends on the type of carb and what you replace it with.

Once again, clinical studies have given conflicting outcomes. Each side of the carbohydrate debate can provide clinical studies to support their position. How can that be? The answer is simple. It depends on what assumptions went into the design of the clinical studies. I have written several articles on this topic in “Health Tips From the Professor”, but let me give you one example here.

In this example, I looked at two major studies. The PURE (Prospective Urban Rural Epidemiology) study included data from 135,000 participants in 18 countries. In this study, the death rate decreased as the % carbohydrate in the diet decreased. The low-carb enthusiasts were doing a victory dance.

However, it was followed by a second, even larger study. The ARIC (Atherosclerosis Risk In Communities) study included 432,000 participants from even more countries. In this study, the death rate decreased as the % carbohydrate decreased to about 40%. Then a curious thing happened. As the % carbohydrate in the diet decreased further, the death rate increased.

How can you explain this discrepancy? When you examine the PURE study:

  • The % carbohydrate only ranged from 70% to 40%.
  • The data for the PURE study was obtained primarily with third world countries. That is an important distinction because:
    • In those countries, it is primarily the well to do that can afford sodas, processed foods, and meat.
    • The poor subsist on what they can grow and inexpensive staples like beans and rice.
  • Simply put, in the PURE study, the type of carbohydrate changed as well as the amount of carbohydrate.
    • At the highest carbohydrate intakes, a significant percentage of the carbohydrate came from sugar and refined grains.
    • At the lowest carbohydrate intakes, most of the carbohydrate intake came from beans, whole grains, and whatever fruits and vegetables they could grow.

When you examine the ARIC study:how much carbohydrates should we eat aric

  • The % carbohydrate ranged from 70% to 20%.
  • The ARIC study added in data from the US and European countries. That is an important distinction because:
    • Low carb diets like Atkins and Keto are popular in these countries. And those are the diets that fall into the 20-40% carbohydrate range.
    • Most people can afford diets that contain a lot of meat in those countries.
  • Simply put, at the lower end of the scale in the ARIC study, people were eating diets rich in meats and saturated fats and eliminating healthy carbohydrate-containing foods like fruits, whole grains and legumes.

My advice: The lesson here is to avoid simplistic nutritionism thinking and focus on diets rather than on foods. When you do that it is clear that carbs aren’t bad for you, it’s unhealthy carbs that are bad for you.

Which Foods Should I Avoid? By now the answer to the question, “Which Foods Should I Avoid?” is clear. Avoid sodas, sugar-sweetened beverages and processed foods (The term processed foods includes convenience foods, junk foods, and most sweets).

What Does This Mean To You?

Questioning ManNow that we are clear on which foods you should avoid, let’s look at the flip side of the coin. Let’s ask, “Which foods should you include in your diet?

As I said at the beginning of this article, “We have 5 food groups for a reason”. We should consider whole foods from all 5 food groups as healthy.

Of course, each of us is different. We all have foods in some food groups that don’t treat us well. Some of us do better with saturated fats or carbs than others. We need to explore and find the foods and diets that work best for us.

However, whenever we assume one diet is best for everyone, we have crossed the line into nutritionism.

What Does The Bible Say?

Let me start this section by saying that I rely on the Bible for spiritual guidance rather than nutritional guidance. However, as part of our church’s Bible reading plan, I was reading 1 Timothy. A passage from 1 Timothy 4:1-5 leapt out at me. It reinforces the theme of Michael Pollan’s book and seems uniquely applicable to the times we live in.

“The Spirit clearly says that in later times some will abandon the faith and follow deceiving spirits and things taught by demons. Such teachings come through hypocritical liars, whose consciences have been seared as with a hot iron. They…order people to abstain from certain foods, which God created to be received with thanksgiving by those who believe and who know the truth. For everything God created is good, and nothing is to be rejected if it is received with thanksgiving, because it is consecrated by the word of God and prayer.”

Interesting.

The Bottom Line

In this article, I have discussed the concept of “nutritionism” introduced in Michael Pollan’s book “In Defense Of Food”. He defines nutritionism as the belief that we can understand food solely in terms of its nutritional and chemical constituents and our requirements for them.

What Michael Pollan is referring to is taking food constituents like saturated fats, cholesterol, sugar, carbohydrates, polyunsaturated fats, monounsaturated fats, fiber, antioxidants, and probiotics and labeling them as either “good” or “bad”. He points out that when we accept these simplistic labels, we often end up creating foods and diets that are less healthy than the ones we were trying to replace.

At the beginning of the article, I asked the question, “Which Foods Should I Avoid?” I then looked at several foods or food groups we have told to avoid, including saturated fats, red meat, high-fructose corn syrup, sugar, and carbs. When you look at the science behind these recommendations from the lens of nutritionism, you come to two conclusions:

  • We should avoid sodas, sugar-sweetened beverages and processed foods (The term processed foods includes convenience foods, junk foods, and most sweets).
  • Whole foods from all 5 food groups should be considered as healthy.

Of course, each of us is different. We all have foods in some food groups that don’t treat us well. Some of us do better with saturated fats or carbs than others. We need to explore and find the foods and diets that work best for us.

However, whenever we assume one diet is best for everyone, we have crossed the line into nutritionism.

For more details and a bible verse that supports the theme of Michael Pollan’s book and seems uniquely applicable to the times we live in, read the article above.

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

Does Diet Affect Sperm Quality?

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Do Real Men Eat Meat?

Enjoying Red MeatMeat has a certain mystique among some men. They believe real men eat meat, especially red meat. The belief is that eating red meat makes them bigger, stronger, and more virile. In that world view, vegetarianism is effeminate.

How much of that is true? Let’s start by looking at the bigger and stronger part:

  • Animal proteins are higher in the branched chain amino acids, especially leucine, which help drive the increase in muscle mass associated with exercise. However, meat protein is digested slowly.
  • Milk protein is also high in branched chain amino acids and is digested more quickly. That’s why many body building supplements are whey protein based.
  • In addition, leucine is now being added to some of the plant protein supplements. Those supplements are often as effective as whey protein supplements at driving the increase in muscle mass associated with exercise

But what about virility? Does meat make men more virile? Fortunately, we now have an answer to these questions. A recent study (L Nassan et al., JAMA Network Open, 2020; 3(2) :e1921610) has looked at the effect of diet on sperm count and sperm quality.

How Was The Study Done?

Clinical StudyIn Denmark, all men are required to undergo a physical examination around age 18 to determine their fitness for military service. Research staff at the University Department of Growth and Reproduction at Rigshospitalet in Copenhagen approached young men undergoing their physical exams and invited them to participate in this study.

The men filled in a food frequency questionnaire, answered questions about their lifestyle and medical history and provided semen and blood samples for the study prior to undergoing their physical exam. 2935 men who were unaware of their fertility status and not using anabolic steroids were included in the data analysis.

The average age of participants in the study was 19 and 78% of them were of normal body weight.

The participants were divided into four groups based on their diet:

1.     Western Diet characterized by a higher intake of pizza, French fries, processed and red meats, snacks, refined grains, sugary beverages and sweets.

2.     Danish Diet characterized by a higher intake of cold processed meats, whole grains, fruits, mayonnaise, cold fish, condiments, and dairy.

3.     Vegetarian Diet characterized by a higher intake of vegetables, soymilk, and eggs, without red meat or chicken.

4.     Prudent (Healthy) Diet characterized by a higher intake of fish, chicken, vegetables, fruit, nuts, and water.

The effect of these diets on sperm count and sperm quality were compared.

Does Diet Affect Sperm Quality?

SpermWhen the authors measured sperm counts in the study participants, the results were as follows:

  • Greatest adherence to a prudent diet resulted in a sperm count of 167 million.
  • Greatest adherence to a vegetarian diet resulted in a sperm count of 151 million.
  • Greatest adherence to a Danish diet resulted in a sperm count of 146 million.
  • Greatest adherence to a Western diet resulted in a sperm count of only 122 million -27% lower than for men eating a prudent diet.
  • Similar results were reported for measure of sperm quality, such as sperm motility (how fast the sperm can swim) and normal sperm morphology (sperm without visible defects).
  • These results are similar to several earlier studies showing that men eating a healthy diet have greater sperm count and sperm quality.

The authors concluded: “Our findings support the evidence that adhering to generally healthy diet patterns is associated with better semen quality and more favorable markers of testicular function. Because diet is modifiable, these results suggest the possibility of using dietary intervention as a potential approach to improving testicular function in men of reproductive age.”

Do Real Men Eat Meat?

SteakNow it is time to come back to the original question, “Do real men eat meat”. Or more specifically, does red meat consumption increase virility? Of course, the whole question of whether a single food affects virility, or any other aspect of manliness, is bogus.

Individual foods don’t affect our health. Diets do. So, let’s review how diets affect men’s sperm count and sperm quality.

  • The highest sperm count and sperm quality was associated with the prudent diet. This diet relied primarily on fish and chicken as protein sources but did not exclude red meat. It was also a diet high in vegetables, fruits, nuts, and water (in place of sugary beverages).
  • The second highest sperm count and sperm quality was associated with the vegetarian diet. This diet relied on beans and eggs as the primary protein sources. It specifically excluded red meat and chicken but did not exclude fish. It was also high in fruits and nuts. Soy milk, tea, and coffee were the main beverages.
  • The third highest sperm count and sperm quality was associated with the Danish diet. This diet relied on cold processed meats (some of which were red meats), cold fish, and dairy for protein. However, it also was rich in whole grains and fruits. Water and sugary beverages were consumed in equal proportions.
  • The lowest sperm count and sperm quality was associated with the Western diet. This diet relied on red and processed meats as the primary protein source. However, it was also high in refined grains, snacks, sugary beverages, sweets, and junk foods.

So, if we are using sperm count and sperm quality as a measure of virility, it is clear that real men don’t eat red meat. Or put another way, a diet rich in red meat is more likely to reduce sperm count and sperm quality than it is to increase it.

However, a small amount of red meat as part of an overall healthy diet can be consistent with good sperm count and quality.

In short, diet does affect sperm quality. For example, based on this study:

  • An 8-ounce steak with French fries, cherry pie, and a soft drink (or, in our part of the country, sweet tea) may not be good for your sex life.
  • If you don’t want to give up red meat, a better choice might be 3-ounces of steak in a vegetable stir fry, fruit for dessert, and water or tea as your beverage.
  • If you want to maximize sperm count and sperm quality, an even better choice would be chicken, fish, or beans with vegetables, fruit for dessert, and water or tea as your beverage.

The Bottom Line

Meat has a certain mystique among some men. They believe real men eat meat, especially red meat. The belief is that eating red meat makes them bigger, stronger, and more virile.

How much of that is true. We already know that meat has no magical power to make men bigger and stronger. But what about virility? Does meat make men more virile? Fortunately, we now have an answer to that question. A recent study has looked at the effect of diet on sperm count and sperm quality.

  • The highest sperm count and quality was associated with a prudent diet. This diet relied primarily on fish and chicken as protein sources but did not exclude red meat. It was also a diet rich in vegetables, fruits, nuts, and water (in place of sugary beverages). In other words, it was a healthy diet.
  • The lowest sperm count and quality was associated with the Western diet. This is a diet that relies on red and processed meats as the primary protein source. However, it is also high in refined grains, snacks, sugary beverages, sweets, and junk foods.

So, if we are using sperm count and sperm quality as a measure of virility, it is clear that real men don’t eat red meat. Or put another way, a diet rich in red meat is more likely to reduce sperm count and quality than it is to increase it.

However, a small amount of red meat as part of an overall healthy diet can be consistent with good sperm count and sperm quality.

In short, it appears that diet does affect sperm quality:

  • An 8-ounce steak with French fries, cherry pie, and a soft drink (or, in our part of the country, sweet tea) may not be good for your sex life.
  • If you don’t want to give up red meat, a better choice might be 3-ounces of steak in a vegetable stir fry, fruit for dessert, and water or tea as your beverage.
  • If you want to maximize sperm count and sperm quality, an even better choice would be chicken, fish, or beans with vegetables, fruit for dessert, and water or tea as your beverage.

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.

Why Do Most Diets Fail?

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How To Lose Weight And Keep It Off

New Year DietTomorrow is the official start of another dieting season. Millions of Americans will be making a New Year’s Resolution to lose weight. The top three reasons for these weight loss resolutions are:

1)    Reduce disease risk (73%). After all, we are being told those excess pounds increase our risk of diabetes, heart disease, cancer, and just about every other disease known to man.

2)    Improve self-esteem (61%). Some of this may be due to the social stigma associated with obesity, but many people simply want to improve the image they see in the mirror every morning when they get out of the shower.

3)    Boost energy (49%).

Those are all good reasons for losing weight. But before you make your New Year’s resolution to embark on another weight loss journey, you should ask yourself “Do weight loss diets work?” If you look at the statistics, they aren’t very encouraging:

1)    45 million Americans go on a weight loss diet every year.

·       50% go on fad diets.

·       They spend $33 billion on weight loss products.

·       90% regain almost all the weight. That’s called the yo-yo effect.

·       On average, Americans gain 11 pounds on every diet yo-yo.

o   They might as well have thrown that $33 billion to the wind.

2)    228,000 Americans get gastric bypass surgery.

·       80% regain almost all the weight.

o   Their digestion and their health will never be the same.

As if those statistics weren’t bad enough, the obesity epidemic gets worse year after year (see the graphic on the Obesity Epidemicright). Americans keep getting fatter. What we are doing clearly isn’t working.

You are probably saying to yourself: “I know that, but this year I’m going to try a new diet.” As the saying goes “Hope springs eternal in the human breast”, but is it realistic to think this time will be different?

Let me share a quote from a book and TV series called “The Weight Of the Nation” by John Hoffman & Dr. Judith Salerno”:

“First we blamed fat – low fat diets didn’t work! Then we blamed carbs, eggs, red meat, dairy, white flour, sugar, juices, sodas, high-fructose corn syrup, & partially hydrogenated fats. One by one, we replaced the evil food du jour…and watched our collective waistlines grow.”

In other words, they are saying it’s not just low-fat diets that don’t work. None of the popular diets work long term. I come across lots of people who tell me the Atkins weight-loss diet works best for them. That would be convincing if they were slender, but they aren’t! They gained it all back and then some. Now that the keto diet has been around for a few years, I am starting to see the same pattern there as well.

Clearly, the problem isn’t losing the weight. Any diet can help you lose weight. The problem is keeping the weight off. Let’s look at why this is.

Why Do Most Diets Fail?

WhyTo understand the answer to this question, let’s start with another quote from “The Weight Of the Nation”: “Our bodies were designed to store fat in times of plenty and retain fat in times of famine”

Essentially, the authors were saying when our ancestors were hunters and gatherers, there were times when food was abundant, and times when food was scarce. In order to survive, our bodies had to store energy in its most efficient form when food was abundant and hold on to those energy stores as long as possible when food was scarce.

Fat provides more than twice as many calories per gram as either carbohydrate or protein. Additionally, our ability to store carbohydrate is limited. And we don’t really have protein stores. All the proteins in our body have essential functions. However, our ability to store fat is unlimited. Now you understand why fat is the preferred energy store in times of plenty and our bodies try to hold on to it as long as possible in times of famine.

With that perspective in mind, there are three reasons why most diets fail:

1)    Most dieters are looking for rapid weight loss (at least 2-5 pounds/week). That is a problem because “Our bodies were designed to…retain fat in times of famine”. When we lose weight quickly, our bodies interpret that as famine. Our bodies respond by decreasing our metabolic rate so we can hold on to those fat stores.

The solution to this problem is to set more reasonable weight loss goals. If we keep the rate of weight loss in the 1-2 pound/week range (0.5-1 pounds/week is even better), we can largely avoid this famine response. You should ask yourself, “What’s the rush?” After all, the average American only gains 1-2 pounds/year. Why do we need to get rid of that excess weight in just a few weeks?

2)    Most dieters are looking for significant weight loss (more than 20 pounds). That is a problem because our bodies are designed to retain fat stores, not protein stores. When our bodies sense a famine they burn our protein stores (lean muscle mass) to spare as much of our fat stores as possible. The longer the diet (famine) lasts, the more muscle mass we lose.

That’s a problem because muscle burns calories much faster than fat. The more muscle we lose, the more our metabolic rate decreases. It gets harder and harder to lose weight, and eventually we reach a plateau. Most people get discouraged at that point and go off their diet.

That’s where the other part of the quote from “The Weight Of The Nation” kicks in: “Our bodies are Yo-Yo with Boydesigned to store fat in times of plenty”. Once again, it is fat we store, not protein. Most people never regain the protein stores they lost, so their metabolic rate remains low. They regain most of the weight they lost, and then some. This is the origin of the yo-yo effect.

There are two solutions to this problem:

·       Increase your resistance exercise and your intake of protein with high levels of the essential amino acid leucine. I have covered this in a previous issue of “Health Tips From The Professor”.

·       Set more reasonable weight loss goals. It is possible to lose more than 20 pounds without losing muscle mass. We just need to think in terms of reaching those weight loss goals in years rather than in months. Once again, remember it took us years to gain the weight. Why not think in terms of years to lose the weight?

3)    Most dieters think in terms of diets rather than lifestyle change. Diets have an expiration date. Then most people just drift back to “the way they really live”. Lifestyle change, on the other hand, is permanent. Once we change to a healthier lifestyle, we no longer need to focus on weight loss. The weight comes off automatically.

To better understand the power of lifestyle change let’s look at something called “The National Weight Control Registry”.

How To Lose Weight And Keep It Off

Happy woman on scaleRather than focus on the abysmal statistics for long-term weight loss, doctors Rena Hill and James O Wing decided to focus on the characteristic of people who manage to keep their weight off. They founded something called “The National Weight Control Registry” and invited people who were successful at keeping the weight off to participate in their program.

Currently, the National Weight Control Registry is tracking over 10,000 individuals who have lost 30 pounds or more and have kept it off for long periods of time. They use detailed questionnaires and annual follow-up surveys to study the behavioral and psychological characteristics and the strategies of weight loss maintainers.

When you look at how they lost weight, they are a very diverse group:

·       They lost weight on every possible diet – from vegan to keto to just plain crazy.

·       50% lost weight on commercial diet programs. 50% lost weight on their own.

·       Some lost weight quickly. Some lost weight slowly.

When you look at weight maintenance, you realize that the dismal weight maintenance statistics don’t have to apply to you. The good news is:

·       On average, people in The National Weight Control Registry have lost 66 pounds and have kept it off for 5 years or more.

·       12-14% of them have maintained a weight loss of 100 pounds or more for 5 or more years.

·       Even better, once they maintained their weight loss for 2-5 years, it became easy.

They no longer had to battle hunger and a sluggish metabolism. They no longer had to think about the lifestyle changes they were trying to maintain. Their new lifestyle became what they did automatically, without even thinking about it. Their weight loss had become permanent.

By now, you are probably wondering how they do it. Here are the top 7 characteristics of those who are successfulhealthy living at keeping the weight off:

1)    They consumed reduced calorie, low-fat, healthy diets.

2)    They had internalized their eating patterns. It had become how they ate every day without even thinking about it.

3)    They monitored their weight regularly. This allowed them to make adjustments whenever they saw their weight start to creep up.

4)    They ate breakfast on a regular basis.

5)    They got lots of exercise (on average, about 1 hour/day).

6)    They watched less than 10 hours of TV/week. If you were wondering where you would find the time to exercise an hour/day, this is probably your answer.

7)    They were consistent. They had no planned “cheat days”. This doesn’t mean they were purists. They still allowed themselves to eat some of their favorite unhealthy foods on an occasional basis. They just didn’t set aside regular times when they planned to “pig out”.

There was one other interesting observation from this study:

·       Those who used meal replacement shakes as part of their weight loss, focused more on diet and included meal replacement shakes as part of their maintenance program.

·       Those who lost weight on their own, also followed healthy eating habits, but put a bit more emphasis on exercise to keep themselves on track.

·       Both approaches were effective.

The take-home message of the National Weight Control Registry is clear. There is no magic diet that guarantees you will keep the weight off. The “secret” to keeping the weight off is a healthy eating pattern and a healthy lifestyle.

In short, if your resolution is to lose weight next year, don’t focus on the diet you will follow to lose the weight. Instead, focus on the healthy lifestyle you will follow to keep the weight off.

Of course, you will be most successful if the diet you are following to lose weight incorporates the healthy lifestyle you plan to follow to maintain your weight loss.

What Role Do Habits Play In Weight Loss?

Habits-Old-vs-NewFinally, I would like to share a recent study (G Cleo et al, International Journal of Obesity, 43: 374-383, 2019) that puts the whole issue of weight loss and weight maintenance in a different perspective. This study looked at the role that habits play in weight loss.

In short, the study enrolled 130 participants who wanted to lose weight. All the participants were told this was a weight loss study, but none of the participants were given detailed diet and exercise recommendations to follow. The study had a 12-week intervention phase followed by a 12-month follow-up phase. The participants were divided into three groups.

1)    Group 1 received no advice during the intervention phase. This was the control group.

2)    Group 2 focused on breaking old habits. During the intervention phase they were sent daily tests suggesting new habit patterns. These were suggestions like “Drive a different route to work today”. None of the texts had anything to do with diet or lifestyle.

3)    Group 3 focused on creating new healthy habits. They were given a list of 10 healthy habits. During the intervention phase they were asked to log how many of these habits they implemented each day. The 10 healthy habits were:

#1: Keep to a daily meal routine.

#2: Choose reduced fat versions of foods.

#3: Walk off the weight (aim for 10,000 steps/day).

#4: Pack a healthy snack (Choose healthy options such as fruits, nuts, or low-fat yogurt).

#5: Read labels.

#6: Be cautious with your portions.

#7: Break up your sitting time (Stand for 10 minutes every hour).

#8: Think about your drinks (Choose water instead of sodas and fruit juices).

#9: Focus on your food (Slow down. Don’t eat while watching TV).

#10: Don’t forget your 5 servings of fruits and vegetables a day.

The results were:

·       People in both habit change groups lost significantly more weight than people in the control group.

·       People in the habit change groups continued to lose weight for 12 months after the intervention ended.

·       Weight loss was essentially identical in the two habit change groups.

The last observation is particularly interesting. Remember that one of the habit change groups was simply focused on breaking old habits, yet people in this group did just as well as people who were taught healthy lifestyle habits. This implies that people already know about healthy lifestyle habits. They just don’t know how to break their old habits. Once they become comfortable breaking old habits, they find it easy to adopt healthier lifestyle habits.

In short, change your habits, change your lifestyle. Change your lifestyle, control your weight.

What Does This Mean For You?

why-do-most-dirts-failI covered a lot of information in this article. Let me sum it up by giving you my top 10 tips for losing weight and keeping it off.

1)    You don’t need to achieve your “ideal weight”. Losing 5-10% of your body weight may be enough.

2)    Ditch diets. Focus on lifestyle change.

3)    Slow and steady wins the day.

4)    Change your habits, change your weight.

5)    Long-term weight loss is possible.

6)    Low-fat, healthy eating patterns are best.

7)    Once you have internalized healthy habits, they become automatic.

8)    If you stick with a healthy lifestyle long enough, keeping the weight off becomes easy.

9)    Focus on all the healthy food choices you have, not what you have to give up. There is a cornucopia of great tasting, healthy foods to choose from.

10)  Never say never. Allow yourself to enjoy your old favorite foods on occasion. Just don’t make it a habit.

The Bottom Line

I cover a lot of information in this article. Let me sum it up by giving you my top 10 tips for losing weight and keeping it off.

1)    You don’t need to achieve your “ideal weight”. Losing 5-10% of your body weight may be enough.

2)    Ditch diets. Focus on lifestyle change.

3)    Slow and steady wins the day.

4)    Change your habits, change your weight.

5)    Long-term weight loss is possible.

6)    Low-fat, healthy eating patterns are best.

7)    Once you have internalized healthy habits, they become automatic.

8)    If you stick with a healthy lifestyle long enough, keeping the weight off becomes easy.

9)    Focus on all the healthy food choices you have, not what you have to give up. There is a cornucopia of great tasting, healthy foods to choose from.

10)  Never say never. Allow yourself to enjoy your old favorite foods on occasion. Just don’t make it a habit.

For more details on how to lose weight and keep it off, read the article above. In fact, if you plan to lose weight in the coming year, you should really read this article first.

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.

 

 

Will A Healthy Lifestyle Help Prevent Alzheimer’s Disease?

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Can Lifestyle Overcome Genetics?

Author: Dr. Stephen Chaney

 

Will a healthy diet help prevent Alzheimer’s disease?

world health organization alzheimersAlzheimer’s disease and other forms of dementia are among the most feared diseases of aging. What use is it to have a healthy body, a loving family, and a successful career if you can’t remember any of it? You should be able to enjoy your Golden years, not see them slip through your fingers.

If you have a family history of dementia or have sent your DNA off for testing and learned you are genetically predisposed to dementia, you are probably worried. You are not alone.

According to the World Health Organization:

  • 50 million people worldwide have dementia.
  • Alzheimer’s Disease accounts for 60-70% of all dementia cases.

According to the Alzheimer’s Association:

  • 8 million Americans are currently living with Alzheimer’s Disease.
  • 1 in 3 seniors will die from Alzheimer’s or another form of dementia.
  • The number of Americans with Alzheimer’s Disease is expected to increase to 14 million by 2050.

Perhaps the scariest thing about Alzheimer’s is that the medical community has no answers. There are no drugs to prevent or cure Alzheimer’s and brain transplants are out of the question. Some medical professionals will tell you nothing can be done, but is that true?

Studies have suggested that a healthy lifestyle can help reduce your risk of developing Alzheimer’s and other forms of dementia. But what about genetics? Will a healthy lifestyle only reduce your risk of dementia if your genetic risk is low or will it be equally effective when your genetic risk is high? Can lifestyle overcome genetics?

This study (I Lourida et al, JAMA, 322: 430-437, 2019 ) was designed to answer that important question.

How Was The Study Done?

alzheimers studyThis study used data collected from the UK Biobank study, which was designed to assess the effect of genetics and lifestyle on health outcomes. The UK Biobank study enrolled more than 500,000 participants between 2006 and 2010.

At the time of enrollment, UK Biobank participants were given a physical exam. Blood samples were taken and preserved for subsequent genetic analysis. They also completed an online questionnaire and were interviewed about lifestyle, medical history, and nutritional habits.

This study used a subset of the UK Biobank data, consisting of 196,383 people who were 60 years or older and free of cognitive impairment or dementia at the time of enrollment. They were followed for an average of 8 years.

The authors created the following scoring system to assess the effect of genetics and lifestyle on Alzheimer’s disease and dementia:

The Genetic Risk Score represents the combined effect of all genetic variants known to increase the risk of Alzheimer’s disease and dementia. [Note: There is no single gene that determines whether you will develop Alzheimer’s and other forms of dementia. There are multiple gene variations that affect your risk.]

The Healthy Lifestyle Score was based on 4 well-established dementia risk factors (smoking status, physical activity, diet, and alcohol consumption). The risk factors were defined as follows:

  • Smoking status was categorized as current or no current smoking.
  • Regular physical activity was defined as meeting the American Heart Association of:
  • ≥ 150 minutes of moderate exercise per week – OR –
  • ≥ 75 minutes of vigorous activity per week.

A healthy diet was defined as meeting at least 4 of these 7 criteria.

  • ≥ 3 servings/day of fruit.
  • ≥ 3 servings/day of vegetables.
  • ≥ 2 servings/week of fish.
  • ≥ 3 servings/day of whole grains.
  • ≤ 1 serving/week of processed meats.
  • ≤ 1.5 servings/week of red meat.
  • ≤ 1.5 servings/day of refined grains.

Moderate alcohol consumption was defined as:

  • Up to one drink a day for women.
  • Up to two drinks a day for men.

Finally, the diagnosis of Alzheimer’s Disease or dementia was obtained from the centralized databank of the UK National Health Service.

 

Will A Healthy Lifestyle Help Prevent Alzheimer’s Disease?

 

healthy-lifestyle-prevent-alzheimersHere are the results from the study:

  • People at high genetic risk were almost twice as likely to develop dementia as those at low genetic risk.

In other words, genetics matter. If you have “bad” genes, your risk of developing dementia is increased significantly.

  • A healthy lifestyle decreased the risk of developing dementia by about 40% for both people at high genetic risk and for people at low genetic risk.

In other words, lifestyle also matters. You can significantly decrease your risk of developing dementia, no matter what your genetic risk.

  • People at high genetic risk and an unhealthy lifestyle were almost three times more likely to develop dementia than people at low genetic risk and a healthy lifestyle.

In other words, the combination of a high genetic risk and an unhealthy lifestyle is the worst of all possible worlds.

  • People at low genetic risk and an unhealthy lifestyle were just as likely to develop dementia as people at high genetic risk and a healthy lifestyle.

In other words, bad genetics does not doom you to Alzheimer’s and dementia. A healthy lifestyle can cut your risk almost in half. Conversely, good genetics is not a “Get Out of Jail Free” card. You can squander the advantage of good genetics with an unhealthy lifestyle.

Simply put, both genetics and lifestyle influence the risk of developing Alzheimer’s Disease and dementia. However, the take-home lesson from this study is that:

  • A healthy lifestyle can partially offset the effect of bad genetics.
  • A healthy lifestyle can enhance the effect of good genetics.
  • An unhealthy lifestyle can negate the benefit of good genetics.

 

Can Lifestyle Overcome Genetics?

 

lifestyle over geneticsThis study clearly suggests that a healthy lifestyle can significantly reduce the effect of “bad” genetics on your risk of developing Alzheimer’s and other forms of dementia as you age. Considering that the medical profession has no other answer for preventing or treating Alzheimer’s Disease, this is really good news.

In the words of Dr. John Haaga of the U.S. National Institute on Aging: “No one can guarantee you’ll escape this awful disease, but you can tip the odds in your favor with clean living.”

The main strength of this study is its very large size. It is also supported by many smaller studies that have come to similar conclusions.

Moreover, a recent intervention study has been performed in Scandinavia in which one group was enrolled in a healthy lifestyle program while the other group continued with their previous health habits. That study also concluded that healthy habits could help prevent mental decline. The Alzheimer’s Association also has a similar intervention study in the United States. We should have more definitive information on this important subject very soon.

Finally, Alzheimer’s Disease may not be unique. Another recent study found that a healthy lifestyle can partially overcome a high genetic risk for developing heart disease.

 

The Bottom Line

 

A recent study looked at the effect of genetics and lifestyle on developing Alzheimer’s Disease and other forms of dementia. Here are the results from the study:

  • People at high genetic risk were almost twice as likely to develop dementia as those at low genetic risk.

In other words, genetics matter. If you have “bad” genes, your risk of developing dementia is increased significantly.

  • A healthy lifestyle decreased the risk of developing dementia by about 40% for both people at high genetic risk and for people at low genetic risk.

In other words, lifestyle also matters. You can significant decrease your risk of developing dementia, no matter what your genetic risk.

  • People at high genetic risk and an unhealthy lifestyle were almost three times more likely to develop dementia than people at low genetic risk and a healthy lifestyle.

In other words, the combination of a high genetic risk and an unhealthy lifestyle is the worst of all possible worlds.

  • People at low genetic risk and an unhealthy lifestyle were just as likely to develop dementia as people at high genetic risk and a healthy lifestyle.

In other words, bad genetics does not doom you to Alzheimer’s and dementia. A healthy lifestyle can cut your risk almost in half. Conversely, good genetics is not a “Get Out of Jail Free” card. You can squander the advantage of good genetics with an unhealthy lifestyle.

In the words of Dr. John Haaga of the U.S. National Institute on Aging: “No one can guarantee you’ll escape this awful disease, but you can tip the odds in your favor with clean living.”

For more details on the study and how a healthy lifestyle was defined in this study, read the article above.

 

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

 

How to Live a Healthy Lifestyle Longer

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Wish I Knew At 20

Author: Dr. Stephen Chaney

how to live a healthy lifestyleI wish I knew how to live a healthy lifestyle when I was 20.  But, I was a typical 20-year-old American. I ate lots of junk food. I thought an occasional tennis game was all the exercise I needed. I never really thought about what I was doing. I just did what all my friends did. If I hadn’t changed what I was doing, I might have had a short, unhealthy life.

Of course, I did change, and those changes made all the difference. Now I’m in my 70s, and I’m in perfect health. I have no diseases. Even the allergies I had when I was younger have gone away as I improved my diet and lifestyle. I am on no medications. I have the blood pressure of a 16-year-old.

I call this article “How to Live a Healthy Lifestyle:  Wish I Knew At 20”, but this article isn’t about me. I wrote this article for all the other 20-year-olds who know as little about nutrition and health as I did at 20. I also wrote this article for all those people who haven’t changed – those people with the same diet and lifestyle they had at 20. It’s never too late to change and begin to live a healthy lifestyle.

 

How to Live a Healthy Lifestyle:  What I Wish I Knew At 20

 

Here are 15 tips I would pass along to all the 20-year-olds, even those 20-year-olds in older bodies:

#1: You Are In Charge: You have a brain. You have free will. You don’t have to do what everyone else is doing. It is time to start thinking about what your health and your life will be like if you don’t change. More importantly, it is time to start thinking about what your health and your life could be like if you do make positive changes.

#2: It Matters: I can’t emphasize strongly enough how important it is to make positive changes in your diet, your exercise, and your overall lifestyle. We know all the major killer diseases (heart disease, cancer, diabetes, hypertension, etc) are affected by diet and lifestyle. However, it is much more than avoiding disease. As you age, your quality of life is dramatically affected by how much you have moved and what you have put in your mouth over your lifetime.

If you have any question about how important healthy eating can be, take time to view documentary movies like “Forks Over Knives” or “Eating You Alive.” I’m not necessarily advocating that extreme a diet, but these films will get you thinking.

fad diets#3: Avoid the Fads: Once you have decided to adopt a healthier lifestyle, the hardest part is deciding which changes you should make. You will need to practice a lot of due diligence. There is a lot of hype and misinformation out there. There is a new fad every week. First, it’s low fat. Then it’s low carb. Then it’s no bananas before noon on Thursdays (I’m joking here, but you get the point. Some of the diets are just plain weird).

Most of those diet recommendations sound plausible. They all have their advocates who are only too happy to offer their testimonials. My advice: If it sounds too good to be true, avoid it. If they tell you the medical profession is trying to keep their diet a secret, avoid it. The consensus advice of the medical and nutrition communities may seem boring, but it is generally based on dozens of clinical studies. It is much more likely to be true than advice from your friends, your trainer, or that blogger who values controversy more than accuracy.

#4: We Are All Different: Health recommendations are usually based on dozens of clinical studies. But, here is the secret that only scientists know. Clinical studies report averages, but none of us are average. Let me give you an example. Let’s say you wanted to do a clinical study to evaluate whether a low-carb diet helps people lose weight. You might enroll several hundred people in your study. If you put them all on an identical low-carb diet for 8 weeks, some of them would lose weight. Others would gain weight. At the end of the 8 weeks, you would average all weight changes together and report the average weight loss.

For the sake of argument, let’s say the average weight loss was 6.4 pounds. That’s fine except that not a single person in the study lost exactly 6.4 pounds, and some may have even gained weight. The bottom line is that your results may be different from conventional wisdom. Your results may be different from your friend’s. You will need to find out what works best for you.

#5: You Don’t Have To Change All At Once: Some people have an iron will and can make drastic changes overnight. Most of us aren’t like that. If we try to change too many things at once, we become overwhelmed. We become discouraged. Sometimes we quit. Think of this as a marathon, not a sprint. Make “Change One” your slogan. Change one thing each week until you are where you want to be. One week it may be replacing sugary desserts with fruits. Another week it may be adding a green vegetable to your dinner plate. Over time, all those small changes will result in a totally different lifestyle.

processed foods#6: Your Tastes Will Change: The first time you choose a low sodium food, it will taste bland. Over time you will come to enjoy the subtle flavors of the food and will come to dislike added salt. The first time you switch from whole milk to low fat milk it will taste like water. Over time you will learn to appreciate low fat milk, and whole milk will taste greasy. I could give lots more examples, but you get the point.

#7: Processed Foods, Sweets, and Sodas Will Kill You: I’m being dramatic here, but they are bad for your health. They have no place as part of a healthy diet. Replace the processed foods and sweets with whole foods. Replace the sodas with water or herbal teas.

#8: It’s What You Do Every Day That Matters: Refined grains, pastries and sweets should be only an occasional indulgence. Fruits, vegetables, and whole grains should be the mainstay of your everyday diet. Eat a plant-based diet as much as possible.

#9: Protein Is Important, Especially As We Get Older: Low fat or vegetarian protein sources should be your first choice. Chicken (with the skin removed) and fish are the healthiest meats. Nuts, beans & seeds are excellent vegetarian protein sources, especially in combination. Think of red meats as no more than an occasional indulgence.

#10: Avoid The Center Of The Supermarket: This is my only shopping advice. In general, supermarkets are arranged with real foods around the edges and the processed foods in the middle.

organic foods#11: Choose Organic: Our planet has become so polluted that is has become impossible to completely avoid toxic chemicals in our environment. They are in our air, our water, our soil, and our homes. Our only defense is to be informed consumers and avoid them whenever possible. If the cost of organic produce is an issue for you, be selective. There is a Dirty Dozen  list of fruits and vegetables that are the ones most likely to be contaminated with pesticides and herbicides.

#12: Get Lots Of Exercise: Most experts recommend at least 30 minutes of moderate intensity exercise 5 times per week. More is even better. For best results choose a combination of aerobic and weight bearing exercise.

#13: Control Your Weight: We are in the midst of an obesity epidemic. The problem is that 80% of us are genetically predisposed to become obese if we eat a typical American diet and follow a typical American lifestyle. The solution isn’t the fad diet du jour. The solution is to change our diet and our lifestyle. For most of us, the changes I have outlined above will allow you to gradually attain & maintain your ideal weight.

#14: Supplementation Plays A Role: Supplementation is not a magic bullet, but it is an important component of a holistic wellness program. Some of us need supplementation to fill in nutritional gaps in our diet. Some of us need supplementation because of increased needs, either because of disease or genetics. Some of us choose supplementation to achieve optimal health.

#15: Enjoy The Journey: If you think of a healthy lifestyle as depriving you of the things you enjoy, you will avoid it. Instead, think of it as an adventure. Have fun exploring new fruits and vegetables. Try cooking with herbs and spices. Seek out restaurants and recipes that turn healthy foods into a gourmet experience. Find exercises that you actually enjoy.  Now you know how to live a healthy lifestyle and for longer.

What Does This Mean For You?

This was not meant to be a diet book. Because each of us is different, I have shared 15 tips rather than a rigid diet plan that everyone should follow. However, I suspect many of you are scratching your heads and saying: “Where do I go from here?”. For those of you who would like more specific recommendations for your new, healthier lifestyle, I recommend my recent article “What Is The Best Diet For You?”.

 

The Bottom Line

 

In this article, I have shared 15 tips for a longer, healthier life. They are:

  • You are in charge.
  • It matters.
  • Avoid the fads.
  • We are all different.
  • You don’t have to change all at once.
  • Your tastes will change.
  • Processed foods, sweets and sodas will kill you.
  • It’s what you do every day that matters.
  • Protein is important, especially as we age,
  • Avoid the center of the supermarket.
  • Choose Organic.
  • Get lots of exercise.
  • Control your weight.
  • Supplementation plays a role.
  • Enjoy the journey.

For more details, read the article above and find out how to live a healthy lifestyle longer.

 

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 We Take Calcium Supplements?

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Clearing Up The Calcium Confusion

Author: Dr. Stephen Chaney

should we take calcium supplementsShould we take calcium supplements?  You have every right to be confused about calcium supplementation. There have been a lot of conflicting headlines in recent months.

It has seemed like a no-brainer for years that calcium supplementation could help post-menopausal women and men over 50 avoid the debilitating effects of osteoporosis.

After all:

  • >99% of adults fail to get the USDA recommended 2.5-3 servings/day of dairy products.
  • 67% of women ages 19-50 and 90% of women over 50 fail to meet the RDA recommendations for calcium intake from diet alone.
  • Men do a little better (but only because we consume more food). 40% of men ages 19-50 and 80% of men over 50 fail to meet the RDA recommendations for calcium intake from diet alone.
  • Inadequate calcium intake over a lifetime is considered a major risk factor for osteoporosis.
  • Osteoporosis is serious business. It doesn’t just cause bone fractures. It can result in chronic pain, disability, long term nursing home care, and even death.

It’s no wonder that some experts have predicted that supplementation with calcium and vitamin D could save over $1 billion per year in health care cost savings. It is also why health professionals have recommended calcium supplementation for years, especially for postmenopausal women and men over 50.

However, recent headlines have claimed that calcium supplementation doesn’t really increase bone density or prevent osteoporosis (more about that later). Other headlines have suggested that calcium supplementation is actually bad for you. It may increase your risk of heart disease.

That’s why the general public, and even many doctors, are confused.  Should we take calcium supplements?  Everyone wants to know the answer to two questions:

  • Do calcium supplements work?
  • Are calcium supplements safe?

I will start with the second question first.

Are Calcium Supplements Safe?

are calcium supplements safeI have discussed the issue of calcium supplements and heart disease risk in a previous issue of Health Tips From the Professor. Briefly, the initial studies suggesting that calcium supplementation might increase the risk of heart attacks and cardiovascular disease were good studies, but they were small, short-term studies.

The initial studies raised an important question, so the scientific community stepped up to the plate and conducted larger, longer term studies to test the hypothesis. Both of those studies concluded that calcium supplementation posed no heart health risks.

Now a third major study on the subject has just been published (Raffield et al, Nutrition, Metabolism & Cardiovascular Disease, doi: 10.1016/j.numecd.2016.07.007). The study followed 6236 men and women ages 45-84 for an average of 10.3 years. The subjects were from four different race/ethnicity groups and came from 6 different locations in the United States. More importantly, there were 208 heart attacks and 641 diagnoses of cardiovascular disease during the study, so the sample size was large enough to accurately determine the relationship between calcium supplementation and heart disease.

The results were pretty straight forward:

  • The authors concluded: “[This study] does not support a substantial association of calcium supplement use with negative cardiovascular outcomes.” If you would like the plain-speak version of their conclusion, they were saying that they saw no increase in either heart attacks or overall cardiovascular disease in people taking calcium supplements.
  • If anything, they saw a slight decrease in heart attack risk in those taking calcium supplements, but this was not statistically significant.

In summary, the weight of evidence is pretty clear. Three major studies have now come to the same conclusion: Calcium supplementation does not increase the risk of either heart attacks or cardiovascular disease.

Of course, once information has been placed on the internet, it tends to stay there for a very long time – even if subsequent studies have proven it to be wrong. So the myth that calcium supplementation increases heart attack risk will probably be with us for a while.

So, should we take calcium supplements?  Let’s first investigate a little further.

 

Do Calcium Supplements Work?

do calcium supplements workAs I mention above, recent headlines have also suggested that calcium supplementation does not increase bone density, so it is unlikely to protect against osteoporosis. I analyzed the study behind those headlines in great detail in two previous issues of Health Tips From the Professor.

In Part 1 Calcium Supplements Prevent Bone Fractures  I pointed out the multiple weaknesses in the study that make it impossible to draw a meaningful conclusion from the data.

 

In Part 2 Preventing Osteoporosis  I discussed the conclusion that the study should have come to, namely: Adequate calcium intake is absolutely essential for strong bones, but calcium intake is only one component of a bone healthy lifestyle.

The bottom line is that calcium supplementation will be of little use if:

  • You aren’t getting adequate amounts of vitamin D and all of the other nutrients needed for bone formation from diet and supplementation.
  • You aren’t getting enough exercise to stimulate bone formation.
  • You are consuming bone dissolving foods or taking bone dissolving drugs.

Conversely, none of the other aspects of a bone healthy lifestyle matter if you aren’t getting enough calcium from diet and supplementation.

The bottom line is that you need to get adequate calcium and have a bone healthy lifestyle to build strong bones and prevent osteoporosis, and calcium supplementation is often essential to make sure you are getting adequate calcium.

 

Should We Take Calcium Supplements?

should we take calcium supplements nowShould we take calcium supplements?  If you are one of the millions of Americans who aren’t meeting the RDA guidelines for calcium from diet alone, the answer is an unqualified yes.  Calcium supplementation is safe, and it is cheap.  Osteoporosis is preventable, and it is not a disease to be trifled with.

However, you also need to be aware that calcium supplementation alone is unlikely to be effective unless you follow a bone healthy lifestyle of diet, exercise and appropriate supplementation to make sure you are getting all of the nutrients needed for bone formation.

Of course, it is always possible to get too much of a good thing. The RDA for calcium is 1,000 – 1,200 mg/day. The suggested upper limit (UL) for calcium is 2,000 – 3,000 mg/day.  I would aim closer to the RDA than the UL unless higher intakes are recommended by your health care professional.

 

The Bottom Line

 

  • 80% of men and 90% percent of women over 50 do not get enough calcium from their diet.
  • Consequently, doctors have consistently recommended calcium supplementation to prevent osteoporosis, and 50% of men and 60% of women over 60 currently consume calcium supplements on a regular basis.
  • Some small, short term studies suggested that calcium supplementation might increase the risk of heart disease, and warnings about calcium supplementation have been widely circulated on the internet. This hypothesis has been evaluated by three larger, longer term studies that have all concluded that calcium supplementation does not increase heart disease risk.
  • A recent study claimed that calcium supplementation was ineffective at increasing bone density, and that report has also been widely circulated. However, there are multiple weaknesses in the study that make it impossible to draw a meaningful conclusion from the data.
  • If you are one of the millions of Americans who aren’t meeting the RDA guidelines for calcium from diet alone, you should consider calcium supplementation.  It is safe.  It is effective when combined with a bone healthy lifestyle of diet, exercise, and appropriate supplementation.  Finally, it is cheap. Osteoporosis is preventable, and it is not a disease to be trifled with.
  • Of course, it is always possible to get too much of a good thing. The RDA for calcium is 1,000 – 1,200 mg/day. The suggested upper limit (UL) for calcium is 2,000 – 3,000 mg/day. I would aim closer to the RDA than the UL unless higher intakes are recommended by your health care professional.

 

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.

Deceptive Food Labels

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What The Food And Supplement Industries Don’t Want You To Know

Author: Dr. Stephen Chaney

 

deceptive food labelsHealthy Eating Is In. We are told we need more fiber, whole grains, fruits & vegetables, nuts and omega-3s in our diet. We are being told that we should be eating “super foods” we’ve never heard of because of their amazing health benefits. As a consequence, more and more Americans are reading labels to be sure that the foods and supplements they are buying are healthy.  We trust the FDA and others not to allow us to be had by deceptive food labels.

But what if those food labels were deceptive? What if the food labels were more about marketing than about real health benefits? Is it possible that BIG FOOD Inc. and the supplement industry could actually be lying to us? Could it be that the manufacturers care more about their profits than about our health?

Deceptive Food Labels? 

Vegetable & Fruit Follies In The Supermarket

Everyone knows that fruits and vegetables are good for us. They are chock-full of vitamins, minerals, and phytonutrients as well as fiber. But who wants to spend the time peeling an orange or washing the pesticides off that broccoli? It’s much more fun to get our fruits and vegetables from chips, pasta, and breakfast cereals.

companies that use deceptive food labelsFood manufacturers are only too happy to oblige. The chemical companies make a variety of fruit and vegetable powders that food manufacturers can add to their products. For example, Powder Pure tells food manufacturers “Whether you want to add nutrition to your label, infuse full color, or formulate a specific flavor profile for your discerning consumers, Powder Pure has the right powder to enhance your presence in the marketplace.”  You will notice they are talking about adding nutrition to the label, not to the food. They are talking about “enhancing your presence in the marketplace,” not making your food healthier.

The problem is that sprinkling a little fruit and vegetable powder into a processed food will never provide the full range of nutrients that those fruits and vegetables would have provided.

Most manufacturers can’t (or won’t) specify the amounts of nutrients and phytonutrients you get from the fruit & vegetable powders they add to their processed foods, but that doesn’t stop them from making label claims like “We pop a flavorful blend of nine veggies…[in our chips]” or there is “half serving of vegetables in a 2 oz serving…[of our pasta].”  Is this using deceptive food labels?

The Fruits & Vegetables in a Capsule Con

One of my pet peeves is the food supplement manufacturers who try to tell you that they have concentrated a cornucopia of fresh fruits and vegetables in a capsule. For example, one company claims that their capsules contain apple, barley, broccoli, beet, cabbage, carrot, cranberry, date, garlic, kale, oats, orange, parsley, peach, pineapple, prunes, spinach, plant enzymes, fiber, and acidophilus.  All this in one capsule!  Does that sound like the use of deceptive food labels?

While this list sounds impressive, you need to ask whether they are providing meaningful amounts of those fruits and vegetables.  For example, the product claims to have oats.  A serving of oats is equal to 1/3 cup dry oats and weighs about 28 grams.  A capsule typically weighs about 0. 5 grams. Therefore, to get the equivalent of one serving of oats from a capsule, you would have to consume 56 capsules!  And that’s assuming that the entire capsule was filled with oats.

Broccoli is another claimed ingredient.  A serving of fresh broccoli weighs 88 grams, but roughly 80 grams of that is water.  So if you dehydrated the broccoli you would be left with about 8 grams of material. Therefore, to get a single serving of dehydrated broccoli you would have to consume 16 capsules. Again, that’s assuming that the capsules were completely filled with just broccoli.

You can do this kind of calculation with each ingredient they claim is in their capsules.  But when you add up the number of capsules needed to get a reasonable amount of each of these ingredients, the capsule total is staggering.

deceptive food labels marketingAs for essential nutrients, when you read the labels on some of these products you discover that their capsules only contain small amounts of a few essential nutrients. They simply do not provide significant amounts of the vitamins, minerals, and phytonutrients you would have been getting if you ate the real foods.

On the other hand, if the label does list significant amounts of the essential nutrients, that’s usually because purified vitamins and minerals have been added to the final product. Those products are no different from any other multivitamin supplement except that they contain insignificant quantities of fruit and vegetable powders that provide no additional health benefits. Once again, it’s all about using deceptive food labels marketing, not your good health.

Faux Protein Supplements

The same deceptive marketing practices have also entered the lucrative protein supplement marketplace. You are being told about protein products that are full of fruits & vegetables, super foods and herbs. It all sounds wonderful, but once again it is all smoke and mirrors. These companies are just mixing a little fruit and vegetable powders in with their protein powder.

You are being told that these products contain dozens of fruits and vegetables that provide vitamins and antioxidants in their natural form. However, when you read the label it is obvious that many of the vitamins and minerals in that product never saw a fruit or vegetable. They were synthesized in a chemical laboratory and added to the final product along with the fruit and vegetable powders.

You are being told that these products contain super foods that provide important phytonutrients, but none of those phytonutrients is present in sufficient quantities to be featured on the nutrition label. You are told that these products contain herbal ingredients with amazing healing powers, but none of the active ingredients of the claimed herbs are present in high enough quantities to be included on the nutrition label.

fruits and vegetablesOnce again, it is all about marketing. Manufacturers are adding fruit and vegetable powders and a pinch of herbal ingredients to their protein powders so that they can make marketing claims, but those fruit and vegetable powders and herbal ingredients aren’t present in large enough quantities to make any significant impact on your health.

Allowed Label Claims

Many of you have asked me about companies that claim their supplement has the amount of vitamin C found in 7 oranges or the amount of folic acid found in 4 cups of cooked green peas.  Those are allowed claims and are generally accurate. Just don’t assume that the vitamin C actually came from 7 oranges (it didn’t) or that their supplement has all the nutrients found in 7 oranges (it doesn’t).  Again, these companies find ways to use deceptive food labels to make sales.

 

The Bottom Line

  • We are being told that we should read labels to make sure that the foods and supplements we buy are good for us. We are also being told that we should be eating more fruits and vegetables. Food manufacturers know an emerging trend when they see one, so many of them are adding fruit and vegetable powders to the foods and supplements they manufacture. This increases the marketing appeal of their products, but does nothing to make their products healthier. It is label deception, pure and simple.

If you want to avoid being deceived by deceptive food labels, you should:

  • Ignore the label claims of fruits and vegetables added to the processed foods you see in the market. The fruit and vegetable powders added to those foods provide no proven benefit. The best place to get your fruits and vegetables is to [surprise] eat your fruits and vegetables.
  • Leave those supplements claiming to have concentrated lots of fruits and vegetables into a single capsule on the shelf. Those claims are grossly deceptive because the capsules do not contain significant amounts of the fruits and vegetables listed on the label. They do not provide the nutrients you would have gotten if you had eaten the real foods. Once again, the best way to get the fruits and vegetables you need in your diet is to actually eat fresh fruits and vegetables.
  • Forget those protein supplements that make amazing claims based on all the fruits, vegetables, super foods, and herbal ingredients they have. Once again, the fruit and vegetable powders and herbal ingredients in these products are not present in sufficient quantities to provide any significant health benefits. It is the marketing that is amazing, not the health benefits.
  • Finally, many of you have asked me about companies that claim their supplement has the amount of vitamin C found in 7 oranges or the amount of folic acid found in 4 cups of cooked green peas. Those are allowed claims and are generally accurate. Just don’t assume that the vitamin C actually came from 7 oranges (it didn’t) or that their supplement has all the nutrients found in 7 oranges (it doesn’t).

 

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

Does Obesity Cause Cancer?

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Is The Obesity Epidemic Killing Us?

Author: Dr. Stephen Chaney

Does obesity cause cancer?

does obesity cause cancerYou probably already know that we are in the midst of a world-wide obesity epidemic. If not, here are some of the alarming statistics that characterize that epidemic:

  • The global prevalence of obesity has increased by 27.5% between 1980 and 2013.
  • 35% of the adult population worldwide is now overweight (BMI ≥ 25), including 12% who are classified as obese (BMI ≥30).
  • According to the NIH the situation is even worse in developed countries like the US where 75.1% of adults are now overweight, including 35.7% who are obese, and 6.3% who are very obese (BMI ≥40).

Unfortunately, overweight and obesity are not benign. You probably already knew that those excess pounds increase your risk of diabetes, heart disease, kidney failure and much more. You probably also knew that those excess pounds increase your risks of certain types of cancer such as colon, rectal, kidney, pancreatic, postmenopausal breast, ovarian and uterine cancer.

It’s been a little more difficult to determine just how much obesity increases cancer risk. However, a recent study suggests that the increased risk could be quite significant. In fact, if this study is correct, obesity may only be second to smoking as a preventable cause of cancer. The truth might just scare you skinny!

Does Obesity Cause Cancer?

cancer epidemicThe International Agency For Research On Cancer did a worldwide study, (Arnold et al, The Lancet Oncology 16: 36-45, 2015),  in which they looked at the effect of BMI on cancer incidence in adults aged 20 years or older. The BMI data was collected in 2002 and was segregated by sex and age groups. Recognizing that cancer takes decades to develop, they then collected data on newly diagnosed cancers in adults 30 and older in the same countries in 2012.  They were determined to get closer to answering the question, does obesity cause cancer?

By comparing BMIs in 2002 with the incidence of newly diagnosed cancers 10 years later they were able to calculate the effect of excess body weight (BMI ≥25) on cancer incidence. The results were startling:

  • They estimated that 481,000 new cases of cancer in 2012 in adults over 30 were attributable to excess weight.
  • That represents 3.6% of all new cancer cases, which makes overweight second only to smoking as a preventable cause of cancer.
  • Uterine cancer, postmenopausal breast cancer, and colon cancer accounted for 63.6% of all cancers caused by overweight. Other cancers affected by excess weight were rectal cancer, pancreatic cancer, kidney cancer, gallbladder cancer, and ovarian cancer.
  • The effect of excess weight on cancer risk was almost 3-fold greater for women (5.4% of new cancer cases) than for men (1.9% of new cancer cases).
  • In North America 111,000 new cases of cancer in 2012 for adults over 30 were attributable to excess weight. That represents 3.5% of all new cancers in men and 9.4% of all new cancers in women.
  • A quarter (about 118,000) of the worldwide cancer cases related to high BMI in 2012 could be attributed to the increase in BMI that has occurred since 1982.

The authors concluded “These findings emphasize the need for a global effort to abate the increasing numbers of people with high BMI. Assuming that the association between the high BMI and cancer is causal, the continuation of current patterns of population weight gain will lead to continuing increases in the future burden of cancer.”

What Does This Study Mean For You?

We have to stop kidding ourselves. That excess flab isn’t harmless. It is killing us, and cancer is a particularly gruesome way to go. It’s time to get serious about weight loss. Here are my top 5 tips for lasting weight loss.

  • fad dietsEat healthy low calorie meals and snacks with plenty of protein so that you maintain muscle mass while you are losing fat.
  • Avoid the fad diets. You don’t need to restrict carbohydrates or fats. You just need to focus on fresh fruits and vegetables, healthy proteins and modest amounts of healthy fats and healthy carbohydrates.
  • Find an exercise program you like and stick with it every day.
  • Focus on true lifestyle change rather than short term diets. A good strategy is to make one healthy change at a time rather than trying to do everything at once.
  • Change how you think about food, think about exercise, and think about your ability to make the kinds of changes that will lead to permanent weight loss. Don’t think of yourself as a fat person who is trying to lose weight. Think of yourself as a skinny person who happens to have a few extra pounds that are on their way out.

Of course, getting to a healthier weight isn’t the only change you want to make if you are trying to reduce your risk of cancer. Here are my top 7 lifestyle change suggestions (besides weight loss) for reducing cancer risk.

  • healthy eatingIf you smoke, stop. No ifs, ands, or buts. Smoking is still the #1 cause of cancer.
  • Eat a healthy diet (including supplements to fill the gaps).
  • Eat plenty of fresh fruits and vegetables, especially those that are good sources of cancer-fighting antioxidants, carotenoids, flavonoids, and polyphenols.
  • Eat fish and fish oil supplements to make sure that you get plenty of omega-3 fatty acids.
  • Minimize saturated fats and avoid trans fats. Substitute olive oil for vegetable oils whenever possible.
  • If you drink alcohol, drink it in moderation.
  • Avoid sun exposure as much as possible, and use sunscreen when outdoors.
  • Eat healthy proteins.
  • Minimize consumption of red meats and processed meats.
  • Use chicken, fish and vegetable proteins whenever possible.
  • Soy protein is particularly helpful for reducing the risk of breast cancer. (Yes, those scary blogs about soy and breast cancer are wrong. For accurate information, just go to https://www.chaneyhealth.com/healthtips and type soy in the search box).
  • Get plenty of exercise.
  • Get regular check-ups.

So, does obesity cause cancer?  I think you now know the answer.

 

The Bottom Line

 

  • A recent study has shown:
  • 481,000 new cases of cancer worldwide each year are attributable to excess weight.
  • That represents 3.6% of all new cancer cases, which makes overweight second only to smoking as a preventable cause of cancer.
  • Uterine cancer, postmenopausal breast cancer, and colon cancer accounted for 63.6% of all cancers caused by overweight.
  • The effect of excess weight on cancer risk was almost 3-fold greater for women (5.4% of new cancer cases) than for men (1.9% of new cancer cases).
  • In North America 111,000 new cases of cancer for adults over 30 are attributable to excess weight. That represents 3.5% of all new cancers in men and 9.4% of all new cancers in women.
  • That excess flab isn’t harmless. It is killing us, and cancer is a particularly gruesome way to go. For my top 5 tips for lasting weight loss and my top 7 tips for reducing your risk of cancer, 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.

Do Multivitamins Reduce Heart Disease Risk?

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Will A Multivitamin A Day Keep The Doctor Away?

Author: Dr. Stephen Chaney

 

Junk foods and convenience foods have become the American way. We are perhaps the most overfed and undernourished country on the planet. Even worse, we are exporting our unhealthy lifestyle to the rest of the world.

Because of the foods we eat experts estimate that only somewhere between 3% and 10% of us get the nutrients we need on a daily basis. For the vast majority of Americans who are undernourished, multivitamin use helps us fill the nutritional gaps in our diet.

But could multivitamin use do more than just fill nutritional gaps? Could it also help us protect our health?  Could multivitamins reduce heart disease risk?  Here things get a bit murky. We are confused by conflicting headlines. One day the headlines blare that multivitamins are placebos. They are useless. They are a waste of money. The next day the headlines claim that multivitamins are panaceas that can help protect us from heart disease, cancer, diabetes, and whatever else ails us.

In this week’s Health Tips From the Professor, I will review the latest study claiming that multivitamin use reduces heart disease risk and help you put that study into perspective.

Do Multivitamins Reduce Heart Disease Risk?

 

reduce heart disease riskThe current study (Rautianinen et al, Journal of Nutrition, doi: 10.3945/jn.115.227884, 2016)  was a re-analysis of data collected in the first Physician’s Health Study between 1982 and 1995. That study was originally designed to test the effect of aspirin and/or beta-carotene on heart disease and cancer. It enrolled a total of 22,071 male physicians over the age of 40 and followed them for an average of 12.2 years. The conclusions of the initial study were that aspirin use decreased cardiovascular risk while beta-carotene had little effect on either heart disease or cancer.

However, the study also collected data on a wide range of lifestyle factors (including diet and supplement use) and clinical outcomes, so it has provided a valuable database for many subsequent studies, including this one.

This study analyzed a subset of the population (18,530 male physicians) that did not have any sign of heart disease or cancer at the beginning of the study and looked at the effect of multivitamin usage on several cardiovascular disease outcomes including:

  • Non-fatal heart attacks
  • Non-fatal strokes
  • Death due to cardiovascular disease
  • Total cardiovascular events (the sum total of the previous three events)

Here were the results of the study:

  • When the authors simply asked whether the participants were using multivitamins or not at the beginning of the study, multivitamin use had no effect on any of the cardiovascular disease outcomes listed above. These results are similar to several similar studies.
  • However, when the authors compared those who had been using multivitamins for 20 years or more at the beginning of the study to non-users, long term multivitamin use was associated with a statistically significant 44% decrease in total cardiovascular events.
  • When the authors looked at each of the individual cardiovascular disease outcomes (heart attack, stroke, and death due to cardiovascular disease) there was a similar percentage decrease when comparing 20+ year multivitamin users with non-users, but there were not enough people in each of these individual categories for the differences to be statistically significant.

The authors concluded that their study suggests that “multivitamin use over a long duration may be associated with a lower risk of major cardiovascular events” but that further studies are needed because of the low number of long-term multivitamin users in the study.

Putting This Study Into Perspective

There are several clinical studies looking at the effect of multivitamin use on cardiovascular outcomes that have come up empty handed. However, there are an equal number of clinical studies that have shown a positive effect of multivitamin use on cardiovascular outcomes, at least under certain conditions and with certain population groups. For example:

  • For those physicians who had a prior history of heart disease, multivitamin use was associated with a 44% reduction in the risk of heart attack.  So, in this case multivitamins were shown to reduce heart disease risk.
  • There was a significant effect of age, with physicians who were 70 or older showing a stronger effect of multivitamin use on the reduction of overall cardiovascular disease.
  • This study did not ask how long the participants had been using multivitamins prior to the study so it could not assess the effects of long term multivitamin use.
  • Other studies suggest that long-term multivitamin use could also reduce heart disease risk in women. For example:

In short, the available data suggest that the benefits of multivitamin use are most likely to be apparent with those who are at highest risk of having a heart attack because of age or pre-existing disease as well as those who have been using multivitamins for decades, not just a few years.

Multivitamins And Heart Disease Risk:  Placebo Or Panacea?

placeboIf you just read the headlines you have every right to be confused. Some headlines claim that multivitamins are just placebos. They are a waste of money. Other headlines seem to suggest that multivitamins are panaceas that will prevent everything from heart disease to cancer and diabetes.  As usual, the truth lies somewhere in between.

Let’s start with the obvious. If you are in great health, have a heart healthy diet and lifestyle, and do not have a genetic predisposition to heart disease, your chances of having a heart attack, stroke or other forms cardiovascular disease are very low. A multivitamin might benefit you in other ways, but it is unlikely to significantly reduce your already low risk of heart disease. Many of the subjects in previous studies fall into this category, which is why many of those studies come up empty handed.

The people who are most likely to benefit from multivitamin use are those who have a poor diet, or are at increased risk of heart disease because of genetic predisposition, pre-existing disease or age. None of the studies to date have looked at groups with poor diets or genetic predisposition to see whether multivitamin use did reduce heart disease risk. The one study that did look at groups who were older or had pre-existing disease found a beneficial effect of multivitamin use in those groups.

The recent study, along with several other studies, also suggests that it may require decades of multivitamin use to significantly impact heart disease risk. That makes sense. Heart disease doesn’t just happen overnight. It takes decades to develop, so it is only logical that it might also require many years of multivitamin use to significantly impact heart disease risk.

If so, this highlights a very serious flaw in those studies reporting no effect of multivitamin use on heart disease risk. Most of the negative studies only inquired about multivitamin use at the beginning of the study. They did not ask how long those people had been using multivitamins. If you ignore the long term multivitamin users, you are very likely to get a negative result.

The study featured in this article (Rautianinen et al, Journal of Nutrition, doi: 10.3945/jn.115.227884, 2016)  is a perfect example. The group who had been using multivitamins for 20+ years had a 44% decrease in heart disease risk. However, this group represented only 5% of the multivitamins users. The size of this group was not large enough to influence the overall results. Consequently, when the authors of the study looked at multivitamin users as a whole, there was no significant effect of multivitamin use on heart disease risk.

 

The Bottom Line

The question of whether multivitamin use could reduce heart disease risk has been contentious in recent years, with some studies claiming that multivitamin use has no effect, and other studies suggesting that multivitamin use significantly reduces heart disease risk. A recent study helps provide a better understanding of why previous studies have reported such conflicting results.

  • This study found that when you just asked whether people were using multivitamins or not at the beginning of the study, there was no significant effect of multivitamin use on heart disease risk – in agreement with all of the previous negative studies.  That is because those studies did not take into account the length of multivitamin use.
  • However, when the authors of the study looked at the subgroup who had used multivitamins for 20 years or more, they had a 44% decreased risk of heart disease compared to non-users. It turns out that most of the previous studies reporting a beneficial effect of multivitamin use on heart disease risk also focused on long term multivitamin users.
  • Previous studies have also suggested that multivitamin use may significantly decrease heart disease risk for people at increased risk of heart attack, either due to age or pre-existing heart disease.
  • Taken together these studies suggest that long term multivitamin use may reduce your risk of heart disease. Even short term multivitamin use may be beneficial if you are at increased risk of heart disease.
  • Of course, multivitamin use is just one piece of the heart health puzzle. For the NIH’s recommendation for a heart healthy lifestyle, click a heart healthy lifestyle.

 

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