Healthy Living Archives - Health Tips From The Professor

Can You Create Your Personal Fountain Of Youth?

March 7, 2023 by Dr. Steve Chaney

Can A Healthy Lifestyle Improve Your Healthspan?

Author: Dr. Stephen Chaney

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”.

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

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

The first study (Y Li et al, Circulation, 138: 345-355, 2018) looks at the effect of a healthy lifestyle on lifespan (how many years you can live).

The second study (Y Li et al, British Medical Journal, 368: 16669, 2020) looks at the effect of a healthy lifestyle on healthspan (how many disease-free years you can live).

How Were The Studies Done?

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

The Nurse’s Health Study, which ran from 1980 to 2014.

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

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

A detailed food frequency questionnaire was administered every 2-4 years. This allowed the investigators to calculate cumulative averages of all dietary variables.

Participants also filled out questionnaires that captured information on disease diagnosis every 2 years with follow-up rates >90%. This allowed the investigators to measure the onset of disease for each participant during the study. More importantly, 34 years is long enough to measure the onset of diseases like heart disease, diabetes, and cancer – diseases that require decades to develop.

- The questionnaires also captured information on medicines taken and lifestyle characteristics such as body weight, exercise, smoking and alcohol use.

For analysis of diet quality, the investigators use something called the “Alternative Healthy Eating Index”. [The original Healthy Eating Index was developed about 10 years ago based on the 2010 “Dietary Guidelines for Americans”. Those guidelines have since been updated, and the “Alternative Healthy Eating Index” is based on the updated guidelines.] You can calculate your own Alternative Healthy Eating Index below, so you can see what is involved.

Finally, the investigators included five lifestyle-related factors – diet, smoking, physical activity, alcohol consumption, and BMI (a measure of obesity) – in their estimation of a healthy lifestyle. Based on the best available evidence, they defined “low-risk” in each of these categories. Study participants were assigned 1 point for each low-risk category they achieved. Simply put, if they were low risk in all 5 categories, they received a score of 5. If they were low risk in none of the categories, they received a score of 0.

Low risk for each of these categories was defined as follows:

- Low risk for a healthy diet was defined as those who scored in the top 40% in the Alternative Healthy Eating Index.

- Low risk for smoking was defined as never smoking.

- Low risk for physical activity was defined as 30 minutes/day of moderate or vigorous activities.

- Low risk for alcohol was defined as 0.5-1 drinks/day for women and 0.5-2 drinks/day for men.

- Low risk for weight was defined as a BMI in the healthy range (18.5-24.9 kg/m²).

Can A Healthy Lifestyle Improve Your Healthspan?

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

The results of the first study were:

Women who had had a healthy lifestyle lived 14 years longer than women with an unhealthy lifestyle (estimated life expectancy of 93 versus 79).

Men who had a healthy lifestyle lived 12 years longer than men with an unhealthy lifestyle (estimated life expectancy was 87 versus 75).

It was not necessary to achieve a perfect lifestyle. Life expectancy increased in a linear fashion for each low-risk lifestyle behavior achieved.

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

The results of the second study were:

Women who had a healthy lifestyle lived 11 years longer free of diabetes, heart disease, and cancer than women who had an unhealthy lifestyle (estimated disease-free life expectancy of 85 years versus 74 years).

Men who had a healthy lifestyle lived 8 years longer free of diabetes, heart disease, and cancer than men who had an unhealthy lifestyle (estimated disease-free life expectancy of 81 years versus 73 years).

Again, disease-free life expectancy increased in a linear fashion for each low-risk lifestyle behavior achieved.

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

Can You Create Your Personal Fountain Of Youth?

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

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

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

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

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

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

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

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

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

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

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

How To Calculate Your Alternative Healthy Eating Index

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

Vegetables

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

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

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

Fruits

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

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

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

Whole Grains

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

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

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

Sugary Drinks and Fruit Juice

Count 10 points if you drink 0 servings per week.

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

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

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

Nuts and Beans

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

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

Count 0 points for 0 servings per week.

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

Red and Processed Meat

Count 10 points if you eat 0 servings per week.

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

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

Count 0 points for ≥1½ servings per day.

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

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

Seafood

Count 10 points if you eat 2 servings per week.

Count 5 points for 1 serving per week.

Count 0 points for 0 servings per week.

1 serving = 4 oz.

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

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

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

The Bottom Line

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

Women who had had a healthy lifestyle lived 14 years longer than women with an unhealthy lifestyle.

Men who had a healthy lifestyle lived 12 years longer than men with an unhealthy lifestyle.

Women who had a healthy lifestyle lived 11 years longer free of diabetes, heart disease, and cancer than women had an unhealthy lifestyle.

Men who had a healthy lifestyle lived 8 years longer free of diabetes, heart disease, and cancer than men who had an unhealthy lifestyle.

It is not necessary to achieve a perfect lifestyle. Lifespan and healthspan increased in a linear fashion for each low-risk lifestyle behavior (diet, exercise, body weight, smoking, and alcohol use) achieved.

These studies did not evaluate whether supplement use also affects healthspan.

- However, if you calculate your diet with the Alternate Healthy Eating Index they used (see above), you will see that most of us fall short of perfection. Supplementation can fill in the gaps.

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

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

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

Healthy Thanksgiving

November 26, 2019 by Dr. Steve Chaney

The Holidays Don’t Have To Be Unhealthy

While “Healthy Thanksgiving” doesn’t quite have the appeal of the more familiar “Happy Thanksgiving” greeting, I used it here to make the point that Thanksgiving dinner (and many other holiday meals) doesn’t have to be an unhealthy affair.

After all, there is a lot to like about the ingredients in Thanksgiving dinner. Turkey can be a healthy, low- fat meat, if prepared correctly. Sweet potatoes, yams, winter squash and pumpkin are all loaded with vitamin A and other important nutrients. And cranberries are a nutrition powerhouse.

Healthy Thanksgiving

Here are some tips to make your Thanksgiving meal one that contributes to your health:

1) Skip the basting. Choose a plain bird and cook in a bag to seal in the moisture. Remove the skin before serving.

2) Refrigerate the turkey juices and skim off the hardened fat before making gravy and use a gravy cup that pours from the bottom to minimize fat.

3) Use ingredients like whole wheat bread, vegetables, fruits (cranberries, raisins, dates or apples), nuts and your favorite spices for the stuffing and bake it in the oven rather than in the turkey.

4) Serve your sweet potatoes or yams baked rather than candied and let your guests add butter and nutmeg to taste.

5) Use skim milk or buttermilk rather than whole milk and skip the butter for your mashed potatoes.

6) Give your meal gourmet appeal by cooking your green vegetables with garlic, nuts and herbs rather than creamy or fat-laden sauces.

7) Don’t serve the meal on your largest plates. By using smaller plates, you ensure smaller portion size and even that second helping isn’t quite so damaging.

8) Consider something like a cranberry, walnut, Greek yogurt parfait for dessert. However, if everyone is expecting grandma’s chocolate pound cake recipe, use small dessert dishes. Of course, you can also experiment with using less fat or sugar when you make the cake.

9) Use a low calorie, plant-based protein shake for one or more meals the day before and/or after Thanksgiving so that your total fat, cholesterol, and caloric intake over the three-day period is not excessive.

By now you have the idea. There are lots of little things that you can do to make your Thanksgiving dinner one that your waist and your heart will thank you for. Bon Appetit and have a Happy, Healthy Thanksgiving!

The Bottom Line

If you make healthy food choices and choose your portion sizes wisely, you can make this a Healthy Thanksgiving as well as a Happy Thanksgiving.

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

Antioxidants and Aging

March 8, 2016 by Dr. Steve Chaney

Author: Dr. Stephen Chaney

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

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

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

How Was The Study Designed?

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

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

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

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

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

Are Antioxidants the Secret to Healthy Aging?

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

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

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

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

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

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

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

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

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

What Are The Strengths And Weaknesses Of This Study?

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

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

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

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

The weaknesses of the study are also pretty apparent.

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

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

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

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

Antioxidants and Aging: Will Antioxidant Nutrients Help You?

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

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

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

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

However, as noted above:

The study has some weaknesses and needs to be repeated.

The beneficial effects of antioxidant nutrients were relatively small.

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

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

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

Controlling your weight.

Staying mentally and physically active.

Maintaining strong social networks.

Maintaining a positive outlook on life.

The Bottom Line

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

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

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

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

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

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

Controlling your weight.

Staying mentally and physically active.

Maintaining strong social networks.

Maintaining a positive outlook on life.

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

Heart Disease Risk and Multivitamins

December 1, 2015 by Dr. Steve Chaney

Author: Dr. Stephen Chaney

It’s so confusing. One week vitamins are going to reduce your heart disease risk and cancer risk. The next week they are worthless. They might even kill you. So when you saw the recent headlines suggesting that multivitamin-mineral supplement use might decrease heart disease risk in women, you probably weren’t sure what to think.

More to the point, you may be thinking “Why is it so hard to get this right? Why can’t scientists decide once and for all whether vitamins are beneficial or not?”

Perhaps, the best way to understand the significance of the present study is to look at the strengths and limitations of previous studies. Then we can start to gain perspective on why it is so difficult to come to a definitive conclusion about this very important question.

How Good Is The Evidence That Multivitamin Use Doesn’t Reduce Heart Disease Risk?

Medical authorities are fond of telling you, with a great deal of confidence, that studies have conclusively proven multivitamin use does not decrease heart disease risk. However, in fact, that conclusion is based on only a few studies, and those studies have their limitations.

For example, the Physician’s Health Study II (Sesso et al, JAMA, 308: 1751-1760, 2012) reported that use of a multivitamin-mineral supplement for 11 years did not decrease cardiovascular incidence or mortality. It was a double-blind, placebo controlled clinical study. That’s the best kind of study, so it would be tempting to consider the case closed.

However, this study looked at a very small segment of the population. The participants were all male, primarily non-Hispanic whites, well to do, highly educated and health conscious. It also turns out that the participants that were in the poorest health and had the poorest health habits tended to drop out of the study and were not included in the final data analysis.

That means that the vast majority of participants in the study were at low risk of heart disease and were eating relatively healthy diets. Those are the people who would be least likely to benefit from supplementation. In short, this study proved beyond a reasonable doubt that the people least likely to benefit from supplementation did, in fact, not benefit from supplementation.

The studies that medical authorities quote as proving their case for women have all looked at antioxidant supplements and cardiovascular disease. There are three double-blind, placebo controlled studies that have all come to the conclusion that antioxidant supplements do not decrease cardiovascular risk in women. Once again, it might be tempting to consider the case closed.

However, in two of those studies (Lee et al, JAMA, 294: 56-65, 2005; Cook et al, Archives of Internal Medicine, 167: 1610-1618, 2007) when they looked at the subset of women who were at high risk of cardiovascular disease (either because of age or pre-existing disease), antioxidant supplements significantly decreased the risk of cardiovascular events and cardiovascular deaths. In short, these studies showed that those people most likely to benefit from supplementation, did, in fact, benefit from supplementation.

Finally, medical authorities have chosen to completely ignore a recent study reporting that multivitamin use significantly decreased heart attack risk in women, especially if they had been using the multivitamins for 5 years or more (Rautiainen et al, American Journal of Clinical Nutrition, 92: 1251-1256, 2010). In short, previous studies have not conclusively proven much of anything except that it is really hard to get definitive answers to this kind of question.

Does Multivitamin Use Decrease Cardiovascular Disease Risk In Women?

The current study (Bailey et al, Journal of Nutrition, 145: 572-580, 2015) compared multivitamin use in 8678 adults(65% women) 40 years or older, from the USDA’s NHANES III database and compared it with cardiovascular death reports in the National Death Index 18 years later.

At the time of the NHANES III study, 45% of the adults surveyed had used some kind of supplement within the past 30 days. When the researchers broke the data down further:

21% were using multivitamin-mineral supplements (3 or more vitamins and 1 or more minerals)

14% were using multivitamin supplements (3 or more vitamins, no minerals).

Among multivitamin-mineral and multivitamin supplement users, only 46% had been using them for 3 years or more.

When they compared supplement usage with cardiovascular deaths 18 years later, the results were as follows:

When they asked if multivitamin-mineral or multivitamin use at the beginning of the study affected cardiovascular mortality 18 years later, the answer was a clear no.

When they looked at women, use of a multivitamin-mineral supplement for 3 years or more was associated with a 35% decreased risk of cardiovascular mortality.

However, they did not find any cardiovascular benefit from long term use of a multivitamin supplement alone for women. From this, they concluded that the beneficial effects of the multivitamin-mineral supplement came from one of the minerals, most likely magnesium or calcium.

There was a slight hint that multivitamin use might be beneficial for men, but the number of cardiovascular deaths in that group was too small for the results to be statistically significant.

What Does This Study Mean?

This study suggests that long term use of a multivitamin-mineral supplement may decrease the risk of cardiovascular disease deaths in women. Whether long term multivitamin use also reduces risk of cardiovascular disease in men is an open question. This study is consistent with another recent study looking at multivitamin use in women (Rautiainen et al, American Journal of Clinical Nutrition, 92: 1251-1256, 2010). However, these studies are just a piece of the puzzle. It will take time and more studies before we will really be able to definitively say whether or not multivitamin use can decrease the risk of heart disease, or any other disease.

How Can You Reduce Your Heart Disease Risk?

The surest way to reduce your risk of heart disease is to develop a heart healthy lifestyle.

Lose weight and/or maintain ideal body weight. Overweight and obesity dramatically increase all of the major risk factors for heart disease – LDL cholesterol, triglycerides, diabetes, hypertension and inflammation.

Exercise for more than 30 minutes – 3 times or more/week. Regular exercise reduces the risk of heart disease by 30-40%.

Follow a diet low in saturated fat and trans-fat (substitute monounsaturated fats like olive oil and omega-3 fats); low in sugars and artificial sweeteners; and high in fiber, whole grains, legumes, fruits, vegetables, and fish.

Work with your physician to control predisposing diseases such as diabetes and hypertension.

What about supplementation? What role does it play in a heart healthy lifestyle? At present it’s pretty clear that the scientific community cannot definitively prove whether supplementation reduces the risk of heart disease or not. All the available evidence suggests that supplementation is most likely to prove beneficial for those who are at highest risk for heart disease and/or are most likely to be deficient in key nutrients – either because of poor diet or genetic variations that increase nutrient requirements.

In the best of all possible worlds we would know who was at high risk for heart disease and who was deficient in key nutrients. We would know who would benefit from supplements and who would not, but we don’t live in the best of all possible worlds.

Most people don’t know they are at risk for heart disease until it is too late. For far too many people the first symptom of heart disease is sudden death.
Genetics can greatly increase the need for key nutrients, and most people are completely unaware of those genetic predispositions until it is too late. In the future, we may be able to design genetic tests to determine individual nutritional requirements with precision, but we are decades away from that Utopian age at present.

Finally, many people are either blissfully unaware how unhealthy their diet is, or they just don’t want to do anything about it.

For all of the reasons above, I recommend a balanced supplementation program as part of a heart healthy lifestyle. The supplements most likely to be beneficial are a multivitamin-mineral supplement, antioxidants, omega-3s, and B vitamins. I have covered the evidence for the role of each of these nutrients in preserving heart health in previous issues of “Health Tips From the Professor”. Of course, I do not recommend supplementation as an alternative to a heart healthy lifestyle. Taking a multivitamin along with your Big Mac is probably not going to do much for your heart health.

The Bottom Line

A recent study reported that women who used a multivitamin – mineral supplement for 3 years or more decreased their risk of dying from heart disease over the next 18 years by 35%. The men in the study may have received some benefit from multivitamin – mineral supplementation, but the numbers were not large enough to be statistically significant.

This study is fully consistent with the results of a previous study with women. However, when we look at all of the available studies it is not possible to definitively conclude whether supplementation decreases the risk of heart disease or not.

All of the available evidence suggests that supplementation is most likely to be beneficial for those people who are at highest risk of heart disease and/or are most likely to be deficient in key nutrients.

In the best of all possible worlds we would know who was at high risk for heart disease and who was deficient in key nutrients. We would know who would benefit from supplements and who would not, but we don’t live in the best of all possible worlds.

Most people don’t know they are at risk for heart disease until it is too late. For far too many people the first symptom of heart disease is sudden death.
Genetics can greatly increase the need for key nutrients, and most people are completely unaware of those genetic predispositions until it is too late. In the future, we may be able to design genetic tests to determine individual nutritional requirements with precision, but we are decades away from that Utopian age at present.

Finally many people are either blissfully unaware how unhealthy their diet is, or they just don’t want to do anything about it.

For the reasons above, I recommend a balanced supplementation program as part of a heart healthy lifestyle. The supplements most likely to be beneficial are a multivitamin-mineral supplement, antioxidants, omega-3s, and B vitamins.

Of course,I do not recommend supplementation as an alternative to a heart healthy lifestyle. Taking a multivitamin along with your Big Mac is probably not going to do much for your heart health.

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.

Bulging Disc Treatment You Can Do At Home

November 17, 2015 by Dr. Steve Chaney

Author: Julie Donnelly, LMT –The Pain Relief Expert

Editor: Dr. Steve Chaney

This past week I taught an ultra-cyclist how to relieve a bulging disc that was causing him a great deal of pain and preventing him from riding the distances he loves.

The problem is aggravated by the aerodynamic position a cyclist is in while riding.

A bulging disc can happen to anyone though, especially if one sits a lot. As we sit we do the same movements, only we contract the muscles and then hold them contracted for a long period of time as we sit

What Causes A Bulging Disc?

It’s easy to see why an ultra-cyclist would have a bulging disc with the extended riding times in the bent over aerodynamic position.

In the aerodynamic position the muscle of your anterior lumbar; the psoas, is held shortened. Also, the muscle on the inside curve of your pelvis, the iliacus, shortens each time the leg is brought up toward the body when pedaling.

This position is great for riding, but when you stop and stand the tight muscles pull your lumbar vertebrae and your pelvis forward and down. At first you may walk bent over, unable to stand up straight. As your muscles relax you’ll begin to straighten, but many times it may take a while before you can fully stand upright and even then you may feel low back pain.

What Happens To The Vertebra?

When a vertebra is pulled downward and toward the vertebra beneath it, it puts pressure on the disc between the two vertebrae. That pushes the gel-like substance inside the disc to press out the side.

A good analogy is to consider what happens if you step on one side of a jelly donut — the jelly pushes out the opposite side!

A bulging disc is when the gel pushes out the side but doesn’t break the outer lining of the disc. A herniated disc is when the membrane cracks and the gel now squeezes out of the disc.

If the bulging disc, or herniated disc, presses into a nerve or your spinal curve, treatment is necessary to reverse the situation. This is definitely a time when prevention is worth a pound of cure!

A Bulging Disc Treatment and Stretch That Works!

The Treatment:

Start by releasing the tension in your thigh muscles. It sounds weird to release the muscles in your thighs to stop a bulging disc problem, but it’s important.

Using your forearm (as shown) press down deeply and slide your arm toward your knee. Place extra focus, 30-60 seconds, on each tender spot (trigger point) you feel as you slide down your thigh.

Do this treatment several times on each leg. This muscle release technique allows your pelvis to rotate back into proper position.

The Stretch:

Stand up straight, as shown, place one of your lower legs on to a chair. Keep your body as straight as possible. Without moving your pelvis at all, lean back with your mid-back.

Visualize your abdominal muscles stretching — be sure not to move your pelvis.

You are now stretching both your psoas and iliacus muscles. Repeat stretch using other leg.

You may feel a twinge of pain in your low back as the muscles stretch and pull on your lumbar. This is normal. It should not be a sharp pain.

An Alternative Stretch:

And as an alternative stretch, if you are able to use the floor, the Sphinx pose is a perfect stretch for the psoas and iliacus. Be sure to keep your pelvis on the floor.

Releasing the tight muscles of your back allow your vertebrae to separate naturally. Whether you sit for hours at a time, or you ride for hours, this bulging disc treatment will give you relief and will prevent further disc injury.

Wishing you well,

Julie Donnelly

About The Author

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

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

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

Repetitive Strain Injury From Sleeping

September 15, 2015 by Dr. Steve Chaney

Get Off To A Great Start Every Morning

Author: Julie Donnelly, LMT – The Pain Relief Expert

Editor: Dr. Steve Chaney

How Can Sleep Cause Repetitive Strain Injury?

For most of us during sleep we stay in one position for hours at a time. So if you wake up with back pain after sleeping, you are experiencing the side effects of muscles held in one position for hours. This is an example of repetitive strain injury or repetitive stress injury.

Because the muscles have to contract to pull your body into your favorite sleeping position and then the muscles stay in a shortened position for hours this can cause pain and tension in your back.

When you wake up with back pain after sleeping you may think you need a new mattress. You might, but it’s definitely worthwhile to address the tight muscles first as they may be the whole problem.

Have you ever seen a dog do their “downward dog” stretch after a nap? Before the dog bounces back into the world it takes time to awaken its body. This is your pain relief “role-model” for stretching your back after sleeping. You’ll be amazed at how simply moving in bed before starting your day eliminates pain and tension.

Let’s get started! While still in bed begin moving around; raise your arms over head and stretch your legs out and flex your feet. Maybe roll to each side stretching the sides of your body. Try these 3 stretches we recommend

Repetitive Strain Injury Treatment: 3 Stretches After Sleeping

The following stretches will help relieve symptoms of repetitive strain injury due to sleeping in one position for long periods.

When you are ready bring yourself to a seated position (still in bed!).

One at a time, bring your arm across the front of your body. Pull your shoulder and shoulder blade toward the front, but without moving the rest of your trunk. This is a great stretch for your triceps, shoulders and upper back.

Next stretch! Bring your feet together, as pictured here.Start with a straight spine then slowly roll your chin into your chest, rounding your back. Mmmmm…this feels good!

And finally, try this juicy spinal twist.Sit with left leg straight out or you can bend it as pictured. Cross the right foot over the left leg, press your right hand behind you, place your left elbow on your right knee now twist. Stretch as far as you are comfortable. Try holding it 15-20 seconds.

This stretch will even help to loosen your hips if you sit as pictured!

As with all stretches, start out easy – stretching should feel GOOD. You’ll feel the tension ease as the blood starts flowing.The tight muscles that cause back pain after sleeping can hamper your entire day, but doing these simple stretches will make a world of difference!

Wishing you well,

Julie Donnelly

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

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

Are Supplements Worth It?

September 8, 2015 by Dr. Steve Chaney

A Cost, Benefit Analysis of Supplementation

Author: Dr. Stephen Chaney

Are supplements worth it? There is no question that supplements add to the family budget. As families juggle their budgets it is natural to wonder whether the supplements they are buying are worth the cost.

It is only natural to ask questions like: “What is the cost, benefit ratio of supplementation?” “Is there any evidence that supplementation today will save us money in health care costs down the road?”

If a recent study is accurate, the answer to that last question may be a resounding yes!

How the Study Was Designed

A number of studies in the past have suggested that supplementation reduces health care costs, but they have suffered from a variety of methodological pitfalls so their conclusions could not be considered definitive.

In a time of skyrocketing health care costs coupled with governments tightening their budgets worldwide, it has become increasingly important for those governments to determine what the most cost effective public health interventions are. Thus, the question of whether supplementation can decrease health care costs has become paramount.

Therefore, an international group of scientists decided to do a systematic review and meta-analysis of the cost effectiveness of supplementation (Elia et al, Clinical Nutrition, doi: 10.1016/j.clnu.2015.07.012). They included only the highest quality previous studies in their analysis. After screening 16,598 published studies they excluded all but 19 in their final evaluation. The studies that they included had the following characteristics.

The subjects were supplementing with a commercially available multi-nutrient supplement that also contained protein and calories (i.e. a meal replacement supplement). Subjects consuming disease-specific supplements or immune-enhancing supplements were excluded from the study.

Subjects were studied in a wide variety of settings, including both free living individuals in the community and those in care homes

In some cases the supplementation was begun while they were in the hospital and continued when they went home. In other cases supplementation was begun while they were at home and continued after admission to the hospital.

Subjects were of all ages.

Are Supplements Worth It — The Money?

From a public health perspective the conclusion from this study was clear. Supplementation with a basic meal replacement supplement saves money. It is an effective public health intervention.

Overall, supplementation decreased health care costs by 8.1%.

For studies lasting less than 3 months, supplementation reduced health care costs by 9.2%. These were most often short-term pre- and/or post-operative supplementation studies. The cost savings ranged from $300-$530 per patient.

For studies lasting more than 3 months, supplementation reduced health care costs by 5%. These were mostly long-term community studies.

Overall, the costs savings attributable to supplementation were most apparent in short term studies involving a hospital component and in those studies involving younger patients.

The first observation was expected, but the second was a bit of a surprise. The general assumption is that elderly patients are more likely to suffer from malnutrition and benefit from supplementation. These data suggest that suboptimal nutrition may be more prevalent in younger adults than generally anticipated.

The reduction in health care costs was primarily due to:

Significant (16.5%) reduction in hospital admissions.

Decreased length of stay in the hospital.

Decreased infections.

Reduced post-operative complications.

Reduced falls and functional limitations in the elderly.

Although, it did not factor into the cost analysis, those subjects using the meal replacement supplement reported greater quality of life as well. Are supplements worth it? For some, a greater quality of life would help answer that question.

Strengths and Weaknesses of the Study

This was an excellent study, but it does have some important limitations.

While the systematic review and meta-analysis was very well done, it is limited by the quality of the studies that were included in the analysis, and most of those studies had one or more limitations. The authors acknowledged the need for future large scale, prospective studies, that are designed specifically to measure the cost effectiveness of supplementation.

The authors focused almost entirely on the cost benefit analysis. No information was provided on:

The health of these subjects

Why they were using a meal replacement supplement

Whether they decided to use the meal replacement supplement on their own or whether it was recommended by their doctor.

Thus, it is a bit difficult to extrapolate these data from a public health perspective to an individual perspective – the question of whether supplementation reduces health care costs sufficiently to be cost effective for you and me.

This study showed that even a basic meal replacement supplement has a significant effect on reducing health care costs in a variety of settings. However, it provides no information on whether individuals would obtain even greater benefit if they included other supplements in their program.

The Bottom Line

A recent study has shown that even a simple meal replacement supplement can be an effective public health intervention because it significantly reduces health care costs and improves quality of life.
The most significant reductions in health care costs came from:
- A significant (16.5%) reduction in hospital admissions.
- Decreased length of stay in the hospital.
- Decreased infections.
- Reduced post-operative complications.
- Reduced falls and functional limitations in the elderly.
The cost savings were most significant when the meal replacement supplement was used just prior to or following hospital admission for a surgical procedure. This argues strongly for a basic program of nutrition supplementation whenever you are preparing for surgery.However, as the saying goes “Stuff happens”. We don’t always know the precise date and time of our next hospital admission. This may be one case where an ounce of prevention is definitely worth a pound of cure.
The study did include some long term studies of free living individuals in the community, but it is difficult to directly extrapolate from this study to the question of how much a basic meal replacement supplement might reduce health care costs for healthy individuals like you and me.However, many of the things we do to improve our health – buy organic, go on a diet program, purchase a gym membership, or go on a supplement program, for example – cost us money. It is studies like this that suggest at least a portion of those costs may be offset by reduced health care costs down the road.
Finally, this study only looked at the cost effectiveness of a basic meal replacement supplement. It does not provide any information on whether addition of other supplements might provide even greater health care savings.There are studies suggesting that a holistic approach to supplementation may reduce disease burden long term (for example; Nutr J. 2007 Oct 24; 6:30). A detailed cost effectiveness analysis has not been performed on those studies, so we cannot say how much money they might save in reduced health care costs over the long term. However, if a holistic program of diet, exercise and supplementation keeps me out of the doctor’s office and out of the hospital, I’m happy.

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.

Leucine And Muscle Gain

August 25, 2015 by Dr. Steve Chaney

Should Your Post-Workout Protein Shake Contain Added Leucine?

Author: Dr. Stephen Chaney

If you are an athlete – or just someone who is exercising to create a lean and healthy body, you are probably interested in increasing your lean muscle mass following each workout. You may already use leucine. Of course, if you read any of the “muscle magazines”, you’ve seen the ads. “Explode Your Muscles.” “Double Your Gains.” They all claim to have the perfect post-workout protein shake, backed by science. They all sound so tempting, but you know that some of them have to be scams.

I told you about some of the sports supplements to avoid in previous “Health Tips From the Professor”. In this issue, I’m going to ask “What does the perfect post-workout protein shake look like?”

For years athletes have been using protein beverages containing branched chain amino acids after their workouts to maximize muscle gain and recovery. There was some science behind that practice, but the major questions were unanswered. Nobody really knew:

How much protein is optimal?

What kind of protein is optimal?

What amount of branched chain amino acids is optimal?

Are some branched chain amino acids more important than others?

Does the optimal amount of branched chain amino acids depend on the amount of protein?

As a consequence, after workout protein supplements were all over the map in terms of protein source, protein amount, branched amino acid amount and type of branched chain amino acids. Fortunately, recent research has clarified many of these questions.

How Much Protein Do You Need and What Kind?

Recent research has shown that the optimal protein intake for maximizing muscle gain post workout is 15-20 gm for young adults (Katsanos et al, Am J Clin Nutr 82: 1065-1073, 2005; Moore et al, Am J Clin Nutr, 89: 161-168, 2009) and 20-25 gm for older adults (Symons et al, Am J Clin Nutr 86: 451-456, 2007).

More protein isn’t necessarily better. The effect of protein intake on post workout muscle gain maxes out at around 25 gm for young adults and 30 gm for older adults (Symons et al, J Am Diet Assoc 109: 1582-1586, 2009).

Whey protein is the best choice for enhancing muscle gain immediately after a workout. Other protein sources (soy, pea, casein, chicken) are better choices for sustaining muscle gain over the next few hours.

Leucine: The Only Branched Chain Amino Acid To Stimulate Muscle Protein

It turns out that leucine is the only branched chain amino acid that actually stimulates muscle protein synthesis (Am J Physiol Endocrinol Metab 291: E381-E387, 2006). And protein is what gives muscles their strength and their bulk.

Recent research has shown that 2-3 gm of leucine (2 gm for young adults; 3 gm for older adults) is sufficient to maximize post workout muscle gain if protein levels are adequate (Am J Physiol Endocrinol Metab 291: E381-E387, 2006).

Unanswered Questions About Optimizing Muscle Gain Post-Workout

Do the other branched chain amino acids play a supporting role, or is leucine alone sufficient to drive post-workout muscle gain?

Can leucine still help maximize post-workout muscle gain if protein intake is inadequate? If so, how much leucine is needed?

Does Leucine Enhancement Improve Low Protein Shakes?

A recent study (Churchward-Venne et al, Am J Clin Nutr, 99: 276-286, 2014) seems to answer those two questions. The authors compared the effect of 5 protein-amino acid combinations on muscle protein synthesis in 40 young men (~21 years old) following unilateral knee-extensor resistance exercise. The protein shakes contained:

25 gm of whey protein, which naturally contains 3 gm of leucine (high protein)

6.25 gm of whey protein, which naturally contains 0.76 gm of leucine (low protein)

6.25 gm of whey protein with 3 gm of leucine (low protein, low leucine)

6.25 gm of whey protein with 5 gm of leucine (low protein, high leucine)

6.25 gm of whey protein with 5 gm of leucine + added isoleucine and valine (the other branched chain amino acids). (low protein, branched chain amino acids).

The results were clear cut:

The high protein shake (25 gm of protein) was far superior to the low protein shake (6.25 gm of protein) at enhancing post workout protein synthesis. This is consistent with numerous other published clinical reports.

Adding 3 gm of leucine to the low protein shake had no effect on post-workout protein synthesis, but 5 gm of added leucine made the low protein shake just as effective as the high protein shake at supporting post-workout protein synthesis.

In short, leucine can improve the effectiveness of a low protein shake, but you need more leucine than if you chose the high protein shake to begin with.

Adding extra branched chain amino acids actually suppressed the effectiveness of leucine at enhancing post-workout protein synthesis. These data suggest:

Leucine probably is the major amino acid responsible for the muscle gain reported in many of the previous studies with branched chain amino acids.

If the other branched chain amino acids play a supporting role in the muscle gain, the quantities that occur naturally in the protein are probably enough. Adding more may actually reduce the effectiveness of leucine at stimulating muscle gain.

While this is a single study, it is consistent with numerous other recent clinical studies. It simply helps clarify whether leucine can increase the effectiveness of a low protein supplement. It also clarifies the role of branched chain amino acids.

Also, while this study focused on protein synthesis, numerous other studies have shown that optimizing post-workout protein and leucine intake results in greater muscle gain (for example, Westcott et al., Fitness Management, May 2008)

The Bottom Line

Research on post-workout nutrition to optimize muscle gain from the workouts has come a long way in recent years. It is now actually possible to make rational choices about the best protein supplements and foods to support your workouts.

If you are a young adult (17-30), you should aim for 15-20 gm of protein and about 2 gm of leucine after your workout.

If you are an older adult (50+), you should aim for 20-25 gm of protein and 3 gm of leucine after your workout.

If you are in between you are on your own. Studies haven’t yet been done in your age group, but it’s reasonable to assume that you should aim for somewhere between the extremes.

If you are getting the recommended amounts of whey protein, the leucine level may also be optimal. If you are using other protein sources you may want to choose ones with added leucine.

The research cited above shows that you can make a low protein supplement effective by adding lots of leucine, but that’s going to require artificial flavors and sweeteners to cover up the taste of that much leucine. I would recommend choosing one that provided adequate protein to begin with.

While the research in this area is still somewhat fluid, I would avoid protein supplements with added branched chain amino acids other than leucine. If the paper I cited above is correct, you probably get all of the other branched chain amino acids you need from your protein and adding more may actually interfere with the effect of leucine on muscle gain.

I’d pretty much forget all the other “magic ingredients” in post-workout supplements. If you’re a novice there is some evidence that arginine and HMB may be of benefit, but if you have been working out for more than 6 months, the evidence is mixed at best. As for the rest, the clinical studies are all over the map. There’s no convincing evidence that they work.

Whey protein is the best choice for enhancing muscle gain immediately after your workout. Soy, pea, and casein are better choices for sustaining muscle gain over the next few hours. If you’re looking at meat protein, chicken is a particularly good choice. Four ounces of chicken will provide the protein and leucine you need to sustain muscle gain for several hours.

Even if you are not working out, recent research on dietary protein and leucine has important implications for your health. In a recent “Health Tips From the Professor” High Protein Diets and Weight Loss, I shared research showing that optimizing protein and leucine intake helps to increase muscle retention and maximize fat loss when you are losing weight.

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

Can Food Affect Your Mood?

May 26, 2015 by Dr. Steve Chaney

An Apple A Day Keeps The Blues Away

Author: Dr. Stephen Chaney

Can food affect your mood? In rural North Carolina you still occasionally see bumper stickers that say “Life Happens”. Of course, the word they use isn’t exactly “Life”, but you get the point.

We can’t always control what happens to us. What is important is how we react when bad things happen to us. Do we brush them off and move on, or do we let them get us down? There is no shortage of experts telling us how we can keep the blues away. We are told to count our blessings, meditate, think happy thoughts, develop support groups – the list goes on and on.

But is there perhaps one important parameter that most of these experts are missing? Could the foods we eat make us blue?

The standard American diet (S.A.D.) is high in processed foods, fat (especially saturated and trans fats), refined grains, simple sugars, salt and calories. As I’ve said before, almost anything would be better.

You probably already know that the S.A.D. leads to obesity and a whole host of diseases – including heart disease, cancer and diabetes – just to name a few. But did you know that the S.A.D. could make you sad? That’s what two recent studies suggest.

Can Foods Affect Your Mood? Does Junk Food Make You Sad?

The first study by Akbaralay et al (British Journal of Psychiatry, 195: 408-413, 2009) looked at the dietary patterns and mental health outcomes of 3486 participants in the Whitehall II Prospective Study.

In case you didn’t know it, Whitehall is the central district in London where most of the British government offices are located. So the 3486 participants in this study were bureaucrats. They were middle aged (average age 55.6 years old) office staff (74% men, 26% women) who spent most of their day sitting and really didn’t like their jobs very much. (I made up the part about not liking their jobs. It is hard to imagine that kind of job would be deeply fulfilling, but I’m sure that some of the bureaucrats liked their jobs better than others – which is the whole point of this study.)

At the beginning of the study the participants were given a 127 item food frequency quiz to fill out. Interestingly enough, the food preferences of the participants in this study clustered neatly into two groups.

The diets of the processed foods groups predominantly consisted of sweetened desserts, chocolates, fried foods, processed meats, refined grains and high fat dairy products. In short the diet of this group was pretty similar to what we think of as the Standard American Diet (S.A.D.). In contrast, the diets of the whole foods group consisted mostly of vegetables, fruits, fish and whole grains.

Five years later the study participants were analyzed for depression using a 20 item standardized depression scale.

The results were pretty eye-catching. The processed food group was 58% more likely to suffer from depression than the whole food group! And this was after correction for age, gender, weight, marital status, education, employment grade, physical activity, smoking and diseases (high blood pressure, heart disease, diabetes, and stroke).

The reasons for this astounding correlation between diet and depression are not clear. Can food affect your mood? Does this give us more insight?

The authors speculated that the diets of the whole food group were likely higher in antioxidants, folic acid and omega-3 fatty acids than the diets of the processed food group – and studies have suggested that each of these nutrients may protect against depression.

The authors also suggested that it might be an indirect effect. Diets that are high in saturated fats and refined grains and low in omega-3 fatty acids increase inflammation, and studies have suggested that inflammation can lead to depression.

Can Food Affect Your Mood? Does Healthy Food Make You Glad?

The previous study suggested that junk food may make you sad. So you might be asking: “Does that mean that healthy foods can make you glad?” According to one recent study (Br J Health Psychol, Jan 24, 2013, doi: 10.1111/bjhp.12021) the answer may be yes.

A team from the University of Otago in New Zealand enrolled 281 young adults (average age = 20) in a study that looked at the effect of diet on their mood. Each day for 21 consecutive days they recorded their mood and what foods they ate using an online questionnaire. In particular, they reported the number of servings of fresh fruit and vegetables and of several unhealthy foods such as biscuits or cookies, potato chips or French fries and cakes or muffins.

The investigators correlated the foods eaten with the moods reported by the participants on the same day, and again on the day after those foods were eaten. Once again, the results were pretty impressive.

On the days when people ate more fruits and vegetables they reported feeling calmer, happier and more energetic than they did on other days (p = .002 – anything less than .05 is considered a statistically significant difference). And the good effects of fruit and vegetable consumption carried over to the next day as well (p < .001).

Can food affect your mood? While I paraphrased the “apple a day” quote to introduce this study, one apple won’t quite do it. According to this study it takes about 7-8 servings of fruits and vegetables to positively affect mood. In addition, it probably wasn’t just the fruits and vegetables that made the difference. Based on the previous study I would guess that the participants in the study may have eaten other healthy foods such as whole grains and fish on their good days.

Can Food Affect Your Mood?

Taken together these two studies suggest that the next time you feel a little blue you may want to look at your diet. You may want to include a healthier diet along with the meditation and positive thinking.

Of course, these studies both measured correlations between diet and mood, and any good scientist will tell you that correlations do not prove cause and effect. It could be that when people are “down in the dumps” they just naturally reach for junk foods rather than fruits and vegetables.

However, since there is no downside to consuming fruits and vegetables, I feel fully comfortable recommending more fruits and vegetables in our diets. If their health benefits aren’t enough to motivate you, maybe the possibility of improving your mood will!

There are some things you just can’t control. To paraphrase those country songs, you can’t keep your girl and dog from running off. Life happens to all of us. Can food affect your mood? If you want to keep your mood where it should be, you can always reach for those fresh fruits and vegetables, whole grains and sources of omega-3 fatty acids.

The Bottom Line

Two recent studies have suggested what we eat can affect our mood.

The first study showed that people who habitually consumed a diet consisting of sweetened desserts, chocolates, fried foods, processed meats, refined grains and high fat dairy products were 58% more likely to suffer from depression than people who habitually consumed a diet consisting mostly of vegetables, fruits, fish and whole grains.

The second study showed that the subjects in their study reported feeling calmer, happier and more energetic on the days when they ate more fruits and vegetables than they did on the days they ate junk foods.

Of course, these studies both measured correlations between diet and mood, and any good scientist will tell you that correlations do not prove cause and effect. It could be that when people are “down in the dumps” they just naturally reach for junk foods rather than fruits and vegetables.

However, since there is no downside to consuming a healthier diet, I feel fully comfortable recommending more fruits and vegetables, whole grains and omega-3s in our diets. If their health benefits aren’t enough to motivate you, maybe the possibility of their improving your mood will!

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 Women Get Enough Omega-3 During Pregnancy?

May 5, 2015 by Dr. Steve Chaney

Should Pregnant Women Take Omega-3 Supplements?

Author: Dr. Stephen Chaney

Long Chain Omega-3 Fatty Acids, Especially DHA, Are Essential For Normal Brain Development

Long chain omega-3 fatty acids, especially DHA, have been shown to be very important during pregnancy, especially during the third trimester when DHA accumulates in the fetal brain at a very high rate. It is during that third trimester that the fetus forms the majority of brain cells that they will have for an entire lifetime.

Inadequate intake of long chain omega-3 during pregnancy and lactation has been shown to be associated with poor neurodevelopmental outcomes. These include poor developmental milestones, problem solving, language development and increased hyperactivity in the children (Coletta et al, Reviews in Obstetrics & Gynecology, 3, 163-171, 2010).

The Current Recommendation is 200 mg DHA/day During Pregnancy & Lactation.

In order to support brain development in the fetus, some experts have recommend intake of 300 mg per day of DHA during pregnancy. The best dietary sources of long chain omega-3 fatty acids such as DHA are fish and fish oil supplements. However, because of concerns about seafood contamination with heavy metals and PCBs (both of which are neurotoxins), the FDA recommended in 2004 that pregnant women limit seafood consumption to two servings a week, which amounts to about 200 mg/day of DHA – and this has been subsequently adopted by the American College of Obstetricians and Gynecologists and the European Union as the amount of DHA recommended during pregnancy and lactation (Coletta et al, Reviews in Obstetrics & Gynecology, 3, 163-171, 2010).

Even that recommendation for DHA from seafood could be overly generous. A recent study using the EPA risk assessment protocol concluded that some farmed salmon were so contaminated with PCBs that they should be eaten no more than once a year (Hites et al, Science, 303: 226-229, 2004).

Most Pregnant & Lactating Women In The US Are Probably Not Getting The Recommended Amount of DHA In Their Diet

Many pregnant women avoid seafood because of concerns about mercury and PCBs. Unfortunately, the other food sources of omega-3 fatty acids in the American diet, even many omega-3 fortified foods and supplements, are primarily composed of the short chain omega-3 fatty acid linolenic acid (also called alpha-linolenic acid or ALA), and only 1-4% of linolenic acid is converted to DHA in the body (Coletta et al, Reviews in Obstetrics & Gynecology, 3, 163-171, 2010).

Consequently, experts have been concerned for some time that American and Canadian women may not be getting enough DHA during pregnancy and lactation, but it was not clear how serious an issue this was.

Do Women Get Enough Omega-3 During Pregnancy?

A group of scientists decided to test the adequacy of DHA intake by comparing DHA intake with the recommended 200 mg/day in a group of 600 pregnant and lactating women enrolled in the Alberta Pregnancy Outcomes and Nutrition study (Jia et al, Applied Physiology, Nutrition & Metabolism, 40: 1-8, 2015). The average age of the women in this study was 31.6. They were primarily Caucasian and married. 92% of them breastfed their infants. Most of them were taking a multivitamin or prenatal supplement on a daily basis. Approximately 1/3 of them were also taking a long chain omega-3 supplement.

The majority of women had completed college and had annual household incomes in excess of $100,000/year. In short, this was a very affluent, well-educated group of women. This is the kind of group one might consider most likely to be getting enough DHA from their diet.

DHA intake was based on 24 hour food recalls and supplement intake questionnaires collected in face-to-face interviews 2-3 times during pregnancy and again 3 months after delivery. The DHA content of the diet was determined from these data using well established methods.

The results were both dramatic and concerning.

Only 27% of pregnant women and only 25% of postpartum women who were breastfeeding met the recommendation of 200 mg of DHA/day. In short, nearly three-quarters of the women in the study were not getting enough (DHA) omega-3 during pregnancy and lactation.

When the women who were taking DHA-containing supplements were excluded from the data analysis, only 13% of pregnant and lactating women were getting enough DHA from their diet. In short, nearly 90% of the women relying on diet alone were not getting enough DHA.

Taking a DHA-containing supplement increased the likelihood of achieving the recommended 200 mg DHA/day by 10.6 fold during pregnancy and 11.1 fold during breastfeeding.

Not surprisingly, seafood, fish and seaweed products were the major contributors to the total dietary DHA intake.

The authors concluded “Our results suggest that the majority of participants in the cohort were not meeting the EU recommendations for DHA during pregnancy and lactation, but taking a supplement significantly improved the likelihood that they would meet the recommendations.”

The Bottom Line

Long chain omega-3 fatty acids, especially DHA, are essential for normal brain development. Inadequate DHA intake during pregnancy and lactation is associated with poor developmental milestones, problem solving, language development and increased hyperactivity in the children.

There is no established Daily Value for omega-3 fatty acids. However, the American College of Obstetricians and Gynecologists and the European Union recommend 200 mg DHA/day during pregnancy and lactation.

This recommendation is based partly on the amount of DHA needed for brain development and partly on the FDA warning that pregnant women should not consume more than 2 servings of fish/week due to heavy metal and PCB contamination.

This recommendation can be met by 1-2 six ounce servings/week of fish or a fish oil supplement containing 550 – 600 mg of omega-3 fatty acids.

Many pregnant women avoid fish because of concerns about contamination with heavy metals and PCBs, both of which are neurotoxins. Therefore, the major source of omega-3s in the American and Canadian diets are short chain omega-3 fatty acids that are only inefficiently (1-4%) converted to DHA.

Consequently, experts have been concerned for some time that American and Canadian women may not be getting enough DHA during pregnancy and lactation, but it was not clear how serious an issue this was.

A recent study done with a group of 600 women enrolled in the Alberta Pregnancy Outcomes and Nutrition study found that:

Only 27% of pregnant women and only 25% of postpartum women who were breastfeeding met the recommendation of 200 mg of DHA/day. In short, nearly three-quarters of the women in the study were not getting enough (DHA) omega-3 during pregnancy and lactation.

When the women who were taking DHA-containing supplements were excluded from the data analysis, only 13% of pregnant and lactating women were getting enough DHA from their diet. . In short, nearly 90% of the women relying on diet alone were not getting enough DHA.

Taking a DHA-containing supplement increased the likelihood of achieving the recommended 200 mg DHA/day by 10.6 fold during pregnancy and 11.1 fold during breastfeeding.

This was a very affluent, well-educated group of women. If any women anywhere are getting enough DHA during pregnancy and lactation, this should have been the group that was.

The authors concluded “Our results suggest that the majority of participants in the cohort were not meeting the EU recommendations for (DHA) omega-3 during pregnancy and lactation, but taking a supplement significantly improved the likelihood that they would meet the recommendations.”

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.