inflammation

Does Processed Food Give You Gas?

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Why Does Processed Food Give You Gas?

Author: Dr. Stephen Chaney 

Does it feel like a war is going on in your belly every time you eat? It could be IBD (inflammatory bowel disease). IBD can take several forms, but the two most common are Crohn’s disease and ulcerative colitis.

What do we know about IBD?

  • The symptoms of IBD can make you miserable. They include:
    • Abdominal pain and cramping.
    • Diarrhea with occasional bouts of constipation.
    • Gas and bloating.
    • Loss of appetite and/or unexpected weight loss.
  • There are about 1.6 million Americans with IBD and 70,000 new cases/year.
    • The prevalence of IBD in the United States has increased by 34% between 2006 and 2016.
  • As you might suspect from its name, IBD is a chronic inflammation of the gastrointestinal tract.
    • It is thought to be caused by “dysbiosis of the gastrointestinal track” (In layman’s terms that means damage to your intestine caused by too many bad bacteria and not enough good bacteria).
    • There is also a genetic component to the disease. Some people are much more susceptible to IBD than others.

If you watch TV, you know that there are drugs for treating IBD. The ads make them sound like miracle drugs. But if you listen carefully, you also know that these drugs have a long list of side effects. And some of the side effects are pretty scary.

Are There Natural Approaches For Controlling IBD?

BacteriaSo, if your belly is a bit rumbly, you might be wondering if there is a more natural approach you could take. We know that diet affects the balance between bad and good bacteria in our intestine. Could something as simple as changing your diet, quell the fire in your belly?

While the answer seems obvious, it has been hard to prove. The results of previous studies have been inconclusive. That is because previous studies:

  • Included too few people. 1.6 million people in the US with IBD may sound like a lot, but that represents only 0.4% of the population. Unless you have a really big study, there won’t be enough people who develop IBD to give you statistically significant results.
  • Were too short. IBD doesn’t develop overnight.
  • Did not include a diverse enough population. Previous studies were confined to individual countries or specific regions within a country.

This study (N Narula et al, British Medical Journal, 2021;374:n1554) was designed to overcome the limitations of previous studies. It also looked at the effect of diet on IBD from a different perspective than most previous studies.

  • It did not focus on the effect of individual foods on IBD. Since consumption of processed foods is known to affect the population of intestinal bacteria, the authors of this study asked whether processed food consumption might influence the likelihood of developing IBD.

How Was The Study Done?

Clinical StudyThe authors of this study used data collected from the PURE (Prospective Urban Rural Epidemiology) study between January 1, 2003, and December 31, 2016. The PURE study collected data from a very diverse population. Specifically, it collected data from 21 low-, middle-, and high-income countries across 7 geographical regions (Europe, North America, South America, Africa, Middle East, South Asia, Southeast Asia, and China).

  • This study followed 116,087 adults aged 35-70 years (average age 50, percent women = 60%) in the PURE study for an average of 9.7 years. During that time, 467 participants (0.4%) developed IBD.
  • All participants filled out a baseline food-frequency questionnaire that had been designed and validated for foods specific to their country.
  • Participants were asked if they had a diagnosis of Crohn’s disease or ulcerative colitis as part of an annual follow-up questionnaire. To assure the accuracy of these answers they were validated with medical records whenever possible.

Does Processed Food Give You Gas?

Does processed food give you gas? Does it give you abdominal pain, diarrhea, and bloating? In short, does it give you IBD? That is the question this study was designed to answer. Here are the results of the study:

  • When comparing those eating the most processed food (≥5 servings/day) to those consuming the least (≤1 serving/day), processed food consumption increased the risk of developing IBD by 1.82-fold. This finding was equally true for:
    • Both Crohn’s disease and ulcerative colitis.
    • Adults <50 and adults >50.
    • Every region of the world included in the PURE study.
  • When the investigators looked at different categories of processed foods:
    • Processed meat intake increased the risk of IBD by 2.07-fold.
    • Soft drink intake increased the risk of IBD by 1.94-fold.
    • Refined sweetened food intake increased the risk of IBD by 2.58-fold.
    • Salty food and snack intake increased the risk of IBD by 2.06-fold.
  • When the investigators looked at different categories of unprocessed foods:
    • White meat, red meat, dairy, starchy foods, fruits, vegetables, and legumes had no effect on the risk of developing IBD.
    • Sodium intake (as measured by urinary excretion of sodium) also had no effect on the risk of developing IBD.

Why Does Processed Food Give You Gas?

Question MarkYou may be wondering why does processed food give you gas – and other symptoms of IBD.

The simplest explanation is that whole grains, unprocessed fruits & vegetables, and legumes provide the fiber that supports the growth of friendly gut bacteria. Processed foods displace these foods from our diet.

But these investigators think something else about processed foods may be contributing to the increased risk of IBD. That is because in their study:

  • Processed meat increased the risk of IBD, but unprocessed white and red meat had no effect on IBD.
  • Processed sweetened foods increased the risk of IBD, but unprocessed starchy foods and naturally sweet fruits had no effect on IBD.
  • Processed salty foods and snacks increased the risk of IBD, but sodium intake had no effect on IBD.

The investigators also noted that in mouse studies:

  • Some food additives found in processed foods cause bacteria to stick to the epithelial lining of the intestine and/or cause leaky gut syndrome, both of which can lead to chronic inflammation of the intestine.

The investigators concluded, “In this study, higher ultra-processed food intake was associated with a higher risk of IBD.”

They went on to say, “As white meat, unprocessed red meat, dairy, starchy foods, fruits, vegetables, and legumes were not found to be associated with development of IBD, this study suggests that it may not be the food itself that confers this risk but rather the way the food is processed or ultra-processed…Further studies are needed to identify specific potential contributing factors among processed foods that might be responsible for the observed associations in our study.”

[Note: This is a fancy way of saying that the detrimental effects of processed foods may be due to more than the fact that they displace healthier foods from the diet. It may also be due to the effect of food additives on the risk of developing IBD.]

What Does This Study Mean For You?

Questioning WomanIBD is a rare disease (0.4% of the population). If you don’t have digestive issues, it would be easy to ignore this study and continue with a diet of highly processed foods.

However, I would remind you that in recent issues of “Health Tips From the Professor”, I have shared recent studies showing that highly processed foods increase your risk of:

And these studies are just the tip of the iceberg. We know that diets rich in whole grains and unprocessed fruits and vegetables decrease the risk of heart attack, stroke, and Alzheimer’s disease. And a diet rich in whole grains, fruits, and vegetables is the antithesis of a processed food diet.

The evidence is overwhelming. Highly processed foods may be convenient and tasty. But if you value your health, they are not your friends.

The Bottom Line 

A recent study looked at the effect of consuming processed foods on the risk of developing inflammatory bowel disease (IBD). The study found:

  • When comparing those eating the most processed food (≥5 servings/day) to those consuming the least (≤1 serving/day), processed food consumption increased the risk of developing IBD by 1.82-fold. This finding was equally true for:
    • Both Crohn’s disease and ulcerative colitis.
    • Adults <50 and adults >50.
    • Every region of the world included in the study.

The investigators concluded, “In this study, higher ultra-processed food intake was associated with a higher risk of IBD.”

They went on to say, “…This study suggests that it may not be the food itself that confers this risk but rather the way the food is processed or ultra-processed…Further studies are needed to identify specific potential contributing factors among processed foods that might be responsible for the observed associations in our study.”

[Note: This is a fancy way of saying that the detrimental effect of processed foods may be due to more than the fact that they displace healthier foods from the diet. It may also be due to the effect of food additives commonly found in processed foods on the risk of developing IBD.]

For more details on the study and what it means for you, read the article above.

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

Is It The Sugar Or Is It The Food?

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Is Fructose Bad For You?

Author: Dr. Stephen Chaney

I don’t usually report on studies done in mice, but this study sheds light on a particularly puzzling question: Why is fructose bad for us?

The studies are clear-cut. High fructose consumption is associated with inflammation, obesity, non-alcoholic liver disease, insulin resistance, type 2 diabetes, kidney disease, increased LDL cholesterol and triglycerides, and heart disease. Based on these associations, fructose appears to be deadly. Why would anyone want to consume it?

Yet fructose is found in virtually every fruit. In fact, fructose, also known as fruit sugar, was first isolated from fruits. Hence the name fructose. Humans have been eating fruits safely for thousands of years. Fruits are very good for us. That raises the question: “If fruits are good for us, how can fructose be bad for us?”.

An important clue can be found by looking at what the food industry has done to the American diet. Because fructose imparts a pleasurable, sweet taste to foods the food industry keeps adding it to more and more foods. As a result, dietary intake of fructose has increased 100-fold over the past two centuries. It has reached the point where fructose now accounts for almost 10% of the caloric intake in the United States.

Is It The Sugar, Or Is It The Food?

Let me expand the discussion by using a couple of graphics I developed for my book, “Slaying The Food Myths”

There Are No Sugar Villains. There Are No Sugar Heroes:

Sugar ComparisonsVirtually all sweeteners are primarily a mixture of fructose and glucose. The graphic on the left compares high fructose corn syrup (the current villain) with other “natural” sweeteners used in foods (our current heroes). High fructose corn syrup ranges from about 40% fructose to 55% fructose. The exact percentage depends on what kind of food product is being made with it.

Honey and coconut sugar are about 45% fructose. Sucrose and grape juice concentrate are around 50% fructose. Apple juice concentrate is around 60% fructose, and agave sugar comes in at a whopping 80% fructose.

In other words, if fructose is the culprit that everyone makes it out to be, “healthy” sugars are no better than high fructose corn syrup. Simply substituting a “healthy” sugar for high fructose corn syrup is unlikely to provide any meaningful benefit.

Is It The Sugar, Or Is The Food?

Apple With Nutrition LabelThis graphic shows us what a nutrition label would look like on a medium apple. I am sure that label is a wake-up call for many of you. The amount of sugar and the percentage of fructose and glucose are about the same as in an 8-ounce soda sweetened with high fructose corn syrup. The same is true for virtually every other fruit you can think of.

Now let me share one more thing you won’t hear from what I refer to as “Dr. Strangelove’s Health Blog” (You probably know the ones I am referring to). Virtually all the studies showing the bad effects of fructose consumption have been done with sodas and sugary junk foods. They haven’t been done with apples.

In fact, virtually every study looking at fruit and vegetable consumption has shown they are incredibly good for us. They lower inflammation and reduce the risk of obesity, diabetes, heart disease, and cancer. And the more the better. One study found that the health benefits of fruit and vegetable consumption topped out at around 10 servings a day.

With this background, you should now fully understand why the question “If fruits are good for us, how can fructose be bad for us?” is so perplexing.

My simplistic explanation has always been that whole foods like fruits have fiber, which slows the absorption of fructose from the intestine. Our bodies were designed to handle fructose in a safe manner when it enters the bloodstream slowly. It is taken up by the liver, converted to glucose, and then slowly metered back into the bloodstream. This provides our brain and other tissues with the glucose they need for energy without blood sugar spikes. This is how fructose is supposed to be metabolized by our bodies.

Sodas and junk foods, on the other hand, have little to slow the absorption of fructose. When lots of fructose enters the bloodstream rapidly, our “safe” metabolic pathways for handling it are overwhelmed, and it is forced into the pathways that are harmful. For example, the “excess” fructose is converted to fat by the liver, which causes inflammation, obesity, fatty liver disease, and triglyceride production.

This is, of course, simply my hypothesis for explaining the different effect of fructose in fruits and sodas. It is based on sound metabolic principles, but it is far from proven. That is why I found a recent study (C. Jang et al, Cell Metabolism, 27: 351-361, 2018) so interesting. It provides a metabolic rationale for my hypothesis.

How Was The Study Done?

Mice were fed a 1:1 mixture of fructose and glucose at doses that approximated the ranges of typical human fructose consumption. The fructose was isotopically labeled so that fructose and its metabolites could be identified by LC-MS (liquid chromatography – mass spectrometry). After feeding the mice the labeled fructose, the investigator measured the amount of fructose and its metabolites in various organs and in the portal vein, which transports sugars from the intestine to the liver for additional metabolism before they enter the bloodstream.

Is Fructose Bad For You?

intestine & liverThe first surprise was that most of the fructose was metabolized by the intestinal mucosal cells that line the small intestine rather than the liver. Previous reports had assumed that fructose was primarily metabolized by the liver because that was where most of the bad effects of fructose metabolism had been observed.

These investigators observed that fructose was primarily converted to glucose and small molecular weight metabolites by the intestinal mucosal cells before being released into the portal vein, where they were transported to the liver. However, there was a strong dose response effect.

  • At low fructose doses, 90% of fructose was metabolized by intestinal mucosal cells before being released to the liver.
  • At high fructose doses, only 70% of fructose was metabolized by intestinal mucosal cells.
  • That means at high fructose doses the amount of fructose reaching the liver unchanged increases from 10% to 30%. That is a 3-fold increase!

The authors concluded:

  • “Based on these findings, we propose that the small intestine shields the liver from fructose and that excessive doses of fructose overwhelm the small intestine, spilling over to the liver where they cause toxicity.”
  • “A key difference between the health effects of fiber-rich fruits (and perhaps even fiber-rich prepared foods) and juices/sodas is their rate of intestinal fructose release.”
  • “It is likely that the appearance rate of free fructose in the small intestine plays a critical role in dictating its metabolic fate. Like the lower doses in our experiments, a slower rate of fructose appearance will result in more complete intestinal clearance, whereas higher doses and faster rates result in fructose overflow to the liver.”

This study needs to be confirmed, and the mechanism may be entirely different in humans. However, whether mechanism is the same in mice and humans is immaterial. We already know that fructose in sodas and junk foods exerts a very different effect on our health than fructose in fruits and other fiber-containing foods.

Despite what Dr. Strangelove tells you, fructose is not bad for you. It isn’t the problem. It is sodas and junk foods containing high-fructose corn syrup that are the problem. And substituting other sugars for high-fructose corn syrup doesn’t make them any better. As I showed you above, the so called “healthy” sugars are chemically and biologically indistinguishable from high-fructose corn syrup.

The Bottom Line

Previous studies have clearly shown that fructose in sodas and junk foods is bad for us, while fructose in fruits is good for us. A recent study in mice provides a metabolic explanation for this difference. The study found:

  • At low fructose doses, 90% of fructose was metabolized by intestinal mucosal cells before being released to the liver.
  • At high fructose doses, only 70% of fructose was metabolized by intestinal mucosal cells.
  • That means at high fructose doses the amount of fructose reaching the liver unchanged increases from 10% to 30%. That is a 3-fold increase!

The authors concluded:

  • “Based on these findings, we propose that the small intestine shields the liver from fructose and that excessive doses of fructose overwhelm the small intestine, spilling over to the liver where they cause toxicity.”
  • “A key difference between the health effects of fiber-rich fruits (and perhaps even fiber-rich prepared foods) and juices/sodas is their rate of intestinal fructose release.”
  • “It is likely that the appearance rate of free fructose in the small intestine plays a critical role in dictating its metabolic fate. Like the lower doses in our experiments, a slower rate of fructose appearance will result in more complete intestinal clearance, whereas higher doses and faster rates result in fructose overflow to the liver.”

This study needs to be confirmed, and the mechanism may be entirely different in humans. However, whether mechanism is the same in mice and humans is immaterial. We already know that fructose in sodas and junk foods exerts a very different effect on our health than fructose in fruits and other fiber-containing foods.

Despite what Dr. Strangelove tells you, fructose is not bad for you. It isn’t the problem. It is sodas and junk foods containing high-fructose corn syrup that are the problem. And substituting other sugars for high-fructose corn syrup doesn’t make them any better. As I showed you above, the so called “healthy” sugars are chemically and biologically indistinguishable from high-fructose corn syrup.

For more details, read the article above.

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

Do Whole Grains Reduce Inflammation?

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Are Low Carb Diets Healthy Long Term?

Author: Dr. Stephen Chaney 

InflammationInflammation is a bit like Dr. Jekyll and Mr. Hyde. Acute inflammation plays a valuable role in our immune response. But chronic inflammation is a scourge. Chronic inflammation:

  • Is a key component of all the “itis” diseases.
  • Can lead to autoimmune diseases.
  • Is thought to play an important role in heart disease.
  • Is associated with many other diseases, such as diabetes, cancer, Alzheimer’s disease, and inflammatory bowel diseases (IBS).

While there are many causes of chronic inflammation, diet plays an important role. In a previous issue of “Health Tips From the Professor” I have described how an anti-inflammatory diet can quell the fires of chronic inflammation.

Fiber from unprocessed plant foods is a key component of an anti-inflammatory diet. But are all plant fibers equally effective at reducing inflammation? Here is what we know:

  • Fiber from whole grains, vegetables, and fruits have different chemical and physical characteristics and support the growth of different species of friendly bacteria in our intestines.
  • Previous studies have shown that higher intakes of dietary fiber are associated with lower risk of heart disease.
    • Studies have suggested that fiber from whole grains may be more effective than fiber from fruits and vegetables at reducing heart disease risk.
  • Chronic inflammation is highly associated with the development of heart disease. This has led to the hypothesis that fiber from whole grains may be more effective than other plant fibers at reducing chronic inflammation.
    • Some studies have supported this hypothesis, but they have all been done with middle-aged participants, not with elderly participants who characteristically have higher levels of inflammation.

The study (R Shivakoti et al, JAMA Network Open, 5(3): e225012, 2022) I will describe today was designed to:

  • Test the hypothesis that whole grain fiber is more effective than vegetable or fruit fiber at reducing inflammation.
  • Determine how important reducing inflammation is at reducing the risk of heart disease.
  • Extending these findings to an older population group.

How Was The Study Done?

Clinical StudyThe data for this study was obtained from the Cardiovascular Health Study (CHS), a study designed to characterize factors influencing cardiovascular health in American adults aged 65 years or older. This study analyzed data from 4,125 participants (40% men, 95% white) who enrolled in the CHS study from 1989 to 1990.

These participants did not have heart disease at the time they were enrolled in the study. They had an average age of 72.6 at the beginning of the study and were followed for an average of 11.9 years. During that time 1,941 (47%) of them developed heart disease.

When the participants were enrolled in the study:

  • A food frequency questionnaire was administered to them by a trained dietitian to assess their long-term usual dietary intake. This information was used to assess:
    • Their total fiber intake and…
    • Their fiber intake from various dietary sources (whole grains, vegetables, and fruits).
  • Fasting blood samples were collected and used to analyze various markers of inflammation.

A follow-up via phone was conducted every 6 months to track an initial diagnosis of cardiovascular disease.

At the end of the study, the investigators analyzed:

  • The effect of total fiber and fiber from different food sources on the risk of developing heart disease.
  • The effect of total fiber and fiber from different food sources on inflammatory markers in the blood.
  • The extent to which decreased inflammation could explain the effect of whole grain fiber on reducing heart disease.

Do Whole Grains Reduce Inflammation?

With respect to inflammation:

  • Increased intake of total fiber was associated with healthier levels of the inflammatory markers CRP, IL-1RA, and sCD163.
    • Increased intake of fiber from whole grains was associated with healthier levels of the inflammatory markers CRP, IL-6, and IL-1RA.
    • Increased intake of vegetable fiber was not significantly associated with healthier levels of any inflammatory marker.
    • Increased intake of fiber from fruits was associated with healthier levels of the inflammatory marker sCD163.

With respect to cardiovascular disease:

  • Every 5g/day increase in total fiber decreased the risk of heart disease by 5%.
    • Every 5g/day increase in fiber from whole grains decreased the risk of heart disease by 14%.
    • Increased intake of fiber from vegetables and fruits did not have a statistically significant effect on the risk of heart disease.

Finally, when the investigators did a statistical analysis to determine to extent to which the effect of whole grain fiber on inflammation, could explain its effect on heart disease, they concluded:

  • The effect of whole grain fiber on inflammation could explain only about 16% of its effect on heart disease.

In the words of the authors, “In this prospective study of older adults, higher intakes of total fiber were associated with lower levels of various inflammatory markers, and this inverse association was primarily due to cereal fiber intake. Vegetable and fruit fiber intakes were not consistently associated with lower levels of inflammatory markers. These results suggest that specifically cereal fibers might be more effective in reducing systemic infection, which will need to be tested in interventional studies of specific populations.

In addition, cereal fiber was associated with a lower risk of CVD, although inflammation mediated less than 20% of the observed inverse association between cereal fiber and CVD. This suggests that the association of cereal fiber is primarily due to factors … other than systemic inflammation.”

Note: This conclusion underplays the role of fruit fiber in reducing inflammation. The statement is correct in saying only whole grain fiber reduces the inflammatory markers CRP, IL-6, and IL-1RA. However, both total fiber and fruit fiber increase the anti-inflammatory marker sCD163. That is why I chose to use the term “healthier levels” rather than lower or higher levels when describing the effects of whole grain and fruit fibers on markers of inflammation.

What Does This Study Mean For You?

confusion#1: The biggest takeaway from this study is that whole grains are good for you.

  • This study shows that whole grain fiber decreases our risk of developing heart disease.
    • This is fully consistent with multiple previous studies showing that whole grains decrease the risk of heart disease.
    • Previous studies have also shown that whole grains reduce the risk of cancer and diabetes.
  • This study also suggests that whole grain fiber reduces chronic inflammation.

There are also some takeaways from this and previous studies that may not be so obvious.

#2: Fiber has many important benefits beyond its effect on inflammation. For example:

  • This study concluded that the reduction in inflammation only explained a small part of the beneficial effect of whole grain fiber on reducing heart disease risk.
  • That is because whole grain fiber also:
    • Feeds friendly bacteria that improve gut function.
    • Provides satiety that can result in reduced fat and calorie intake.
    • Binds cholesterol, which improves blood cholesterol level.
    • Slows the rate at which dietary sugar enters the bloodstream, which improves blood sugar control.

#3: Whole plant foods have many benefits beyond their fiber content.

  • This study concluded that whole grain fiber was more beneficial than fiber from fruits and vegetables at reducing inflammation and reducing the risk of heart disease.
  • Previous studies have also shown that fruit and vegetables significantly decrease the risk of heart disease, stroke, and cancer.
  • That is because whole grains and unprocessed fruits and vegetables:
    • Displace sugar, refined flour, and highly processed foods from the diet.
    • Have a lower caloric density than processed foods, making it easier to achieve a healthy weight.
    • Provide nutrients and phytonutrients not found in processed foods.
    • Support a wide variety of healthy gut bacteria.

Are Low Carb Diets Healthy Long Term?

low carb dietconfusionWhen you consider all the benefits of whole grains, fresh fruits, and vegetables, it brings us to the final take home message.

#4: Despite what Dr. Strangelove has told you, low-carb diets may not be healthy long term.

  • There are no long-term (10 or 20-year) studies of low-carb diets. We simply have no evidence to support the claim that they are healthy long term.
  • Most low-carb diets eliminate or severely limit fruits and whole grains. Considering the many health benefits they provide, it is unlikely that any diet that restricts them is healthy long term.

The Bottom Line 

A recent study looked at the effect of plant fiber on inflammation and on heart disease.

With respect to inflammation the study found:

  • Increased intake of total fiber was associated with healthier levels of the inflammatory markers CRP, IL-1RA, and sCD163.
    • Increased intake of fiber from whole grains was associated with healthier levels of the inflammatory markers CRP, IL-6, and IL-1RA.
    • Increased intake of vegetable fiber was not significantly associated with healthier levels of any inflammatory marker.
    • Increased intake of fiber from fruits was associated with healthier levels of the inflammatory marker sCD163.

With respect to cardiovascular disease:

  • Every 5g/day increase in total fiber decreased the risk of heart disease by 5%.
  • Every 5g/day increase in fiber from whole grains decreased the risk of heart disease by 14%.
    1. The biggest takeaway from this study is that whole grains are good for you.

 Other takeaways from this and previous studies are:

2) Fiber has many important benefits beyond its effect on inflammation.

3) Whole plant foods have many benefits beyond their fiber content.

4) Despite what Dr. Strangelove has told you, low-carb diets may not be healthy long term.

For more details on this study and what it means for you, read the article above.

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

Does Olive Oil Help You Live Longer?

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Which Fat Is Healthiest?

Author: Dr. Stephen Chaney

If you believe the headlines, olive oil is a superfood. It is often described as the star of the Mediterranean diet. It is referred to as the healthiest of dietary fats. Is this true, or is it hype?

Olive oil’s resume is impressive:

  • It is rich in monounsaturated fatty acids, which…
    • Are less susceptible to oxidation than polyunsaturated oils.
    • Make our arteries more flexible, which lowers blood pressure.
    • Lower LDL-cholesterol levels, which reduces the risk of heart disease.
  • Extra-virgin olive oil contains phytonutrients and tocopherols (various forms of vitamin E), which…
    • Have anti-inflammatory properties.
    • Improve insulin sensitivity and blood sugar control.
  • Olive oil consumption is also associated with healthier gut bacteria, but it is not clear whether this is due to olive oil or to the fact that a Mediterranean diet is also richer in fresh fruits, vegetables, and whole grains.

Several recent studies have shown that olive oil consumption is associated with a lower risk of heart disease. However, these studies were conducted in Mediterranean countries where the average intake of olive oil (3 tablespoons/day) is much greater than in the United States (0.3 tablespoons/day).

The current study (M Guasch-Ferré et al, Journal of the American College of Cardiology, 79: 101-112, 2022) was designed to test whether:

  • The amount of olive oil Americans consume decreases the risk of heart disease.
  • Whether olive oil consumption had benefits beyond a reduction in heart disease risk.

How Was This Study Done? 

Clinical StudyThis study combined data from 60,582 women enrolled in the Nurses’ Health Study and 31,801 men enrolled in the Health Professionals Follow-Up Study). The participants:

  • Were free of heart disease and diabetes at the start of the study.
  • Were 56 at the start of the study with an average BMI of 25.6 (Individuals with BMIs in the 25-30 range are considered overweight, so they were at the lowest end of the overweight range).

The Nurses’ Health Study and Health Professional Follow-Up Study are both association studies, meaning they looked at the association between olive oil consumption and health outcomes. They cannot directly prove cause and effect. However, they are very strong association studies because:

  • Every 2 years, participants filled out a questionnaire that updated information on their body weight, smoking status, physical activity, medications, multivitamin use, and physician-diagnosed diseases.
  • Every 4 years, participants filled out a comprehensive food frequency questionnaire.
  • In other words, this study did not just rely on the participant’s lifestyle, dietary intake, and health at the beginning of the study, as so many association studies do. It tracked how each of these variables changed over time.

The participants were followed for an average of 28 years and their average olive oil intake over those 28 years was correlated with all-cause mortality and mortality due to specific diseases.

  • Deaths were identified from state vital statistics, the National Death index, reports by next of kin, or reports by postal authorities.
  • Causes of death were determined by physician review of medical records, medical reports, autopsy reports, or death certificates.

Does Olive Oil Help You Live Longer?

During the 28 years of this study:

  • Olive oil consumption in the United States increased from an average of ~1/3 teaspoon/day to ~1/3 tablespoon/day.
  • Margarine consumption decreased from 12 g/day to ~4 g/day.
  • The consumption of all other fats and oils remained about the same.

As I mentioned above, olive oil consumption was averaged over the life of the study for each individual. When the investigators compared people consuming the highest amount of olive oil (>0.5 tablespoon/day) with people consuming the least olive oil (0 to 1 teaspoon/day):

  • Mortality from all causes was decreased by 35% for the group consuming the most olive oil.

However, the group consuming the most olive oil also was more physically active, had a healthier diet, and consumed more fruits and vegetables than the group who consumed the least olive oil.

  • After correcting for all those factors, mortality from all causes was decreased by 19% for the group consuming the most olive oil.

The authors concluded, “We found that greater consumption of olive oil was associated with lower risk of total…mortality… Our results support current dietary recommendations to increase the intake of olive oil…to improve overall health and longevity.” (I will fill in the blanks in this statement once I have covered other aspects of this study)

The authors also said, “Of note, our study showed that benefits of olive oil can be observed even when consumed in lower amounts than in Mediterranean countries.”

Are There Other Benefits From Olive Oil Consumption?

Mediterranean dietThe study didn’t stop there. The investigators also looked at the effect of olive oil consumption on the major killer diseases in the United States and other developed countries. When they compared the effect of olive oil consumption on cause-specific mortality, they found that the group who consumed the most olive oil reduced their risk of dying from:

  • Cardiovascular disease by 19%.
  • Cancer by 17%
  • Respiratory disease by 18%.
  • Neurodegenerative disease (cognitive decline and Alzheimer’s disease) by 29%.
    • The reduction in neurodegenerative disease was much greater for women (34% decrease) than for men (19% decrease).

With this information I can fill in one of the blanks in the author’s conclusions: “We found that greater consumption of olive oil was associated with lower risk of total and cause-specific mortality… Our results support current dietary recommendations to increase the intake of olive oil…to improve overall health and longevity.”

Which Fats Are Healthiest?

Good Fat vs Bad FatThe sample size was large enough and the dietary information complete enough for the investigators to also estimate the effect of substituting olive oil for other dietary fats and oils.

They found that every ¾ tablespoon of olive oil substituted for an equivalent amount of:

  • Margarine decreased total mortality by 13%.
  • Butter decreased total mortality by 14%.
  • Mayonnaise deceased total mortality by 19%
  • Dairy fat decreased total mortality by 13%.
    • The same beneficial effects of substituting olive oil for other fats were seen for cause-specific mortality (cardiovascular disease, cancer, respiratory disease, and neurodegenerative disease).
    • There was a linear dose-response. This means that substituting twice as much olive oil for other dietary fats doubled the beneficial effects on total and cause-specific mortality.
  • However, substituting olive oil for polyunsaturated vegetable oils had no effect on total and cause-specific mortality.

Now I can fill in the remaining blanks in the author’s conclusion: “We found that greater consumption of olive oil was associated with lower risk of total and cause-specific mortality. Replacing other types of fat, such as margarine, butter, mayonnaise, and dairy fat, with olive oil was also associated with a lower risk of mortality. Our results support current dietary recommendations to increase the intake of olive oil and other unsaturated vegetable oils in place of other fats to improve overall health and longevity.”

What Does This Study Mean For Us?

ConfusionAs I said above, this is an association study, and association studies do not prove cause and effect. However:

1) This is a very strong association study because:

    • It is a very large study (92,383 participants).
    • It followed the participants over a long time (28 years).
    • It utilized a very precise dietary analysis.
    • Most importantly, it tracked the participant’s lifestyle, dietary intake, and health at regular intervals throughout the study. Most association studies only measure these variables at the beginning of the study. They have no idea how they change over time.

2) This study is consistent with several previous studies showing that olive oil consumption decreases the risk of dying from heart disease.

3) This study draws on its large population size and precise dietary analysis to strengthen and extend the previous studies. For example:

    • The study showed that increased olive oil consumption also reduced total mortality and mortality due to cancer, respiratory disease, and neurodegenerative disease.
    • The study measured the effect of substituting olive oil for other common dietary fats.
    • The study showed that increased olive oil consumption in the context of the American diet was beneficial.

I should point out that the headlines you have seen about this study may be misleading.

  • While the headlines may have depicted olive oil as a superfood, this study did not find evidence that olive oil was more beneficial than other unsaturated vegetable oils. Again, this is consistent with many previous studies showing that substituting vegetable oils for other dietary fats reduces the risk of multiple diseases.
  • The headlines focused on the benefits of increasing olive oil consumption. However, they neglected the data showing that increasing olive oil (and other vegetable oils) was even more beneficial (35% reduction in total mortality) in the context of a healthy diet – one with increased intake of fruits, vegetables, whole grains, nuts, legumes, and long-chain omega-3s and decreased intake of red & processed meats, sodium, and trans fats.

So, my recommendation is to follow a whole food, primarily plant-based diet and substitute extra-virgin olive oil and cold pressed vegetable oils for some of the animal fats in your diet.

Some vegan enthusiasts recommend a very low-fat whole food plant-based diet. They point to studies showing that such diets can actually reverse atherosclerosis. However:

  • Those studies are very small.
  • The overall diet used in those studies is a very healthy plant-based diet.
  • The studies did not include a control group following the same diet with olive oil or other vegetable oils added to it, so there is no comparison of a healthy vegan diet with and without vegetable oils.

If you have read my book, “Slaying the Food Myths”, you know that my recommendations encompass a variety of whole food, primarily plant-based diets ranging all the way from very-low fat vegan diets to Mediterranean and DASH diets. Choose the one that best fits your food preferences and the one you will be most able to stick with long term. You will be healthier, and you may live longer.

The Bottom Line

A recent study looked at the effect of olive oil consumption on the risk dying from all causes and from heart disease, cancer, respiratory disease, and neurodegenerative diseases. When the study compared people consuming the highest amount of olive oil (>0.5 tablespoon/day) with people consuming the least olive oil (0 to 1 teaspoon/day):

  • Mortality from all causes was decreased by 19% for the group consuming the most olive oil.

They also found that the group who consumed the most olive oil reduced their risk of dying from:

  • Cardiovascular disease by 19%.
  • Cancer by 17%
  • Respiratory disease by 18%.
  • Neurodegenerative disease (cognitive decline and Alzheimer’s disease) by 29%.

They also found that every ¾ tablespoon of olive oil substituted for an equivalent amount of:

  • Margarine decreased total mortality by 13%.
  • Butter decreased total mortality by 14%.
  • Mayonnaise deceased total mortality by 19%
  • Dairy fat decreased total mortality by 13%.
  • However, substituting olive oil for polyunsaturated vegetable oils had no effect on total and cause-specific mortality.

The authors concluded, “We found that greater consumption of olive oil was associated with lower risk of total and cause-specific mortality. Replacing other types of fat, such as margarine, butter, mayonnaise, and dairy fat, with olive oil was also associated with a lower risk of mortality. Our results support current dietary recommendations to increase the intake of olive oil and other unsaturated vegetable oils in place of other fats to improve overall health and longevity.”

For more details and a summary of what this study means for you, read the article above.

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

Treatment For A Painful Thumb

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Is It Arthritis Of The Thumb Joint? 

Author: Julie Donnelly, LMT –The Pain Relief Expert

Editor: Dr. Steve Chaney 

Is It Arthritis of the Thumb Joint?

Sore ThumbI was pondering what to write about in this month’s newsletter and then I had three clients come in, all suffering from the same problem.  That made up my mind. The topic this month is thumb pain.

Several years ago, when I was still in New York, I had a regular client come in and tell me she had just been told she had arthritis in her thumb joint. I asked how she knew that, and she showed me her hand.  Her thumb was bent all the way in toward her palm and when she tried to bring her hand flat, the joint was painful, preventing her thumb from moving.

She had been given medications for the arthritis, but when she checked it out on the internet, the potential side-effects scared her so much she decided to just suffer with the arthritis.

But it wasn’t arthritis at all. The pain she was experiencing was caused by a tight muscle. I taught her the self-treatment I’m going to show you, and the results were fantastic!

Why a Tight Muscle Causes the Symptoms of Arthritis of the Thumb Joint

We use our thumbs uncountable times every day. It is impossible to even consider how many times we have used our thumb muscles over the course of our lives, but we never think about the muscles that enable us to do that movement. Yet, think of what life would be like if you lost your ability to use your thumb.Thumb Muscle

 

Your thumb muscle, called Opponens Pollicis, originates on the ligament that forms the bridge to your carpal tunnel. (More about carpal tunnel syndrome in a future newsletter) It inserts into the joint that is at the base of your thumb.  It forms the bulge at the base of your thumb, right where the thumb of the right hand, shown on the graphic on the left, is pressing into the left hand.

For example, do the movement shown above, pressing your right thumb into the thick muscle at the base of your thumb.  Then move your left thumb in toward the palm of your hand.  You’ll feel the muscle contract.

As the muscle is repetitively strained it shortens.  The problem is, as it’s shortening it is pulling on the bridge to the carpal tunnel and moving your thumb in toward your palm. When it gets tight, if you try to bring your thumb out it will pull at the joint.  It’s like pulling your hair and then your scalp hurts.

The good news is it’s simple to release the tension in the muscle fibers, it just takes a long time to get it to fully release.

Treatment For A Painful Thumb

It’s simple to treat your Opponens Pollicis muscle.

Treatment 1 For Sore Thumb

 

Place your opposite elbow directly onto the muscle. Wrap your fingers around your elbow to stabilize it so it won’t slide off the muscle.

 

Press deeply into the muscle and either stay still or move very slightly back and forth to lengthen the muscle fibers.

 

Or you can…

 

Place your bent middle finger directly into the muscle and wrap your hand around your hand to stabilize so your Treatment 2 For Sore Thumb Muscleknuckle won’t keep sliding off the muscle.

Hold the pressure for about 30 seconds and then move ¼” along them muscle to a new spot.

I developed this technique when I had carpal tunnel syndrome. It took me hours of self-treatment to get the muscle to final relax and not be painful.  That’s when you know you have finally released the tension and the strain is removed from the bridge to your carpal tunnel (flexor retinaculum).

Even if you don’t have the symptoms of carpal tunnel syndrome, doing this technique will make your hand feel so much better, more flexible, and light.

Treat Yourself to Pain-Free Living!

pain free living book

 

It’s the name of my book, and it says exactly what you will experience when you discover how to release tight muscles that cause joint pain.

People have told me this book is their first “go to” when they have aches and pains, and it has saved them hundreds of dollars in doctor visits and pain medications.

For only $49.00 you can treat muscles that cause everything from headaches to foot pain…a bargain at twice the price!

Order Now and start to feel more flexible and pain-free quickly.

 

Wishing you well,

Julie Donnelly

www.FlexibleAthlete.com 

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 Your Diet Cause You To Lose Your Mind?

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What Is A Mind-Healthy Lifestyle? 

Author: Dr. Stephen Chaney

Cognitive-DeclineMost of us look forward to our golden years – that mystical time when we will be free from the workday pressures and have more time to spend with friends and family doing the things we love.

But cognitive decline can cast a dark cloud over those expectations.

  • By the age of 65, 11% of adults suffer from some degree of cognitive impairment.
  • And by the age of 80 the percentage of adults suffering from cognitive impairment has increased to 26-30%, depending on which study you cite.

The results of cognitive decline can be devastating.

  • First you start to lose the cherished memories of a lifetime.
  • Then comes confusion and an inability to perform basic tasks and participate in your favorite activities.
  • Eventually you may reach a stage where you no longer recognize the ones you love.

In short, cognitive decline can rob you of everything that makes you you.

The causes of cognitive decline are complex, but recent studies have pointed to the role of chronic inflammation in cognitive decline. If that is true, it is a good news – bad news situation.

  • The bad news is:
    • Some increase in chronic inflammation appears to be an inevitable consequence of aging.
    • Chronic inflammation can be caused by certain diseases that are beyond our control.
    • Chronic inflammation can be triggered by viral or bacterial infections.
  • The good news is that chronic inflammation is also controlled by your diet and lifestyle. For example, as I said above, chronic inflammation is often triggered by a viral infection, but whether the inflammation is mild or severe is strongly influenced by diet and lifestyle.

In this issue of “Health Tips From the Professor” I share a study (S Charisis et al, Neurology, In Press, November 10, 2021) showing that diets high in inflammatory foods increase the risk of dementia. Then, I answer 3 important questions.

  • Can your diet cause you to lose your mind?
  • What is a mind-healthy diet?
  • What is a mind-healthy lifestyle?

How Was This Study Done?

Clinical StudyThe data for this study were taken from the first three years of the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD), a study designed to look at the effect of diet on dementia and other neuropsychiatric conditions in the Greek population.

There were 1059 participants (40% male, average age = 75 at the beginning of the study) in this study. At the beginning of the study the participants completed a food frequency questionnaire administered by a trained dietitian. The foods were broken down into individual nutrients using the USDA Food Composition tables adapted for foods in the Greek diet.

The diet of each participant was then rated on a 15-point scale ranging from pro-inflammatory to anti-inflammatory based on something called the Diet Inflammation Index (DII).

Simply put, the DII is a validated assessment tool based on the effect of food nutrients on 6 inflammatory biomarkers found in the blood (IL-1β, IL-4, IL-6, IL-10, TNF-α, and CRP). Nutrients that decrease these markers are considered anti-inflammatory. Nutrients that increase these inflammatory biomarkers are considered pro-inflammatory.

For example, anti-inflammatory nutrients include:

  • Carotenoids and flavonoids (found in fruits and vegetables).
  • Omega-3 polyunsaturated fatty acids (found in cold-water fish, walnuts, flaxseeds, and chia seeds).
  • Monounsaturated fatty acids (found in olive, avocado, and peanut oils).
  • Fiber (found in minimally processed plant foods).
  • Antioxidants, most B vitamins, and vitamin D.
  • Magnesium and zinc.
  • Garlic, onions, most herbs & spices.

Pro-inflammatory nutrients include:

  • Refined carbohydrates.
  • Cholesterol.
  • Total fat.
  • Saturated fats.
  • Trans fats.

The participants were followed for 3 years, and all new diagnoses of dementia were recorded. The diagnoses were confirmed by a panel of neurologists and neuropsychologists.

Can Your Diet Cause You To Lose Your Mind?

Forgetful Old ManAs described above, the diet of each participant in the study was rated on a 15-point DII (Diet Inflammatory Index) scale ranging from pro-inflammatory to anti-inflammatory. The association of the DII score of the participant’s diets with the onset of dementia was evaluated in two ways.

  • Each one-point increase from an anti-inflammatory diet to a pro-inflammatory diet was associated with a 21% increase in the risk for dementia.
  • In other words, even small changes in your diet can have a significant impact on your risk of developing dementia.

The investigators then divided the participants into three equal-sized groups based on the DII score of their diets.

  • The group with the highest DII scores were 3 times more likely to develop dementia than the group with the lowest DII scores.
  • In other words, a major change in your diet can have a major effect on your risk of developing dementia.

The authors concluded, “In the present study, higher DII scores (indicating greater pro-inflammatory diet potential) were associated with an increased risk for incident dementia [newly diagnosed dementia]. These findings may avail the development of primary dementia strategies through tailored and precise dietary interventions.”

What Is A Mind-Healthy Diet?

Vegan FoodsThis and other studies show that an anti-inflammatory diet is good for the mind. It helps protect us from cognitive decline and dementia. But what does an anti-inflammatory diet look like?

One hint comes from analyzing the diets of participants in this study:

  • Those with the lowest DII scores (most-anti-inflammatory diets) consumed 20 servings of fruit, 19 servings of vegetables, 4 servings of beans or other legumes, and 11 servings of coffee or tea each week. That’s almost 3 servings of fruit and 3 servings of vegetables every day!
  • Those with the highest DII scores (most pro-inflammatory diets) consumed only half as many fruits, vegetables, and legumes.
  • In short, a diet rich in fruits, vegetables, and legumes is a good start.

I have described anti-inflammatory diets in more detail in a previous issue of “Health Tips From the Professor.” Let me summarize that article briefly.

Anti-inflammatory foods include:

  • Colorful fruits and vegetables.
  • Whole grains.
  • Beans and other legumes.
  • Nuts, olive oil, avocados, and other sources of monounsaturated fats.
  • Fatty fish and other sources of omega-3 fatty acids.
  • Herbs and spices.

Pro-inflammatory foods include:

  • Refined carbohydrates, sodas, and sugary foods.
  • Foods high in saturated fats including fatty and processed meats, butter, and high fat dairy products.
  • Foods high in trans fats.
  • French fries, fried chicken, and other fried foods.
  • Foods you are allergic or sensitive food. For example, gluten containing foods are pro-inflammatory only if you are sensitive to gluten.

If your goal is to reduce chronic inflammation and keep your mind sharp as a tack as you age, you should eat more anti-inflammatory foods and less pro-inflammatory foods.

Of course, we don’t just eat random foods, we follow dietary patterns. It should be apparent from what I have Mediterranean Diet Foodscovered above that whole food, primarily plant-based diets are anti-inflammatory. This is true for diets ranging from vegan through semi-vegetarian, to the Mediterranean, DASH, and MIND diets.

All these diets are anti-inflammatory and likely protect the brain from cognitive decline. However, the best evidence for brain protection is for the Mediterranean, DASH, and MIND diets.

  • The Mediterranean and DASH diets have been shown to prevent cognitive decline in multiple studies.
  • The MIND diet is a combination the Mediterranean and DASH diets that was specifically designed to prevent cognitive decline. It has been shown to cut the risk of developing Alzheimer’s disease in half.

What Is A Mind-Healthy Lifestyle?

Diet is just one aspect of a holistic approach for reducing cognitive decline as we age. Other important factors include:

  • Reduce excess body weight.
  • Exercise regularly.
  • Get adequate sleep.
  • Reduce and/or manage stress.
  • Eliminate smoking and reduce alcohol consumption.
  • Socialize with friends and family who support you. Numerous studies have shown that a strong support network reduces dementia risk in the elderly.
  • Keep your brain active. Work crossword puzzles. Learn new things. An active brain is forced to lay down new neural pathways.

The Bottom Line 

Recent studies have suggested that chronic inflammation increases the risk of cognitive decline and dementia as we age. Some causes of chronic inflammation are beyond our control, but others, such as diet, we can control.

Recently, a precise scoring system called the Diet Inflammatory Index (DII) has been developed. This scoring system allows studies to look at the correlation between the inflammatory potential of the diet and cognitive decline.

A recent study enrolled 1,000 participants with an average age of 75 in a 3-year study to determine the impact of diet on cognitive decline. The association of the DII score of the participant’s diets with the onset of dementia was evaluated in two ways.

  • Each one-point increase from an anti-inflammatory diet to a pro-inflammatory diet was associated with a 21% increase in the risk for dementia.
  • In other words, even small changes in your diet can have a significant impact on your risk of developing dementia.

The investigators then divided the participants into three equal-sized groups based on the DII score of their diets.

  • The group with the highest DII scores were 3 times more likely to develop dementia than the group with the lowest DII scores.
  • In other words, a major change in your diet can have a major effect on your risk of developing dementia.

The authors concluded, “In the present study, higher DII scores (indicating greater pro-inflammatory diet potential) were associated with an increased risk for incident dementia [newly diagnosed dementia]. These findings may avail the development of primary dementia strategies through tailored and precise dietary interventions.”

For more details and a description of mind-healthy diets and a mind-healthy lifestyle 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 Diet And Gut Bacteria Affect Our Health

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Why Is Your Microbiome Important? 

Author: Dr. Stephen Chaney

Vegan FoodsWe have known for years that primarily plant-based diets are healthy. As I have shared in my book, “Slaying The Food Myths”, people who consume primarily plant-based diets have lower risk of heart disease, diabetes, and some cancers and live longer than people who consume the typical American diet.

But why is that?

  • Is it the nutrients, phytonutrients, and fiber plant foods provide?
  • Is it because plant foods are lower in saturated fats and are good sources of healthier monounsaturated and polyunsaturated fats?
  • Or is it because plant foods have a low caloric density, which makes it easier to maintain a healthy weight?

The answer, of course, is that all the above are important. But is there something else? Is there a “missing link” we don’t talk about much? Many experts think our microbiome (our gut bacteria) is that missing link.

You have heard the saying, “We are what we eat”. You might be scratching your head and saying, “I could eat cabbages all day long, but I am never going to become a cabbage.” It seems like a crazy saying.

But for our microbiome that saying is true. What we call fiber, our gut bacteria call food. Consequently, microbiomevegetarians and meat eaters have very different populations of gut bacteria in their microbiome. The question, of course, is whether these differences influence our health. This central question has spurred multiple research studies on our microbiome in recent years.

Two central themes have emerged from these studies:

  • There are certain populations of gut bacteria that are associated with healthy outcomes (lower risk of obesity, diabetes, heart disease, and some cancers). We can think of these as “good bacteria”.
    • There are certain populations of gut bacteria that are associated with unhealthy outcomes (increased risk of obesity, diabetes, heart disease, and some cancers). We can think of these as “bad bacteria”.
  • People consuming primarily plant-based diets tend to have more of the “good bacteria” and less of the “bad bacteria” in their gut microbiome.

However, most of these studies have been small and have looked at individual foods rather than the effect of the overall diet.

The study (KK Koponen et al, American Journal Of Clinical Nutrition, 2021; doi.org/10.1093/ajcn/nqab077 I will describe today was designed to overcome those limitations.

Metabolism 101: What Are Short Chain Fatty Acids And Why Are They Important?

professor owlTo fully understand the findings of this study, you need to understand what short chain fatty acids are and why they are important. Simply put, short chain fatty acids are the end products of fiber digestion by some species of gut bacteria in our intestines. The major short chain fatty acids in our intestines are acetate (2 carbons), propionate (3 carbons), and butyrate (4 carbons).

There are the key facts about short chain fatty acids you should know:

  1. They are formed by anaerobic fermentation of dietary fiber by our gut bacteria. However:
    • Not all gut bacteria can produce short chain fatty acids.
    • The amount and type(s) of dietary fiber determine whether the gut bacteria that can produce short chain fatty acids are present.

2) Acetate is readily absorbed into the bloodstream and is utilized for fat production and other biosynthetic pathways.

3) Short chain fatty acids, especially butyrate, are the primary energy source for cells lining the colon. Because of this, they have several important health benefits.

    • They support the immune cells that line our intestine. This helps strengthen our immune system.
    • They help maintain the integrity of the intestinal wall. This helps protect against leaky gut syndrome.
    • They reduce inflammation. This reduces the risk of inflammatory bowel diseases like ulcerative colitis and Crohn’s disease.
    • They reduce the risk of colon cancer.

4) In addition, small amounts of propionate and butyrate can be absorbed into the bloodstream. Butyrate is of particular interest because it has the potential to regulate gene expression.

    • There is some evidence that short chain fatty acid production in the intestine is correlated with reduced risk of inflammatory diseases, obesity, type 2 diabetes, and heart disease, but these studies remain controversial.

How Was This Study Done?

Clinical StudyThis study made use of data from the FINRISK Study. This study was conducted by the Finnish Institute of Health and Welfare every 5 years between 1972 and 2012 to assess risk factors for noncommunicable diseases, health behavior, and their changes in adult Finns.

This study included 4930 individuals from the 2002 FINRISK assessment. The characteristics of the group were:

  • 53% female, 47% male.
  • Average age = 48.
  • Average BMI = 26.9 (slightly overweight).

Upon entry into the study, the participants were asked to fill out a food frequency questionnaire.

  • The data from this questionnaire were used to calculate a Healthy Food Choices (HFC) score based on the Nordic Nutrition Dietary Guidelines for a healthy diet.
    • The HFC score ranged from 9-745 and was based on the consumption of fiber-rich breads; vegetables (including beans and lentils); fruits; berries; fresh, non- sweetened berry and fruit juices; fish; poultry; low-fat cheeses; salad dressings and oils; nuts; and seeds.
    • In the words of the authors, “A high HFC score effectively acts as an indicator of a healthy omnivorous Nordic diet rich in plants, fiber, and polyunsaturated fatty acids.”
  • The data were also used to calculate a total dietary fiber score.

The participants were also asked to provide a stool sample. DNA was extracted from the stool sample and sequenced to determine the number and types of bacteria in their gut microbiome. These data were analyzed for:

  • Bacterial diversity (greater bacterial diversity is associated with better health outcomes).
  • Species of gut bacteria known to be associated with better health outcomes.
  • Species of bacteria known to produce short chain fatty acids.

How Diet And Gut Bacteria Affect Our Health

MicrobiomeMicrobiome research is complex. But here is a description of the results in simple terms.

Both the Healthy Food Choice (HFC) and fiber scores correlated positively with:

  • Bacterial diversity (greater bacterial diversity is associated with better health outcomes).
  • Species of gut bacteria known to be associated with better health outcomes.
  • Species of bacteria known to produce short chain fatty acids that are associated with better health outcomes.

Simply put, a healthy, primarily plant-based Nordic diet produces the kind of gut microbiome that is associated with better health outcomes.

When the authors analyzed the contribution of individual components of the diet to a healthy microbiome:

  • Vegetables; berries; fruits; fiber-rich breads; salad dressings and oils; low-fat cheeses; poultry; fresh, unsweetened juices; and fish were all positively associated with a healthy microbiome.
    • Each of these foods supported the growth of different gut bacteria that contributed to the healthy microbiome.
    • Simply put, none of these foods was sufficient by itself. It was a healthy diet with all these foods that resulted in a healthy microbiome.
  • Nuts and seeds did not affect the microbiome. This may have been because there was too little of them in the diet to have a significant effect.
  • Red and processed meats were negatively associated with a healthy microbiome.

The authors concluded, “Our results from a large, population-based survey confirm and extend the findings of other, smaller-scale studies that plant- and fiber-rich dietary choices are associated with a more diverse and compositionally distinct microbiome with a greater potential to produce short chain fatty acids.”

The authors also said, “The associated between red and processed meat products and the gut microbiome cannot be ignored either…[Our data] indicate that increased usage of red and processed meat is associated with the microbiome composition in an opposite manner to that of a healthy diet.”

Why Is Your Microbiome Important?

happy gut bacteriaThe most important message from this and previous studies is that your gut microbiome is the “missing link” between a healthy diet and a healthy body.

Simply put,    healthy diet →→→healthy microbiome→→→healthy body

However, I also need to acknowledge microbiome research is in its infancy. That is because our microbiome is very complex:

  • We have around 38 trillion microorganisms (give or take a few trillion) in our intestine. That means we have slightly more microorganisms than we do cells in our body.
  • Each of us have more than 1,000 different species of bacteria in our intestine.
  • Collectively, these bacteria have around 750,000 genes. That is 30 times more than the number of genes in our DNA.
  • Finally, we all have different species of bacteria in our intestines. We are all unique.

The only simplifying principle is that these bacteria exist in communities that generally group together. Unraveling the complexities and identifying the communities of bacteria in our intestines requires high throughput DNA sequencing and supercomputers to analyze the data.

Studies like this one can identify the associations between diet and distinct communities of bacteria. They can even identify which foods in the diet support the growth of these bacterial communities. Other studies can identify the association between distinct communities of bacteria and healthy outcomes.

The strength of this study is that it identifies the kind of diet and the kinds of food that support the communities of bacteria associated with healthy outcomes. However, these are just associations. They don’t tell us why these associations occur. Specifically:

  • We don’t know why certain diets are associated with different communities of gut bacteria. However, we do know several things.
    • High fiber diets are a major driving force in creating a healthy gut microbiome. This is because what we call fiber, our gut bacteria call food.High Fiber Foods
    • The diet should contain a variety of high fiber foods. This is because different kinds of fiber support the growth of different kinds of gut bacteria, and the diversity of our gut microbiome is associated with healthy outcomes. As I have said before, “We have 5 food groups for a reason”.
    • However, the type of fat and the type of protein in the diet also influence the type of bacteria that thrive in our intestines. We know less about why that is.
  • We also don’t know why certain communities of gut bacteria are associated with healthy outcomes.
    • The exception is communities of bacteria that produce short chain fatty acids. We do have a good idea why short chain fatty acids are associated with gut health.

However, the fact we don’t know why these associations occur, doesn’t detract from the strength of these associations.

  • The associations between a healthy, primarily plant-based diet and a healthy microbiome are not based on this study alone. The same associations have been seen in multiple studies.
  • The associations between a healthy microbiome and better health outcomes have also been seen in multiple studies.

The evidence for these associations is too strong to ignore.

What Does This Study Mean For You?

Questioning WomanThis study shows that a healthy Nordic diet is associated with a healthy microbiome. “But what is a healthy Nordic diet?”, you might ask. Simply put, it is a whole food, omnivorous, primarily plant-based diet with Scandinavian food preferences.

And, if pickled herring, potato pancakes, and meatballs aren’t your favorite foods, never fear. You have lots of other options:

  • The Mediterranean diet is essentially the same diet with Mediterranean food preferences.
  • The DASH diet is essentially the same diet with American food preferences.
  • You can start with a semi-vegetarian diet and tailor it to your food preferences. Of course, some common sense is required here. You will need to primarily include whole, unprocessed food preferences in your diet.

Let me close with some simple advice I have shared before:

  • We are what we eat. Our microbiome (gut bacteria) reflects what we eat.
  • What we call fiber, our gut bacteria call food. A primarily plant-based diet is best because our friendly gut bacteria thrive on the fiber it provides.
  • We have 5 food groups for a reason. Each plant food group provides different kinds of fiber and feeds different families of friendly gut bacteria. We eliminate plant food groups at our peril.
  • We should think of red meat as a condiment, not a main course. Plants contain antidotes to many of the harmful ingredients in red meat. Two to three ounces of steak as part of a green salad or stir fry is much healthier than an 8-ounce steak and fries.

The Bottom Line

Most previous studies on the effect of diet on our microbiome have been small and have looked at individual foods rather than the effect of the overall diet. In this week’s “Health Tips From the Professor” I report on a large, well-designed study that examined the effect of a healthy Nordic diet on our microbiome.

In case you were wondering, the investigators defined a healthy Nordic diet as a whole food diet that:

  • Includes lots of fruits, vegetables, and whole grains and is, therefore, high in fiber.
  • Uses fish, poultry, and low-fat cheeses as its primary protein source.
  • Minimizes red and processed meats.
  • Has more polyunsaturated oils than saturated fats.
  • Reflects Scandinavian food preferences.

This study found that a healthy Nordic diet correlated positively with:

  • Bacterial diversity (greater bacterial diversity is associated with better health outcomes).
  • Species of gut bacteria known to be associated with better health outcomes.
  • Species of bacteria known to produce short chain fatty acids that are associated with better gut health outcomes.

Simply put, a healthy, primarily plant-based Nordic diet produces the kind of gut microbiome that is associated with better health outcomes. To put this into perspective, a healthy Nordic diet is similar to a healthy Mediterranean diet or a healthy DASH diet except that the Mediterranean diet reflects Mediterranean food preferences, and the Dash diet reflects American food preferences.

The most important message from this and previous studies is that your gut microbiome is the “missing link” between a healthy diet and a healthy body.

Simply put,    healthy diet →→→healthy microbiome→→→healthy body

I summed up the article with some simple advice I have shared before:

  • We are what we eat. Our microbiome (gut bacteria) reflects what we eat.
  • What we call fiber, our gut bacteria call food. A primarily plant-based diet is best because our friendly gut bacteria thrive on the fiber it provides.
  • We have 5 food groups for a reason. Each plant food group provides different kinds of fiber and feeds different families of friendly gut bacteria. We eliminate plant food groups at our peril.
  • We should think of red meat as a condiment, not a main course. Plants contain antidotes to many of the harmful ingredients in red meat. Two to three ounces of steak as part of a green salad or stir fry is much healthier than an 8-ounce steak and fries.

For more details about this study and what it means for you, read the article above.

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

 

What Is An Anti-Inflammatory Diet?

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Can Diet Douse The Flames?

Author: Dr. Stephen Chaney

InflammationIf you have arthritis, colitis, bursitis, or any of the other “itis” diseases, you already know that inflammation is the enemy. Chronic, low level inflammation is also a contributing factor to heart disease, cancer, and many other diseases. Clearly, inflammation is a bad actor. It is something we want to avoid.

Obesity and diabetes are two of the biggest contributors to inflammation, but does diet also play a role? With all the anti-inflammation diets circulating on the internet, you would certainly think so. How good is the evidence that certain foods influence inflammation, and what does an anti-inflammatory diet look like?

The Science Behind Anti-Inflammatory Diets

ScientistLet me start by saying that the science behind anti-inflammatory diets is nowhere near as strong as it is for the effect of primarily plant-based diets on heart disease and diabetes. The studies on anti-inflammatory diets are mostly small, short duration studies. However, the biggest problem is that there is no standard way of measuring inflammation.

There are multiple markers of inflammation, and they do not change together. That means that in every study some markers of inflammation are altered, while others are not. There is no consistent pattern from one study to another.

In spite of these methodological difficulties, the studies generally point in the same direction. Let’s start with the strongest evidence and work our way down to the weakest evidence. 

Omega-3 fats are anti-inflammatory (I. Reinders et al, European Journal of Clinical Nutrition, 66: 736-741, 2011). The evidence is strongest for the long chain omega-3s found in fish and fish oil, but the shorter chain omega-3s found in foods like walnuts, flaxseeds, chia seeds and flaxseed oil, soybean oil, and canola oil also appear to be anti-inflammatory. 

Inflammation is directly correlated with glycemic index (L. Qi and F.B. Lu, Current Opinion in Lipidology, 18: 3-8, 2007). This has a couple of important implications.

The most straightforward is that refined carbohydrates and sugars (sodas, pastries, and desserts), which have a high glycemic index, increase inflammation. In contrast, complex carbohydrates (whole grains, most fruits and vegetables) decrease inflammation. No surprise there. The second implication is that it is the glycemic index, not the sugar, that is driving the inflammatory response.

That means we need to look more closely at foods than at sugars. Sodas, pastries and desserts are likely to cause inflammation, but sugar-containing foods with a low glycemic index are unlikely to be inflammatory. 

Fruits and vegetables are anti-inflammatory. This has been shown in multiple studies. At this point most of the research is centered on identifying the nutrients and phytonutrients from fruits and vegetables that are responsible for the reduction in inflammation. I suspect the investigators are hoping to design an anti-inflammatory supplement and make lots of money. I will stick with the fresh fruits and vegetables. 

Saturated fats are inflammatory. At face value, the data on saturated fats appear to be contradictory. Some Fatty Foodsstudies say that saturated fats increase inflammation, while others say they do not. However, similar to my earlier discussion on saturated fats and heart disease), the outcome of the study depends on what the saturated fats are replaced with.

When saturated fats are replaced with refined carbohydrates, sugar and highly processed foods (the standard American low-fat diet), inflammation doesn’t change. This doesn’t mean that a diet high in saturated fat is healthy. It just means that both diets are bad for you. Both are inflammatory.

However, when saturated fat is replaced with omega-3 polyunsaturated fats (J.A. Paniagua et al, Atherosclerosis, 218: 443-450, 2011) or monounsaturated fats (B. Vessby et al, Diabetologia, 44: 312-319, 2001), markers of inflammation decrease. Clearly, saturated fats are not the best fat choice if you wish to keep inflammation in check.

I would be remiss if I did not address the claims by the low-carb diet proponents that saturated fats do not increase inflammation in the context of a low-carb diet. I want to remind you of two things we have discussed previously:

  • The comparisons in those studies are generally with people consuming a diet high in simple carbohydrates and sugars.
  • These studies have mostly been done in the short-term when the participants are losing weight on the low-carb diets. Weight loss decreases inflammation, so the reduction in inflammation on the low-carb diet could be coming from the weight loss.

The one study (M. Miller et al, Journal of the American Dietetic Association, 109: 713-717, 2009) I have found that compares a low-carb diet (the Atkins diet) with a good diet (the Ornish diet, which is a low-fat, lacto-ovo vegetarian diet) during weight maintenance found that the meat based, low-carb Atkins diet caused greater inflammation than the healthy low-fat Ornish diet.

Red meat is probably pro-inflammatory. Most, but not all, studies suggest that red meat consumption is associated with increased inflammation. If it is pro-inflammatory, the inflammation is most likely associated with its saturated fat, its heme iron content, or the advanced glycation end products formed during cooking.

What Is An Anti-Inflammatory Diet?

Colorful fruits and vegetablesAnti-inflammatory diets have become so mainstream that they now appear on many reputable health organization websites such as Harvard Health, WebMD, the Mayo Clinic, and the Cleveland Clinic. Each have slightly different features, but there is a tremendous amount of agreement. 

Foods an anti-inflammatory diet includes: In a nutshell, an anti-inflammatory diet includes fruits and vegetables, whole grains, plant-based proteins (like beans and nuts), fatty fish, and fresh herbs and spices. Specifically, your diet should emphasize:

  • Colorful fruits and vegetables. Not only do they help fight inflammation, but they are a great source of antioxidants and other nutrients important for your health.
  • Whole grains. They have a low glycemic index. They are also a good source of fiber, and fiber helps flush inflammatory toxins out of the body.
  • Beans and other legumes. They should be your primary source of protein. They are high in fiber and contain antioxidants and other anti-inflammatory nutrients.
  • Nuts, olive oil, and avocados. They are good sources of healthy monounsaturated fats, which fight inflammation.
  • Fatty fish. Salmon, tuna, and sardines are all great sources of long chain omega-3 fatty acids, which are fish and fish oilincorporated into our cell membranes. Those long chain omega-3s in cell membranes are, in turn, used to create compounds that are powerful inflammation fighters.

Walnuts, flaxseeds, and chia seeds are good sources of short chain omega-3s. The efficiency of their conversion to long chain omega-3s that can be incorporated into cell membranes is only around 2-5%. If they fight inflammation, it is probably because they replace some of the saturated fats and omega-6 fats you might otherwise be eating.

  • Herbs and spices. They add antioxidants and other phytonutrients that fight inflammation.

Foods an anti-inflammatory diet excludes: In a nutshell, an anti-inflammatory diet should exclude highly processed, overly greasy, or super sweet foods, especially sodas and other sweet drinks. Specifically, your diet should exclude:

  • Refined carbohydrates, sodas and sugary foods. They have a high glycemic index, which is associated with inflammation. They can also lead to weight gain and high blood sugar, both of which cause inflammation.
  • Foods high in saturated fats. This includes fatty and processed meats, butter, and high fat dairy products.
  • Foods high in trans fats. This includes margarine, coffee creamers, and any processed food containing partly hydrogenated vegetable oils. Trans fats are very pro-inflammatory.
  • French fries, fried chicken, and other fried foods. They used to be fried in saturated fat and/or trans fat. Nowadays, they are generally fried in omega-6 vegetable oils. A little omega-6 in the diet is OK, but Americans get too much omega-6 fatty acids in their diet. Most studies show that a high ratio of omega-6 to omega-3 fatty acids is pro-inflammatory.
  • Foods you are allergic or sensitive to. Eating any food that you are sensitive to can cause inflammation. This comes up most often with respect to gluten and dairy because so many people are sensitive to one or both. However, if you are not sensitive to them, there is no reason to exclude whole grain gluten-containing foods or low-fat dairy foods from your diet.

Can Diet Douse The Flames?

FlamesIn case you didn’t notice, the recommendations for an anti-inflammatory diet closely match the other healthy diets I have discussed previously. It should come as no surprise then that both the Mediterranean (L. Gallard, Nutrition in Clinical Practice, 25: 634-640, 2010; L. Schwingshackl and G. Hoffmann, Nutrition Metabolism and Cardiovascular Diseases, 24: 929-939, 2014) and DASH (D.E. King et al, Archives of Internal Medicine, 167: 502-506, 2007) diets are anti-inflammatory.

Vegan and vegetarian diets also appear to be anti-inflammatory as well. The anti-inflammatory nature of these diets undoubtedly contributes to their association with a lower risk of heart disease, diabetes, and cancer.

As for the low-carb diets, the jury is out. There are no long-term studies to support the claims of low-carb proponents that their diets reduce inflammation. The few long-term studies that are available suggest that low-carb diets are only likely to be anti-inflammatory if vegetable proteins and oils replace the animal proteins and fats that are currently recommended.

What does this mean for you if you have severe arthritis or other inflammatory diseases? An anti-inflammatory diet is unlikely to “cure” your symptoms by itself. However, it should definitely be a companion to everything else you are doing to reduce inflammation.

The Bottom Line 

If you have arthritis, colitis, bursitis, or any of the other “itis” diseases, you already know that inflammation is the enemy. Chronic, low level inflammation is also a contributing factor to heart disease, cancer, and many other diseases. Clearly, inflammation is a bad actor. It’s something we want to avoid.

Obesity and diabetes are two of the biggest contributors to inflammation, but does diet also play a role? With all the anti-inflammation diets circulating on the internet, you would certainly think so. In this article I review the evidence that certain foods influence inflammation and describe what an anti-inflammatory diet looks like.

For more details read the article above.

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

Health Tips From The Professor