Premature Death Archives - Health Tips From The Professor

Are Low Carb Diets Healthier?

April 25, 2023 by Dr. Steve Chaney

The “Goldilocks Effect”

Author: Dr. Stephen Chaney

The low-carb wars rage on. Low-carb enthusiasts claim that low-carb diets are healthy. Many health experts warn about the dangers of low-carb diets. Several studies have reported that low-carb diets increase risk of mortality (shorten lifespan).

However, two recent studies have come to the opposite conclusion. Those studies reported that high carbohydrate intake increased mortality, and low carbohydrate intake was associated with the lowest mortality.

One of those studies, called the Prospective Urban Rural Epidemiology (PURE) study was published a few years ago. It included data from 135,335 participants from 18 countries across 5 continents. That’s a very large study, and normally we expect very large studies to be accurate. The results from the PURE study had low-carb enthusiasts doing a victory lap and claiming it was time to rewrite nutritional guidelines to favor low-carb diets.

Whenever controversies like this arise, reputable scientists are motivated to take another look at the question. They understand that all studies have their weaknesses and biases. So, they look at previous studies very carefully and try to design a study that eliminates the weaknesses and biases of those studies. Their goal is to design a stronger study that reconciles the differences between the previous studies.

A third study published a year later (SB Seidelmann et al, The Lancet, doi.org/10.1016/S2468-2667(18)30135-X was such a study. This study resolved the conflicting data and finally answered the question: “How much carbohydrate should we be eating if we desire a long and healthy life?” The answer is “Enough”.

I call this “The Goldilocks Effect”. You may remember “Goldilocks And The Three Bears”. One bed was too hard. One bed was too soft. But one bed was “just right”. One bowl of porridge was too hot. One was two cold. But one was “just right”. According to this study, the same is true for carbohydrate intake. High carbohydrate intake is unhealthy. Low carbohydrate intake is unhealthy. But moderate carbohydrate intake is “just right”.

How Was The Study Done?

This study was performed in two parts. This first part drew on data from the Atherosclerosis Risk in Communities (ARIC) study. That study enrolled 15,428 men and women, aged 45-64, from four US communities between 1987 and 1989. This group was followed for an average of 25 years, during which time 6283 people died. Carbohydrate intake was calculated based on food frequency questionnaires administered when participants enrolled in the study and again 6 years later. The study evaluated the association between carbohydrate intake and mortality.

The second part was a meta-analysis that combined the data from the ARIC study with all major clinical studies since 2007 that measured carbohydrate intake and mortality and lasted 5 years or more. The total number of participants included in this meta-analysis was 432,179, and it included data from previous studies that claimed low-carbohydrate intake was associated with decreased mortality.

Are Low Carb Diets Healthier?

The results from the ARIC study were:

The relationship between mortality and carbohydrate intake was a U-shaped curve.

- The lowest risk of death was observed with a moderate carbohydrate intake (50-55%). This is the intake recommended by current nutrition guidelines.

- The highest risk of death was observed with a low carbohydrate intake (<40%).

- The risk of death also increased with very high carbohydrate intake (>70%).

When the investigators used the mortality data to estimate life expectancy, they predicted a 50-year old participant would have a projected life expectancy of:

- 33.1 years if they had a moderate intake of carbohydrates.

- 4 years less if they had a low carbohydrate intake.

- 1.1 year less if they had a very high carbohydrate intake.

The risk associated with low carbohydrate intake was affected by what the carbohydrate was replaced with.

- When carbohydrates were replaced with animal protein and animal fat there was an increased risk of mortality on a low-carb diet. The animal-based low-carb diet contained more beef, pork, lamb, chicken, and fish. It was also higher in saturated fat.
- When carbohydrates were replaced with plant protein and plant fats, there was a decreased risk of mortality on a low-carb diet. The plant-based low-carb diet contained more nuts, peanut butter, dark or whole grain breads, chocolate, and white bread. It was also higher in polyunsaturated fats.

The effect of carbohydrate intake on mortality was virtually the same for all-cause mortality, cardiovascular mortality, and non-cardiovascular mortality.

There was no significant effect of carbohydrate intake on long-term weight gain (another myth busted).

The results from the dueling meta-analyses were actually very similar. When the data from all studies were combined:

Both very low carbohydrate diets and very high carbohydrate diets were associated with increased mortality.

Meat-based low-carb diets increased mortality, and plant-based low-carb diets decreased mortality.

Once again, the results were the same for total mortality, cardiovascular mortality, and non-cardiovascular mortality.

The authors concluded: “Our findings suggest a negative long-term association between life-expectancy and both low carbohydrate and high carbohydrate diets…These data also provide further evidence that animal-based low carbohydrate diets should be discouraged. Alternatively, when restricting carbohydrate intake, replacement of carbohydrates with predominantly plant-based fats and proteins could be considered as a long-term approach to healthy aging.”

Simply put, that means if a low carb diet works best for you, it is healthier to replace the carbs with plant-based fats and protein rather than animal-based fats and protein.

The “Goldilocks Effect”

This study also resolved the discrepancies between previous studies. The authors pointed out that the average carbohydrate intake is very different in Europe and the US than in Asian countries and low-income countries.

In the US and Europe mean carbohydrate intake is about 50% of calories and it ranges from 25% to 70% of calories. With that range of carbohydrate intake, it is possible to observe the increase in mortality associated with both very low and very high carbohydrate intakes.

The US and European countries are affluent, which means that low-carb enthusiasts can afford diets high in animal protein.

White rice is a staple in Asian countries, and protein is a garnish rather than a main course. Consequently, overall carbohydrate intake is greater in Asian countries and very few Asians eat a truly low carbohydrate diet. High protein foods tend to be more expensive than high carbohydrate foods. Thus, very few people in developing countries can afford to follow a very low carbohydrate diet, and overall carbohydrate intake also tends to be higher.

Therefore, in Asian and developing countries the average carbohydrate intake is greater (~61%) than in the US and Europe, and the range of carbohydrate intake is from 45% to 80% of calories. With that range of intake, it is only possible to see the increase in mortality associated with very high carbohydrate intake.

Both the studies that low-carb enthusiasts quote to support their claim that low-carb diets are healthy relied heavily on data from Asian and developing countries.

In fact, when the authors of the current study overlaid the data from the PURE study with their ARIC data, there was an almost perfect fit. The only difference was that their ARIC data covered both low and high carbohydrate intake while the PURE study touted by low-carb enthusiasts only covered moderate to high carbohydrate intake.

[I have given you my rendition of the graph on the right. If you would like to see the data yourself, look at the paper.]

Basically, low-carb advocates are telling you that diets with carbohydrate intakes of 30% or less are healthy based on studies that did not include carbohydrate intakes below 40%. That is misleading. The studies they quote are incapable of detecting the risks of low carbohydrate diets.

What Does This Study Mean For You?

There are several important take-home lessons from this study:

All major studies agree that very high carbohydrate intake is unhealthy. In part, that reflects the fact that diets with high carbohydrate intake are likely to be high in sodas and sugary junk foods. It may also reflect the fact that diets which are high in carbohydrate are often low in plant protein or healthy fats or both.

All studies that cover the full range of carbohydrate intake agree that very low carbohydrate intake is also unhealthy. It shortens the life expectancy of a 50-year-old by about 4 years.

The studies quoted by low carb enthusiasts to support their claim that low-carb diets are healthy don’t include carbohydrate intakes below 40%. That means their claims are misleading. The studies they quote are incapable of detecting the risks of low carbohydrate diets.

Meat-based low-carb diets decrease life expectancy while plant-based low carb diets increase life expectancy. This is consistent with previous studies. For more details on those studies, see my article, “Are Any Low-Carb Diets Healthy?”, in “Health Tips From The Professor” or my book, “Slaying The Food Myths”.

The health risks of meat-based low-carb diets may be due to the saturated fat content or the heavy reliance on red meat. However, the risks are just as likely to be due to the foods these diets leave out – typically fruits, whole grains, legumes, and some vegetables.

Proponents of low-carb diets assume that you can make up for the missing nutrients by just taking multivitamins. However, each food group also provides a unique combination of phytonutrients and fibers. The fibers, in turn, influence your microbiome. Simply put, whenever you leave out whole food groups, you put your health at risk.

The Bottom Line

The low-carb wars are raging. Several studies have reported that low-carb diets increase risk of mortality (shorten lifespan). However, two studies published a few years ago have come to the opposite conclusion. Those studies have low-carb enthusiasts doing a victory lap and claiming it is time to rewrite nutritional guidelines to favor low-carb diets.

However, a study published a year later resolves the conflicting data and finally answers the question: “How much carbohydrate should we be eating if we desire a long and healthy life?” The answer is “Enough”.

I call this “The Goldilocks Effect”. According to this study, high carbohydrate intake is unhealthy. Low carbohydrate intake is unhealthy. But, moderate carbohydrate intake is “just right”.

Specifically, this study reported:

Moderate carbohydrate intake (50-55%) is healthiest. This is also the carbohydrate intake recommended by current nutritional guidelines.

2) All major studies agree that very high carbohydrate intake (60-70%) is unhealthy. It shortens life expectancy of a 50-year old by about a year.

3) All studies that cover the full range of carbohydrate intake agree that low carbohydrate intake (<40%) is also unhealthy. It shortens life expectancy of a 50-year old by about 4 years.

4) The studies quoted by low carb enthusiasts to support their claim that low-carb diets are healthy don’t include carbohydrate intakes below 40%. That means their claims are misleading. The studies they quote are incapable of detecting the risks of low carbohydrate diets.

5) Meat-based low-carb diets decrease life expectancy while plant-based low carb diets increase life expectancy. This is consistent with the results of previous studies.

Simply put, that means if a low carb diet works best for you, it is healthier to replace the carbs with plant-based fats and protein rather than animal-based fats and protein.

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.

Does Olive Oil Help You Live Longer?

March 8, 2022 by Dr. Steve Chaney

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?

This 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?

The 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?

The 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?

As 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.

Are We Killing Our Children With Kindness?

November 2, 2021 by Dr. Steve Chaney

The Danger Of Ultraprocessed Foods

Author: Dr. Stephen Chaney

It breaks my heart when I see a mom and her children in the checkout line of a supermarket with a cart filled with sodas, sweets, and convenience foods and devoid of fresh fruits and vegetables – or when I see fast food restaurants packed with parents and their children.

I get it. Our kids love these foods. It seems like an act of kindness to give them the foods they crave. But are we killing our children with kindness?

Let me explain. The human brain is hardwired to crave sweets, salt, and fat. In prehistoric times each of these cravings had a survival benefit. For example:

Mother’s milk is naturally sweet. It only makes sense that babies should crave the nutrition source that is essential for their early growth and development.

Fruits provide a cornucopia of vitamins, minerals, and phytonutrients. But fruits were scarce and seasonal in prehistoric times. Their sweetness provided an incentive for early man to seek them out.

Some salt is essential for life. Yet in early history it was scare. It was worth its weight in gold.

In prehistoric times it was feast or famine. The human body has an unlimited capacity to store fat in times of plenty, and those fat stores carried early man through times of famine.

Today most Americans live in a time of food abundance. There are fast food restaurants on almost every street corner and in every shopping mall. We think of famine as the days we skipped lunch because we were busy.

Yet these cravings remain, and the food industry has weaponized them. They are churning out an endless supply highly processed foods and beverages. These foods are not being designed to improve their nutritional value. They are designed to satisfy our cravings and lure us and our children into consuming more of them every year.

Scientists have developed a classification system that assigns foods in the American diet to different groups based on the degree of processing of that food. As you might expect, the best classification is unprocessed foods. The worst classification is called “ultraprocessed foods”. [I will describe this classification system in more detail in the next section.]

It is time we asked how much ultraprocessed foods our children are eating and what it is doing to their health. That is the topic of the study (L Wang et al, JAMA, 326: 519-530, 2021) I will discuss today.

How Was This Study Done?

The data for this study were obtained from NHANES (National Health and Nutrition Examination Survey) dietary data collected from 33,795 American children (ages 2-19, average age = 10) between 1999 and 2018.

NHANES is a program conducted by the CDC to survey the health and nutritional status of adults and children in the United States. The survey has been conducted on a continuous, yearly basis since 1999.

The dietary data are collected via 24-hour dietary recalls conducted by trained interviewers, with a second recall administered over the phone 3-10 days later to improve the accuracy of the data.

Children aged 12-19 completed the dietary survey on their own.

For children aged 6-11, a parent or guardian assisted them in filling out the survey.

For children aged 2-5, a parent or guardian filled out the survey for them.

The foods and beverages consumed by the children were divided into 4 major groups based on the extent of processing using a well-established classification system called NOVA. The 4 groups are:

1) Unprocessed Or Minimally Processed Foods.

This includes whole foods and foods that are minimally processed without the addition of oils, fats, sugar, salt, or other ingredients to the food.

Examples of minimally processed foods include things like oatmeal, nut butters, dried fruit, frozen fruits or vegetables, and dried beans.

2) Processed Culinary Ingredients.

This includes recipes from restaurants or in-home cooking that add small amounts of oils, fats, sugar, salt, and seasonings to whole foods.

3) Processed Foods

This includes foods made in factories by the addition of salt, sugar, oil, or other substances added to whole or minimally processed foods.

Examples include tomato paste, canned fruits packed in sugar syrup, cheese, smoked or cured meat.

4) Ultraprocessed Foods

These are industrial formulations created in factories mostly or entirely from substances extracted from foods (oils, fats, sugar, starch, and proteins), derived from food constituents (hydrogenated fats and modified starch), or synthesized in laboratories (flavor enhancers, colors, and food additives).

Examples include sugar sweetened beverages; sweet or savory packaged snacks; chocolates and candies; burgers, hot dogs, and sausages; poultry and fish nuggets, pastries, cakes, and cake mixes.

Are We Killing Our Children With Kindness?

As I said above, the important question is, “Are we killing our children with kindness when we give them the sugary drinks, sweets, convenience foods, and fast foods they crave?” After all, the foods we give them when they are young are the ones they are most likely to select when they get older.

Let’s start by looking at how pervasive these foods have become. That was the purpose of the study I am discussing today, and the results of this study are alarming. When they looked at the changes in food consumption by our children between 1999 and 2018:

The percentage of calories from ultraprocessed foods increased from 61.4% to 67%. That means:

- Today, more than 2/3 of the calories our children consume daily come from ultraprocessed foods!

The percentage of calories from unprocessed and minimally processed foods decreased from 28.8% to 23.5%. That means:

- In the span of just 19 years the diets of our children have gone from bad to worse!

Ultraprocessed foods were more likely to be consumed away from home and at fast food restaurants.

When the investigators looked at individual categories of ultraprocessed foods:

The percentage of calories coming from ready to heat and eat dishes like frozen pizzas and other frozen meals or snacks increased from 2.2% to 11.2%.

The percentage of calories coming from sweet snacks and desserts increased from 10.7% to 12.9%.

The percentage of calories coming from sugar sweetened beverages decreased from 10.8% to 5.3%.

- This is potentially the only good news from this study.

The authors concluded. “Based on NHANES data from 1999 to 2018, the estimated energy intake from consumption of ultraprocessed foods has increased among youths in the US and has consistently comprised the majority of their total energy intake.”

“These results suggest that food processing may need to be considered as a food dimension in addition to nutrients and food groups in future dietary recommendations and food policies.”

The Danger Of Ultraprocessed Foods

This study clearly shows that ultraprocessed foods have become the mainstay of our children’s diets. Forget a balanced diet! Forget “Eat your fruits and vegetables”! Our children’s diets have been fundamentally transformed by “Big Food, Inc”.

You might be saying to yourself, “So, they are eating their favorite processed foods. What’s the big deal? How bad can it be?” My answer is, “Pretty Bad”. I chose the title, “Are we killing our children with kindness”, for a reason.

When you look at what happens to children who eat a diet that is mostly ultraprocessed foods:

#1: Their nutrition suffers. When the investigators divided the children into 5 groups based on the percentage of calories coming from ultraprocessed foods, the children consuming the most ultraprocessed food had:

Significantly higher intakes of carbohydrates (mostly refined carbohydrates); total fats; polyunsaturated fats (mostly highly processed omega-6-rich vegetable oils); and added sugars.

Significantly lower intakes of fiber; protein; omega-3 polyunsaturated fatty acids; calcium; magnesium; potassium; zinc; vitamins A, C, D, and folate.

- The low intake of fiber means our children will be less likely to have health-promoting friendly bacteria and more likely to have disease-promoting bad bacteria in their guts.

- The low intake of calcium, magnesium, and vitamin D means they will be less likely to achieve maximum bone density as young adults and will be more likely to suffer from osteoporosis as they age.

#2: They are more likely to become obese. Remember, these are foods that are made in a factory, not grown on a farm.

They are high in fat, sugar, and refined carbohydrates. That means they have a high caloric density. Each bite has 2-3 times the calories found in a bite of fresh fruits and vegetables.

As I said earlier, the food industry has weaponized our natural cravings for sweet, salty, and fatty foods. They feed their prototypes to a series of consumer tasting panels until they find the perfect blend of sugar, salt, and fat to create maximum craving.

And if that weren’t enough, they add additives to create the perfect flavor and “mouth appeal”.

- It is no wonder that clinical studies have found a strong correlation between high intake of ultraprocessed food and obesity in both children and adults.

- It is also no wonder that the rate of childhood obesity has almost quadrupled (5% to 18.5%) in the last 40 years.

#3: They are more likely to become sick as adults and die prematurely.

Obesity; high intake of fat, sugar, and refined carbohydrates; and low intake of fiber, omega-3s, and essential nutrients all contribute to an increased risk of diabetes, heart disease, and some cancers.

- It is no wonder that clinical studies have found a strong correlation between high intake of ultraprocessed food and increased risk of diabetes, heart disease, some cancers, and premature death in adults.

- It is also no wonder a recent study found that type 2 diabetes in children has almost doubled between 2001 and 2017.

The data are clear. When we allow our children to subsist on a diet mostly made up of the ultraprocessed foods they crave, we may be giving them, not love, but a lifetime of obesity and declining health instead. And yes, we may be killing them with kindness.

Instead, my recommendations are:

expose your children to a variety of fresh fruits, vegetables, and minimally processed foods at an early age.

They will reject some of them, and that’s OK. Introduce others until you find whole, minimally processed foods they like. Reintroduce them to some of the foods they initially rejected as they get older.

Don’t keep tempting ultraprocessed foods in your house.

You may just succeed in putting your children on the path to a healthier diet and a healthier, longer life.

The Bottom Line

I get it. Our kids love these foods. It seems like an act of kindness to give them the foods they crave. But are we killing our children with kindness?

It is time we asked how much ultraprocessed foods our children are eating and what it is doing to their health. A recent study did just that. When they looked at the changes in food consumption by our children between 1999 and 2018:

The percentage of calories from ultraprocessed foods increased from 61.4% to 67%. That means:

- Today, more than 2/3 of the calories our children consume daily come from ultraprocessed foods!

The percentage of calories from unprocessed and minimally processed foods decreased from 28.8% to 23.5%. That means:

- In the span of just 19 years the diets of our children have gone from bad to worse!

When you look at what happens to children who eat a diet that is mostly ultraprocessed foods:

Their nutrition suffers.

They are more likely to become obese.

They are more likely to become sick as adults and die prematurely.

For more details about this study, read the article above.

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

Is Low Omega-3 Intake As Bad For You As Smoking?

August 31, 2021 by Dr. Steve Chaney

What Is The Omega-3 Index And Why Is It Important?

Author: Dr. Stephen Chaney

We already know that smoking is one of the worst things we can do to our bodies. It dramatically increases our risk of cancer, heart disease, diabetes, and lung diseases, including chronic obstructive pulmonary disease (COPD).

It also leads to premature death. People who smoke regularly die 5 years earlier than those who don’t.

That is the bad news. The good news is that smoking is what is called a “modifiable risk factor”. Simply put, that means it is a risk factor we are in control of. The message has been clear for years.

If you don’t smoke, keep it that way.

If you do smoke, stop. If you are a smoker, quitting isn’t easy, but it is worth it. The damage caused by smoking can largely be reversed if you stay off cigarettes long enough.

Obesity and diabetes are also modifiable risk factors that have a huge effect on the risk of both heart disease and premature death. People with diabetes die 4 years earlier than those without diabetes. But obesity and diabetes are harder for most people to reverse than smoking.

Diet is another modifiable risk factor, but, in general, its effect on the risk of heart disease and premature death is not as great as smoking and diabetes. But what if there were one component of diet that had huge effect on both heart disease and premature death?

The long chain omega-3 fatty acids (EPA & DHA) might just fill that bill. We already know they significantly reduce the risk of heart disease (see below), but could they also help us live longer? This study (MI McBurney et al, American Journal of Clinical Nutrition, published online June 16, 2021) was designed to answer that question.

Metabolism 101: What Is The Omega-3 Index And Why Is It Important?

Clinical studies on the benefits of omega-3s have been plagued by the question of how to best measure the omega-3 status of the participants.

You can ask the participants to fill out a dietary survey and calculate how many omega-3-rich foods they are eating, but:

- Dietary recall is notoriously inaccurate. People don’t remember everything they ate and have a hard time estimating portion sizes.

You can measure omega-3 fatty acids in the blood, but:

- Blood levels are transient. Omega-3 fatty acids enter the bloodstream from the intestine and then disappear from blood as they are taken up by the cells.

- Different forms of omega-3s (esters versus acetate, for example) are absorbed from the intestine and taken up by cells at different rates.

You can measure the omega-3 content of cellular membranes. This is the best assay for omega-3 status because:

- The long chain omega-3 fatty acids (EPA and DHA) that have the biggest effect on heart disease risk accumulate in our cell membranes.

- Omega-3 fatty acids are essential (our bodies can’t make them). That means the omega-3 content of our cell membranes reflect the omega-3 content of our diet. This is one of the cases where the saying, “We are what we eat”, is literally true.

- The omega-3 content of our cell membranes is relatively stable. It reflects the omega-3 content of our diet over the last few months.

In theory, you could measure the omega-3 content of cell membranes from any tissues in the body, but red blood cells can easily be obtained by a simple blood draw, so they are the tissue of choice.

A group lead by Dr. William H Harris standardized this measurement by creating something called the Omega-3 Index. Simply put, the Omega-3 Index is the percentage of EPA and DHA in red blood cell membranes.

It turns out that the Omega-3 Index is an excellent indicator of heart disease risk.

An Omega-3 Index of less than 4% is associated with a high risk of heart disease.

An Omega-3 Index of more than 8% is associated with a low risk of heart disease.

But could a low Omega-3 Index also be associated with an increased risk of premature death? This is what the current study was designed to find out.

How Was This Study Done?

The data for this study were obtained from the ongoing Framingham Offspring Heart Study.

To put this statement into perspective, the original Framingham Heart Study began in 1948 in Framingham Massachusetts with the goal of identifying the factors that contributed to heart disease. It was one of the first major studies to identify the role of saturated fats, elevated blood cholesterol, and elevated blood triglycerides on heart disease risk.

The study is continuing today with the second and third generation descendants of the original study participants. It has also been broadened to include other diseases and additional risk factors, such as the Omega-3 Index.

This study selected 2240 participants from the Framingham Offspring study who had no heart disease and also had Omega-3 Index measurements at the beginning of the study. The study then followed them for 11 years. The goal of the study was to compare the Omega-3 Index with the two most potent risk factors for heart disease (smoking and diabetes) in predicting the risk of premature death.

The characteristics of the participants at the beginning of the 11-year study were:

43% male, 57% female.
Average age = 65.
3% were smokers.
8% were diabetic.
Average Omega-3-Index = 5.8%. This is slightly higher than the American average of ~5%.

Is Low Omega-3-Intake As Bad For You As Smoking?

The participants in the study were divided into 5 quintiles based on their Omega-3 Index.

The 20% of the group in the lowest quintile had an Omega-3 Index of <4.2%.

The 20% of the group in the highest quintile had an Omega-3 Index of >6.8%.

First, the scientists running the study did a direct comparison of the top three risk factors on the risk of premature death. Here is what they found.

The group with the lowest average Omega-3 Index died 4.74 years earlier than the group with the highest average Omega-3 Index.

Smokers died 4.73 years earlier than non-smokers.

People with diabetes died 3.90 years earlier than people without diabetes.

That means low omega-3 intake was just as bad for the participants in this study as smoking. Even the authors of the study were surprised by this result. They had expected omega-3 fatty acids to be beneficial, but they had not expected them to be as beneficial as not smoking.

Because omega-3 fatty acid intake and smoking were the two most potent risk factors for premature death, the authors looked at the interaction between the two. They found that the predicted 11-year survival was:

85% for non-smokers with high omega-3 intake.

71% for either…

- Smokers with high omega-3 intake, or…

- Non-smokers with low omega-3 intake.

Only 47% for smokers with low omega-3 intake.

Simply put, this study predicts if you were a 65-year-old smoker with low omega-3 intake, you could almost double your chances of surviving another 11 years by giving up smoking and increasing your omega-3 intake.

In the words of the authors, “Smoking and omega-3 intake seem to be the most easily modified risk factors [for premature death]…Dietary choices that change the Omega-3 index may prolong life.”

The Bottom Line

We know that smoking is deadly, but could low intake of omega-3 fatty acids be just as deadly?

A recent study compared omega-3 intake with the two most potent risk factors (smoking and diabetes) in predicting the risk of premature death. Here is what it found.

The group with the lowest average omega-3 intake died 4.74 years earlier than the group with the highest average omega-3 intake.

Smokers died 4.73 years earlier than non-smokers.

People with diabetes died 3.90 years earlier than people without diabetes.

That means high omega-3 intake was just as beneficial for the participants in this study as not smoking. Even the authors of the study were surprised by this result. They had expected omega-3 fatty acids to be beneficial, but they had not expected them to be as beneficial as not smoking.

85% for non-smokers with high omega-3 intake.

71% for either…

- Smokers with high omega-3 intake, or…

- Non-smokers with low omega-3 intake.

Only 47% for smokers with low omega-3 intake.

In the words of the authors, “Smoking and omega-3 intake seem to be the most easily modified risk factors [for premature death]…Dietary choices that change the Omega-3 index may prolong life.”

For more details about this study, read the article above.

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

Premature Death: Reduce Your Risk by 31%

March 14, 2017 by Dr. Steve Chaney

Add 3.4 Disease-Free Years To Your Life

Author: Dr. Stephen Chaney

If you could reduce your risk of:

Heart Disease (primarily heart attack) by 24%,
Stroke by 33%,
Cancer by 14%
Premature death by 31% (That would add approximately 3.4 years of disease-free years to your lifespan),

Would you be interested in knowing more?

What if you could enjoy all these benefits:

Without it costing you an extra penny?
Without any side effects?
And you felt great?

Would you like to know the secret? The secret is a diet rich in fruits and vegetables – probably a lot more fruits and vegetables than you are currently eating. Let’s look at the evidence.

How Was The Study Done?

You may be saying “That’s not news. I’ve heard that before.” Yes, there have probably been hundreds of clinical studies looking at the benefits of diets rich in fruits and vegetables. There have also been several meta-analyses that have combined the data from many individual studies to improve that statistical power of their conclusions.

However, this study (Aune et al, International Journal of Epidemiology, DOI: 10.1093/ije/dyw319 ) is unique.

It is the largest and most comprehensive meta-analysis looking at the benefits of fruit & vegetable consumption ever undertaken.

It analyzed 142 published clinical studies with over 2.1 million subjects from around the globe.
There were 43,000 cases of heart disease, 47,000 cases of stroke, 112,000 cases of cancer, and 94,000 deaths in these studies.

It had enough statistical power to determine even minor effects of fruit and vegetable intake.

It is the first meta-analysis with enough data to accurately determine the optimal intake of fruits and vegetables.

Premature Death: Reduce Your Risk By 31%

For most of the health outcomes examined in this study, the optimal intake of fruits and vegetables was 10 servings a day. When they compared people who were consuming 10 servings a day to people who were consuming less than one serving a day,

Heart disease was reduced by 28%.
Stroke was reduced by 33%.
Premature death was decreased by 31%.
The fruits and vegetables most strongly associated with this benefit were apples, pears, citrus fruit, green leafy vegetables, and cruciferous vegetables.

For cancer, the optimal intake of fruits and vegetables was 6 servings a day. When they compared people who were consuming 6 servings a day to people who were consuming less than one serving a day,

Cancer was reduced by 14%.
The fruits and vegetables most strongly associated with reduced cancer risk were green vegetables such as green beans, yellow vegetables such as peppers and carrots, and cruciferous vegetables.

The authors speculated that the relatively small reduction in cancer risk they observed may have been because they were looking at total cancer cases rather than looking at individual cancers. Previous studies have suggested that fruits and vegetables reduce the risk of some cancers much more than others.

Finally, the authors estimated that:

6 million premature deaths/year worldwide could be prevented if people consumed 6 servings of fruits and vegetables a day, and…
8 million premature deaths/year worldwide could be prevented if people consumed 10 servings of fruits and vegetables a day.

What Does This Mean For You?

When the USDA rolled out the “Food Guide Pyramid” in 1992, they recommended 2-4 servings of fruit and 3-5 servings of vegetables a day. They tried educating the American public for almost a decade to no avail. Only 3% of Americans even came close to that recommendation.

In 2011 they threw in the towel and introduced “My Plate”, which recommended 5 servings (2 fruits and 3 vegetables). This is also the current recommendation of the WHO and England. “How well are we doing with this recommendation?”, you might ask.

The answer is “not very well.” The bad news is the CDC estimates that less than 13% of Americans eat 2 servings of fruit and 2-3 servings of vegetables a day. An average American eats one serving of fruit a day and less than 2 servings of vegetables a day. Clearly, we have a long way to go.

My guess is that only vegans come close to the recommended 10 servings a day, and that’s only if they skimp on beans, nuts, and grains so they can load up on fruits and vegetables.

The good news is every added serving of fruits and vegetables is beneficial. The authors of the study estimate that for every increase of 2.5 servings a day:

Heart disease would be reduced by 8%
Stroke would be reduced by 13%
Cancer would be reduced by 3%.
Premature death would be reduced by 10%

If we were to increase our intake of fruits and vegetables to even 6 servings a day:

Heart disease would be reduced by 16%
Stroke would be reduced by 22%
Cancer would be reduced by 13%.
Premature death would be reduced by 27%.

What About Supplementation?

The authors of the study stated: “Most likely it is the whole package of beneficial nutrients you obtain by eating fruits and vegetables that is crucial to health. This is why it is important to eat whole plant foods to get the benefit, instead of taking antioxidant or vitamin supplements…”

I agree in principle. It is impossible to duplicate the myriad of nutrients found in whole foods in a supplement. More importantly, we can do better. We should all work towards increasing the amount of fruits and vegetables in our diet.

However,

When there is such a huge gap between what Americans are eating and the optimal intake of fruits and vegetables, and…
The USDA has tried for decades to get Americans to eat more fruits and vegetables without success, and…
We know many of the beneficial nutrients found in those fruits and vegetables…

Supplementation also makes sense. Choose a company that you can trust and try to fill the gap between what you need and what you are getting from your diet. And, increase your intake of fruits and vegetables to decrease your risk of premature death.

The Bottom Line

A new meta-analysis that combined the data from 142 published clinical studies with over 2.1 million subjects has concluded that increasing our intake of fruits and vegetables to 10 servings a day would:
- Reduce heart disease (primarily heart attacks) by 24%.
- Reduce strokes by 33%.
- Reduce cancer by 14%.
- Reduce premature death by 31% (That would add approximately 3.4 years of disease-free years to your lifespan).
- Result in 7.8 million fewer premature deaths/year worldwide.
The bad news is that:
- The CDC estimates that less than 13% of Americans eat even 2 servings of fruit and 2-3 servings of vegetables a day.
- The CDC also estimates that the average American eats one serving of fruit and less than 2 servings of vegetables per day.
My guess is that only vegans come close to the recommended 10 servings a day, and that’s only if they skimp on beans, nuts, and grains so they can load up on fruits and vegetables.
The good news is every added serving of fruits and vegetables is beneficial. The authors of the study estimate that for every increase of 2.5 servings a day:
- Heart disease would be reduced by 8%
- Stroke would be reduced by 13%
- Cancer would be reduced by 3%.
- Premature death would be reduced by 10%
We can do better. We should all work towards increasing the amount of fruits and vegetables in our diet.
However,
- When there is such a huge gap between what Americans are eating and the optimal intake of fruits and vegetables, and…
- The USDA has tried for decades to get Americans to eat more fruits and vegetables without success, and…
- We know many of the beneficial nutrients found in those fruits and vegetables…
Supplementation also makes sense. Choose a company that you can trust and try to fill the gap between what you need and what you are getting from your diet.

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.