Can You Trust Your Herbal Supplements?

It’s A Jungle Out There

Author: Dr. Stephen Chaney

JungleIn 2020 the annual retail sales of herbal supplements in the United States exceeded $12 billion, and the sales of herbal supplements continues to grow at almost 10% per year.

Each of those herbal supplements are marketed to help with a particular health issue. The promise is that they are “natural”. They don’t have the side effects associated with most medications.

But what if it were all a hoax? What if the supplement was adulterated – it contained an inactive powder rather than the active herbal ingredient claimed on the label?

Would you be outraged? You should be.

Unfortunately, it is a jungle out there! Popular botanical ingredients are expensive. It is a lot cheaper to substitute cheaper inactive ingredients for the botanical ingredients listed on the label. This is a shady practice called intentional adulteration.

And equally unfortunately, many manufacturers don’t perform the kind of quality controls that would allow them to identify adulterated herbal ingredients before they end up in their products.

So, you might be wondering:

  1. “Are the herbal supplements I am using adulterated? Am I wasting my money?”
  1. “How can I protect myself from this unethical practice?” “How can I become an informed consumer?”

The study (N Orhan et al, Natural Product Reports, DOI: 10.1039/d4np00014e, March 27, 2024) I am reviewing today answers the first question. It estimates the prevalence of adulteration in the top 5 most popular herbal supplements in the United States; black cohosh, echinacea, elderberry, ginkgo, and turmeric.

I answer the second question below.

What Is Adulteration And How Does It Occur?

questionsTo understand how adulteration occurs it’s best to start from the beginning.

How Do Herbal Ingredients Get Into The Product You Buy?

  • It starts with individual farmers who sell raw ingredients to a supplier.
  • The supplier combines the raw ingredients from multiple farmers into bulk botanical ingredients which they sell to a manufacturer.
  • The manufacturer combines ingredients from several suppliers and creates the herbal supplements you buy.

How Is Adulteration Defined? Adulteration can be accidental, but it is most often intentional. The authors of this paper defined intentional adulteration as “the fraudulent addition of non-authentic substances or the removal and replacement of authentic substances without the purchaser’s knowledge [usually] for the economic gain of the seller.”

How Does Adulteration Occur? Two things are required for the adulteration of herbal supplements – adulteration by the seller and either lack of quality controls or quality controls that are unable to detect the adulteration by the buyer. For example:

  • A farmer sells adulterated raw ingredients to the supplier, and the supplier does not employ adequate quality controls to detect the adulteration.
  • A supplier sells adulterated bulk botanical ingredients to a manufacturer, and the manufacturer does not employ adequate quality controls to detect the adulteration.
  • Of course, when it comes to adulteration of ingredients by the manufacturer, you are the buyer. You have no way to do quality controls on the herbal supplements you buy. But you can become an informed consumer. I tell you how below.

How Was The Study Done?

clinical studyThe investigators focused on five of the top-selling herbal ingredients in the United States for which there were a substantial number of published studies on adulteration. The five herbal ingredients they chose were black cohosh, echinacea, elderberry, ginkgo, and turmeric.

They then searched public databases for all papers on adulteration of these ingredients between January 2000 and July 2023. They identified 78 publications with 2,995 samples of herbal ingredients analyzed.

The samples analyzed included raw ingredients sold by farmers, bulk botanical ingredients sold by suppliers, and herbal supplements sold online or at retail outlets.

The extent of adulteration of each of the five herbal ingredients was calculated as the total number of adulterated samples in relation to the total number of samples analyzed. Overall, 818 of the 2,995 samples analyzed (27%) were adulterated.

Can You Trust Your Herbal Supplements?

AvoidThe results of this study were astonishing and depressing. The extent of adulteration was:

  • 56.7% for ginkgo.
  • 42.2% for black cohosh.
  • 28.5% for echinacea.
  • 17.1% for elderberry.
  • 16.5% for turmeric.

And this is just the tip of the iceberg.

  • The Botanical Adulterants Prevention Program has identified almost 30 botanicals (herbal ingredients) that are subject to adulteration. And this program is just getting started. Many more herbal ingredients remain to be tested for adulteration.
  • This study just reported on adulteration of herbal ingredients. It did not assess contaminants such as pesticides, herbicides, fungicides, and heavy metals. Any manufacturer with quality controls unable to detect adulteration would likely miss many of these contaminants as well.

 

The authors concluded,

  • “The data show that a substantial portion of botanical dietary supplements do not contain what is on their labels.”
  • “Quality control methods used by suppliers, manufacturers, researchers, and regulators need to be sufficiently specific to detect possible adulterants in botanical ingredients and produce high-quality authentic products.”
  • “There are numerous examples where analytical methods used in industry quality control…have been shown to be inadequate to detect adulteration and properly authenticate botanical materials.”

How To Become An Informed Consumer

SkepticThis study just confirms what many of you have already suspected. For many herbal supplements on the market, you can’t trust that what’s on the label is in the product. You can’t trust the products will deliver on their claims. It’s all “smoke and mirrors”.

So, how can the consumer protect themselves from herbal supplements that are worthless – supplements that are just a waste of money? I have two recommendations for you.

#1: Become a skeptic. Don’t believe what sales representatives tell you, ads show you, and websites tell you about the quality of a company’s herbal supplements. Over the years I have seen many company websites that raved about their quality controls and claimed their products were as pure as “the driven snow” – until the day the FDA shut them down because none of that was true.

#2: Become an investigator. If you are thinking about using a company’s herbal supplements, ask:

  • How many quality controls they do on the botanical ingredients used in their products and whether those quality controls can detect both contaminants and adulterants. The answers to those two questions should be, “hundreds” and “yes”.
  • How many quality controls do they do on their final product before they release it to the public. The answer should be “dozens” to “hundreds” depending on how many ingredients they have in the product. And don’t be fooled because they tell you their products are “third party tested”. Ask the same questions about the third party that is testing them.
  • How many clinical studies have they published in peer-reviewed scientific journals showing their products are safe and effective. The answer should be “hundreds”.

If you can’t find answers to these specific questions on the company’s website or through direct inquiry, move on. Find another company that can give the correct answers to these questions.

No matter how impressive the claims sound, a company’s product is only as good as the testing and proof behind it.

The Bottom Line

A recent study looked at adulteration (the substitution of worthless ingredients for the active ingredient) of the top 5 botanical ingredients used in herbal supplements in the United States.

The results of this study were depressing. The extent of adulteration was:

  • 56.7% for ginkgo.
  • 42.2% for black cohosh.
  • 28.5% for echinacea.
  • 17.1% for elderberry.
  • 16.5% for turmeric.

And this is just the tip of the iceberg.

The authors concluded,

  • “The data show that a substantial portion of botanical dietary supplements do not contain what is on their labels.”
  • “Quality control methods used by suppliers, manufacturers, researchers, and regulators need to be sufficiently specific to detect possible adulterants in botanical ingredients and produce high-quality authentic products.”
  • “There are numerous examples where analytical methods used in industry quality control…have been shown to be inadequate to detect adulteration and properly authenticate botanical materials.”

For more details about this study and how you can protect yourself from worthless supplements by becoming an informed consumer, 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.

_______________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

________________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”. Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 45 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

600th Issue Celebration

Nutrition Advances Over The Last Two Years

Author: Dr. Stephen Chaney 

celebrationIn the nearly twelve years that I have been publishing “Health Tips From The Professor”, I have tried to go behind the headlines to provide you with accurate, unbiased health information that you can trust and apply to your everyday life.

The 600th issue of any publication is a major cause for celebration and reflection – and “Health Tips From The Professor” is no different.

I am dedicating this issue to reviewing some of the major stories I have covered in the past 100 issues. There are lots of topics I could have covered, but I have chosen to focus on three types of articles:

  • Articles that have debunked long-standing myths about nutrition and health.
  • Articles that have corrected some of the misinformation that seems to show up on the internet on an almost daily basis.
  • Articles about the issues that most directly affect your health.

Here are my picks from the last two years:

Weight Loss Diets

weight lossSince it is almost January, let’s start with a couple of articles about diet and weight loss (or weight gain). I have covered the effectiveness of the Paleo, Keto, Mediterranean, DASH, vegetarian, and Vegan diets for both short and long-term weight loss in my book “Slaying The Food Myths”, so I won’t repeat that information here. Instead, I will share a few updates from the past 100 issues.

Is Time-Restricted Eating Better Than Other Diets? Time-restricted eating is one of the latest fads. But is it really better than other diets for weight loss and improved health? In this article I reviewed two studies that compare time-restricted eating with diets that do not restrict time of eating but cut calories to the same extent. You may be surprised at the results.

Can You Lose Weight Without Dieting? In this article I share 8 tips for losing weight without going on a diet. The article is based on research by Dr. Brian Wansink, a behavioral psychologist who specializes in studying how external clues influence our eating patterns. As you might suspect his 8 tips for losing weight have nothing to do with counting calories or going on restrictive diets.

Healthy Diets

dairy foodsIs Whole Fat Dairy Healthy? For years dietary guidelines have been telling us to select low fat dairy foods. But some health gurus are telling you that isn’t true. They claim whole fat dairy is healthy. So, you are probably wondering, “What is the scoop (as in ice cream) on whole fat dairy?” In this article I look at the study behind the headlines and answer that question. But the answer is not a simple “Yes” or “No”. The answer is more nuanced. It turns out that whole fat dairy is healthier in some diets than in others. 

Are Low Carb Diets Healthy? Are low carb diets good for you or bad for you? It depends on which study you quote. Two major studies in recent years have come to opposite conclusions. In this article I help you sort through the conflicting studies and rephrase the question. Instead of, “Are low carb diets healthy”, the question should be, “Which low carb diets are healthy?”

Are All Plant-Based Diets Healthy? Plant-based diets have acquired a “health halo” in recent years. Your mama told you to eat your fruits and vegetables. And many health gurus have been telling you not to neglect your grains, legumes, nuts, and seeds as well. But some of these foods require a lot of food preparation.

Never fear! The food industry has come to your rescue with a wide variety of processed plant-based foods. No need for food prep. But are they as good for you as the unprocessed plant foods they replace? In this article I review a study that answers that question.

You probably know what that answer is, but the article is worth a read anyway. That is because the study also asks whether vegan and vegetarian diets are healthier than other primarily plant-based diets. And you may not know the answer to that question.

Diet And Heart Disease

egg confusionAre Eggs Bad For You? For years we were told that eggs are bad for us because they contain cholesterol. Then we were told that eggs in moderation may not increase our risk of heart disease. And recently studies have appeared claiming eggs may be good for our hearts. What is the truth about eggs and heart disease? In this article I review a recent study claiming eggs are bad for our heart and put that study into the context of other recent studies to clear up the “eggfusion”.

Which Diets Are Heart Healthy? Every popular diet claims to help you lose weight, reduce your risk of diabetes, and reduce your risk of heart disease. All these claims can’t be true. Which diets deliver on their promises, and which are just pretenders? In this article I review a recent study that answered that question for heart disease.

This study was a very large metanalysis of over 40 studies with 35,548 participants that looked at the effect of different diets on heart disease outcomes. The study identified two diets that significantly reduced the risk of heart disease. There are other diets that might reduce the risk of heart disease, but their benefits have not been proven by high quality clinical studies. They are merely pretenders.

The Dangers Of Processed Foods 

In previous issues of “Health Tips From the Professor” I have shared articles showing that diets high in processed foods are associated with an increased risk of obesity, diabetes, and heart disease. But the story keeps getting worse. Here are two articles on recent studies about processed foods that appeared in “Health Tips From The Professor” in the last two years.

Why Does Processed Food Make You Fat? We already know that eating a lot of highly processed food is likely to make us fat. But what is it about processed food that makes us fat? In this article I review a recent study that answers that question.

This study is interesting for two reasons.

  • It identifies the characteristics of processed foods that make us want to eat more.
  • It identifies some minimally processed foods that have the same characteristics and suggests we should choose minimally processed foods wisely. Simply put, knowledge is power. We may want to avoid minimally processed foods that have the same obesity-inducing characteristics as processed foods.

Do Processed Foods Cause Cancer? Previous studies have shown that processed food consumption is associated with a higher risk of obesity, diabetes, and heart disease. Can it get any worse? In this article I review a recent study that shows processed food consumption is associated with an increased risk of several kinds of cancer.

Maintaining Muscle Mass As We Age

As we age, we begin to lose muscle mass, a process called sarcopenia. Unless we actively resist loss of muscle mass it will eventually impact our quality of life and our health.

We can prevent this loss of muscle mass with resistance exercise, adequate protein intake, and adequate intake of the amino acid leucine. Previous studies have shown people over 50 need more of each of these to maintain muscle mass, but the amount they need has been uncertain until now. Three recent studies have given seniors better guidelines for maintaining muscle mass.

Can You Build Muscle In Your 80s? In this article I review a recent study that enrolled a group of octogenarians in a high-intensity exercise program to see if they could gain muscle mass. They were able to increase their muscle mass, but the intensity of the exercise required may surprise you.

Optimizing Protein Intake For Seniors. In this article I review two recent studies that looked at the amount, timing, and kind of protein needed for seniors in their 60s and 70s to maximize gain in muscle mass.

How Much Leucine Do Seniors Need? In this article I review a recent study that determined the amount of leucine seniors in their 70s need to optimize gains in muscle mass and strength.

The Benefits And Risks Of Supplementation

Omega-3s And Heart DiseaseIf you listen to Big Pharma or the medical profession, you hear a lot about the “risks” of supplementation and very little about the benefits. In “Health Tips From the Professor” I try to present a more balanced view of supplementation by sharing high-quality studies showing benefit from supplementation and studies that put the supposed risks into perspective.

The Good News About Omega-3s and Stroke. Multiple studies have shown that omega-3 supplementation reduces the risk of ischemic strokes (strokes caused by a blood clot). But it has been widely assumed they might increase the risk of hemorrhagic strokes (strokes caused by bleeding). In this article I review a meta-analysis of 29 clinical studies with 183,000 participants that tested that assumption.

How Much Omega-3s Are Best For Blood Pressure? Multiple studies have shown that omega-3 supplementation can reduce high blood pressure. But the doses used vary widely from one study to the next. In this article I review a meta-analysis of 71 double-blind, placebo-controlled clinical studies that determined the optimal dose of omega-3s for controlling blood pressure.

Omega-3 Supplements Are Safe. As I said above, it has been widely assumed that omega-3 supplementation increases the risk of bleeding and hemorrhagic stroke. In this article I review the definitive study on this topic. More importantly, it reveals which omega-3 supplements might increase bleeding risk and which do not.

Are Calcium Supplements Safe? Big Pharma and the medical profession have been warning us that calcium supplements may increase heart disease risk. In this article I review the definitive study on this topic.

Prenatal Supplements

prenatal dha supplementIf you are pregnant or thinking of becoming pregnant, your health professional has likely recommended a prenatal supplement. You probably assume that prenatal supplements provide everything you need for a healthy pregnancy. Unfortunately, recent research has shown that assumption is not correct.

Is Your Prenatal Supplement Adequate? In this article I review a study that should serve as a wakeup call for every expectant mother. It showed that most prenatal supplements were woefully inadequate for a healthy pregnancy.

What Nutrients Are Missing In Prenatal Supplements? In this article I review a study that identified additional nutrients that are missing in most prenatal supplements.

Prenatal Supplements Strike Out Again. In this article I review a study that looked at the diet of pregnant women to determine their needs and compared that to the nutrients found in prenatal supplements. Once again, most prenatal supplements were woefully inadequate. Is it, “Three strikes and you are out”?

Exercise

Walking FastWalking Your Way To Health. We have been told that walking is good for our health. But how many steps should you take, how fast should you walk, and does it matter whether these steps are part of your daily routine or on long hikes? In this article I review a study that answers all these questions.

Which Exercise Is Best For Reducing Blood Pressure? If you have high blood pressure, you have probably been told to exercise more. But which exercise is best? In this article I review a study that answers that question. And the answer may surprise you.

Did You Know? 

Question MarkIf you have been reading “Health Tips From the Professor” for a while, you probably know that I enjoy poking holes in popular myths. Here are two new ones I deflated in past two years.

Is Low Alcohol Consumption Healthy? You have probably heard that low alcohol intake (that proverbial glass of red wine) is good for you. But is that true? In this article I review a recent study that shows that myth was based on faulty interpretation of the data and provides a more nuanced interpretation of the data.

Is HDL Good For Your Heart? You have been told that increasing your HDL levels reduces your risk of heart disease so many times it must be true. But is it? In this article I review HDL metabolism and a recent study to provide a more nuanced interpretation of the relationship between HDL and heart disease risk.

How To Talk With Your Doctor About Cancer 

Because of my years in cancer research, I am often asked whether someone should follow their oncologist’s advice and go on a recommended chemotherapy or radiation regimen. Of course, it would be unethical for me to provide that kind of advice.

In this article I tell you the questions to ask your oncologist about the prescribed treatment regimen, so you can make an informed decision. However, I also recommend you only ask these questions if you can handle the answers.

The Bottom Line

I have just touched on a few of my most popular articles above. You may want to scroll through these articles to find ones of interest to you that you might have missed over the last two years. If you don’t see topics that you are looking for, just go to https://chaneyhealth.com/healthtips/ and type the appropriate term in the search box.

In the coming years, you can look for more articles debunking myths, exposing lies and providing balance to the debate about the health topics that affect you directly. As always, I pledge to provide you with scientifically accurate, balanced information that you can trust. I will continue to do my best to present this information in a clear and concise manner so that you can understand it and apply it to your life.

Final Comment: You may wish to share the valuable resources in this article with others. If you do, then copy the link at the top and bottom of this page into your email. If you just forward this email and the recipient unsubscribes, it will unsubscribe you as well.

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

_______________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

 _______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”. Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com/lifestylechange/.

For the past 45 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

Which Exercise Is Best For Reducing Blood Pressure?

How Can You Keep Your Blood Pressure Under Control? 

Author: Dr. Stephen Chaney 

high blood pressureHypertension (high blood pressure) is called a silent killer. That’s because you often don’t notice any symptoms until you die from a stroke or heart attack.

Nearly half of all American adults (120 million or 48%) have high blood pressure. Of Americans with high blood pressure:

  • About half (46%) of them don’t know it.

And of those who know they have high blood pressure:

  • Only half of them have it under control.
    • In case you weren’t doing the math, that means that only 1 in 4 Americans with high blood pressure has it under control.

That is scary because every 20 mm Hg increase in systolic blood pressure:

  • Doubles your risk of death from a stroke or heart attack.

And if the personal costs of high blood pressure were not enough, the cost of high blood pressure to our health care system is enormous.

  • The CDC estimates that the cost of high blood pressure in the United States is around $131 to $198 billion per year. And this may be an underestimate because it does not include productivity losses from non-fatal illnesses caused by high blood pressure.

Medications are effective at reducing blood pressure, but they have significant side effects. And those side effects have two unintended consequences.

  • Around half of patients stop taking their blood pressure medication within the first year because of side effects or cost.
  • For patients who continue taking blood pressure medication, they are usually prescribed other medications to reduce the side effects from their blood pressure medication.

This is often the start of a downward spiral in which they need more medications to reduce the side effects of the medicines they were just prescribed. And they end up on multiple medications, and a poor quality of life because of it.

Because of this, many patients and health care practitioners are looking for natural ways to keep blood pressure under control. One of the most recommended approaches is to increase exercise, and the type of exercise most frequently recommended is aerobic exercise.

But is that the best advice? That advice is based on clinical studies performed 20 to 30 years ago. And those studies were an excellent example of “the tail wagging the dog”.

Let me explain. In the early days most experts believed that aerobic exercise would be the most effective exercise for reducing blood pressure. So, most of the original studies on the effect of exercise at reducing blood pressure were done using aerobic exercise.

From those studies we knew that aerobic exercise was effective at reducing blood pressure, but we didn’t really know whether it was the most effective exercise for reducing blood pressure. And more recent studies have suggested a more nuanced view of exercise and blood pressure control.

For that reason, the authors of the current article (JJ Edwards et al, British Journal of Sports Medicine, 57: 1317-1326, 2023) decided to conduct a comprehensive review of all randomized controlled studies between 1990 and February 2023 on the effect of exercise on reducing blood pressure.

How Was The Study Done? 

clinical studyThe investigators performed a comprehensive, systematic review of all randomized controlled studies (meaning patients were randomly assigned to an exercise or non-exercise group) looking at reductions in blood pressure following an exercise intervention of ≥ 2 weeks.

They excluded studies that:

  • Included dietary counseling or exercise recommendations in the control group.
  • Included dietary counseling, supplementation, or medication in the exercise group.

However, there were no exclusions based on the health or disease state in the patient population.

Their analysis included 270 randomized controlled trials with a total of 15,827 participants. All the studies reported systolic and/or diastolic blood pressure before and after the exercise intervention.

Exercise interventions were divided into five classifications:

  • Aerobic exercises.
  • Resistance exercises.
  • Combined exercises (a combination of aerobic and resistance exercises).
  • High-intensity interval exercises (high-intensity, short-duration exercises).
  • Isometric exercises.

Several of these exercise classifications were further subdivided into individual exercises (see below)

Which Exercise Is Best For Reducing Blood Pressure? 

When the reduction in systolic blood pressure was considered, the rank order of exercise effectiveness was:

  • High-intensity interval exercise (4.08 mm Hg reduction).
  • Aerobic exercise (4.48 mm Hg reduction).
  • Resistance exercise (4.53 mm Hg reduction).
  • Combined aerobic and resistance exercise (6.04 mm Hg reduction).
  • Isometric exercise (8.24 mm Hg reduction).

When the reduction in diastolic blood pressure was considered, the amount of reduction was less but the rank order of exercise effectiveness was the same:

  • High-intensity interval exercise (2.50 mm Hg reduction).
  • Aerobic exercise (2.53 mm Hg reduction).
  • Resistance exercise (3.04 mm Hg reduction).
  • Combined aerobic and resistance exercise (3.54 mm Hg reduction).
  • Isometric exercise (4.00 mm Hg reduction).

When the exercise classifications were subdivided into individual exercises.

  • Running and cycling were significantly more effective than walking for aerobic exercise, with running being the most effective form of aerobic exercise.
  • Cycling was the most effective form of high-intensity interval exercise.
  • No effect of exercise type was seen for the effectiveness of resistance training.
  • Isometric wall squats and leg extensions were much more effective than isometric handgrip exercises.

There was not enough data from diastolic blood pressure studies to subdivide into individual exercises.

There were two other results of interest.

  • Aerobic exercise interventions were slightly more effective with lower exercise frequency, suggesting that 3 times a week may be more effective than 5 or more times a week.
  • All exercise interventions were much more effective for people with significantly elevated blood pressure than for people with slightly elevated blood pressure or normal blood pressure.

Of course, the important question for people with normal blood pressure is the effectiveness of exercise in preventing future increases in blood pressure, and this study is not designed to answer that question.

The authors concluded, “Various exercise training modes improve resting blood pressure, particularly isometric exercise. The results of this analysis should inform future exercise guideline recommendations for the prevention and treatment of arterial hypertension.”

What Does This Study Mean For You? 

Question MarkThe takeaways from this study are clear.

If you wish to reduce your blood pressure:

  • Any kind of exercise is helpful, but current recommendations that prioritize aerobic exercise may be misleading.
  • If you want to get the most “bang for your buck”:
    • Isometric exercise is the most effective and high intensity interval exercise is the least effective.
    • Aerobic and resistance exercise are equally effective.
    • A combination of aerobic and resistance exercise is more effective than either alone.
  • And if you want to know the most effective individual exercises:
    • Wall squats and leg extensions are the most effective isometric exercises.
    • Running and cycling are the most effective aerobic exercises.
    • Any kind of resistance exercise is equally effective.

Here are my thoughts about this study:

  • If you haven’t been keeping up with clinical studies on exercise and blood pressure (like me), the conclusions of this comprehensive review are probably a surprise. I would not have expected isometric exercises to be more effective than aerobic exercises for lowering blood pressure.
  • The authors of this review postulated that isometric exercise decreases blood flow to the muscles involved. When those muscles relax, blood flow increases which sends metabolic signals that cause blood vessels to relax.
  • This study is good news for people with health conditions that limit their ability to do aerobic exercises or traditional resistance exercises.
  • We also need to remember that lowering blood pressure is not the only value of exercise.
    • Aerobic exercise improves cardiovascular function.
    • Resistance exercise increases muscle mass, which is particularly important for seniors who are trying to maintain muscle mass and function. Regular resistance exercise also helps minimize bone loss as we age.

Isometric exercise can be considered a form of resistance exercise, but it may need to be supplemented with resistance exercises that target other muscle groups.

  • As I said above, this study shows that all forms of exercise reduce blood pressure. The most effective exercise for you is the one you enjoy and will do on a regular basis.
  • Finally, while this study looked at the effectiveness of different exercises at reducing high blood pressure, these findings are probably also applicable to the types of exercise that can reduce risk of developing high blood pressure as we age.

How Can You Keep Your Blood Pressure Under Control?

dash dietExercise alone is not a “magic bullet” for controlling blood pressure. And therein lies a story.

One reason so many people choose medications to control their blood pressure is that there is no “magic bullet” natural approach for controlling blood pressure. Exercise is just one part of a holistic approach for controlling blood pressure that also includes:

  • The DASH (Dietary Approaches To Stop Hypertension) was designed to prevent high blood pressure. I refer to it as an Americanized version of the Mediterranean diet.

Both diets are rich in fruits, vegetables, and whole grains and limit high fat meats and dairy products. And both diets have been shown to reduce the risk of high blood pressure.

  • Weight control. Overweight and obesity are both associated with increased risk of high blood pressure. One estimate is that every two pounds of weight gain increases blood pressure by 1 mm Hg.
  • Supplementation. The most effective supplements appear to be:
    • Omega-3 fatty acids.
    • Supplements containing grape seed extract and/or nitrates from beetroots and leafy greens.
    • Calcium and magnesium if dietary intakes are not optimal.

Diet, weight control, supplementation, and exercise are the top 4 lifestyle factors for keeping blood pressure under control, but a comprehensive holistic approach to controlling blood pressure includes:

  • Low sodium/potassium ratio. I mention it here for completeness, but it is an integral part of the DASH diet.
  • Stress management. Chronic stress can increase blood pressure.
  • Adequate sleep.

We may be outliers, but my wife and I have followed this approach for years and in our 80s have the blood pressure of teenagers.

The Bottom Line 

Most experts recommend aerobic exercise for reducing blood pressure, but these recommendations are based on outdated studies. A recent study examined the effectiveness of various exercises at reducing blood pressure based on all randomized controlled clinical trials between 1990 and 2023.

This study shows:

If you wish to reduce your blood pressure:

  • Any kind of exercise is helpful, but current recommendations that prioritize aerobic exercise may be misleading.
  • If you want to get the most “bang for your buck”:
    • Isometric exercise is the most effective and high intensity interval exercise is the least effective.
    • Aerobic and resistance exercise are equally effective.
    • A combination of aerobic and resistance exercise is more effective than either alone.

For more information on this study, what it means for you, and recommendations for a holistic approach for controlling blood pressure naturally, 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.

______________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

_____________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 45 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

Do GLP-1 Drugs Increase Suicide Risk?

The Pros and Cons Of GLP-1 Drugs 

Author: Dr. Stephen Chaney 

MagicYou’ve seen the ads. You just inject these “miracle” drugs into your thigh once a week, and your excess weight magically disappears. They look like the simple solution for weight loss everyone has been looking for.

More about that in a minute. Let’s first talk about what these drugs are how they work.

What GLP-1 Drugs Are: These drugs are commonly referred to as GLP-1 drugs. But their full name is GLP-1-like receptor agonists. That’s a mouthful, so let me break it down for you.

GLP-1 stands for glucagon-like peptide-1. Glucagon-like peptide-1 is produced by the stomach whenever we eat a meal. It is a hormone that binds to receptors in key organs and reduces appetite and lowers blood sugar (more about this in a minute).

GLP-1-like drugs are peptides designed to resemble the portion of the glucagon-like peptide that binds to GLP-1 receptor. The term agonist means that these drugs have the same effect as the naturally occurring GLP-1 peptide.

The difference is that the naturally occurring GLP-1 peptide hormone is rapidly degraded, so it stays in the bloodstream for a very short time after each meal. In contrast, the GLP-1-like receptor agonist drugs are designed to be much more stable, remaining in the bloodstream for a week or more. That’s why these drugs only need to be injected on a weekly basis.

How GLP-1 Drugs Work: GLP-1 drugs:

  • Bind to GLP-1 receptors on the pancreas and stimulate insulin release. This can help type 2 diabetics control their blood sugar levels.
  • Bind to GLP-1 receptors on the stomach and reduce the rate of gastric emptying. This prolongs the feeling of fullness after each meal.
  • Bind to GLP-1 receptors on the small intestine and reduce gut motility, which increases transit time through the small intestine. This also prolongs the feeling of fullness. But it can also lead to gastrointestinal side effects.
  • Bind to GLP-1 receptors on the brain and turn down your “appestat”. This reduces feelings of hunger between meals.

A Brief History Of GLP-1 Drugs

ProfessorGLP-1 drugs have been around since 2005.But the newest and most successful class of GLP-1 drugs (e.g., Ozempic) was developed in 2017 by a Danish pharmaceutical company called Novo Nordisk to help type 2 diabetics control their blood sugar levels.

However, once it became apparent that patients on Ozempic achieved significant weight loss, doctors started prescribing it for weight loss even though it had only been approved for controlling blood sugar. This is a practice described as “off label” use. It became so popular for weight loss that diabetics started to have trouble getting their prescriptions filled.

Novo Nordisk ramped up their production of Ozempic and introduced a second, higher potency drug, Wegovy, that is marketed primarily for weight loss. And, of course, where there is money to be made other companies have introduced their own GLP-1-like receptor agonists for both controlling blood sugar and weight loss.

The popularity of these drugs can only be described as a tsunami. To help you put it into perspective:

  • Novo Nordisk’s market value is currently over $500 billion. That is larger than the GDP of Denmark where it is located.
  • One in eight adults in the United States are either taking or have taken a GLP-1 drug.
  • GLP-1 drugs have had 1.2 billion Tik Tok views since 2021.

The Pros And Cons Of GLP-1 Drugs

pros and consLet me be clear. These drugs work. For people with poorly controlled type 2 diabetes or severe obesity-related health issues, they can be a godsend. But like any “quick fix” weight loss drugs they are overprescribed.

The reality is that unless people on the drugs make healthy lifestyle changes, the weight comes back as soon as they quit using the drugs. So, for most people these drugs are not a short-term weight loss solution. They are a long-term necessity if they want to keep the weight off.

And whenever we are thinking about long-term drug use, we need to ask whether they are safe for long-term use.

That brings me to a story. When I was still teaching medical students, the co-director of the first-year course we ran was a medical geneticist. In his introductory lecture to the medical students he made the comment, “The only safe drug is a new drug”. After a dramatic pause he completed the statement with, “That’s because they haven’t discovered all the side effects yet.”

Let me elaborate. Before a drug can be approved by the FDA it must be proven safe and effective in a series of clinical trials. But those clinical trials have their drawbacks. They are relatively short and include a relatively small group of patients.

Sometimes it is only after a drug has been used by millions of patients for several years that we know of some of their most dangerous side-effects. For that reason, the FDA and regulatory agencies in other countries have a monitoring system for detecting “adverse drug reactions” (side-effects) after the drug has been approved.

Simply put, doctors report adverse drug reactions to a central agency. When enough adverse events of a particular type have been detected, clinical studies are initiated to determine how significant that side effect is.

Medical history is littered with drugs that passed the initial company-run clinical studies with flying colors and were introduced to the general public with great fanfare – only to be withdrawn a few years later once serious side-effects had been discovered. One might ask whether GLP-1 drugs may be in the same category.

When you look at the official Ozempic and Wegovy websites they say that the most common adverse reactions, reported in ≥5% of patients in their clinical trials, were nausea, vomiting, diarrhea, abdominal pain, and constipation. These side effects are fully predictable for drugs that inhibit gastric emptying and reduce gut motility. They are also easy to detect in short term clinical studies.

More recently, several reports have suggested that these drugs reduce muscle mass. This is not life-threatening, but it is concerning for older patients trying to maintain muscle mass and for anyone trying to lose weight.

That’s because your muscles are among the most metabolically active tissues in your body. When muscle mass decreases, basal metabolic rate (the rate at which you burn calories 24 hours per day) also decreases. With that in mind, you don’t need to be a genius to understand why loss of muscle mass is a concern for anyone trying to lose weight.

However, more troubling reports have recently surfaced about increases in suicidal behavior in people using GLP-1 drugs. During the company-run clinical trials only 0.27% of drug users reported an increase in suicidal thoughts or behavior, so the drug companies are saying, “Nothing to see here”. However, those clinical trials excluded patients with suicidal tendencies from their analysis, while no such exclusion is recommended for prescribing these drugs.

The authors of the study (G Schoretsanitis et al, JAMA Network Open, 7(8):e2423385, 2024) I will describe today decided to take a closer look at the association of suicidal behavior with GLP-1 drug use.

How Was This Study Done?

clinical studyThe authors obtained their data from the WHO Individual Case Safety Reports database. It is the largest database of its kind in the world, with over 28 million reports of suspected adverse drug reports from 140 member countries.

From this database they identified 107 reports of suicidal and/or self-injurious adverse drug reactions associated with the class of GLP-1 drugs that include Ozempic and Wegovy between July 2011 and August 2023. Key characteristics from these 107 reports were:

  • Median age = 48 years.
  • Percentage of female patients = 55%.
  • Length of GLP-1 use before symptoms were reported = 80 days.
  • Other medications used were primarily medications for diabetes (15.9%), depression (13.1%), and anxiety (4.7%).
  • The suicide was successful in 6.5% of the reports.
  • Suicidal thoughts and/or behaviors disappeared in 62% of the cases after discontinuing the drug.

The authors performed a statistical method known as a disproportionality analysis of suicidal thoughts and behaviors in this group of GLP-1 users. Simply put, they asked whether the frequency of suicidal thoughts or behaviors was disproportionally high for patients using GLP-1 drugs compared to all other drugs in the database for which suicidal tendencies have been reported.

In case you are thinking this is a strange comparison, let me explain why it was chosen.

  • The WHO Individual Case Safety Reports database (and similar databases maintained by the FDA and other national health organizations) only contains reports of adverse drug reactions. There is no way of comparing the number of adverse drug reactions with the number of people taking the drug. So, you cannot use the database to estimate the percentage of people using GLP-1 drugs who develop suicidal thoughts or behaviors.
  • Even if it were possible to estimate the percentage of GLP-1 users who develop suicidal tendencies, databases like this significantly undercount the percentage of adverse drug reactions. That’s because if the symptoms are mild, patients often do not report them to their doctors. And busy doctors don’t always report them to the FDA or WHO. It is primarily the cases that result in hospitalization that get reported.

Do GLP-1 Drugs Increase Suicide Risk?

For simplicity, I am restricting myself to the data in this paper related to the Ozempic and Wegovy class of GLP-1 drugs. The results with other classes of GLP-1 drugs were not as clear.

The authors reported:

  • The Ozemic/Wegovy class of GLP-1 drugs were associated with a disproportionately higher risk of suicidal thoughts and behaviors compared with other drugs in the WHO database.
  • The disproportionately higher risk remained significant when the authors looked at patients who were using the GLP-1 drugs with either antidepressants or anxiety medications.
    • The authors interpreted this as suggesting that people with anxiety or depression may be at higher risk of suicidal thoughts and behaviors when taking this class of GLP-1 drugs.

The authors concluded, “This study using the WHO database found a signal of semaglutide [the class of GLP-1 drugs that includes Ozempic and Wegovy] associated suicidal ideation [suicidal thoughts and behaviors], which requires urgent clarification.”

What Does This Study Mean For You?

Question MarkI don’t want to overemphasize the significance of this study.

  • It does not prove an association of this class of GLP-1 drugs with suicidal thoughts and behaviors.
  • It does not provide definitive information about other classes of GLP-1 drugs. There appeared to be an increased risk, but the data were not statistically significant.
  • However, it is the first study to show there might be an association with GLP-1 drugs and suicidal behavior.
    • Suicide is not a trivial side-effect, which is why the authors said it “requires urgent clarification” by future clinical studies designed specifically to address this possibility. For example, the premarketing clinical trials by the drug companies excluded patients with depression, anxiety, or suicidal tendencies. Since these are likely to be the most vulnerable group, future clinical studies should perhaps focus on this group.

As I said at the beginning of this article, we often don’t know about the most serious side effects of new drugs until they have been on the market for a few years. And it is studies like this one that are often the first indication of serious side effects.

So, here are my recommendations for you:

  • We don’t yet know for sure whether suicidal tendencies are a side-effect of GLP-1 drugs, but you need to be aware that this is a possibility.
  • If you suffer from depression, anxiety, or suicidal thoughts GLP-1 drugs may not be the best choice for you. At the very least you should discuss the risks and benefits with your doctor before using them.
  • If you are using GLP-1 drugs and experience an increase in depression, anxiety, or suicidal tendencies you should discontinue the drug immediately and report your side effects with your doctor.

My most important recommendation is that unless you are dangerously obese, you should consider healthier, drug-free approaches to losing weight. Simple changes in diet and lifestyle can give you gradual weight loss. More importantly, diet and lifestyle change can lead to permanent weight loss. And you will experience side benefits rather than side effects

The Bottom Line

GLP-1 drugs have become immensely popular for weight loss. If you believe the ads, all you need to do is to inject yourself with the drug and those excess pounds will magically appear.

However, we often don’t know about the most serious side effects of new drugs until they have been on the market for a few years. And there have been reports of increased suicide risk associated with the use of GLP-1 drugs.

A recent study looked the increased risk of suicidal thoughts and behaviors associated with the use of GLP-1 drugs. If found:

  • GLP-1 drugs were associated with a disproportionately higher risk of suicidal thoughts and behaviors compared with other drugs.
  • The disproportionately higher risk remained significant when the authors looked at patients who were using the GLP-1 drugs along with either antidepressants or anxiety medications.
    • The authors interpreted this as suggesting that people with anxiety or depression may be at higher risk of suicidal thoughts and behaviors when taking GLP-1 drugs.

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.

______________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

________________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 45 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

Quick Relief For Calf Cramps

Be Prepared When Muscle Pain Happens

Author: Julie Donnelly, LMT – The Pain Relief Expert

Editor: Dr. Steve Chaney

I hope your summer went well and that you survived Debbie and Francine without too much damage.  When Debbie came through South Florida the building where I have my office was flooded with 18” of water, and the area around Unity Church was under 3’ of water in some places!

There are long pine needles that have been blanketing my garden for several years.  They always annoyed me until I decided to just use them as mulch and get over it.

They turned out to be a blessing. As the water rushed toward my front door, it picked up the needles, which got pushed under the rubber mat at my door. Between the mat and the needles, it formed a dam, and the water rushed to both sides, but not in my office!

So, I’m working as usual even though the building is going through some construction caused by the floods.

September ended with two wonderful things happening, proving to me that I can’t stop doing my work until I have someone trained to take my place.

Pain Relief After 38 Years!

The first example was a woman who has been in terrible pain since a surgery she had in 1986.  On her first visit we were able to lower her pain level by about 90% and on her second visit it ended the pain totally.  Then muscle memory set in and, since the muscles were held tight for 38 YEARS, 2 days later they tightened up again.

She came back into the office, and it didn’t take long to release the tension and go over the self-treatments I’d taught her on her first visit.  She left feeling good. She also left feeling empowered because she felt more comfortable doing the self-treatments correctly.

A Reader Who Helped A Friend 

The second example was really interesting.  A woman named Margie, who lives in California, sent me an email.  I’ve never met her in person, and she had only read my book. But when a friend was having a severe calf cramp, Margie was able to help her.

She wrote:

“Hi Julie, I just had to share what happened this past weekend. I was at a performance of the Pasadena Symphony orchestra when my friend sitting next to me was hit with an excruciating cramp in her calf! It happened at a quieter moment during the concert and not at a time when she could stand up or do anything except be in intolerable pain!!

I was able to quickly apply the Julstro Method for cramps that you had taught me. Within moments she said the pain had subsided enough to be doable until it eventually went totally away. It made me feel so good to be able to help her.

Thank you for your great instruction to me and she thanks you also!! Needless to say, you have another fan.”

I can’t tell you how happy this message made me.  I asked her permission and then I posted it on my LinkedIn page for others to see.

You don’t need to stay in pain, you can treat the muscles. Frequently that is all that was wrong in the first place!

Quick Relief For Calf Cramps 

calf cramps remedy squeezeHere are the steps I teach for leg cramps:

1) Grip your calf muscle as shown in this picture.  This will really hurt, but a calf cramp hurts for minutes at a time, and this will shorten the time span for the cramp

Hold your hands and continue pushing the muscle together until you can begin to breathe normally again. Continue holding it another 30 seconds, bringing in as much oxygen as possible with slow, deep, breathing.

2) Release your hands and keep breathing deeply.

3) Repeat #1. This time it won’t hurt, but you are helping any last muscle fibers to complete the contraction before you move to release the spasm.

4) Begin to squeeze your entire calf as if you were squeezing water out of a thick towel. Move from the top of your calf and go down toward your ankle. This will feel good, so do it for as long as you can.

5) It is now safe to stretch your calf muscle because the cramp has completed, and you have flushed out the toxins. Stretch slowly, and don’t go past the point of “feels so good”. You don’t want to overstretch.

May it help you out with your next leg cramp and/or those you are near who suffer a leg cramp. Enjoy!

Be Prepared For When Muscle Pain Happens 

pain relief bookThis is the book that Margie has, and where she learned what to do with a calf cramp.

For only $47 you can discover how to stop pain from headaches to foot pains. You never know when you will need this valuable resource!

Click here for information on books, and other self-treatment products I’ve developed to help you stop pain FAST!

If you, or someone you know, is having chronic pain, please call me and we will work together to get relief 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.

_____________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

 _______________________________________________________________________

About The Author

Julie DonnellyJulie Donnelly has been a licensed massage therapist since 1989, specializing in the treatment of chronic pain and sports injuries. The author of several books including Treat Yourself to Pain-Free Living, The Pain-Free Athlete, and The 15 Minute Back Pain Solution.

Julie has also developed a proven self-treatment program for the symptoms of carpal tunnel syndrome.

She has a therapy practice in Sarasota, Florida, and she travels around the USA to teach massage and physical therapists how to do the Julstro Method, and she also teaches self-treatment clinics to anyone interested in taking charge of their own health and flexibility.

She may be reached at her office: 919-886-1861, or through her website: www.FlexibleAthlete.com

About The Editor

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”. Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 45 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

Is It Achilles Tendonitis Or Something Else?

Treatment For The Flexor Digitorum and Hallucis Muscles

Author: Julie Donnelly, LMT – The Pain Relief Expert

Editor: Dr. Steve Chaney

The snowbirds are long gone!  The plus is that it’s easier to get into restaurants, and the roads aren’t as crowded.  Of course, the minus is the weather. August is the hottest month of the year.

August is definitely a s-l-o-w month in Florida.  The temperature is in the mid-upper 90’s, which isn’t too bad for a Floridian, but the humidity feels like it’s 120°!

You walk out of your cool house, and it hits you like a wet washcloth, immediately making you sweat from your hair to your toes.

So, it’s time to just relax, enjoy the beach and read a good book.   And thank heaven for air-conditioning!

Helping Others

Helping HandSeveral years ago, I was curious as to who is the poorest Native American tribe in the USA.  I did a search through the internet and found that it is the Lakota Sioux who live in Pine Ridge, SD.  I found that 97% of the population has a median household income that ranges between $2,600 and $3,500 A YEAR!  That means that the median household income ranges between $215 and $290 a month!  That is appalling!

This is the United States of America, and the First Nation, who was here before any of our ancestors arrived on this land, is starving, freezing, and living in squalor.  They don’t even have running water!

There is so much more that you can read for yourself by going to https://www.truesiouxhope.org/single-post/2015/02/10/the-lakota-sioux-tribe-a-look-at-the-statistics.

The only way the Lakota Sioux are going to be able to enjoy even some of the freedoms that we take for granted, is for them to be educated so they can raise their standard of living.

With that in mind, about four years ago I started a monthly donation that is earmarked specifically for education.  I’m continuing that donation, but I want to take it a bit further.

I called Jeri Baker, the Director of www.OneSpiritLakota.org to find out how to collect the items that would help the children get an education.

Ms. Baker said that 75% of the children don’t finish high school because they are ashamed of the clothes they are wearing.

Kids/teenagers can be so cruel, making fun of them because of their poverty.

We can help!  I am setting up a box in my office and I’m asking you to help.  If you have gently used clothes, or winter coats, that are appropriate for teenagers to wear to school, or maybe a pair of new sneakers (kids really make fun of their beat-up shoes), that would be wonderful.

If you don’t have anything you can donate, perhaps you could help pay for the postage to South Dakota.  That would help so I can send more boxes.

Or if you’d rather do this on your own, go to https://www.onespiritlakota.org and you can see how you can donate directly to the tribe.

Thank you for your kindness!

Is It Achilles Tendonitis Or Something Else? 

It may feel like Achilles Tendonitis, but the area of the body that we are talking about this month is underneath your Achilles Tendon.

Especially runner’s think that they are having Achilles Tendonitis, which is caused by your calf muscles getting tight and putting pressure on the Achilles Tendon.  However, the muscles we’ll be treating are underneath your calf muscles and cause the same pattern as Achilles Tendonitis.

The muscles are the flexor digitorum longus (on left) which inserts into the bottom of your four toes

and the flexor hallucis longus (on right) which inserts into the bottom of your big toe

These muscles curl your toes down, toward your arch.

Treatment For The Flexor Digitorum and Hallucis 

Click on the link below and you can watch a video on how to self-treat both of these muscles.

https://www.capcut.com/view/7368473939858686470?workspaceId=7296693802712973318

Helping Yourself 24/7 At Home

Pain-Free AthleteYou don’t have to be an athlete to get the most out of this book!

Not only are there pictures demonstrating how to treat your entire body, but there is a LOT of information about the muscles and why they are causing problems.

There are also 4 color charts that show you where you feel the pain, and where the source of the pain is coming from.

This book also has a detailed nutrition chapter, and an exercise chapter that can be altered to fit every level of ability.

Stop rubbing on the symptoms of pain and treat the source!

https://julstromethod.com/product/pain-free-athlete-book/

And Finally, Look At This!!!! 

Julie Donnelly – TALK SHOW INTERVIEW – Fabulous with Fabio

I’m so excited!  I was interviewed by an amazing man named Fabio Marques.  It’s almost an hour long, but you may find it interesting, so I wanted to share it with you.

If you know anyone who owns a business, and whose employees do a repetitive movement, please share it with them. I want to bring the ability to stop pain FAST to millions of people.  It could change their lives!

Have a beautiful summer!

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.

____________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

 _____________________________________________________________________

About The Author

Julie DonnellyJulie Donnelly has been a licensed massage therapist since 1989, specializing in the treatment of chronic pain and sports injuries. The author of several books including Treat Yourself to Pain-Free Living, The Pain-Free Athlete, and The 15 Minute Back Pain Solution.

Julie has also developed a proven self-treatment program for the symptoms of carpal tunnel syndrome.

She has a therapy practice in Sarasota, Florida, and she travels around the USA to teach massage and physical therapists how to do the Julstro Method, and she also teaches self-treatment clinics to anyone interested in taking charge of their own health and flexibility.

She may be reached at her office: 919-886-1861, or through her website: www.FlexibleAthlete.com.

About The Editor

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”. Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 45 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

Can You Build Muscle in Your 80s?

What Does It Take to Build Muscle in Your 80s?

Author: Dr. Stephen Chaney

As we age it becomes harder to build muscle, so we start to lose muscle mass and strength, a physiological process called sarcopenia. In last week’s issue of “Health Tips From the Professor” I shared studies showing it was possible to slow, and even reverse, age-related loss of muscle mass in our 60’s and 70’s with the correct combination of resistance exercise, protein, and leucine.

But what about those of us in our 80s? Here recent studies have not been as reassuring. The results have been mixed, with some studies suggesting it is impossible to maintain muscle mass in our 80s.

But we know that it is possible for some people to maintain their muscle mass and accomplish incredible physical feats in their 80s. For example, those of you who are my age or older may remember Jack LaLanne, the so-called “Father of the Fitness Movement” who had a popular fitness show on TV from 1953 to 1985. He celebrated his 80th birthday by swimming one and a half miles in the Long Beach harbor towing 80 rowboats with 80 people in them.

Was Jack LaLanne a “freak of nature” or was it his incredible dedication and focus that allowed him to perform incredible physical feats in his 80’s? After all:

  • He ate only whole, unprocessed foods. He did not allow processed foods, fast foods, or convenience foods to cross his lips.
  • He did two hours of high-intensity workouts every day until the day before he died at age 96 in 2011.

More important is the question of what his physical feats mean for us. Does his example hold out hopes for all of us who wish to maintain our strength and vigor until the Lord calls us home? Or did he set a standard too high for mere mortals like us to achieve?

That is essentially the question that today’s study (GN Marzuca-Nassr et al, International Journal of Sports Nutrition and Exercise Metabolism, 34: 11-19, 2024) set out to answer.

The authors postulated that previous studies with subjects in their 80s came up short because they included infirm subjects in their studies and/or the intensity of exercise was too low. This study was designed to overcome those shortcomings.

How Was This Study Done?

clinical studyThe investigators recruited 29 healthy, elderly adults (9 men and 20 women) who were either 65-75 (average age = 68) or over 85 (average age = 87) who were still living in the community rather than being institutionalized for health reasons. The average BMI was 26.4 (moderately overweight) for both groups.

The participants selected for the study had not engaged in any kind of regular resistance training in the previous 6 months. The study excluded individuals with any kind of heart disease, health conditions, or physical limitations that would prevent them from participating in the resistance exercise training program associated with this study.

Participants were asked to fill in a three-day dietary recall at the beginning and end of the study. They were asked not to change their habitual dietary intake or physical activity during the study The diet recall at the end of the study showed compliance with this request. Their dietary intake was calculated based on the average of the two diet recalls.

No significant difference in macronutrient content of the diet was found between groups. For example, the 65-75 group consumed 1.1 g of protein/kg of body weight/day, and the over 85 group consumed 1.2 g of protein/kg of body weight/day.

Both groups were enrolled in a 3-times/week resistance exercise program for 12 weeks. The exercise training program was designed as follows:

  • Warm up consisted of 5-minutes on a cycle ergometer followed by full range of motion upper limb movements and one warm up set on both leg press and leg extension machines.
  • This was followed by 4 sets on the leg press and leg extension machines and 2 sets of upper body exercises (chest press, lat pulldown, and horizontal row).
  • Cool-down consisted of 5 minutes of stretching exercises.

Just prior to the study, the maximum strength on each exercise machine was determined for each participant. The intensity of their workouts was increased from 60% to 80% of that maximum over the 12 weeks of exercise training.

The outcomes of the study were as follows:

  • Quadriceps (the muscles on the front of the thigh) cross-sectional area was measured at the beginning and end of the study.
  • Whole body lean mass and appendicular lean mass (The lean mass in legs and arms) were measured at the beginning and end of the study.
  • The maximum strength for one repetition on each exercise machine was measured at the beginning and end of the study.

The increase in quadriceps cross-sectional area, lean mass, and strength was compared for the 65-75 group and the over 85 group.

Can You Build Muscle In Your 80s? 

Frail ElderlyAt the beginning of the study, the over 85 age group scored lower in every category measured in this study. For example:

  • Quadriceps cross-sectional area was 7% less in the over 85 age group than in the 65-75 age group.
  • Leg extension strength was 10% less in the over 85 age group than in the 65-75 age group.

This loss of muscle mass and strength is to be expected. Although the over 85 age group was consuming enough protein, they were not exercising on a regular basis. Consequently, they were experiencing sarcopenia, age-related loss of muscle mass.

The results of this 12-week resistance exercise intervention were impressive.

  • Quadriceps cross-sectional area increased by 10% in the 65-75 age group and by 11% in the over 85 age group. These increases were not statistically different.
    • Quadriceps cross sectional area increased for everyone in the study, but the increase varied widely from individual to individual.
    • The increase varied from 1% to 18% in the 65-75 age group and from 6% to 21% in the over 85 age group.
  • Whole body lean muscle mass increased by 2% in both the 65-75 and over 85 age groups.
  • Appendicular lean muscle mass (lean muscle mass in the arms and legs) also increased by 2% in both groups.
  • Leg extension strength increased by 38% in the 65-75 age group and by 46% in the over 85 age group.
    • Once again, the increase in leg extension strength varied considerably from individual to individual. The increase varied from 5% to 76% in the 65-75 age group and from 26% to 70% in the over 85 age group.
  • Similar results were seen for leg press, lat pull down, chest press, horizontal row, and grip strength.

The authors concluded, “Prolonged [12 week] resistance exercise training increases muscle mass, strength, and physical performance in the aging population, with no differences between 65-75 and 85+ adults. The skeletal muscle adaptive response to resistance exercise training is preserved even in male and female adults older than 85 years.”

What Does It Take To Build Muscle In Your 80s?

Why did this study show a benefit of resistance exercise for building muscle mass in octogenarians when previous studies have come up short? The authors postulated this was due to differences in the subjects included in the study and the intensity, frequency, and duration of resistance exercise.

  • This study included only healthy, community dwelling seniors who could engage in a rigorous training program. Some previous studies included institutionalized seniors who may have been less healthy and more frail.
  • The resistance exercise training used in this study involved multiple sets on exercise machines three times a week at 60-80% of maximum intensity for a total of 12 weeks. Previous studies included 1-2 sets, once or twice a week, at lower intensity, and for a shorter duration.

Much more research needs to be done, but the take-home lessons appear to be:

1) It is possible to increase muscle mass in your 80s with sufficient protein and a sufficiently intense resistance exercise program.

2) Not every 80-year-old adult will be able to increase their muscle mass. At the very least, this and previous studies suggest that frail, institutionalized men and women in their 80s may not be able to increase their muscle mass.

    • Whether this is because their health conditions interfere with their muscle’s ability to build muscle, or they are simply unable to perform the high intensity exercises required to build muscle mass in their 80’s is unclear. More research is needed. While everyone in this study increased muscle mass and strength, the increase varied widely from individual to individual (see above).

My guess is that some of the people in the study did not get enough protein in their diet to support an increase in muscle mass at 85 and older. The over 85 group averaged 1.2 gm of protein/kg body weight/day, but their intake ranged from 0.8gm/kg/day to 1.6 gm/kg/day.

However, the difference in gain of muscle mass and strength could have been due to almost anything. Unfortunately, this study was too small to reliably determine what caused the differences in response to the resistance training.

3) It may require a high intensity resistance exercise program to increase muscle mass in your 80s. Unfortunately, there are very few studies like this for people in their 80s. All we know is that this was a high intensity, high frequency, and long duration resistance exercise program, and it worked. Studies with lower intensity exercise programs have not worked. But nobody has done a study comparing the effectiveness of different intensity exercise programs for people in their 80s.

4) There are too few studies on what it takes for people in their 80s and beyond to stay fit and healthy. The authors of this report argued that this information is vital for guiding government programs designed to support an aging population. It is equally important for all of us who want to remain fit and healthy in our 80s and beyond.

What Does This Study Mean For You?

good news bad newsIn my previous “Health Tips From the Professor” I have discussed multiple studies looking at sarcopenia or age-related muscle loss.

The bad news is that we start losing muscle mass and strength around age 50, and the rate of decline starts to accelerate in our 60s and beyond. This is a normal part of aging. It affects all of us. And if left unchecked, it can have devastating effects on our quality of life in our golden years.

The good news is that we can slow and even reverse the age-related loss of muscle mass by a combination of adequate intake of protein, adequate intake of the essential amino acid leucine, and resistance exercise. Leucine intake is usually adequate when we rely on animal proteins as our main protein source but may be a concern if we rely primarily on plant proteins. So, let’s take a deeper look at protein and exercise requirements.

  1. We need more protein to build muscle in our golden years than we did in our 30s. If you want more information on the studies supporting that statement, go to https://chaneyhealth.com/healthtips/ and type sarcopenia in the search box. Most experts in this field of study recommend around 1.2 gm of protein/kg of body weight/day rather than the RDA of 0.8 gm of protein/kg of body weight/day for people 65 or older who wish to maintain or increase muscle mass. This study suggests that 1.2 gm/kg/day is also sufficient for people who are 85 and older.

Previous studies have shown that the protein is best utilized to preserve muscle mass when it is spread evenly through the day. That is a concern because many seniors get most of their protein in the evening meal. The article I shared last week showed that adding 20 grams of supplemental protein to the low-protein meals (typically breakfast and/or lunch) was sufficient to balance protein intake and minimize age-related muscle loss.

[Note: To help you with the calculations, 1.2 gm of protein/kg of body weight/day is equal to 0.54 gm of protein/pound of body weight/day. Some quick calculations show that amounts to 78 grams if you weigh 140, 95 grams if you weigh 170, and 112 grams if you weigh 200. Or to simplify, that amounts to 25-30 grams of protein/meal for most people – more if you weigh above 170 pounds.]

2) We need a higher intensity of resistance exercise to build muscle in our golden years than we did in our 30s. Several previous studies have hinted at that possibility. This study shows that a high intensity resistance exercise program is effective at building muscle mass for people 85 and above. Previous studies suggest that lower intensity exercise programs are not effective in this age group. 

This is an important finding because it is opposite to the usual recommendations for this age group. In the words of the authors, “At an advanced age, people are generally recommended to partake in low-intensive physical activities. We strongly advocate that resistance exercise should be promoted without restriction to support more active, healthy aging.”

Of course, the caveat is that this study excluded frail, institutionalized adults and people with health or physical limitations that would prevent them from participating in a high-intensity resistance exercise program.

So, here are my recommendations:

  • Discuss your desire to implement a high intensity resistance exercise program with your health professional. Ask them about any health issues or physical limitations that would affect the exercises you choose.
  • Ask your health professional to refer you to a physical therapist to design a high-intensity exercise program you can do at home that is appropriate to your health and physical condition. If the referral comes from your health professional, these sessions may be covered by insurance.
  • If you want to utilize the exercise equipment in a gym, start by having a personal trainer knowledgeable about working with people like you design a workout program for you. My personal preference is to continue working with a personal trainer who challenges me to maximize the intensity of my training while taking into account any temporary physical limitations I may be experiencing.

Finally, I recognize that the exercise program described in this study may be too intense for many of my readers. But I also suspect that none of you want to become so frail you can’t enjoy your golden years. So, do what you can. But do something.

The Bottom Line

Most Americans lose lean muscle mass as they age, a physiological process called sarcopenia. This loss of muscle mass leads to reduced mobility, a tendency to fall (which often leads to debilitating bone fractures) and a lower metabolic rate – which leads to obesity and all the illnesses that go along with obesity.

Fortunately, sarcopenia is not an inevitable consequence of aging. There are 3 things we can do to prevent it.

  • Optimize resistance exercise training.
  • Optimize protein intake.
  • Optimize leucine intake.

Last week I talked about optimizing protein and leucine intake. This week I review an article that compared the effectiveness of a 12-week high intensity resistance exercise program for increasing muscle mass and strength with people in the 65-75 age group with those who were age 85 and above.

The results of this 12-week resistance exercise intervention were impressive.

  • Quadriceps cross-sectional area increased by 10% in the 65-75 age group and by 11% in the over 85 age group. These increases were not statistically different.
  • Whole body lean muscle mass increased by 2% in both the 65-75 and over 85 age groups.
  • Leg extension strength increased by 38% in the 65-75 age group and by 46% in the over 85 age group.
  • Similar results were seen for leg press, lat pull down, chest press, horizontal row, and grip strength.

The authors concluded, “Prolonged [12 week] resistance exercise training increases muscle mass, strength, and physical performance in the aging population, with no differences between 65-75 and 85+ adults. The skeletal muscle adaptive response to resistance exercise training is preserved even in male and female adults older than 65 years.”

“At an advanced age, people are generally recommended to partake in low-intensive physical activities. We strongly advocate that resistance exercise should be promoted without restriction to support more active, healthy aging.”

For more details about 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.

______________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

 ______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”. Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 45 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

Optimizing Protein Intake For Seniors

The Role Of Muscle Protein In Energy Metabolism 

Author: Dr. Stephen Chaney 

We’ve been told, It’s all downhill after 30.” That may or may not be true depending on the lifestyle choices we make.

But for muscle mass, “It’s all downhill after 50!” Simply put, we start to lose muscle mass at an accelerating pace after 50, a process scientists call sarcopenia.

Sarcopenia should be a major concern for everyone over 50. Loss of muscle mass:

  • Causes unsteadiness which can lead to falls, bone fractures, and death.
  • Increases the risk of obesity because muscle burns more calories than fat. That increases our risk of obesity-related diseases such as heart disease, diabetes, some cancers, osteoarthritis, and other inflammatory diseases.
  • Robs us of the fun activities we would like to enjoy in our golden years.

But sarcopenia is not inevitable. As I have discussed in previous issues of “Health Tips From the Professor”, there are three things we can do to minimize sarcopenia as we age.

  • Get adequate weight-bearing exercise. In other words, pump iron or use your body weight.
  • Get adequate protein.
  • Get adequate amounts of the branched-chain amino acid leucine.

In this article I will focus on the last two, especially the fact that we need more protein and leucine to prevent loss of muscle mass as we age. To help you understand why that is, I am going to share my favorite topic – Metabolism 101 (Once a biochemistry professor, always a biochemistry professor).

Metabolism 101: The Role Of Muscle Protein In Energy Metabolism 

ProfessorMost people associate muscle mass with strength and endurance. Many understand the important role muscle mass plays in burning off excess calories and keeping us slim. But few people understand the important role that muscle protein plays in our everyday energy metabolism.

Let’s start with an overview of metabolism [Note: If you are not interested in this, you can just skip over the bullets and read the take-home message at the bottom of this section.]

  • We get energy from the carbohydrate, fat, and protein we consume. Excess carbohydrate, fat, and protein in our meals are stored to provide the energy our body needs between meals and during prolonged fasting.
    • We have a virtually unlimited ability to store fat, as some of you may have noticed.
    • We have a very limited ability to store carbohydrates in the form of glycogen in our liver.
    • Our ability to store protein is even more limited, even when protein intake is coupled with exercise. And muscle protein plays other very important functions. It is a precious resource.
    • Finally, any carbohydrate and protein beyond our body’s ability to store it is converted to and stored as fat.
  • In the fed state most of our energy is derived from blood glucose. This is primarily controlled by the hormone insulin. As blood glucose levels fall, we move to the fasting state and start to call on our stored energy sources to keep our body functioning. This process is primarily controlled by a hormone called glucagon.
    • In the fasting state most tissues easily switch to using fat as their main energy source, but…
      • Red blood cells and a few other tissues in the body are totally dependent on glucose as an energy source.
      • Initially our brain is totally dependent on glucose as an energy source, and our brains use a lot of energy. [Note: Our brain can switch to ketones as an energy source with prolonged starvation or prolonged carbohydrate restriction, but that’s another story for another day.]
  • Because our brain and other tissues need glucose in the fasting state, it is important to maintain a constant blood glucose level between meals.
    • Initially, blood glucose levels are maintained by calling on the glycogen reserves in the liver.
    • But because these reserves are limited, our body starts to break down muscle protein and convert it to glucose as well – even in the normal dinner/sleep/breakfast cycle.

You may have found the explanation above was excessive, but I couldn’t think of a simpler way of helping you understand that in addition to its other important role in the body, muscle protein is also an energy store.

When we eat, we make a deposit to that energy store. Between meals we withdraw from that energy store. When we are young the system works perfectly. Unless we fast for prolonged periods of time, we are always adding enough muscle protein in the fed state to balance out the withdrawals between meals.

But as we age, our ability to build muscle in the fed state becomes less efficient. Withdrawals exceed deposits, and we experience age-related muscle loss (sarcopenia).

What We Know About Preventing Age-Related Muscle Loss 

As I said above, there are three things needed to prevent age-related muscle loss:

  • Adequate resistance exercise.
  • Adequate amounts of protein.
  • Adequate amounts of the essential, branched-chain amino acid called leucine.

And, as I said above, I am going to focus on the last two.

In previous issues of “Health Tips From the Professor” I have shared articles showing that the amount of both protein and leucine needed to maximize the gain in muscle mass following a meal or a workout increase as we age. For example:

  • For someone in their 30s, 15-20 grams of protein with 1.7 grams of leucine per meal is optimal.
  • But someone in their 60’s and 70s needs 25-30 grams of protein and 2.5-2.7 grams of leucine per meal to achieve the same effect.
  • Most of these studies have been done with men, but a recent study showed the results are identical with post-menopausal women.

However, previous studies have not addressed the role of protein supplementation in achieving adequate protein intake or what kind of protein supplements were best. The studies I will discuss today were designed to answer these questions.

How Were These Studies Done? 

clinical studyStudy #1: As I said above, previous studies have suggested that 25-30 grams of protein per meal is optimal for preventing age-related loss of muscle mass in seniors. However, many seniors get most of their protein in their evening meal. On average, seniors consume 8-15 grams of protein at breakfast, 15-20 grams of protein at lunch, and 30-40 grams of protein at dinner.

This study (C Norton et al, The Journal of Nutrition, 146: 65-67, 2016) was designed to ask whether optimizing protein intake at each meal by adding a protein supplement at breakfast and lunch would increase lean muscle mass in seniors over a 24 week period.

The investigators recruited 60 adults, aged 50-70 (average age = 61) from the city of Limerick, Ireland. The participants were 73% women and had an average BMI of 25.8 (slightly overweight).

The participants were randomly assigned to receive either a milk-based supplement or an isocaloric, non-protein containing, maltrodextrin control. The protein supplement provided 15 grams of protein. The participants were instructed not to change any other aspect of their diet or activity level.

The protein supplement and placebo were provided in identical sachets and the participants were told to mix them with water and consume them with breakfast and lunch. The protein supplement and placebo looked and tasted identical, so the subjects did not know which group they were in. Compliance was assessed by collecting the used sachets at the end of the study.

The participants completed 4-day diet recalls under the supervision of a dietitian before and during the study. Lean muscle mass was determined prior to and at the end of the 24-week study.

protein shakesStudy #2: This study (J McKendry et al, The American Journal Of Clinical Nutrition, doi: 10.1016/j.ajcnut.2024.05.009) was designed to determine whether the ability to stimulate muscle protein synthesis depended on the type of supplemental protein.

This study was built on the results of the first study. Specifically, the investigators compared the effect on muscle protein synthesis of adding 25 grams of whey, pea, or collagen protein to the breakfast and lunch meals.

The investigators enrolled 31 healthy, older (average age = 72) subjects from the Hamilton, Ontario area. Subjects were excluded from the study if:

  • They had a medical condition or were taking any medication that might influence the results.
  • They used tobacco or tobacco related products.
  • They consumed a vegan or vegetarian diet
  • They used a walking device or were inactive for any reason.

The participants were placed on a standardized diet consisting of prepackaged meals (breakfast, lunch, and dinner) and a mix of fruits, vegetables, snacks, and drinks. They were instructed to only eat the foods provided to them and to maintain their normal activity levels.

The diet was designed to provide the RDA for protein (0.8 gram of protein/kilogram of body weight) and to mimic the habitual dietary patterns of seniors in the United States and Canada.

  • Around 55% carbohydrate, 30% fat, and 15% protein.
  • Uneven distribution of protein through the day (19% at breakfast, 26% at lunch, and 55% at dinner).

After one week on the control diet, participants were randomly assigned to receive 25-gram protein supplements of either whey, pea, or collagen protein and instructed to add them to their standardized diet for breakfast and lunch (total protein intake was increased by 50 grams/day). They followed this regimen for 7 days.

On day one and 7 of the control phase and on day 7 of the intervention phase (when the participants were consuming additional protein) muscle biopsies were obtained 90 minutes after breakfast for determination of the effect of the meal on muscle protein synthesis.

[Note: The participants were consuming a protein supplement containing an additional 25 grams of protein at both breakfast and lunch. But the effect of this additional protein on protein synthesis was only determined after the breakfast meal.]

Optimizing Protein Content For Seniors 

Each of the studies provided important insights for anyone wanting to minimize age-related muscle loss.

Study #1: The effect of the whey protein supplement for breakfast and lunch on protein intake was as follows:Optimize

Protein Intake In Grams
Meal Baseline Plus Protein Supplement
Breakfast 15 27
Lunch 22 34
Dinner 38 38
Snacks 8 7
Total 83 106

[Note: The amount of additional protein from diet and supplementation averaged around 12 grams/meal instead of 15 grams in the supplemental protein provided. The investigators did not address this, but I suspect the participants may have cut back on their regular food intake because the protein supplement reduced their appetite.]

The results were clear cut:

  • Protein supplementation at breakfast and lunch resulted in a 1.3-pound gain in lean body mass over 24 weeks compared to the control group using an isocaloric, non-protein containing maltodextrin supplement.

The authors concluded, “Protein supplementation at breakfast and lunch for 24 weeks in healthy older adults resulted in a positive (1.3 pound) difference in lean muscle mass compared with an isoenergetic, nonnitrogenous maltodextrin control. These observations suggest that an optimized and balanced distribution of meal protein intakes could be beneficial in the preservation of lean tissue mass in the elderly.”

I would add two things:

  • This study did not show that these protein levels were optimal. It only showed that using a protein supplement to increase protein intake at breakfast and lunch was beneficial for seniors consuming most of their protein at dinner.
  • This study also did not show that a total intake of 106 grams of protein in the supplemented group was necessary for maintaining lean muscle mass.

If the 83 grams of protein in the control group were evenly divided between breakfast, lunch, and dinner it would have come to almost 28 grams of protein per meal. That would fall within the 25-30 grams of protein per meal that most experts feel is sufficient to help seniors prevent age-related loss of lean muscle mass.

Study #2: The effect of the three protein supplements at breakfast and lunch on protein intake was as follows:

Protein Intake In Grams
Protein Source Control Phase Supplemental Phase
Collagen 70 112
Whey Protein 68 108
Pea Protein 64 104

[Note: The amount of additional protein from the control diet plus supplementation averaged around 40 grams/meal instead of 50 grams in the supplemental protein provided. This means that study participants were actually consuming an extra 20 grams of protein at breakfast and lunch.]

Again, the results were clear cut:

  • Adding ~20 grams of either whey or pea protein to a relatively low-protein (15 grams) breakfast increased muscle protein synthesis by ~9%.
  • Adding ~20 grams of collagen to the same low-protein breakfast had no effect on muscle protein synthesis.

The authors concluded, “We discovered that the RDA [for protein] was insufficient to support higher rates of MPS [muscle protein synthesis] in older adults. Manipulating dietary protein to increase daily consumption of higher quality – whey and pea but not collagen – proteins by targeting the lowest protein-containing meals offers a viable strategy to enhance…MPS in older adults.”

“Consuming protein much closer to expert group consensus recommendations [1.2 gm/kg instead of the current 0.8 gm/kg for adults over 50] may help to increase…MPS with advancing age and extend health-span – compressing the years of disease and disability commonly experienced by older individuals closer to the end of life.”

My comments are:

  • You may recall from the previous discussion that age-related muscle loss occurs because muscle protein synthesis (MPS) becomes less efficient as we age.
    • Therefore, an increase in muscle protein synthesis following each meal will lead to an increase in muscle mass over time, such as was seen in the first study.
  • In our 60’s and beyond we require higher amounts of both protein and leucine to maximize muscle protein synthesis.
  • The collagen supplement used in this study provided enough supplemental protein. But it probably was ineffective because it only provided 0.86 grams of leucine.
    • The amount of leucine in the control diet was not specified, but with only 15 grams of protein for breakfast there was probably enough leucine to make up for the lack of leucine in the collagen supplement.
  • In contrast the whey and pea supplements provided 2.7 and 2.1 grams of leucine, respectively. When added to the leucine in the control diet, this would be more than enough to drive muscle protein synthesis.
    • Not every pea protein supplement may be as effective as the one used in this study. When I looked it up, it was described as an “enriched pea protein designed as a soy and milk alternative.” The manufacturer did not say how it was “enriched”, but I suspect it was enriched by adding extra leucine.
  • Finally, this study does not show that seniors need to consume more than 100 grams of protein per day. It simply shows that adding an extra 20 grams of supplemental protein to a low-protein meal can help maximize muscle protein synthesis and minimize age-related muscle loss.

What Do These Studies Mean For You? 

Don’t Leave Out Resistant Exercise. These studies were focused on the timing and quality of protein. But don’t forget that adequate protein and leucine are only two of the requirements for preventing age-related muscle loss. The third, and arguably the most important, is resistance exercise.

Aim for at least three 30-minute resistance exercise sessions per week. If you have physical limitations consult with your health professional about the type, duration, and intensity of resistance exercise that is right for you.

Forget What You Have Been Told About Protein. You have been told that American consume too much protein. That’s probably true for the average couch potato. But it is not true for seniors. The average American does consume too much of the wrong kind of protein, but that’s another story for another day.

You have been told that the average woman only needs 46 grams of protein per day and the average man needs only 56 grams of protein per day. That’s based on the RDA of 0.8 gm/kg (0.36 gm/pound) and an average weight of 127 pounds for women and 155 pounds for men.

We haven’t weighed that since the 50’s. Today the average woman weighs 170 pounds, and the average man weighs 201 pounds. That means protein intake should be at least 61 gm/day for women and 72 gm/day for men.

But that’s only if you are in your twenties or thirties. The consensus among those who study protein needs in seniors is that the RDA should be 1.2 gm/kg (0.54 gm/pound) for adults over 50. That’s 91 gram/day and 108 grams/day, respectively, for average weight women and men.

With that perspective, it is easy to understand the recommendation that seniors get 25-30 grams of protein and 2.5-2.7 grams of leucine per meal. That’s 75-90 grams of protein and 7.5-8.1 grams of leucine per day. But that is probably not what you are hearing from your doctor.

CerealWhy Is Supplemental Protein Important? It’s easy to say that seniors should get 25-30 grams of protein per meal, but that’s not the way most seniors eat.

When I was a child growing up in Alabama the standard breakfast was eggs, ham, grits with ham gravy and biscuits. I’m not saying that was a healthy breakfast, but it was the standard breakfast where I lived at the time. And it provided plenty of protein.

In today’s world most seniors have been told to avoid eggs and red meat. Breakfasts are more likely to be some type of cereal with a fruit garnish and perhaps some toast. That’s a much healthier breakfast, but it’s a low-protein breakfast. That’s why most seniors only get 8-15 grams of protein at breakfast time.

I won’t go into lunches, but similar transformations have taken place at lunch time.

So, if you want to avoid age-related muscle loss you have two choices:

  • Completely change your diet and incorporate more healthy protein foods into your breakfast and lunch menus or…
  • Add a protein supplement to your low-protein meals. The second study suggests that 20 grams of supplemental protein will be sufficient to transform a low-protein meal into one that will support muscle protein synthesis and minimize age-related muscle loss.

Why Is Protein Quality Important? The second study shows that having enough protein is not sufficient to stimulate muscle protein synthesis. It must be high quality protein.

The authors of the study suggested that collagen did not stimulate muscle protein synthesis due to its low leucine content.

And, as I mentioned earlier, the pea protein used in the study was “enriched” so it could be used as a “whey or soy alternate”, and the “enrichment” probably included adding extra leucine.

So, if you are planning to use a plant protein supplement with your low-protein meal(s), I would recommend choosing one with added leucine.

How Much Protein Is Too Much? The ability of a protein meal and/or supplement to stimulate muscle protein synthesis begins to plateau at around 30 grams of protein, so there is little advantage to protein intakes above 30 grams at one time. And as I said above, excess protein is stored as fat.

What About An After-Workout Supplement? Previous studies have shown that the numbers are about the same for after-workout supplements.

  • For someone in their 30s, 15-25 grams of protein with 1.7 grams of leucine per meal is enough to maximize muscle gain after a workout.
  • But someone in their 60s or 70s needs 25-30 grams of protein and 2.5-2.7 grams of leucine per meal to maximize muscle gain.
  • After-workout supplements can also be designed to optimize the insulin response, but that is another story for another day.

One Final Pearl

At the very beginning of this article, I told you that the breakdown of muscle protein to keep blood sugar levels constant during fasting and starvation was driven by a hormone called glucagon.

And the active ingredient in the latest weight loss drugs like Wegovy, Ozempic, and Trulicity is GLP-1, which stands for glucagon-like peptide-1.

So, it should be no surprise that those drugs cause loss of muscle mass. That’s a side effect you probably haven’t been told about.

The Bottom Line 

It’s all downhill after age 50! That’s when we start to experience age-related muscle loss, something called sarcopenia.

Age-related muscle loss can be prevented with resistance exercise, adequate protein, and adequate leucine. And the amount of both protein and leucine we need to prevent muscle loss increases as we age.

Previous studies have defined the amount of protein and leucine we need to prevent muscle loss in our 60s and 70s. The studies described in today’s health tip show the benefit of adding a protein supplement to our low-protein meals and the importance of a high-quality protein supplement for minimizing age-related muscle loss.

For more information on these studies and what they mean 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.

_____________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 45 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

Treatment For Shin Splints

What Causes Shin Splints?

Author: Julie Donnelly, LMT – The Pain Relief Expert

Editor: Dr. Steve Chaney

HotJuly is here and Florida is hot! The “Snowbirds” have gone north to the cooler weather (a goal of mine!) and life is moving in the slow lane.

For me, the slow down time is giving me the opportunity to work on some big projects such as my self-treatment videos and my information videos explaining all kinds of info about muscles and pain.  In future months my newsletter will have one of those explanatory videos, and 1-2 self-treatment videos that relate to the topic being discussed.

This month’s topic is on Shin Splints. I hope you enjoy all the outdoor activities that go with the month of July. This newsletter will help you deal with the shin splints that go along with some of those outdoor activities.

What Are Shin Splints?

If you are a runner, play any sport that involves a lot of running, or if you drive for long distances, you may have experienced pain &/or burning along the front of your leg, next to your shin bone.  This pain is commonly called Shin Splints.

I’ve searched all through the internet and while I’ve found LOTS of articles about the cause of shin splints, the definition of shin splints, and treatments such as rest, ice, various meds, etc., I’ve never found anything that resembles the self-treatment I’ve been teaching for years and that is in each of my books.

I’m going to share that self-treatment with you. A plus is the treatment for the muscle that causes shin splints is also one of the main muscles that cause plantar fasciitis.  So, you may get some pain relief that you weren’t even expecting.

What Causes Shin Splints?

The Tibialis Anterior muscle cause shin splints. The tibialis anterior muscle runs along the outside of your shin bone (the tibia bone), merges into a tendon at your lower leg, crosses over your ankle and then inserts into your arch.  When it contracts, it lifts your foot and rolls it toward the outside.  Because of these attachments, it is also a key muscle in a sprained ankle and in plantar fasciitis, but these are topics for different newsletters.

The muscle fibers are directly on your shin bone, so when they are tightening due to a repetitive strain, such as running or pressing down on the gas pedal while driving long distances, they start to tear off the bone.  You can visualize this by considering how you rip meat off a bone while eating a steak or spareribs.

As the muscle is slowly tearing away from the bone you feel pain along the entire length of the bone, and it really hurts!  Fortunately, it’s easy to release the tension in the muscle. Plus, as you’re doing the self-treatment I’m showing you, you are pressing the fibers back on to the bone, so it stops them from ripping away completely.

Relief From Shin Splints

You can get immediate relief from shin splint pain by treating your tibialis anterior muscle.

Begin to warm up the muscle by putting your leg straight out and running your opposite heel down the length of the muscle.

Right at the point where the picture is showing the model’s heel on her leg is the point where you’ll find the most sensitive trigger point.

Continue from just below your knee to just above your ankle joint.

Next kneel down as shown in the picture on the right, placing the ball at the top of the muscle and right next to your shin bone.

Notice the way his toes are bent.  This will help prevent your arch from feeling like it’s going to cramp as the muscle pulls on the insertion point

Begin to move your leg so the ball is rolling down toward your ankle.  Stop when you find a tight point.

When you get to your ankle you can roll back up toward your knee again.  Ultimately it won’t hurt, but if it’s especially painful in the beginning just lighten up on the pressure.  You may even need to lift your leg off the ball at first which will allow blood to come into the muscle fiber and help lessen the tension.

This technique has helped so many people over the years, I know it will help you too!

Snowbirds And Clients Around The World – Zoom Consultations Are Available

I’ve successfully worked with people around the world for many years.

I also love working with Snowbirds who are in Sarasota all winter, and then head north when it gets hot here.  It’s so nice to see you, and to help you stop aches and pains.

The way we work together is simple:

  1. You go to https://julstromethod.com/product/one-on-one-zoom-consultation/ and order a private consultation.
  1. You send me an email explaining what is wrong, where you feel the pain, what you’ve done to treat it so far, etc., etc. Don’t tell me about medications because that is far out of my scope of practice so I can’t give any advice about them.
  1. We meet on Zoom and work together to find and eliminate the source of your pain.
  1. You receive the Zoom recording so you can watch it again later to refresh your memory about the treatments.

All this for only $147.

Have a beautiful summer!

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.

About The Author

Julie Donnelly has been a licensed massage therapist since 1989, specializing in the treatment of chronic pain and sports injuries. The author of several books including Treat Yourself to Pain-Free Living, The Pain-Free Athlete, and The 15 Minute Back Pain Solution.

Julie has also developed a proven self-treatment program for the symptoms of carpal tunnel syndrome.

She has a therapy practice in Sarasota, Florida, and she travels around the USA to teach massage and physical therapists how to do the Julstro Method, and she also teaches self-treatment clinics to anyone interested in taking charge of their own health and flexibility.

She may be reached at her office: 919-886-1861, or through her website: www.FlexibleAthlete.com

About The Editor

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”. Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 45 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

How Much Leucine Do Seniors Need?

Where Can Seniors Find The Protein And Leucine They Need?

Author: Dr. Stephen Chaney 

Frail ElderlyMost Americans lose lean muscle mass as they age, a physiological process called sarcopenia. There are three factors that influence the rate at which we lose muscle mass as we age:

  • Our physiology changes. Our bodies break down our protein stores more rapidly and we have a harder time utilizing the protein in our diet to replenish those protein stores.
  • We become less active. In some cases, this reflects physical disabilities, but all too often it is because we are not giving weight-bearing exercises the proper priority in our busy lives.
  • Our diets have become inadequate. A major driver of this phenomenon is loss of appetite which results in decreased caloric intake. However, physical disability, isolation, and insufficient income also contribute.

Some of you may be saying “So what? I wasn’t planning on being a champion weightlifter in my golden years.” The “So what” is that loss of muscle mass leads to reduced mobility, a tendency to fall (which often leads to debilitating bone fractures) and a lower metabolic rate – which leads to obesity and all the illnesses that go along with obesity.

Fortunately, sarcopenia is not an inevitable consequence of aging. There are things that we can do to prevent it. The most important thing that we can do to prevent muscle loss as we age is to exercise – and I’m talking about resistance (weight) training, not just aerobic exercise.

But we also need to optimize our protein intake and our leucine intake. Protein is important because our muscle fibers are made of protein.

Leucine is an essential amino acid. It is important because it stimulates the muscle’s ability to make new protein. Leucine and insulin act synergistically to stimulate muscle protein synthesis after exercise.

In a previous issue of “Health Tips From the Professor” I shared studies showing that the amount of protein and leucine we need to prevent muscle loss increases as we get older. The study (ME Lixandrao et al, Nutrients, Volume 13, Issue 10, 10.3390/nu13103536) I am reviewing today is an update on the leucine needs for seniors.

How Was This Study Done?

clinical studyThe investigators recruited 67 healthy, elderly, overweight adults (34 men and 33 women; average age = 69.7; average BMI = 26.4) in Basel, Switzerland for the study. The participants selected for the study were not engaged in any kind of regular resistance or aerobic training in the previous 6 months.

Participants were asked to fill in three 24-hour dietary recalls (2 on non-consecutive weekdays and one on a weekend day). A trained nutritionist gave instructions on how to perform the dietary recalls. After the dietary recalls were completed, the nutritionists used pictures of foods included in each participant’s diet recall to confirm the accuracy of their portion size estimates. This diet information was used to calculate habitual daily protein and leucine intake.

The investigators used magnetic resonance imaging (MRI) to measure quadriceps cross-sectional area – a measure of muscle mass. They also used performance on a leg extension machine to measure unilateral maximum dynamic muscle strength – a measure of muscle strength.

The study correlated leucine intake with both muscle mass and muscle strength. The data were corrected for sex, age, and total protein intake normalized to body weight.

How Much Leucine Do Seniors Need? 

leucineThere was a biphasic correlation between leucine intake and both muscle mass and muscle strength in this population.

  • There was a positive association between leucine intake and muscle mass up to 7.6 gm/day. After that a plateau was reached. Additional leucine had no effect on muscle mass.
  • There was a positive association between leucine intake and muscle strength up to 8.0 gm/day. After that a plateau was reached. Additional leucine had no effect on muscle strength.
  • These associations held true even after correcting for total protein intake. This is an important control because none of these participants were taking a leucine supplement, so those consuming more leucine were also consuming more protein.

The authors concluded, “We demonstrated that total daily leucine intake is associated with muscle mass and strength in healthy older individuals, and this association remains after correcting for multiple factors, including overall protein intake. Furthermore, our…analysis revealed…a potential threshold for habitual leucine intake, which may guide future research on the effect of chronic leucine intake in age-related muscle loss [sarcopenia].

Randomized control trials should test the utility of additional leucine to counteract frailty in the elderly.”

What Does This Study Mean For You?

ConfusionLet me start by saying that leucine is not a “magic bullet” that will prevent sarcopenia (age-related loss of muscle mass) by itself. Three things are essential for preventing sarcopenia:

  • Resistance (weight bearing) exercise. You should aim for at least 3 days/week of moderate intensity weight bearing exercise a week.

If you have physical limitations, consult with your health professional before beginning an exercise program. And if you have not done weight bearing exercise before, it is best to start with instruction from a personal trainer to be sure you are using appropriate weights and appropriate form.

[Note: The participants in this study had not done weight bearing exercise for 6 months prior to the study and did not exercise during the study.]

  • Adequate protein. I have discussed this in a previous issue of “Health Tips From the Professor”. If you are in your 30’s, 15-20 grams of protein per meal will do. But if you are in your 60’s and above, it’s better to aim for 25-30 grams of protein per meal.

[Note: On average the men in this study were consuming 87 grams of protein per day. That’s 29 grams per meal. The women in this study averaged 67 grams of protein per day or 22 grams per meal. So, most of the participants in this study were consuming adequate protein.]

  • Adequate leucine. This study showed that the benefits of leucine plateaued at around 7.6-8.0 grams per day or 2.5 to 2.7 grams per meal for non-exercising adults in their 60’s and 70’s.

This is in close agreement with studies showing that 25-30 grams of protein and 2.7 grams of leucine were optimal for seniors in this age range following weight bearing exercise.

[Note: This study only determined the optimal intake of leucine. Remember for maximal effectiveness at reducing age-related muscle mass (sarcopenia) you need optimal protein, optimal leucine, and an optimal resistance (weight bearing) exercise program.]

Where Can Seniors Find The Protein And Leucine They Need?

For most Americans this is not too difficult as the table above shows. If you look at single foods, chicken and soybeans are the best sources of both protein and leucine. Other meats and other beans & legumes are also good choices.

I included things like eggs, dairy foods, broccoli, and spinach as a reminder that you don’t need to get all your protein and leucine from a single food source. Other whole foods included in your meal can contribute to your protein and leucine totals.

This table also shows that you don’t need to be a carnivore to get the protein and leucine you need. However, if you avoid most meats or are a pure vegan, you will need to plan your diet a bit more carefully.

Finally, if you are looking to optimize your workouts with an after-workout plant-based protein shake, soy protein would be your best choice. If you chose plant protein, you should look for high-quality protein shakes with added leucine to make sure you meet both your protein and leucine goals.

The Bottom Line

Most Americans lose lean muscle mass as we age, a physiological process called sarcopenia. This loss of muscle mass leads to reduced mobility, a tendency to fall (which often leads to debilitating bone fractures) and a lower metabolic rate – which leads to obesity and all the illnesses that go along with obesity.

Fortunately, sarcopenia is not an inevitable consequence of aging. There are 3 things we can do to prevent it.

  • Exercise – and I’m talking about resistance (weight) training, not just aerobic exercise. This is the most important thing that we can do to prevent muscle loss as we age.
  • Optimize our protein intake.
  • Optimize our leucine intake.

Previous studies have determined the optimal protein intake for preventing sarcopenia. The study I describe above determined the optimal leucine intake.

For more details about 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.

______________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

 ______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”. Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 45 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

Health Tips From The Professor