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Do High Protein Diets Reduce Fat And Preserve Muscle?

Author: Dr. Stephen Chaney

Are high protein diets your secret to healthy weight loss? There are lots of diets out there – high fat, low fat, Paleolithic, blood type, exotic juices, magic pills and potions. But recently, high protein diets are getting a lot of press. The word is that they preserve muscle mass and preferentially decrease fat mass.

If high protein diets actually did that, it would be huge because:

• It’s the fat – not the pounds – that causes most of the health problems.

• Muscle burns more calories than fat, so preserving muscle mass helps keep your metabolic rate high without dangerous herbs or stimulants – and keeping your metabolic rate high helps prevent both the plateau and yo-yo (weight regain) characteristic of so many diets.

• When you lose fat and retain muscle you are reshaping your body – and that’s why most people are dieting to begin with.

So let’s look more carefully at the recent study that has been generating all the headlines (Pasiakos et al, The FASEB Journal, 27: 3837-3847, 2013).

The Study Design:

This was a randomized control study with 39 young (21), healthy and fit men and women who were only borderline overweight (BMI = 25). These volunteers were put on a 21 day weight loss program in which calories were reduced by 30% and exercise was increased by 10%. They were divided into 3 groups:

• One group was assigned a diet containing the RDA for protein (about 14% of calories in this study design).
• The second group’s diet contained 2X the RDA for protein (28% of calories)
• The third group’s diet contained 3X the RDA for protein (42% of calories)

In the RDA protein group carbohydrate was 56% of calories, and fat was 30% of calories. In the other two groups the carbohydrate and fat content of the diets was decreased proportionally.

What Did The Study Show?

• Weight loss (7 pounds in 21 days) was the same on all 3 diets.

• The high protein (28% and 42%) diets caused almost 2X more fat loss (5 pounds versus 2.8 pounds) than the diet supplying the RDA amount of protein.

• The high protein (28% and 42%) diets caused 2X less muscle loss (2.1 pounds versus 4.2 pounds) than the diet supplying the RDA amount of protein.

• In case you didn’t notice, there was no difference in overall results between the 28% (2X the RDA) and 42% (3X the RDA) diets.

Pros And Cons Of The Study:

• The con is fairly obvious. The participants in this study were all young, healthy and were not seriously overweight. If this were the only study of this type one might seriously question whether the results were applicable to middle aged, overweight coach potatoes. However, there have been several other studies with older, more overweight volunteers that have come to the same conclusion – namely that high protein diets preserve muscle mass and enhance fat loss.

• The value of this study is that it defines for the first time the upper limit for how much protein is required to preserve muscle mass in a weight loss regimen. 28% of calories is sufficient, and there appear to be no benefit from increasing protein further. I would add the caveat that there are studies suggesting that protein requirements for preserving muscle mass may be greater in adults 50 and older.

The Bottom Line:

1)    Forget the high fat diets, low fat diets, pills and potions. High protein diets (~2X the RDA or 28% of calories) do appear to be the safest, most effective way to preserve muscle mass and enhance fat loss in a weight loss regimen.

2)     That’s not a lot of protein, by the way. The average American consumes almost 2X the RDA for protein on a daily basis. However, it is significantly more protein than the average American consumes when they are trying to lose weight. Salads and carrot sticks are great diet foods, but they don’t contain much protein.

3)     Higher protein intake does not appear to offer any additional benefit – at least in young adults.

4)     Not all high protein diets are created equal. What some people call high protein diets are laden with saturated fats or devoid of carbohydrate. The diet in this study, which is what I recommend, had 43% healthy carbohydrates and 30% healthy fats.

5)    These diets were designed to give 7 pounds of weight loss in 21 days – which is what the experts recommend. There are diets out there promising faster weight loss but they severely restrict calories and/or rely heavily on stimulants, they do not preserve muscle mass, and they often are not safe. In addition they are usually temporary.  I do not recommend them.

6)    This level of protein intake is safe for almost everyone. The major exception would be people with kidney disease, who should always check with their doctor before increasing protein intake. The only other caveat is that protein metabolism creates a lot of nitrogenous waste, so you should drink plenty of water to flush that waste out of your system. But, water is always a good idea.

7)     The high protein diets minimized, but did not completely prevent, muscle loss. Other studies suggest that adding the amino acid leucine to a high protein diet can give 100% retention of muscle mass in a weight loss regimen – but that’s another story for another day.

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

Are You Just Wasting Your Money On Supplements?

Author: Dr. Stephen Chaney

You’ve seen the headlines. “Recent Study Finds Vitamin and Mineral Supplements Don’t Lower Heart Disease Risk.”  You are being told that supplements are of no benefit to you. They are a waste of money. You should follow a healthy diet instead. Is all of this true?

If I were like most bloggers, I would give you a simple yes or no answer that would be only partially correct. Instead, I am going to put the study behind these headlines into perspective. I am going to give you a deeper understanding of supplementation, so you can make better choices for your health.

 Should we use supplements for cardiovascular health?

In today’s article I will give you a brief overview of the subject. Here are the topics I will cover today:

• Is this fake news?
• Did the study ask the right questions?
• Is this a question of “Garbage In – Garbage Out?“
• Reducing Heart Disease Risk. What you need to know.

All these topics are covered in much more detail (with references) in my book “Slaying The Supplement Myths”, which will be published this fall.

How Was This Study Done?

This study (D.J.A. Jenkins et al, Journal of the American College Of Cardiology, 71: 2540-2584, 2018 ) was a meta-analysis. Simply put, that means the authors combined the results of many previous studies into a single database to increase the statistical power of their conclusions. This study included 127 randomized control trials published between 2012 and December 2017. These were all studies that included supplementation and looked at cardiovascular end points, cancer end points or overall mortality.

Before looking at the results, it is instructive to look at the strengths and weaknesses of the study. Rather than giving you my interpretation, let me summarize what the authors said about strengths and weaknesses of their own study.

The strengths are obvious. Randomized control trials are considered the gold standard of evidence-based medicine, but they have their weaknesses. Here is what the authors said about the limitations of their study:

• “Randomized control trials are of shorter duration, whereas longer duration studies might be required to fully capture chronic disease risk.”
• “Dose-response data were not usually available [from the randomized control studies included in their analysis]. However, larger studies would allow the effect of dose to be assessed.”

There are some other limitations of this study, which I will point out below.

Is This Fake News?

When I talk about “fake news” I am referring to the headlines, not to the study behind the headlines. The headlines were definitive: “Vitamin and Mineral Supplements Don’t Lower Heart Disease Risk.” However, when you read the study the reality is quite different:

• In contrast to the negative headlines, the study reported:
  • Folic acid supplementation decreased stroke risk by 20% and overall heart disease risk by 17%.

• • B complex supplements containing folic acid, B6, and B12 decreased stroke risk by 10%.
  • That’s a big deal, but somehow the headlines forgot to mention it.
• The supplements that had no significant effect on heart disease risk (multivitamins, vitamin D, calcium, and vitamin C) were ones that would not be expected to lower heart disease risk. There was little evidence from previous studies of decreased risk. Furthermore, there is no plausible mechanism for supposing they might decrease heart disease risk.
• The study did not include vitamin E or omega-3 supplements, which are the ones most likely to prove effective in decreasing heart disease risk when the studies are done properly (see below).

Did The Study Ask The Right Question?

Most of the studies included in this meta-analysis were asking whether a supplement decreased heart disease risk or mortality for everyone. Simply put, the studies started with a group of generally healthy Americans and asked whether supplementation had a significant effect on disease risk for everyone in that population.

That is the wrong question. We should not expect supplementation to benefit everyone equally. Instead, we should be asking who is most likely to benefit from supplementation and design our clinical studies to test whether those people benefit from supplementation.

I have created the graphic on the right as a guide to help answer the question of “Who is most likely to benefit from supplementation?”. Let me summarize each of the points using folic acid as the example.

Poor Diet: It only makes sense that those people who are deficient in folate from foods are the most likely to benefit from folic acid supplementation. Think about it for a minute. Would you really expect people who are already getting plenty of folate from their diet to obtain additional benefits from folic acid supplementation?

The NIH estimates that around 20% of US women of childbearing age are deficient in folic acid. For other segments of our population, dietary folate insufficiency ranges from 5-10%. Yet, most studies of folic acid supplementation lump everyone together – even though 80-95% of the US population is already getting enough folate through foods, food fortification, and supplementation. It is no wonder most studies fail to find a beneficial effect of folic acid supplementation.

The authors of the meta-analysis I discussed above said that the beneficial effects of folic acid they saw might have been influenced by a very large Chinese study, because a much higher percentage of Chinese are deficient in folic acid. They went on to say that the Chinese study needed to be repeated in this country.

In fact, the US study has already been done. A large study called “The Heart Outcomes Prevention Evaluation (HOPE)” study reported that folic acid supplementation did not reduce heart disease risk in the whole population. However, when the study focused on the subgroup of subjects who were folate-deficient at the beginning of the study, folic acid supplementation significantly decreased their risk of heart attack and cardiovascular death.  This would seem to suggest using supplements for cardiovascular health is a good idea.

Increased Need: There are many factors that increase the need for certain nutrients. However, for the sake of simplicity, let’s only focus on medications. Medications that interfere with folic acid metabolism include anticonvulsants, metformin (used to treat diabetes), methotrexate and sulfasalazine (used to treat severe inflammation), birth control pills, and some diuretics. Use of these medications is not a concern when the diet is adequate. However, when you combine medication use with a folate-deficient diet, health risks are increased and supplementation with folic acid is more likely to be beneficial.

Genetic Predisposition: The best known genetic defect affecting folic acid metabolism is MTHFR. MTHFR deficiency does not mean you have a specific need for methylfolate. However, it does increase your need for folic acid. Again, this is not a concern when the diet is adequate. However, when you combine MTHFR deficiency with a folate-deficient diet, health risks are increased and supplementation with folic acid is more likely to be beneficial. I cover this topic in great detail in my upcoming book, “Slaying The Supplement Myths”. In the meantime, you might wish to view my video, “The Truth About Methyl Folate.”

Diseases: An underlying disease or predisposition to disease often increases the need for one or more nutrients that help reduce disease risk. The best examples of this are two major studies on the effect of vitamin E on heart disease risk in women. Both studies found no effect of vitamin E on heart disease risk in the whole population. However, one study reported that vitamin E reduced heart disease risk in the subgroup of women who were post-menopausal (when the risk of heart disease skyrockets). The other study found that vitamin E reduced heart attack risk in the subgroup of women who had pre-existing heart disease at the beginning of the study.

Finally, if you look at the diagram closely, you will notice a red circle in the middle. When two or three of these factors overlap, that is the “sweet spot” where supplementation is almost certain to make a difference and it may be a good idea to use supplements for cardiovascular health.

Is This A Question Of “Garbage In, Garbage Out”?

Unfortunately, most clinical studies focus on the “Does everyone benefit from supplementation question?” rather than the “Who benefits from supplementation?” question.

In addition, most clinical studies of supplementation are based on the drug model. They are studying supplementation with a single vitamin or mineral, as if it were a drug. That’s unfortunate, because vitamins and minerals work together synergistically. What we need are more studies of holistic supplementation approaches.

Until these two things change, most supplement studies are doomed to failure. They are doomed to give negative results. In addition, meta-analyses based on these faulty supplement studies will fall victim to what computer programmers refer to as “Garbage In, Garbage Out”. If the data going into the analysis is faulty, the data coming out of the study will be equally faulty. It won’t be worth the paper it is written on. If you are looking for personal guidance on supplementation, this study falls into that category.

Should We Use Supplements For Cardiovascular Health?

If you want to know whether supplements decrease heart disease risk for everyone, this meta-analysis is clear. Folic acid may decrease the risk of stroke and heart disease. A B complex supplement may decrease the risk of stroke. All the other supplements they included in their analysis did not decrease heart disease risk, but the analysis did not include vitamin E and/or omega-3s.

However, if you want to know whether supplements decrease heart disease risk for you, this study provides no guidance. It did not ask the right questions.

I would be remiss, however, if I failed to point out that we know healthy diets can decrease heart disease risk. In the words of the authors: “The recent science-based report of the U.S. Dietary Guidelines Advisory Committee, also concerned with [heart disease] risk reduction, recommended 3 dietary patterns: 1) a healthy American diet low in saturated fat, trans fat, and meat, but high in fruits and vegetables; 2) a Mediterranean diet; and 3) a vegetarian diet. These diets, with their accompanying recommendations, continue the move towards more plant-based diets…” I cover the effect of diet on heart disease risk in detail in my book, “Slaying The Food Myths”.

The Bottom Line

You have probably seen the recent headlines proclaiming: “Vitamin and Mineral Supplements Don’t Lower Heart Disease Risk.” The study behind the headlines was a meta-analysis of 127 randomized control trials looking at the effect of supplementation on heart disease risk and mortality.

• The headlines qualify as “fake news” because:
  • The study found that folic acid decreased stroke and heart disease risk, and B vitamins decreased stroke risk. Somehow the headlines forgot to mention that.
  • The study found that multivitamins, vitamin D, calcium, and vitamin C had no effect on heart disease risk. These are nutrients that were unlikely to decrease heart disease risk to begin with.
  • The study did not include vitamin E and omega-3s. These are nutrients that are likely to decrease heart disease risk when the studies are done properly.
• The authors of the study stated that a major weakness of their study was that that randomized control studies included in their analysis were short term, whereas longer duration studies might be required to fully capture chronic disease risk.
• The study behind the headlines is of little use for you as an individual because it asked the wrong question.
• Most clinical studies focus on the “Does everyone benefit from supplementation question?” That is the wrong question. Instead we need more clinical studies focused on the “Who benefits from supplementation?” question. I discuss that question in more detail in the article above.
• In addition, most clinical studies of supplementation are based on the drug model. They are studying supplementation with a single vitamin or mineral, as if it were a drug. That’s unfortunate, because vitamins and minerals work together synergistically. What we need are more studies of holistic supplementation approaches.
• Until these two things change, most supplement studies are doomed to failure. They are doomed to give negative results. In addition, meta-analyses based on these faulty supplement studies will fall victim to what computer programmers refer to as “Garbage In, Garbage Out”. If the data going into the analysis is faulty, the data coming out of the study will be equally faulty. It won’t be worth the paper it is written on. If you are looking for personal guidance on supplementation, this study falls into that category.
• If you want to know whether supplements decrease heart disease risk for everyone, this study is clear. Folic acid may decrease the risk of stroke and heart disease. A B-complex supplement may decrease the risk of stroke. All the other supplements they included in their analysis did not decrease heart disease risk, but they did not include vitamin E and/or omega-3s in their analysis.
• If you want to know whether supplements decrease heart disease risk for you, this study provides no guidance. It did not ask the right questions.
• However, we do know that healthy, plant-based diets can decrease heart disease risk. I cover heart healthy diets in detail in my book, “Slaying The Food Myths.”

For more details, read the article above.

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

Do They “Cherry Pick” Scientific Studies?

Author: Dr. Stephen Chaney

When we buy a food supplement from a company we assume that it will provide a benefit. We are trusting that company to be honest in their product claims. But, are there any honest nutritional supplement companies?

• What if they were lying to us?
• What if they had no clinical studies done with their product?
• What if they were just quoting studies done with ingredients found in their product?
• What if they were “cherry picking” the studies they listed to support the claims they wanted to make?

Unfortunately, that happens far too often in the nutraceutical industry. As an example, I came across an article in a recent issue of www.nutraingredients.com about a FDA warning letter (http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2016/ucm518533.htm) to a noni juice company.  In case you are wondering, noni fruit is the latest in a long line of “magical fruits” that is going to cure everything that ails you.

The thing that brought this company to the FDA’s attention in the first place was the health claims the company made on their website. The company claimed or implied that their product would cure cancer, cure gout, cure arthritis, lower cholesterol, and help fight infections. Claims like that always invite FDA scrutiny.

What caught my attention, however, was the quote by an attorney specializing in FDA compliance issues that the studies cited on their website were “cherry picked” to support their claims. He said that the studies they cited “…do not meet the standards of third party literature…You have to include a full range [of published studies], and not just cherry pick the positive studies. It has to be a balanced presentation. It looks like they just did a literature search on noni and included only the positive studies.”

That statement caught my attention because it doesn’t just apply to just this one company. It is a practice that is common in the nutraceutical industry.  Many supplement companies cherry pick studies from third party literature. They list only the studies that support their product claims and ignore the rest. That is misleading because it implies a level of proof for their product claims that does not exist.  It is fundamentally dishonest. These are certainly not honest nutritional supplement companies.

Using Borrowed Science

The noni juice company cited in the FDA letter had no clinical studies to support their claims. Instead they quoted studies done with ingredients found in their product. This is what I call “borrowed science.”

I call this “borrowed science” because the studies were not actually done with their products. They were simply trying to “borrow” results done with individual ingredients and pretend that they applied them to their product.

Let me be clear. Third party studies done with ingredients found in a company’s product are of little value in predicting whether that product will provide any benefit to you. To claim otherwise is dishonest.  Again, these are not honest nutritional supplement companies.

There are several reasons this is true.

• In many cases, the amount of that ingredient provided by the supplement does not match the amount actually used in the clinical study they quote. The ingredient may or may not be effective at the dose provided in the supplement.

• More importantly, a supplement usually contains multiple other components that may influence how a single ingredient works in your body. The other components may enhance the effectiveness of the ingredient in question, or they may inhibit it.

• Without clinical trials done with their product, companies actually have no idea whether their product works or not.

Unfortunately, I see this practice all too frequently in the nutraceutical industry. Clinical trials are expensive. It’s cheaper and easier to search the literature for published studies you can “borrow” to support your product.

Honest Nutritional Supplement Companies Do Not“Cherry Pick” Studies

Even worse, many companies cherry pick studies from the literature to support the product claims they want to make.

To understand what that statement means you need to know a little bit about the scientific method. Most scientists design their experiments to disprove what other scientists have published. This is a self-correcting process that is a strength of the scientific method.

However, it also means that you will find articles in the literature supporting and refuting the benefits of almost every nutraceutical ingredient. The scientific community waits until enough studies have accumulated and then relies on the weight of evidence before drawing any conclusions.

Unfortunately, unscrupulous supplement companies decide first on what claims they want to make and quote only the studies that support those claims. This is what is referred to as “cherry picking” the studies.

The Dietary Supplement Health and Education Act of 1994 (otherwise known as DSHEA) is very clear about that. Section 5 of DSHEA states “…scientific journal articles, books and other publications can be used in the sale of dietary supplements provided…[they] are presented with other materials to create a balanced view of the scientific information…”

In plain words this legalese simply means that you can’t cherry pick studies. You can’t select only the studies that support your product claims and ignore those that don’t.  Honest nutritional supplement companies would not use these deceitful practices.

However, this is a practice that I see all too often in the nutraceutical industry. It is dishonest. It is disgraceful

Are There Any Honest Nutritional Supplement Companies?

The bad news is that there are lots of supplement companies that do no clinical studies of their own. Instead they rely on borrowed science from studies that really do not provide proof that their products are either safe or effective. Even worse, many of those companies cherry pick only the studies that support their product claims and ignore studies that do not. This is a practice I regard as clearly dishonest. Those are companies I would avoid.

The good news is that there are a few companies that actually support clinical studies on their key products and publish those studies in peer reviewed scientific journals. Those are companies worthy of your consideration.

There are other things to take into account in selecting the best of the best – things like the number of studies and the quality of the studies. However, that’s a topic for another day.

Many Blogs Cherry Pick As Well

I can’t leave this topic without pointing out that many popular health and nutrition blogs, including those written by some well-known doctors, do exactly the same thing.

The pressures that lead to this behavior are obvious. The very popularity of these blogs depends on them being sensational week after week.

Unfortunately, true science is rarely sensational. It’s usually pretty wishy-washy. If you do a complete search of the literature, you usually find articles that are both for and against any point of view you wish to express. Occasionally, enough evidence accumulates on one side of an issue that scientists are willing to come to a definitive conclusion, but that conclusion is hardly ever sensational.

The only way that the authors of these popular blogs can make sensational claims each week is to cherry pick only the studies that support their point of view and ignore everything else.

Unfortunately, the average reader doesn’t realize this. They see the list of references supporting the claims and believe what they read. Then these bizarre claims get reposted over and over until the general public actually starts believing that they are true.

It really is a shame that DSHEA doesn’t apply to blogs. If it did, they wouldn’t be nearly as sensational, but they would be much more accurate. They would have to report on the whole body of scientific literature, rather than cherry picking just the studies that support their point of view.

In conclusion, there are some honest nutritional supplement companies, but be sure the company you choose to believe is citing studies on their actual products and not just ingredients in their products.  Also, watch out for “cherry picking.”

The Bottom Line

• The FDA recently sent a warning letter to a noni juice company for making unsupported health claims for their product. The company was claiming their product could cure things like cancer, gout and arthritis. Whenever a company makes claims like that, they can expect to draw the attention of the FDA.

• An outside attorney specializing in FDA compliance pointed out that the company also had no good evidence to support their product claims. The company had done no clinical studies on the products. Instead they had “borrowed” the results of third party studies done with ingredients found in their product. Even worse, they had cherry picked only the studies that supported their product claims and ignored the studies that did not.

• Third party studies done with ingredients found in a company’s product are often worthless in predicting whether that product will provide any benefit to you. I discuss the reasons for that in the article above.

• Cherry picking only the studies that support a company’s product claims runs afoul of the Dietary Supplement Health and Education Act of 1994 (DSHEA) requirement that companies provide a balanced view of the scientific literature relating to their products. It is also misleading and dishonest.

• Unfortunately, the practice of using “borrowed science” from third party studies and cherry picking only the studies that support their product claims is common in the nutraceutical industry. Supplement companies that rely on this kind of evidence to support their product claims are dishonest and should be avoided.

• For products you can trust, choose companies that support clinical studies on their key products and published those studies in peer-reviewed journals. You should also look at the number and quality of studies, but that is a topic for another day.

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

How To Treat Sciatic Nerve Pain Naturally

Author: Julie Donnelly, LMT –The Pain Relief Expert

Editor: Dr. Steve Chaney

Stretches for sciatica pain work,

but only when muscle spasms are released first!

Most people have been told to stretch tight muscles but they haven’t been told that muscle spasms (trigger points) shorten the fibers and tie the muscles in tiny micro knots.

This analogy helps explain how muscle spasms cause pain.

Consider what happens if you have two trees, a big strong one and one that easily moves. Tie a rope straight across from tree to tree. If you pull on the rope it’s easy to see that the flexible tree bends.

However, if you tie several knots in the rope the flexible tree leans over toward the strong tree. Now if you try to stretch the rope to make the flexible tree stand up straight the knots put a strain on the points where the rope is tied.

Trying to stretch the rope causes the knots to tighten and overstretches the rope on either side of the knot.

This is what happens with your muscles.

In the case of sciatica, the muscle that crosses over your sciatic nerve is the piriformis. When the piriformis is shortened by a muscle spasm it places a downward pressure on the sciatic nerve, impinging the nerve. This gets complicated because other muscles cause your pelvis to rotate and press the bone up into your sciatic nerve.

If you try to stretch the piriformis muscle it causes the tight muscle to press down onto the sciatic nerve, and can potentially tear the muscle.

Release the Muscle Knots Before Stretches for Sciatica Pain

Before stretching, it’s easy and essential to release the muscle that causes sciatica pain.

Lie on the floor, place the Trigger Point Therapy Ball, or a new tennis ball, onto the piriformis muscles (pictured left).

Ease onto the ball until it doesn’t hurt. Then move the ball just a bit to search for other tender points. Hold 30-60 seconds on each tender point to release the muscle knots

Now You Are Ready To Do The Stretches for Sciatica Pain Relief!

This seated spinal twist is a great stretch for sciatica pain relief.

Make sure you are seated tall and exhale as you twist. Hold for a minute and switch sides.

Wishing you well,

Julie Donnelly

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

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

Is The Cure Worse Than The Disease?

Author: Dr. Stephen Chaney

High blood pressure has been called a silent killer. This is because it is possible to go for years with high blood pressure and not even know it. Even worse, the consequences of untreated high blood pressure can be catastrophic – stroke, heart attack, congestive heart failure, kidney failure – the list goes on and on.  But, what about when high blood pressure is treated?  Do blood pressure medications cause memory loss?

Because of that, the standard medical recommendation for years has been to:

• Have your blood pressure tested frequently (at least once a year if your blood pressure is in the normal range and more frequently if it is elevated).

• If your blood pressure is elevated, get on a blood pressure medication and try to keep your blood pressure as close to normal as possible.

But, is this always the best advice? Maybe not, particularly when we consider the confusing effects of blood pressure on cognitive function.

We have known for years that untreated high blood pressure in middle aged individuals significantly increases the probability that they will suffer cognitive decline in their later years (for example, R. F. Gottesman et al, JAMA Neurology, 71: 1218-1227, 2014).

Conversely, when we look at the elderly as a group we find that those with the lowest blood pressure actually have a higher risk of cognitive decline than those with the highest blood pressure (for example, B. Sabayan et al, Journal of the American Geriatric Society, 60: 2014-2019, 2012).

How can we reconcile such conflicting data on the correlation between blood pressure and cognitive decline in the elderly? Could it possibly be that it was the blood pressure drugs rather than blood pressure itself that was causing cognitive decline in the elderly?

Do Blood Pressure Medications Cause Memory Loss?

A group of scientists in Italy set up a clinical study to determine whether blood pressure or use of blood pressure drugs better correlated with cognitive decline in elderly patients who already have some degree of cognitive impairment (E. Mossello et al, JAMA Internal Medicine, doi: 10.1001/jamainternmed.2014.8164).

They enrolled 172 patients from 2 outpatient memory clinics in the study. The average age of the participants was 79 and all of them had some degree of cognitive impairment (68% with dementia and 32% with mild cognitive impairment). 70% of the study participants were on blood pressure drugs. Their blood pressure was measured on a daily basis, and they were tested for cognitive function at the beginning of the study and 9 months later.

The results of the study concerning:

• Those with the lowest blood pressure had the highest rate of cognitive decline over the 9 month period. These results were similar to several previous clinical trials with the elderly.

• The association between low blood pressure and cognitive decline was only seen in those subjects on blood pressure medications. Low blood pressure did not increase the risk of cognitive decline in unmedicated subjects.

There are, of course, some significant limitations to this study:

• It is a small study of short duration.

• It is the first study of its kind. It needs to be repeated.

• It was done in an elderly population who already suffered from cognitive decline. We don’t yet know to what extent these conclusions will apply to younger people and to people without cognitive impairment.

Is The Cure Worse Than The Disease?

However, this study does raise a huge red flag that needs to be evaluated very carefully. It raises the issue of whether aggressive drug treatment to bring blood pressure under control may, under some conditions, cause more problems than it cures. It is not unlike the study a few years ago showing that aggressive treatment to lower blood sugar levels in type 2 diabetics actually increased the death rate (C. J. Currie et al, The Lancet, 375: 481-489, 2010).

It turns out that increased risk of cognitive decline is just one of several risks associated with aggressive drug treatment to lower blood pressure. Because of that realization an expert panel recently recommended that the threshold for the use of blood pressure drugs be raised from 130/90 to 140/90 for adults under 60 and to 150/90 for adults over 60.

Do blood pressure medications cause memory loss?  It’s not that high blood pressure has suddenly become healthier. Rather, the experts realized that the risks of aggressive drug treatment to lower moderately elevated blood pressure outweighed the benefits. The cure was worse than the disease!

Is There Another Option?

The answer is a resounding yes, and we have known about it for years. It is called the DASH (Dietary Approaches To Stop Hypertension) diet. It is recommended by the American Heart Association, the National Heart, Lung & Blood Institute, the USDA 2010 Dietary Guidelines for Americans and the US Guidelines for Treatment of High Blood Pressure). Coupled with a few simple lifestyle changes it has been shown to be as effective as drugs at reducing high blood pressure, without the side effects of the drugs.

You can find the details of the DASH diet here (http://dashdiet.org/), but in simple terms, it is low in fat, high in fresh fruits and vegetable, fiber and low fat dairy products. The recommended lifestyle changes are weight control, restricted sodium intake and exercise.

Although not all experts agree, I personally recommend that you also make sure that you are getting the DV for calcium, magnesium and vitamin D from food and supplements and consider supplementing with long chain omega-3 fatty acids and polyphenols – especially resveratrol and related polyphenols from grape skins and seeds.

The Bottom Line

• High blood pressure is a silent killer because people often don’t know they have it. If left untreated it can cause stroke, heart attack, congestive heart failure and kidney failure.

• However, a recent study suggested that aggressive drug treatment to treat high blood pressure in the elderly can increase the rate of cognitive decline.

• Because of this and other risks associated with aggressive drug treatment for high blood pressure, especially in the elderly, an expert panel recently recommended that the threshold for the use of blood pressure drugs be raised from 130/90 to 140/90 for adults under 60 and to 150/90 for adults over 60.

• It’s not that high blood pressure has suddenly become healthier. Rather, the experts realized that the risks of aggressive drug treatment to lower moderately elevated blood pressure outweighed the benefits. The cure was worse than the disease!

• Fortunately, there is another option, namely the DASH diet. The DASH diet, along with a few simple lifestyle modifications, has been shown to be as effective as drugs at reducing high blood pressure without the side effects of high blood pressure medications. Both the American Heart Association and the National Heart, Lung and Blood Institute recommend that the DASH diet and lifestyle changes be tried first, before considering use of blood pressure medications.

• Although not all experts agree, I personally recommend that you also make sure that you are getting the DV for calcium, magnesium and vitamin D from food and supplements and consider supplementing with long chain omega-3 fatty acids and polyphenols – especially resveratrol and related polyphenols from grape skins and seeds.

• Finally, high blood pressure is dangerous. Don’t ignore it. Get your blood pressure tested regularly. If it is elevated, talk with your doctor about the best combination of diet, and lifestyle change and whether medications are absolutely necessary to keep your blood pressure under control.

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

Can BIG FOOD Inc. Be Trusted?

Author: Dr. Stephen Chaney

Healthy Eating Is In. We are told we need more fiber, whole grains, fruits & vegetables, nuts and omega-3s in our diet. As a consequence more and more Americans are reading food labels to be sure that the foods they are buying are healthy.

But are those food labels deceptive? Is it possible that BIG FOOD Inc. could actually be lying to us? Could it be that the food manufacturers care more about their profits than about our health?

Normally I base my health tips on clinical studies published in peer-reviewed scientific journals. However, this week I am reporting on an article called “Hijacked. How the Food Industry Turns Diet Advice into Profits” from the October 2014 issue of Nutrition Action Health letter because they do an excellent job of exposing the lies of the food industry.

The Food Label:  The Lies of the Food Industry

False Fiber

For example, Nutrition Action describes how the food industry tries to fool us into thinking that their processed foods are healthy by making fiber claims on their labels that are deceptive, if not downright false.

Everyone knows that eating fiber rich foods like fruits, vegetables, whole grains, and legumes is good for us. But wouldn’t it be more fun if you could get the same amount of fiber in your breakfast bars, cakes, cookies and even yoghurt?

The food manufacturers are only too happy to oblige. DuPont, for example, manufacturers and artificial fiber called Litesse by chemically linking glucose (dextrose) molecules into a non-digestible polydextrose polymer. They tell the food manufacturers that they can use Litesse to “tap into this market opportunity and project a healthier image for your product”. I’d be much more impressed if they were talking about a healthier product rather than a “healthier image for your product” It’s all about image, isn’t it.

Similarly, Archer Daniels Midland manufactures a digestion-resistant form of maltodextrin they call Fibersol-2. They tell food manufacturers “who knew fiber could be clean and clear?” (Translation: Adding bran to your products might make them denser and chewier. You can add Fibersol-2 to your doughnuts or cookies and it won’t change their taste or texture).

The problem is that there are few clinical studies showing that these artificial fibers have the same benefits as the fibers we find in fresh fruits, vegetables and whole grains. In addition, these fibers don’t fill you up the way that unprocessed fibers found in foods do (something we scientists refer to as satiety). For example, if you eat a bowl of oatmeal you’re not going to be hungry for a long time. However, recent studies show that adding an equivalent amount of one of these artificial fibers to a muffin or breakfast bar has no effect on how hungry you feel after eating it.

Nutrition Action also raised concerns about highly processed natural fibers such as inulin, maltodextrin, soluble corn fiber or resistant wheat starch. In this situation, they may be oversimplifying their messaging a bit. I agree with their statement that adding these purified fibers to solid foods like cookies or muffins has relatively little effect on either satiety or regularity, but these fibers do have some benefits when used in the right kinds of foods.

For example, inulin is an excellent prebiotic. Its addition to processed foods as a prebiotic, rather than a source of fiber, is appropriate. Maltodextrin needs to be digested before its component sugars are absorbed into the bloodstream, so it enters the bloodstream a bit more slowly than simple sugars. When used in sports drinks it helps stabilize blood sugar and provide more sustained energy. Similarly, the addition of soluble corn starch to a protein shake slows gastric emptying, which also stabilizes blood sugar and provides sustained energy. Wheat bran in a protein shake, on the other hand, would be an inappropriate choice. It would just settle to the bottom of the glass.

The Bottom Line: The best place to get your fiber is from fresh fruits, fresh vegetables, and whole grains. Before you reach for a processed food that claims to be high in fiber read the label carefully. Make sure that fiber comes from foods rather than artificial fibers. If the main fiber ingredient is a processed fiber, make sure that the type of fiber is appropriate for the food you are consuming.

Vegetable & Fruit Follies

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

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

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

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

The Bottom Line: Ignore the label claims of fruits and vegetables added to the processed foods you see in the market. The fruit and vegetable powders added to those foods provide no proven benefit. The best place to get your fruits and vegetables is to [surprise] eat your fruits and vegetables.

The Fruits & Vegetables in a Capsule Con

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

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

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

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

As for essential nutrients, when you read the label you usually discover that their capsules only contain small amounts of a few essential nutrients. They simply do not provide significant amounts of the vitamins, minerals, and phytonutrients you would have been getting if you ate the real foods.

The Bottom Line: Leave those supplements claiming to have concentrated lots of fruits and vegetables into a single capsule on the shelf. Those claims are grossly deceptive because the capsules do not contain significant amounts of the fruits and vegetables listed on the label. They do not provide the nutrients you would have gotten if you had eaten the real foods. Once again, the best way to get the fruits and vegetables you need in your diet is to actually eat fresh fruits and vegetables.

Omega Oops

Omega-3 fatty acids are in fashion, so omega-3 claims are springing up everywhere. You can find omega-3 enriched eggs, milk, juices, bars, and even pasta. I won’t address the controversies about omega-3 benefits in this article because I have written about them previously (“Is Fish Oil Really Snake Oil?” , “Can Fish Oil Make Children Smarter?” , or “Do Omega-3s Slow Cognitive Decline?”.

The other point that Nutrition Action made was that the amount of omega-3s provided by these omega-3 enriched foods was seldom enough to provide any significant health benefit. It is the long chain omega-3 fatty acids such as EPA and DHA that are thought to provide the health benefits. The American Heart Association recommends 500 mg/day of these long chain fatty acids for people who have no history of heart disease, and over 1,000 mg/day for people with prior history of heart disease. In that context the few mg of long chain omega-3s provided by most omega-3 enriched foods is a drop in the bucket.

The story is even more tenuous for those manufacturers who add the short chain omega-3 fatty acid ALA, which is found in most vegetable oils and plant seed oils, to their products. That’s because the efficiency of conversion of short chain to long chain fatty acids in the body is only 10-15% for most people. One tablespoon of canola or soy oil provides about 1,000 mg of ALA. Once again, those products providing only a few mg of short chain omega-3s provide little benefit.

When asked why they added omega-3s to their pasta, one manufacturer said “We have to because of the competition”, not “We wanted to make our product healthier”.

The Bottom Line: Avoid those omega-3 enriched processed foods that provide only a few mg of omega-3 fatty acids, especially if their source of omega-3 fatty acids is listed as ALA, vegetable oils or plant seed oils. The best place to get your omega-3s in the amounts that you need is still cold water fish and fish oil supplements.

The Bottom Line

The October 2014 issue of Nutrition Action Healthletter exposed many of the deceptive labeling practices that food manufacturers use to make their products seem healthier than they are. In particular:

• The best place to get your fiber is from fresh fruits, fresh vegetables, and whole grains. Before you reach for a processed food that claims to be high in fiber, read the label carefully. Make sure that fiber comes from foods rather than artificial fibers. If the main fiber ingredient is a processed fiber, make sure that the type of fiber is appropriate for the food you are consuming.

• Ignore the label claims of fruits and vegetables added to the processed foods you see in the market. The fruit and vegetable powders added to those foods provide no proven benefit. The best place to get your fruits and vegetables is to [surprise] eat your fruits and vegetables.

• Leave those supplements claiming to have concentrated lots of fruits and vegetables into a single capsule on the shelf. Those claims are grossly deceptive because the capsules do not contain significant amounts of the fruits and vegetables listed on the label and do not provide the nutrients you would have gotten if you ate the real foods. Once again, the best way to get the fruits and vegetables you need in your diet is to actually eat fresh fruits and vegetables.

• Avoid those omega-3 enriched processed foods that provide only a few mg of omega-3 fatty acids, especially if their source of omega-3 fatty acids is listed as ALA, vegetable oils or plant seed oils. The best place to get your omega-3s in the amounts that you need is still cold water fish and fish oil supplements.

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.