Relief From Pain Between Your Shoulder Blades

March 17, 2020 by Dr. Steve Chaney

Happy St. Patrick’s Day

Even if you’re not Irish, Happy St. Patrick’s Day! I think it’s one of those days that really isn’t necessarily an ethnic holiday anymore, it’s an “everybody” holiday.

I’m from New York and St. Patty’s Day is a HUGE day, with a big parade (I walked in it when I was in high school) and a LOT of partying! The first recorded St. Patrick’s Day parade was held not in Ireland but in New York City in 1762 because there were so many Irish immigrants.

I wasn’t too thrilled with aspects of the party part, but it’s still fun to wear green and have all the trappings of the day. My favorites are green cookies and cupcakes (you can tell where my weakness lies – LOL).

Here are 10 fun facts about St. Patrick’s Day, Thanks to https://www.proflowers.com/blog/interesting-st-patricks-day-facts

The first St. Patrick’s Day celebration in the United States was held in Boston (1737).

Shamrocks are the national flower/emblem of Ireland.
Legend says that each leaf of the clover has a meaning: Hope, Faith, Love and Luck.
Your odds of finding a four-leaf clover are about 1 in 10,000 (I don’t know about this one. I must be pretty lucky because when I was a kid, we used to always find them in the grass).
The color of St. Patrick’s Day was originally blue.

There are 34.7 million U.S. residents with Irish ancestry. This number is more than seven times the population of Ireland itself

The real St. Patrick wasn’t Irish. He was born in Britain around A.D. 390 to an aristocratic Christian family

Patrick never got canonized by a pope, making his saintly status somewhat questionable.

The world’s shortest St. Patrick’s Day parade is held in an Irish village. It lasts only 100 yards, between the village’s two pubs.

1962 marked the first time Chicago dyed their river green for St Patrick’s Day.

Your Questions Answered

I have so many people asking me questions about the cause of their aches and pains that I’ve decided to add a new section to this newsletter – it’s a Q&A section where you can send in a question and I’ll pick one each month to answer. I’ll explore the most logical cause of the pain and tell you where in my books you can find the self-treatment to eliminate it quickly.

Q: When I yawn or chew my jaw clicks, close to my ear. I can feel the bones rubbing together. I’ve been told it may be TMJ. What do you think?

A: I agree that it is most likely TMJ.

If you press your three middle fingers into your cheeks, right where your back teeth meet, and then clench your teeth, you’ll feel the muscle bulge. The name of the muscle is Masseter and it goes from your cheek bones (above your top back teeth) to your jaw line (below your lower back teeth.

When you chew, you are contracting that muscle, and you lengthen it as you open your mouth wide to put food into your mouth. Chewing gum or clenching your teeth contracts the muscle without the opposite movement of opening your mouth wide. As a result, it’s being repetitively strained, and the body reacts by shortening the muscle fibers. This causes your jaw to shift over to the side of the shortened muscle each time you try to open your mouth.

The clicking you are feeling is the bones rubbing across each other because the muscle is too tight to allow your jaw to open correctly. This can potentially cause real problems in your jaw, but fortunately it’s simple to reverse.

The treatment is shown on page 52-53 in Treat Yourself to Pain Free Living. Most times you can reverse the problem after just 2-3 self-treatments.

What Causes Pain Between Your Shoulder Blades?

I had to solve a mystery in my office. A client was complaining of a pain between her shoulder blades, and after looking at the usual muscles (Rhomboids) I needed to do some detective work. It’s a little confusing, but if you visualize it while you’re reading it will help a lot.

Your rhomboids attach to the medial border of your scapula (between your shoulder blades). When they contract normally, they pull your shoulder blades in toward your spine.

Your pectoralis minor muscle is in your chest, originating on your ribs and inserting into a small part of your shoulder blade (scapula), called the coracoid process. When the pecs minor contacts normally it pulls on your scapula, moving your shoulder forward and rounding out your back.

Here’s what was happening to my client.

When your pecs minor is pulling your scapula forward it’s causing your rhomboids to be pulled up toward your head. This isn’t a movement that works well for the rhomboids, so they go into a spasm, or at the very least they are over-stretched, and you feel the pull on the bone.

Relief From Pain Between Your Shoulder Blades

Simply releasing the tight pectoralis minor muscles allowed her shoulder blade to return to its proper location and the strain was taken off her rhomboids.

Looking at the pictures, begin by placing a ball on the front of your chest, just below your shoulder. Basically, it is where your fingers are when you do the Pledge of Allegiance. Lean into a wall and bend your legs so you move the ball up and down on the muscle.

You can also squeeze the muscle by putting your fingertips into your armpit and your thumb in the same place as the location of the ball as shown in the picture. Squeeze the muscle and pull down toward the floor as you are squeezing. As a bonus, you’ll be stretching the muscle as your releasing the tension in the muscle fibers.

I’m happy to say, treating my client’s pectoralis minor took the strain off her rhomboids, and her back pain disappeared!

The most important thing is she also learned how to self-treat her muscles, so the pain won’t return.

All my self-treatments are in either Treat Yourself to Pain-Free Living or The Pain-Free Athlete. If you have nagging aches and pains, you can release the tension and stop pain FAST!

Graphic Credit: Pectoralis Minor muscle graphic thanks to https://www.quora.com/What-is-the-difference-between-a-pectoralis-major-and-a-pectoralis-minor-muscle

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You really CAN “Treat Yourself to Pain-Free Living!” As you already know, I’ve written a book, “Treat Yourself To Pain-Free Living“, that shows you how to self-treat muscles from your head to your feet, but maybe you would like to have me help you.

Just because you aren’t in Sarasota, Florida, we can still work together very successfully via the computer. I’ve worked with people all over the world, and the results are excellent! To request a consult, click here.

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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 31 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.

Could A Probiotic Supplement Make You Healthier?

February 25, 2020 by Dr. Steve Chaney

What Is The Truth About Our Microbiome?

Our gut bacteria, often referred to as our microbiome, are a “hot” topic in today’s world. They have been in the news a lot in recent years. If you believe the headlines, the right gut bacteria can make you smarter, healthier, and cure what ails you. They appear to have almost mystical powers. Could a probiotic supplement make you healthier?

How much of this is true and how much is pure speculation? It’s hard to say. Our microbiome is incredibly complex. To make matters more confusing, the terminology used to classify our gut bacteria into groups is not consistent. It varies from study to study.

Perhaps it is time to take an unbiased look at the data and separate fact from speculation.

Could A Probiotic Supplement Make You Healthier?

To answer the question of whether a probiotic supplement could make you healthier, we need to differentiate between what we know is true and what we think might be true. Let’s start with what we know for certain:

Our gut bacteria are affected by diet. People consuming a primarily plant-based diet have different populations of gut bacteria than people consuming a primarily meat-based diet.

- The populations of gut bacteria found in people consuming a plant-based diet are associated with better health outcomes, but associations have their limitations as discussed below.

Our gut bacteria are affected by exercise.

- It’s not clear whether it is the exercise or the fitness (increased muscle mass, decreased fat mass, improved metabolism) associated with exercise that is responsible for this effect.

Most of the other claims for the effects of gut bacteria on our health are based on associations. However, associations do not prove cause and effect. For example:

Certain populations of gut bacteria are associated with obesity.

- Do our gut bacteria make us obese, or does obesity affect our gut bacteria? There is evidence to support both viewpoints.

Certain populations of gut bacteria are associated with better mental health.

- Do gut bacteria influence mental health, or does the stress associated with poor mental health influence our gut bacteria? Again, there is evidence to support both viewpoints.

Certain populations of gut bacteria are associated with better health outcomes (reduction in diseases like heart disease, diabetes, and high blood pressure).

- Here the question is a little different. In general, the populations of gut bacteria associated with disease reduction are produced by a healthy diet, exercise, and weight control. In this case, the question becomes: Is it the gut bacteria that caused disease reduction, or is it diet, exercise, and weight control that caused disease reduction?

To better understand these points, let’s look at four recently published studies. After reviewing those studies, I will come back to the question of whether a probiotic supplement might decrease our disease risk.

Is Our Microbiome Better Than Our Genes For Predicting Disease?

This study (T. Tierney et al, bioRxiv, 2020) reviewed 47 studies that analyzed people’s microbiome (their gut bacteria) and their genes and asked which was better at predicting their risk of various diseases. The study focused on 13 diseases that are considered “complex” because they are caused by both genetic and environmental factors such as diet and exercise. Examples include diabetes, high blood pressure, digestive disorders, asthma, Parkinson’s disease, and schizophrenia.

The study found that our microbiome was a better predictor of these diseases than our genes. This finding is not surprising. Our microbiome is heavily influenced by diet and other environmental factors. Our DNA sequence is not.

This study supports previous studies in suggesting that our microbiome is a better predictor of most diseases than our DNA sequence. The exception would be diseases that are clearly caused by gene mutations, such as sickle cell disease.

Does this mean our microbiome is directly influencing these diseases, or is it merely serving as a marker for diet and other environmental factors that are influencing these diseases? Nobody knows.

Does The Mediterranean Diet Support Gut Bacteria Linked To Healthy Aging?

This study ( TS Ghosh et al, Gut, 17 February 2020) divided people aged 65-79 into two groups. One group consumed a Mediterranean diet rich in fruits, vegetables, nuts, legumes, olive oil, and fish and low in red meat and saturated fat. The other group consumed a typical western diet. After a year on the diets the gut bacteria in the microbiomes of the two groups was analyzed.

The study found that the group consuming the Mediterranean diet had an increase in gut bacteria associated with healthy aging, reduced inflammation, and reduced frailty.

The title of the paper describing this study was “Mediterranean diet intervention alters the gut microbiome in older people, reducing frailty and improving health status”. But is that true?

There is already good evidence that the Mediterranean diet improves health status. Is it the gut bacteria supported by the Mediterranean diet that were responsible for healthy aging, or were other aspects of the Mediterranean diet responsible for healthy aging? Nobody knows.

Are Low Fat Diets Healthy Because Of Their Effect On Our Microbiome?

This study (Y Wang et al, Gut Microbes, 21 January 2020) put participants on a low fat diet (20% fat and 66% carbohydrates), a moderate fat diet (30% fat and 56% carbohydrate) or a high fat diet (40% fat, 46% carbohydrates). To assure the accuracy of the diets, participants were provided with all foods and beverages they consumed. After 6 months on the three diets, the gut bacteria of each group were analyzed.

Note: Because all food and beverages were provided, none of the diets included sodas, added sugar, refined flour, saturated fats, or highly processed food. In short, the diets were very different than the typical low fat or low carb diets consumed by the average American.

This study found that participants consuming the high fat, low carb diet had gut bacteria associated with increased risk of heart disease and diabetes. In contrast, the low fat, high carbohydrate diet group had gut bacteria associated with decreased risk of heart disease and diabetes.

To understand this study, you need to reevaluate what you may have learned from Dr. Strangelove’s health blog. It is true that low fat diets in which fat has been replaced with sugar, refined flour, and highly processed low-fat foods are unhealthy. But that’s not what happened in this study.

Remember that all the food and drink the participants consumed was selected by dietitians.

When you replace the fat with whole foods – fresh fruits and vegetables, whole grains, nuts, and legumes, as was done in this study, you end up with a very healthy diet.

The authors talked about the importance of the “diet-gut axis” for reducing the risk of heart disease and diabetes. However, is it the gut bacteria that influenced the risk of heart disease and diabetes, or is it the diets themselves that influenced disease risk? Nobody knows.

Can Gut Bacteria Reduce Heart Disease Risk?

This study (Y Heianza et al, Journal of The American College Of Cardiology, 75: 763-772, 2019) focused on the interactions between diet, gut bacteria, and a metabolite called TMAO (trimethylamine N-oxide).

Here is what we know for certain:

L-carnitine (found in high levels in red meat) can be converted to TMA (trimethylamine) by gut bacteria and then to TMAO in the liver.

The gut bacteria of meat eaters are very efficient at converting L-carnitine to TMA. Thus, meat eaters tend to have high levels of TMAO in their blood.

The gut bacteria of vegans and vegetarians are very inefficient at converting L-carnitine to TMA. Thus, people consuming a primarily plant-based diet tend to have low TMAO levels in their blood.

Here is what we are uncertain about:

High TMAO levels are associated with increased heart disease risk. However, there is no direct evidence that TMAO causes heart disease.

What made this study unique is that it measured TMAO levels in the study participants at their entrance into the study and again 10 years later. The study found:

Participants with the greatest increase in TMAO levels over the 10 years had a 67% increased risk of heart disease compared to participants whose TMAO levels remained constant.

Participants consuming a healthy, primarily plant-based diet had little or no increase in TMAO levels over 10 years. It was the participants consuming an unhealthy diet who had significant increases in their TMAO levels.

This study strengthens the association between TMAO levels and heart disease risk. Because gut bacteria are required to produce TMAO, it also strengthens the association between gut bacteria and heart disease risk. However, is it the high TMAO levels that increased heart disease risk or is it the unhealthy diet that increased heart disease risk? Nobody knows.

What Is The Truth About Our Microbiome?

By now you have probably noticed a common theme that runs through all four studies. This is also true of most published studies on our microbiome.

We have good evidence that whole food, primarily plant-based diets lead to improved long-term health outcomes.

We also have good evidence that whole food, primarily plant-based diets influence the populations of gut bacteria found in our microbiome.

We know the populations of gut bacteria supported by primarily plant-based diets are associated with improved health outcomes.

We don’t really know whether it is the gut bacteria or the diets that are responsible for the improved health outcomes.

Don’t misunderstand me. I am not a microbiome skeptic. I think we have enough evidence to say that our gut bacteria are likely to have an important effect on our health. However, to claim that gut bacteria play a primary role in influencing our health would be pure speculation at this point.

A Cautionary Tale

Why do I make this point? It’s because I suspect that some in the supplement industry will be tempted to make probiotic supplements and claim they contain bacteria “known” to reduce the risk of heart disease, diabetes, or cancer. You wouldn’t need to change your diet. All you would need to do to improve your health would be to take their probiotic supplement.

Lest you be taken in by such future claims, let me share a cautionary tale.

High HDL cholesterol levels are associated with a reduced risk of heart disease. Exercise and weight loss increase HDL levels. However, those require work. They aren’t easy. So, pharmaceutical companies were constantly looking for ways to raise HDL levels without the hard work.

A few years ago, a pharmaceutical company discovered a drug that increased HDL levels. They thought they had discovered a wonder drug that would bring in billions of dollars. People wouldn’t need to exercise. They wouldn’t need to lose weight. All they would need to do would be to take their drug. HDL levels would go up and heart disease risk would go down.

However, when they tested their drug in a major clinical trial, it didn’t move the needle. HDL levels went up, but heart disease risk stayed the same. It turns out it was the exercise and weight loss that decreased heart disease risk, not the increase in HDL levels.

My message is simple. Even if our gut bacteria are found to play a major role in mediating the effect of diet on health outcomes, don’t assume we can take a probiotic and forget about the role of diet and exercise. Good health starts with a whole food, primarily plant-based diet and a healthy lifestyle.

The Bottom Line

Our gut bacteria, often referred to as our microbiome, are “hot”. If you believe the headlines, the right gut bacteria can make you smarter, healthier, and cure what ails you. How much of this is true and how much is pure speculation? In this article I reviewed four recent studies on diet, gut bacteria, and health outcomes. I took an unbiased look at the data and separated fact from speculation.

There was a common theme that ran through all four studies. This is also true of most published studies on our microbiome.

We have good evidence that whole food, primarily plant-based diets lead to improved long-term health outcomes.

We also have good evidence that whole food, primarily plant-based diets influence the populations of bacteria found in our gut, also known as our microbiome.

We know the populations of gut bacteria supported by primarily plant-based diets are associated with improved health outcomes.

We don’t really know whether it is the gut bacteria or the diets that are responsible for the improved health outcomes.

My message is simple. Even if our gut bacteria are found to play a major role in mediating the effect of diet on our health outcomes, don’t assume we can take a probiotic and forget about the role of diet and exercise. Good health starts with a whole food, primarily plant-based diet and a healthy lifestyle.

For more details, read the article above. You may be particularly interested in the cautionary tale I shared about HDL and heart disease risk.

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

Relief From Plantar Fasciitis Pain

February 18, 2020 by Dr. Steve Chaney

Get Rid Of Foot Pain And Enjoy Running Again

Sometimes I like to start my blog with ideas I think you may find helpful. This year, I’m not only writing goals, I’m doing something that was suggested by Pegine Echevarria. I’m looking back on last year and writing down as many of my successes as I can remember. Goals are the roadmap for the future, but remembering past successes lifts our confidence that we’ll be able to achieve the goals we have set.

In fact, this year I’m going to look at each day and write down a success that I’ve had that day. How wonderful it will be on New Year’s Eve to look back and read 365 successes for 2020!

I hope you are enjoying a wonderful start to 2020. Here’s to a year of adventure, joy, health, prosperity, and fulfillment of all your dreams!

Foot Pain And Plantar Fasciitis

With the new year here, lots of people have decided to get into a routine of walking, or running, to improve their health. I’ve also spoken to so many people about pain in the arch of the foot, a condition called plantar fasciitis. Most people have been told to focus their attention on the foot.

However, the muscles of your lower leg are responsible for the movements of your foot, so ignoring them and focusing on your foot is useless.

That’s like pulling your hair and then putting your focus on the pain in your head…while you’re still pulling your hair. It doesn’t work! You’re looking in the wrong place!

The vast majority of pain in your arch isn’t coming from your foot, it’s coming from your lower leg.

Stick with me, this is going to be so logical that you’ll wonder why you haven’t already heard about treatment and stretches for the real source of plantar fasciitis.

Relief From Plantar Fasciitis Pain

Let’s take a look at the muscles that move your foot. There are many tiny, intrinsic muscles but we’re not talking about them today…we’re talking about the major movers of your foot.

In case you would like to find the muscles in an anatomy book or on the internet, they are:

· Gastrocnemius: A calf muscle that merges into the Achilles tendon.

· Soleus: Under the gastrocnemius, the soleus also merges into the Achilles tendon. These two muscles pull your heel up so you can stand on your toes. When they are tight, they are pulling up on your Achilles tendon and pulling the bone up, even when you want to keep your foot flat on the ground. This causes your arch muscle to be pulled backward, causing arch pain.

· Tibialis Anterior: Primary muscle causing plantar fasciitis because it inserts into your arch. The tibialis anterior muscle is along the outside of your shin bone and inserts into the long bone on the inside of your arch. When it contracts the foot rolls toward the outside of the foot. This muscle also causes shin splints. When it is tight it is pulling hard on the bone and you feel pain in your arch.

· Peroneals: A group of two muscles inserting into the outside of your foot and arch. The peroneals originate along the length of your lower leg bone (Fibula) and insert into the bones on the outside and the inside of your arch. When they are tight, they pull the bones toward the outside of your foot, and you have arch pain.

These four muscles are pulling your arch in three different directions at the same time. This creates arch pain, but the source is in your lower leg!

Before jumping into the stretches for plantar fasciitis, I recommend first doing the self-treatments to release the tension in these muscles.

3 Self-Treatments For Plantar Fasciitis Pain

To treat your tibialis anterior, place a ball just below your knee and on the outside of your shin. Then move your leg so the ball rolls down toward your ankle.

If your arch feels like it’s going to cramp, simply roll your toes as shown in this picture.

To treat your peroneals, place a ball as shown in the picture on the right. Put your hand on your leg so you can press the muscle down into the ball. Then move your leg so the ball rolls down toward your ankle

There are several ways to treat your calf but they all use the same principle. Put the center of your calf directly on your opposite kneecap. Press your leg down so your kneecap goes deeply into your calf muscle.

Don’t slide, just rock your leg up and down, along the length of the muscle.

You can also do this treatment while sitting in a chair.

3 Stretches For Plantar Fasciitis Pain

Note: It is most beneficial to release the spasms (muscle knots) in the muscles as shown above before doing the stretches for plantar fasciitis relief. This is the case for any muscle as it “unties the knot” that has shortened the muscle allowing you to stretch without injuring the muscle fibers.

The picture on the left shows a common, runners stretch for the gastrocnemius muscle.

In order to get a proper stretch, it is important to keep your heel on the ground as you tilt your body forward.

Notice that you don’t need to be leaning forward and holding on to anything. Stand up straight.

To stretch the deeper muscle, the soleus, slowly bring your bottom back while bending the knee of the leg you are stretching.

Keep your heel firmly on the floor.

This stretch is deeper and often overlooked by runners, yet it is a key muscle for calf pain, Achilles tendonitis, heel pain, and plantar fasciitis.

You can stretch both the tibialis anterior muscle and the peroneal muscles by just a slight rotation of your ankle.

Curl your toes so the top of your toes are on the ground.

If your foot is squared so the top of your toes are flat on the ground, this stretches the tibialis anterior.

If you move slightly (as shown), this stretches the peroneal muscles.

You will feel the lengthening along your entire lower leg as you are doing an excellent series of stretches for plantar fasciitis and shin splints.

As a bonus, this is also the treatment for a sprained ankle!

BTW, all the pictures in this newsletter were taken from The Pain-Free Athlete. You can easily learn how to self-treat all of the major muscles in your body by using The Pain-Free Athlete or Treat Yourself to Pain-Free Living. These books show you how to self-treat muscles from your head to your feet, but maybe you would like to have me help you.

Relieve Stress Headaches Naturally

January 21, 2020 by Dr. Steve Chaney

What Causes Stress Headaches?

Stress is an unfortunate byproduct of the festivities of the holiday season. The holidays are supposed to be fun. But you are adding all the festive gatherings, Christmas shopping, and family drama to an already crowded schedule.

Then the New Year comes. This should be a time you can relax. But no, the holiday bills start rolling in, and you have the stress of figuring out how to pay them. Then, there are New Year’s resolutions. You know you should be making resolutions, but you also know you’ve never successfully kept them in the past. Now, that is real stress.

That stress often shows up as tight muscles and muscle spasms that can cause headache pain. If you already have one of my books, especially either Treat Yourself to Pain-Free Living, or The Pain-Free Athlete, you have the tools necessary to get relief. You can look at the colorful charts and find the area where you are feeling pain or stiffness. Then look for the muscle name that is in the same color as the shaded area of your discomfort. Then, follow the arrow and it will bring you directly to the spasm(s) that cause the pain. The figures above show some of the muscles that can cause headache pain when stress causes them to get tight and spasm.

Relief From Stress Headaches

As you see in the charts above there are multiple places where spasms will cause headaches. Actually, there are a lot more than this, but that’s why I wrote my “Pain-Free Living” book. It’s just too much for a newsletter.

Each of the spasms noted in these two charts can be treated by applying direct pressure onto the spasm and then holding it for 15-30 seconds. Use as much pressure as you can, but it must always be in the tolerable range, this is NOT a “no pain-no gain” situation. It is going to hurt because you are forcing toxins out of the muscle fibers, and the toxin is an acid (from lactic acid) so it burns. However, you’ll find that as you continue holding the pressure it will lessen.

After 30 seconds, keep your fingers in the same place but take off the pressure. Wait for 5 seconds and then re-apply the pressure. It won’t hurt as much this time because blood has filled the void and it’s already starting to heal the muscle.

Keep doing this until you don’t feel pain anymore, and then look for another point. I call these points “hot spots” because that’s exactly what they remind me of.

Feel around your head, your neck, and your shoulders and apply pressure on each painful point. You’ll be pleased when you feel the results! If it’s stress related, your headache pain will be gone.

What Supplements Help Mental Health?

January 14, 2020 by Dr. Steve Chaney

Do Omega-3s Reduce Depression?

Author: Dr. Stephen Chaney

We are in the midst of a mental health crisis. According to the latest statistics:

· 19% of adults in the United States have some form of mental illness.

· 16.5% of youth ages 6-17 have some form of mental illness.

· The 5 most commonly diagnosed forms of mental illness are anxiety, depression, post-traumatic stress disorder, bipolar disease, and ADHD.

Even worse, mental illness appears to be increasing at an alarming rate among young people. For example:

· Between 2005 and 2017 depression increased 52% among adolescents.

· Between 2002 and 2017 depression increased 63% in young adults.

· Between 1999 and 2014 suicides have increased 24% in young adults. In the past few years suicides have been increasing by 2% a year in this group.

Much has been written about the cause of this alarming increase in mental illness. The short answer is that we don’t really know. But the most pressing question is what do we do about it?

The medical profession relies on powerful drugs to treat the symptoms of mental illness. These drugs don’t cure the illness. They simply keep the symptoms under control. Plus, if you have ever listened closely to the advertisements for these drugs on TV, you realize that they all have serious side effects that adversely affect your quality of life.

My “favorite” example is drugs for anxiety and depression. You are told that one of the side effects is “suicidal thoughts”. That means that the very drug someone could be prescribed to prevent suicides might actually increase their risk of suicide. Why would anyone take such a drug?

If drugs are so dangerous, what about supplements? Do they provide a safe, natural alternative for reducing the symptoms of mental illness? Some supplement companies claim their products cure mental illness. Are their claims true or are they just trying to empty your wallet?

How is a consumer to know which of these supplement claims are true and which are bogus? Fortunately, an international team of scientists has scoured the literature to find out which supplements have been proven to reduce mental health symptoms.

How Was The Study Done?

This was a massive study (J. Firth et al, World Psychiatry, 18: 308-324, 2019. It was a meta-review of 33 meta-analyses of randomized, placebo-controlled trials with a total of 10,951 subjects. The clinical trials included in this analysis analyzed the effect of 12 nutrients, either alone or in combination with standard drug treatment, on symptoms associated with 10 common mental disorders.

To help you understand the power of this meta-review, let me start by defining the term “meta-analysis”. A meta-analysis combines the data from multiple clinical studies to increase the statistical power of the data. Meta-analyses are considered to be the gold standard of evidence-based evidence.

However, not all meta-analyses are equally strong. They suffer from the “Garbage-In, Garbage-Out” phenomenon. Simply put, they are only as strong as the weakest clinical studies included in their analysis.

That is the strength of this meta-review. It did not simply combine the data from all 33 meta-analyses. It used stringent criteria to evaluate the quality of each meta-analysis and weighted the data appropriately.

What Supplements Help Mental Health?

The strongest evidence was for omega-3 supplements. In the worlds of the authors:

· “Across 13 independent randomized control clinical trials in 1,233 people with major depression, omega-3 supplements reduced depressive symptoms significantly.”

o The average dose of omega-3s in these studies was 1,422 mg/day of EPA.

o The effect was strongest for omega-3 supplements containing more EPA than DHA and for studies lasting longer than 12 weeks.

o There was no evidence of publication bias in these studies. This is a very important consideration. Publication bias means that only studies with a positive effect were published while studies showing no effect were withheld from publication. That makes the effect look much more positive than it really is. The fact there was no evidence of publication bias strengthens this conclusion.

o Omega-3 supplements were more effective when used in combination with antidepressant drugs, but there was some evidence of publication bias in those studies.

· “Across 16 randomized control clinical trials reporting on ADHD symptom domains, significant benefits were observed for both hyperactivity/impulsivity and inattention.”

· Omega-3s had no significant effect on schizophrenia or bipolar disorder other than a mild reduction in depressive symptoms.

There was strong, but not definitive, evidence for folic acid and methylfolate supplements for depression.

· When used in conjunction with antidepressants both folic acid and methylfolate supplements “…were associated with significantly greater reductions in depressive symptoms compared to placebo, although there was large heterogeneity between trials.”

· The largest effects were observed with high dose methylfolate. In the words of the authors: “Two randomized control clinical trials examining a high dose (15 mg/day) of methylfolate administered in combination with antidepressants found moderate-to-large benefits for depressive symptoms.” However, to put this into perspective:

o 15 mg/day is 3,750% of the RDA. This is a pharmacological dose and should only be administered under the care of a physician.

o A smaller dose of 7.5 mg/day is ineffective.

o No comparison was made with folic acid at this dose, so we do not know whether folic acid would be equally effective.

· The authors concluded that there is emerging evidence for positive effects of vitamin D (>1,500 IU/day) for major depressive disorders and N-acetylcysteine (2-3 gm/day) in combination with drugs for mood disorders and schizophrenia. The term “emerging evidence” means there have been several recent studies reporting positive results, but more research is needed.

· The authors did not find evidence supporting the use of other vitamin and mineral supplements (E, C, zinc, magnesium, and inositol) for treating mental health disorders.

· The authors did not find enough high-quality studies to support claims about the effects of prebiotics or probiotics on mental health disorders.

Do Omega-3s Reduce Depression?

The evidence supporting the effectiveness of omega-3s in reducing symptoms of depression is strong. In the words of the authors: “The nutritional intervention with the strongest evidentiary support is omega-3, in particular EPA. Multiple meta-analyses have demonstrated that it has significant effects in people with depression, including high-quality meta-analyses with good confidence in findings…”

However, before you throw away your antidepressants and replace them with an omega-3 supplement, let me put this study into perspective for you.

· Depression can be a serious disease. If you just feel a little blue from time to time, try increasing your omega-3 intake. However, if you have major depression, don’t make changes to your treatment plan without consulting your physician.

· The best results were obtained when omega-3s were used in combination with antidepressants. This should be your starting point.

· Ideally, adding omega-3s to your treatment plan will allow your doctor to reduce or eliminate the drugs you are taking. That would have the benefit of reducing side effects associated with the drugs. However, I would like to re-emphasize this is a decision to take in consultation with your doctor. [My only caveat is if your doctor is unwilling to even consider natural approaches like omega-3 supplementation, it might be time to find a new doctor.]

· Finally, omega-3 supplementation is only one aspect of a holistic approach to good mental health. A healthy diet, exercise, supplementation, and stress reduction techniques all work together to keep your mind in tip-top shape.

The Bottom Line

There are lots of supplements on the market promising to cure depression and other serious mental health issues. Are they effective or are the claims bogus? Fortunately, a recent meta-review of 33 meta-analyses of high-quality clinical trials has answered that question. Here is their conclusion:

· The evidence is strongest for omega-3s and depression.

o The average dose of omega-3s in these studies was 1,422 mg/day of EPA.

o The effect was strongest for omega-3 supplements containing more EPA than DHA and for studies lasting longer than 12 weeks.

· There is fairly strong evidence for folate/folic acid supplements and depression, although there was large heterogeneity between trials.

· There is emerging evidence for vitamin D (>1,500 IU/day) and depression and N-acetylcysteine (2-3 gm/day) for depression and schizophrenia.

· Evidence for other supplements is currently inconclusive.

However, before you throw away your antidepressants and replace them with an omega-3 supplement, let me put this study into perspective for you.

· The best results were obtained when omega-3s were used in combination with antidepressants. That should be your starting point.

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.

High Protein Diets and Weight Loss

October 16, 2018 by Dr. Steve Chaney

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.

Should We Use Supplements For Cardiovascular Health?

July 10, 2018 by Dr. Steve Chaney

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.

Iron Deficiency In Children May Negatively Affect Their Brains

July 3, 2018 by Dr. Steve Chaney

Is Your Teen Getting Enough Iron?

Author: Dr. Stephen Chaney

For those of you with teenagers – or who have had teenagers in the past – you may suspect that there’s nothing between their ears. But actually, there is a lot going on between their ears, and some of the neural contacts laid down in the brain during the teen years influence the health of their brain during their adult life.

And – no surprise here – what they eat can affect the health of their brain as well. Iron deficiency in children may negatively affect their brains later in life.

Which brings me to a study (N. Jahanshad et al, PNAS 109 E851-E859, 2012 ) that looks at the adequacy of dietary iron intake during the teenage years and their brain health as adults.

Basics of Iron Metabolism

Before I describe the study perhaps a little bit of what I call Biochemistry 101 is in order.

Free iron is toxic to living cells. For that reason, our body produces multiple proteins to bind and transport the iron. The protein that binds and transports iron through the bloodstream is called transferrin. Under normal conditions 2/3 of the transferrin in our bloodstream has iron bound to it and 1/3 does not. And that is the ideal ratio of bound and unbound transferrin for delivery of iron to brain cells and other cells in our body.

When our diet is iron deficient (or we have excessive blood loss) the percent iron saturation of transferrin decreases. The body tries to compensate by producing more transferrin, but this doesn’t really help since the problem was inadequate iron supply, not inadequate transferrin supply. Consequently, elevated transferrin levels are generally indicative of an iron-deficient diet.

Iron Deficiency In Children

The study was led by Dr. Paul Thompson of the UCLA Department of Neurology. He and his team performed brain scans on 631 healthy young adults with an average age of 23. The brain scans were of a type that measured strength and integrity of the connections between the nerves in the brain – in other words, the brain’s wiring. They then went back and looked at the amount of iron available to each subject’s brain during adolescence by looking at their blood transferrin levels from routine physical exams performed at ages 12, 14 and 16 (blood transferrin levels are often measured as part of routine physical exams).

The results were clear cut. Elevated transferrin levels during the teenage years were associated with reduced brain-fiber integrity in regions of the brain that are known to be vulnerable to neurodegeneration. These individuals did not show any cognitive impairments as young adults, but the concern is that they might be more likely to develop cognitive impairments as they age. From this, we can determine iron deficiency in children may make them susceptible to mental disease as they age.

Dr. Thompson summarized his team’s findings by saying that “Poor iron levels in childhood erode your brain reserves which you need later in life to protect against aging and Alzheimer’s. This is remarkable, as we were not studying iron deficient people, just around 600 normal healthy people. It underscores the need for a balanced diet in the teenage years, when your brain command center is still actively maturing.”

Questions Every Parent Should Ask

If you have teenagers, you might want to ask yourself questions like:

What is your teenager’s diet like?
Is it balanced?
Are you sure that it meets their nutritional needs?
Should you consider supplementation to make sure that they are getting all the nutrients that they need?

The Bottom Line

A recent study suggested that inadequate iron intake in the teenage years may affect how our brains are wired in our adult years. The authors of the study interpreted the study as suggesting that an inadequate diet during the teen years could predispose us to cognitive decline and Alzheimer’s as adults.
This study only looked at structural differences in the brain circuitry. We can’t conclude from this study alone that inadequate iron intake as a teenager will doom somebody to cognitive impairment and increased Alzheimer’s risk as they age. But we can conclude that adequate iron intake during adolescence is required for normal brain development.
And it’s probably not just iron. This study focused on iron status because transferrin levels are routinely measured during physical exams, so it was easy to go back and determine what each subject’s iron status was during their teenage years. Many other important nutrients are required for normal brain development, but we don’t have an easy way of going back and determining what someone’s nutritional status was for those nutrients in their teen years. What was shown to be true for iron in this study is likely to be true for other nutrients as well.
These were normal teens eating a normal American diet. They weren’t from a third world country and there was nothing weird about what they were eating. But, clearly some of the subjects in the study weren’t getting the iron that they needed from diet alone.
The teen years are a time of rapid growth and maturation. It’s not just the brain that needs the proper balance of nutrients during the teen years. All their tissues require proper nutrition.

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 There Any Honest Nutritional Supplement Companies?

November 8, 2016 by Dr. Steve Chaney

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.

Teen Obesity and Heart Disease

May 4, 2016 by Dr. Steve Chaney

Author: Dr. Stephen Chaney

I don’t need to tell you that we are in the midst of an obesity epidemic. Sadly, that obesity epidemic has even affected our children. Currently, one third of the adolescent population of the United States and other developed countries is overweight or obese, and those numbers are rapidly increasing. Teen obesity and heart disease are not uncommon.

You probably also knew already that overweight and obesity in the early years increases the risk of death from cardiovascular disease and other causes among young adults, but a new study suggests that the consequences of overweight during the teen years may be much worse than we thought.

How Was This Study Done?

This study (Twig et al, The New England Journal of Medicine, DOI:10.1056/NEJMoa1503840, Published April 13, 2016) was based on a national database of 2.3 million Israeli adolescents ages 16-19 (average 17.1) for whom height and weight were measure between 1967 and 2010. Israel has such an extraordinarily large database because one year before military service all Israeli adolescents are required to undergo a medical evaluation. This is predominantly a male population because Orthodox women are excluded from service.

Israel also has a national health service that keeps a comprehensive database of deaths. Therefore, the investigators were able to record all deaths in this group that were attributable to coronary heart disease, stroke, sudden death from an unknown cause, or a combination of all three categories, which they classified as total cardiovascular deaths through June 30, 2011. That means that the median age at the end of the study was around 40.

The investigators divided the subjects into groups based on their BMI (weight (kg)/ height (m)²), a measure of the leanness or obesity of each individual and compared BMI with deaths due to various kinds of heart disease.

What sets this study apart from all previous studies was the size of the database (2.3 million). Because of the very large number of subjects in the study the investigators:

Were able to accurately measure the effect of BMI on cardiovascular deaths in people aged 30-40, an age at which the incidence of cardiovascular deaths is relatively low.
Were able to divide the subjects into seven BMI groupings, rather than the two or three used in most previous studies.

For example, most previous studies have simply compared individuals who were obese (BMI > 95^th percentile) or overweight (BMI in 85^th to 94^th percentile) with everyone in the normal range (BMI in the 5^th to 84^th percentile).

This study further separated individuals within the normal BMI range to high-normal (BMI in the 75^th to 84^th percentile), mid-normal (BMI in the 50^th to 74^thpercentile), and low normal (BMI in the 25^th to 49^th percentile) and compared each group to individuals with BMIs in the 5^th to 24^th percentile.

Teen Obesity and Heart Disease: Will Your Teen Die Prematurely?

The results of the study were pretty sobering.

1) For teens who are obese (210 pounds for a 6’ boy and 175 pounds for a 5’6” girl) at 17, their risk of dying prematurely from:

Heart attack increases 4.9 fold
Stroke increases 2.6 fold
All cardiovascular causes increases 3.5 fold
The increased risk of dying from all kinds of cardiovascular disease was 2-fold greater by age 27 and 4-fold greater by the time the subjects had reached age 37-47.

2) For teens who are overweight (185-209 pounds for a 6’ boy and 155-174 pounds for a 5’6” girl) at 17, their risk of dying prematurely from:

Heart attack increases 3.0 fold
Stroke increases 1.8 fold
All cardiovascular causes increases 2.2 fold

3) For teens who are at high-normal weight (175-184 pounds for a 6’ boy and 145-154 pounds for a 5’6” girl) at 17, their risk of dying prematurely from:

Heart attack increases 2.0 fold
Stroke increases 1.4 fold
All cardiovascular causes increases 1.8 fold

4) Perhaps the most surprising finding was that even for teens who are at mid-normal weight (155-174 pounds for a 6’ boy and 130-144 pounds for a 5’6” girl) at 17, their risk of dying prematurely from:

Heart attack increase 1.5 fold
All cardiovascular causes increases 1.3 fold

5) The number of teen girls in the study was much less, but they appeared to have similar increased risk of cardiovascular deaths with increased BMI compared to the boys in the study.

The message is clear on teen obesity and heart disease.

Obesity and overweight during the teen years are killers. They can lead to a significant increase in deaths due to heart attacks, strokes and all cause cardiovascular mortality long before those teens reach the age of 50.

Even teens who are in the higher end of what is considered a normal weight range are at increased risk of cardiovascular mortality long before they reach their golden years.

The Bottom Line

A recent study compared the BMI of 2.3 million Israeli teens (average age 17) with cardiovascular deaths over the next few decades

1) Teens who were overweight or obese had a 2-fold greater risk of dying from cardiovascular disease by age 27 and 4-fold greater risk by the time they reached age 37-47.

2) Even teens who were at the upper end of the normal weight range had a 1.8-fold increased risk of dying from cardiovascular disease.

The message is clear.

Obesity and overweight during the teen years are killers. They can lead to a significant increase in deaths due to heart attacks, strokes and all cause cardiovascular mortality long before those teens reach the age of 50.

Even teens who are in the higher end of what is considered a normal weight range are at increased risk of cardiovascular mortality before they reach their golden years.

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.