Monthly Archives: December 2005

The Best News of 2005: What you can do to be healthier in 2006

The Best News of 2005:  What you can do to be healthier in 2006

Competency #20  LIFESTYLES OF THE LONG LIVED

Reference:  The best literature in 2005 and from the Tufts Health and Nutrition Letter, December 2005.

This news is condensed from the best literature in 2005 and from the Tufts Health and Nutrition Letter, December 2005.  (One of many good ones)

1.  New food guidelines say:  WHOLE GRAINS.  Breakfast is a great place to start.  If you can start your day with a whole grain breakfast, your metabolic response to lunch is better.  And the data shows that women who eat breakfast end up eating 200 calories a day less and end up being slimmer.

2.  EXERCISE makes a huge difference.  You lower your blood sugar.  There is data that shows all levels work.  Even if it’s just on weekends.  Do it: 30 minutes.

3.   DASH Diet:  says 3 servings of calcium a day.  Milk, cheese and yogurt.  Try and make it low fat.  Lowers your BP.  You are likely to feel full faster and have less risk for diabetes.  Women probably get a little less PMS.  What’s not to like.

4.  VITAMIN D.  Makes two national newsletters now.  NO excuses.  This is winter.  You need AT LEAST 1000 additional units a day.  Buy it.  Take it until April.

5.  FRUITS AND VEGETABLES make the headlines.  DASH diet again.  There is clear evidence on reduced BP,  reduced CAD,  less cancers, and  probably less arthritis.  9 servings is easy.  A serving is only 1/2 cup.  (1 cup of salad)   Count every day and make it colorful:  Red, orange, green, yellow

6.  Be a POPEYE.  The DASH diet wants you to eat veggies.  But SPINACH is a special hit.  The green leafy veggies are so packed with vitamins and antioxidants, that the data now shows reduced Coronary Artery disease (11% for every serving a week of spinach) and Alzheimer’s.  To get with the guidelines from the FDA, eating more leafy green spinach, kale, collards, mustard (NOT iceberg lettuce) means adding about 2 cups a week.  You can do it.

7.  Popeye’s Girl was OLIVE OIL.  Change your fats.  All veggie oil is pretty good.  Olive is a champion.  It hasn’t had it’s omega threes removed like canola oil has.  Just get rid of animal fats, lard, bacon grease, and TRANS fats.

8.  Popeye was a …SAILOR and sailors eat FISH.   Fish twice a week slows your average mental decline by 13% a year.  That’s huge.  By age 80, your brain is still just 77.

9.  TRANS FATS are on the label starting 1/1/2006.  Learn to read the label.  And avoid them like the plague.  They are poisons.  Candy bars, junk food machines, Dream Whip, French Fries.  We Americans are eating 9% of our calories from trans fats.  Remember, every candy bar you eat is another tuition payment for your cardiologist’s kid in a private college.

10.  High FRUCTOSE  Corn Syrup is a NO GO.  There is more and more evidence.  POISON number 2 (after trans fats).  It’s cheap.  It’s sweet.  It pays the second semester’s tuition.  Don’t do it.

New Way to Weigh

New Way to Weigh

Competency #1RISK

Reference:  The Lancet, Volume 366, Issue 9497, 5 November 2005-11 November 2005, Pages 1640-1649

This is a simple little message but the evidence is now pretty conclusive.  We sometimes use BMI to measure ourselves.  The article in Lancet just a month ago referenced below shows some very interesting data.  It suggests that the Body Mass Index is not as accurate as we would like in predicting risk for coronary artery disease.  The formula for BMI is

BMI =  (weight in pounds)/(height in inches)2   * 703

Under 25 is a great BMI.  Over 30 is obese.

This method has faults.  Superbly conditioned athletes have BMIs in the 30s, but lots of muscle.  The Lancet study confirms the inability for the BMI to actually predict what risk you have.

Instead, it suggests that we use the WAIST/HIP ratio.  Simple.  Measure your waist in inches.  Divide by your hips (in inches).  A ratio under .9 for men and .85 for women is predictive of least risk.  This accounts for the risk associated with abdominal fat or the “apple” shape of being overweight.  Fat on hips and thighs is not near as problematic.

In fact, this is not the first article to address this issue.  If you start following the literature, this idea has been around for a couple of years.  This appears to be a nail in the coffin on the evidence.  We can now say confidently, this is the better way to measure and talk about obesity.

WWW: What works for me.  I find it a “bummer”.  My ratio is .96.  I was 26 on the BMI, much closer to a good ratio.  I’ve got more work to do today.

So, starting in January I’m joining a Weight Loss program.  More to follow on that.

 

“Resolvin” to Eat More Fish

How Fish Oil Works: The Method

Competency #13 FATS

Reference:  Journal of Experimental Medicine Vol 196, #8 pp 1025-1037; Current Nutrition and Metabolic Care:  Vol 8(2), March 2005, p115-121

For those who wonder why, here is a fascinating line of explanation to show how fish oil works.

Charles N. Serhan, at Harvard, has been studying the inflammatory response and how aspirin modulates it.  In the Journal of Experimental Medicine (Vol 196, #8 pp 1025-1037) his group has isolated and described a whole new set of “eicosanoids” that are cell to cell messengers.  Aspirin turns them on sharply.  An eicosanoid analogy: it’s like an intercom in your office to your next door work mate compared to a local phone call or a long distance internet call.  The most local of hormones, eiconsanoids included prostaglandins, leukotrienes, lipoxins.  The precursors to these chemicals are what we call DHA or EPA or most simply: fish oil.  Eiconsanoids last only a millioneth of a second and are degraded promptly.  We are used to the language of prostaglandins and are familiar with how ibuprofen affects prostaglandins.

Serhan has found a new class of eicosanoids that he has called Resolvins in that they turn on the resolution of inflammation.  Aspirin turns them on even more.  Interestingly, the huge GISSI Prevenzione trial evaluated the use of fish oil and was the source of the American Heart Association recommendation that we all eat more omega-3 fatty acid fish because of the remarkable reduction in sudden death.  Many patients were also taking aspirin in that study, as ASA is part and parcel of early MI treatment.

What we do know is that unresolved inflammation is important in many chronic disorders which include heart disease, asthma, and Alzheimer’s.  The “resolvin” class of chemicals turn off that inflammation and signal the body to clean up the mess by mobilizing macrophages to eat up all the dead stuff and stop the inflammatory cascades.  This is significant because this opens up a whole new arena for research on chemicals to turn off inflammation.  We have one potent drug that works here, aspirin.  Are there others?  This is another place where aspirin has a profound and potent effect.  If this drug was discovered today, it would sell for $ 10 a tablet.  Fortunately, you pay $. 01 a tablet.

WWW: What works for me.   I take three fish oil pills a day before breakfast.  If I take it at bedtime, I burp fish.  If I take them before eating breakfast, I’m fine.  All the bottles want you to take more.  Enough already.  And, I take a baby aspirin.  I’m 54, sudden death is an issue for any of us over 45 and male, over 55 and female.  Take your one a day for the rest of your life.  I’ll let you know if I find anything to the contrary.

One good article to read:  There is now a Review article published just this year Current Nutrition and Metabolic Care:  Vol 8(2), March 2005, p115-121.  It talks about the possibilities for future research as we unfold the implications of this whole new class of chemical messengers that are manufactured from fish oil.

Tea for Two: Reducing Ovarian Cancer Risk

Tea for Two:  Reducing Ovarian Cancer Risk

Competency #14 SUPERFOODS

Reference:  Archives of Internal Medicine,  Dec 12, 2005:165, 2683-2686  Author Susanna Larrson)

Ovarian Cancer is # 4 on the Hit List.  You can screen for breast cancer (#1).  You can screen for colon cancer.  You can not smoke.  But it’s really hard to screen for ovarian cancer.  So, it remains on the hit list of nasty diseases.  And I’ve just had my life affected by a death from ovarian cancer, so I have a grudge.

Prospective studies are few and hard to find.  So when the Swedish researchers at the Karolinska Institute in Sweden released their study there was lots of attention paid to it.  They have followed over 61,000 women from 1987 till 2004. (This prospective study is almost as large as Harvard’s Nurses study, and for almost as long, so it has large numbers of people for a long period of time.  That adds validity). Because of prior population studies that hint at beneficial effects from tea, they specifically asked the study participants how much tea they drank.  This was followed prospectively, not backwards from memories of behaviors past.  In that cohort of women, 301 developed ovarian cancer, prospectively.

The results showed that many women never drank tea at all.  Those who drank two cups of tea a day had a 46% reduction in their ovarian cancer risk.  And for each cup of tea a day past two, another 18% reduction occurred.   The linear relationship with consumption suggests validity.  Interestingly, no effect at all was found for coffee.  The p value was .03.  Reasonably solid.

This doesn’t prove anything because it’s just a first study.  We don’t understand the actual mechanism.  This is just a population-based association.  But it is prospective, and the numbers are huge.  It will take many years to ever repeat such a study.  It will take even longer to find a population of humans willing to do one precise behavior for 20 years.  I haven’t got that many years left myself.  But it adds to the body of knowledge that leads us to agree that foods high in antioxidant value (the presumption here) keep showing themselves to have benefit in varieties of different studies.

WWW: What will work for me:  I drink a big mug of tea each day at breakfast.  I like mine the Chai way: lots of milk and Stevia with a hint of cardamom and cinnamon.  Chai spice tea is available now from multiple different companies.  It makes tea more interesting. A comfort food with few calories.   I get a calcium serving out of it because my mug is 1/3 skim milk.  It keeps me warm as I walk our pooch in the yard.  You can make your own Chai Spice:  experiment with a tiny shake of cardamom.  Try adding a tiny touch of cinnamon your next go around.  Some folks like adding black pepper and some like heavy cream.