Monthly Archives: June 2006

When You Lose Weight: Does it Make You Live Longer?

When You Lose Weight: Does it Make You Live Longer?

Competency #1: Know Your Ideal Body Size

Reference: JAMA. April 5, 2006, Heilbronn et al.

This is a complex question that has been hotly debated.  In many small mammals, calorie restriction leads to markedly longer life spans, as much as 30%.  Does that apply to humans?  Is it worth it to lose weight?  We have population studies that show a virtual linear relationship with risk for heart disease, cancer and Alzheimer’s with increasing weight.  But how does weight loss and gain help?  We have “associations” and “assumptions” and “population studies”.  We haven’t had direct proof.  We haven’t had proof that total energy expenditure is reduced in humans after weight loss.  Nor have we had proof that markers for various kinds of stress are improved with weight loss.  But one of the going theories is that we gradually damage our bodies over time with oxidative stress.  About 1-2% of our oxygen consumption gets turned into free oxygen radicals, and that damages our DNA, our proteins, our membranes.  We can show that this happens.  And we can show that eating lots of anti-oxidants reduces free oxygen radicals.  (That’s why I buy blueberries.  Last week it was all about the champion of antioxidant foods: blueberries)

NOW, we have some PROOF by experimental design in humans.  This is a great leap forward.  In JAMA, April 5 this year, a study was published from LSU in Baton Rouge by Dr. Heilbronn et al titled “Effect of 6 month calorie restriction on Biomarkers of Longevity, Metabolic Adaptation and Oxidative Stress in Overweight Individuals.”  This is a cool study.  48 people were randomized into 4 groups for a 6-month diet intervention.  Only 2 dropped out.  The groups were:  “control” (no change in diet), “calorie restriction” (25% less calories), “diet plus exercise” (12.5% calorie reduction with 12.5% increased burn by exercise) and “very low calorie” (890 calories until a 15% weight loss.)

Findings:  Two biomarkers of longevity (fasting insulin level and body temperature) are decreased by prolonged calorie restriction.  And reduced more so than change in body mass.  Thyroid blood tests were in sync with the slow down, suggesting that our thyroid glands are pretty smart and are part of changing our body’s overall metabolic rate.  That means that calorie restriction really does reduce your actual need for calories.  We all know that.  I try to lose weight and immediately find that my body gets along on less so I have to try even harder.   And I get freezing cold at night and need another blanket.  That’s very self evident to me.  But it hasn’t been “proven” before.  Now it has!  And there is less DNA damage to boot.  It doesn’t seem to matter which path you take.  These changes occurred in all three study groups.  And the changes were maintained even after the baseline was achieved.  Losing weight to a lower body mass fundamentally changes your internal markers of stress and longevity.  It works.  The living longer question will have to weight, I mean wait, another 30 years.  I haven’t got that much time to weight.  I need to skinny up a little bit more.

WWW:  What will work for me?  This is basic science data that supports the concept of losing weight to add to longer-lived healthy life plans.  It explains to me why it’s so hard to do too.  The reward is worth it.  It’s a life long journey.  Back to my blueberries.

Berries You Can Bank On

Berries You Can Bank On

Competency # 14 SUPERFOODS

Reference: Tufts University Health and Nutrition Letter 2005 May:1-4;  British Journal of Sports Medicine.2006 Aug:40(8):679-83

Dr. Joseph at Tuft’s University School of Public Health loves blueberries.  It’s his research that has given the boost to blueberries.  His team uses the ORAC (Oxygen Radical Absorption Capacity) scoring developed by the NIH.  This is a measure of how effective an antioxidant a food is.  Blueberries are the top of the pyramid with an ORAC score of 2400 for a cup of blueberries.  Their intense blue color comes from anthocyanins, of which there are at least 5 different ones identified so far.  Strawberries, cranberries, cherries and other brightly colored fruits all have ORAC scores in the 600-1800 range, but it’s blueberries that come out on the very top.

Dr. Joseph discovered that a line of mice that developed an illness that looks identical to Alzheimer’s in humans, can be virtually completely prevented from getting their Alzheimer’s by adding blueberries to their diet (10% of calories).  Without the blueberries, their brain cells don’t stay connected with their normal diet, and they get confused, can’t find their way through mazes and act like Alzheimer’s.  When you add the blueberries, their brains show that their neurons stay connected, even though they still develop other signs of brain pathology consistent with Alzheimer’s.  Because I sent out an email last year about blueberries, some of you may question whether my memory is holding up all that well. The value of flavonoids is such an important concept to integrate into your personal health care that we are doing it again.  And its blueberry season now.

We do know that people with the highest levels of antioxidants in their blood have lower rates of cancer.  We have been unable to find good research to date that has been prospective in nature that shows eating more antioxidants to have short-term health effects.

Well, this month I found one.  The sour cherry story has been anecdotal to date.(Cherries: ORAC score 670)  Thousands of people have  “anecdotally” felt that their sore legs and joints got better when  they drank sour cherry juice.  All the nutrition gurus seemed to cautiously poo-poo that evidence.  You can now “poo-poo” back. This last week, in the British Journal of Sports Medicine, 14 male college students were studied in a double blind, cross over prospective study that had “muscle damaging” exercise as its component.  There was a 22% difference in strength between the groups when they had the real cherry juice and a faster recovery from pain.  Of course, this is a small study but it was blinded and appears rigorous in its methodology.   The antioxidant in cherries is called quercetin.  It’s different than in blueberries, but functions in nature in the same way.  All of these classes of “antioxidants” are active in soaking up free oxygen radicals that are chemicals our body makes that have inflammatory properties and DNA damaging properties to them.  Even the inflammation of exercise and overuse seems to have a responsive component.  Is it an anti-inflammatory effect or an antioxidant effect?  Are those two different, or part of the same story?  Stay tuned.  I’m curious too.  We will found out.

But for now, cherries and blueberries are in season.  It’s time to party. (Ok, get a life.  Partying with blueberries?)

What Will Work for Me:  I went to the grocery story and bought a case of blueberries today.  I’m going to freeze them and eat them all winter on my cereal.  And instead of taking donuts to share at work, I’ve got 2 pounds of cherries to take in.  Make yourself popular.  Take some of those magnificent huge cherries to work tomorrow.   And if you feel a little achy, you can try cherry juice now and feel like the world of science is finally catching up with you.

Switch to Spinach

Switch to Spinach

Competency # 14  SUPERFOOD

Reference:  Superfoods by Steven Pratt, M.D. and Kathy Matthew

It’s summer and spinach is in!  This is a SUPERFOOD, a term coined by authors Steven Pratt and Kathy Matthews.  Spinach is an amazing vegetable and here’s the reason why.  I have seen article after article about the various ingredients of spinach over the last few years.  It’s time to just weigh in and switch.  Pratt and Matthews have now published a book called “Superfoods”.    It’s great summer reading because all the good stuff is now in at the grocery store or farmer’s market.  Time to feast on really good food.

Popeye talked about the iron.  His girl friend, Olive Oil (intentional misspelling) was the perfect friend.  But the benefits of spinach are hardly limited to its iron content.  It’s the other nutrients in spinach that make it a superstar.  Did you know that half of spinach’s calories are from protein?  Yes, protein.  In fact, it’s one of the plant kingdom’s most concentrated sources of protein.  Then there’s a ton of vitamin A and a bunch of other carotinoids.  It contains Vitamin K, which is crucial for bone health.  It’s one of only two foods that give you CoEnzyme Q.  Then, there are all the other antioxidants.  All around, spinach has very high nutritional density.  That’s the key.  We need so many nutrients a day, we need to make sure the foods we eat have enough of them to justify and make up for the low density calories we find ourselves eating when we have a donut or a piece of white cake at the company picnic.

What’s important to know about spinach is that it’s not a solo actor.  All the foods in its group are about as good.  Kale and collards are very similar.  Swiss chard and mustard greens are up there too.  When our grandparents ate collards, and greens, and chard, they were getting great food.

When you get into the research articles about the benefits of spinach, you find things like:  heart disease benefit: for each serving of spinach a week you get a 7% reduction in your risk profile for coronary artery disease.  I’m not sure if you eat 14 servings a week you drop to zero, but the data suggests it works up to 2-4 servings.  And every ophthalmologist wants you to eat more to protect your eyes.  If you Google spinach, you will find dozens of web sites that continue the rave.   Do it, and switch.

WWW: What will work for me.  This is easy.  We’ve really stopped eating most of our iceberg lettuce.  When I have any choice, I make my salad from spinach, with olive oil dressing.  Now, I’m trying to explore and find out other spinach recipes that aren’t just boiled.  There are wonderful Greek recipes, Indian curries, southern recipes that are just delicious.  Time to explore!

Vitamins and Antibiotics

Vitamins and Antibiotics

Competency # 13 VITAMINS

Reference: Science.2006;312(5778),p1355-9

This is unique and very interesting.  I have always thought that we humans were a unique creation that existed by the sweat of our brow and the fruitfulness of the earth around us.  Well, now we need to expand that a little.  We need to start thinking of ourselves as unique communities, not just unique individuals.  The community I’m talking about is our bacterial colonies in our guts.  I, all by myself, am a unique community.   I live in a partnership with about 10,000,000,000,000 bacteria in my gut.  That’s trillion.

In the, is an article about the DNA present in the bacteria in our gut.  It represents almost 100 times the variety of DNA that we have in our individual cells.  And in that DNA turns out to be a very rich source of variety and usefulness.  Most notably, our flora in our intestines have the metabolic pathways to digest many foods we can’t digest at all, and the ability to make many vitamins and amino acids we can’t make at all, or that we make in limited quantity.

When we eat indigestible complex carbohydrates, we would not digest those nutrients at all were it not for the bacteria in our colons.  Well, that’s what cows and other ruminants do.  And many of the essential amino acids that we need to construct our proteins aren’t made in our own cells, they are made by the bacteria in our colons and then absorbed for our use.  And the vitamins that we can’t make at all, are often actually made in our gut in greater bounty than what we eat.

Now, I thought all our vitamins came from eating bountiful fruits and vegetables.  I thought the nature of a vitamin was that we couldn’t make it ourselves.  That’s true.  Where the vitamin comes from is what is news to me.

This also raises very interesting thoughts about what antibiotics we so easily allow ourselves to be exposed to.  We have found occasional episodes where those antibiotics cause great harm: like when we get Clostridium dificile superinfections.  Now, we have another venue to explore.  Giving lots of antibiotics may mean our bacteria in our colons are being injured and depriving us of essential nutrients.

WWW.  What will work for me.  I’m going to think a little more about antibiotics before I let them be given to me.  And I’m going to watch this topic.  This is a whole new field of inquiry.  I always wanted to have a condo in some exotic spot.  I never knew that I was a condo association, all by myself, for some 10 trillion helpful neighbors.  I just didn’t know that cows were so “close” to me.


Taking B Vitamins and Heart Disease Risk

Taking B Vitamins and Heart Disease Risk

Competency # 15 VITAL VITAMINS

Reference:  New England Journal of Medicine 354(15):1567-1577 April 13, 2006

It doesn’t work!  At least in the short term according to NBC, CNN and ABC news last month.  We all heard it in the news and felt frustration and confusion.  How could it be that we have another negative trial?  What’s the deal with these ideas that seem so promising?  My Aunt takes all three of these vitamins separately because she has read in various health promoting news letters that they improve your risks with heart disease.  In the New England Journal of Medicine, lead article in April, the HOPE Study (Heart Outcomes Prevention Evaluation) announced that taking folate, B6 and B12 did not reduce the risk of major cardiovascular events.  How disappointing!  But maybe not the final word…

Here is my read on it.  The study lasted 5 years.  The age of the volunteers was 55 or older.  They did find 5522 volunteers for 5 years.  That is a huge and very expensive study to conduct.  There are two conclusions I think you can draw.  One, the authors state: perhaps homocysteine is a passive marker of illness, not a cause.  If you do observational studies, you will find it but it is really just an innocent bystander.  Like chasing taillights, you are behind the real culprit.  That’s one plausible explanation.

Two, what we do know from observational population studies is that the chemical homocysteine in your blood is seemingly bad for you. The higher it is, the more likely you are to have vascular disease.  Populations with low homocysteine levels have lower rates of heart attacks.  We know from this study that taking the vitamins also doubled your blood levels of the vitamins, as you would expect.   And homocysteine levels did go down.  The authors claimed they had enough patients to show a 17-20 % reduction by their statistical evidence.  It just didn’t happen.

My thoughts are as follows.  We do know that autopsies done on 20-year old Americans show fatty streaks at age 20.  We don’t get heart attacks until age 50 or so.  Vascular disease is not something that starts at age 55.  It starts with weaning from baby carrots and milk to

Mac Donald’s and Macaroni and Cheese.  A life long disease needs life long changes.  And one megavitamin at a time can’t reverse those.  We need the whole food with the whole list of vitamins in it, not just the folate or B6, B12.  That way we will reduce our homocysteine the natural way.  Unfortunately, you have to do it everyday.

What Will Work for Me!  I’m not deterred.  I take a multivitamin every day.  I eat lots of fruit and vegetables where I get lots of vitamins.  Balanced, sensible nutrition.  It’s the whole package, just not one that contains Mac and Cheese.   What I can’t figure out is how the full fat Mint Chocolate Chip ice cream got into my grocery cart last week.  I clearly need help.

Sunburn and Melanomas

Sunburn and Melanomas

Competency #8  Good Fats and Bad Fats

Reference:  In 2003, the National Academy of Sciences published a comprehensive review of melanoma

“Don’t go out in the sun without sunscreen.  You might get a melanoma!”  It’s summer time and each of us has that well-worn phrase echoing in the back of our minds.  We’ve thought it’s all about childhood blistering sunburns and our fair skin that puts it all at risk.  This all may still be true.  But there is a caveat.

and concluded that a component of melanoma risk was inadequate omega three fatty acids.  One of the citations it referred to was a 10-year old Australian study that showed a 40% reduction of melanoma by the addition of fish to Australian diets.  Australia sure has sun and has lots of melanomas.  I have a dear friend who has melanoma.  It’s a horrible cancer we should all fear.

Here is the logic for why fish oil reduces melanoma risk.  For 100 years we have gradually processed our foods more and more.  Omega–3 fatty acids spoil rapidly.  Vegetable oils that keep the omega-3 fatty acids in them spoil in just a few weeks.  Purify them and they last for months if not years.  So, grape seed oil, rich in omega threes is purified and we end up with what we now call canola oil, with very low omega threes and composed mostly of omega-6 fatty acids.  This is good for shelf life. Omega–6s don’t spoil.  You can mass manufacture the oil for low cost.  Our food costs much less than it did 100 years ago. That’s good. It has taken decades to discover the long term consequences.

The inadvertent unintended consequence is that the ratio of omega–3 to omega-6 fatty acids in our diet has changed from 1:2 to 1:20.  That’s a 10- fold shift.  Anyone knows that a 10-fold change in a recipe will change the recipe’s flavor.  10 times more sugar in a cake may make it taste differently.  Same idea for your body.  With dramatically altered ratios, our cell membranes are different and have different ability to respond to the stresses placed on them.  The hint we see in this research is that our skin can respond to sun’s rays a lot better when we raise our omega-3s in our diet.  So, it may be the amount of our ability to respond to the stress of the sun that matters as much as the stress itself. This is now the 4th article I’ve written with evidence that we need more omega-3 fatty acids: not for short term effects but for long term health consequences.  The American Heart Association has shown it’s good to prevent sudden death.  The Avon Pregnancy study from England shows pregnant women have smarter babies.  The Japanese have shown their autopsied brain cells have higher omega–3 content than American brains.  Now, the Australians are hinting our skin cells are healthier with more fish oil (omega-3 fatty acids) too.  I suspect there will be more ideas to come.  The weave of this fabric is becoming more clear.  We need more omega-3 fatty acids in our diet.

What Will Work for Me This Summer:  You still can’t get sun burned.  Start out slowly in the sun.  10 minutes a day at first.  And did I mention, at least one fish oil tablet a day?  I personally put light protective clothing on to avoid the sun.  Sunscreens don’t block UVA light very well, which also may be a big part of skin cancer, so I don’t use them much.  That’s another story.