Monthly Archives: November 2008

Walking the dog is as good as the gym!

Walking the dog is as good as the gym!

Competency # 4 Activity

Reference: Am J Clin Nut  Nov 2008 Miyashita et al p 1225

This is a treasure of a study.  Repeated moderate exercise is as good as all at once.  This research study explains a lot and it gives us all lots of hope.  We all have an image in our minds that exercise means going to the gym.  You have to pay a monthly fee and find some sort of Spandex you can squeeze yourself into.   And then you have to actually go.  We know that walking 20 minutes every day will keep your brain healthy.  We reviewed that last month.  The question remains, do I have to squirm into Spandex and go to the gym?  Do I have to do it all at once?   We all have excuses and the inconvenience of going somewhere to exercise is a high barrier.

Well, no more.  Miyashita did a very interesting experiment.  He recruited healthy young men with no illnesses and divided them into teams.  The teams had a variety of exercise regimens.  One was to do nothing at all but read and watch TV.  (That’s us).   The second was to walk on a flat treadmill for 30 minutes once a day.  The final was to walk 3 minutes, 10 times a day.   Men were not allowed to have any extra activity. They all ate a precisely similar dinner and breakfast, Dr Miyashita carefully measured blood pressure the NEXT day, as well as the effect of the standard breakfast and dinner on body fats all day long the next day.

What he found is eye opening.  It turns out the 10 bouts of 3 minutes each was JUST AS GOOD as the 30-minute bout.  He was precise.  They measured blood pressure all day and it was 7 points lower for both exercise groups.  It dropped from 117 mm Hg to 110.  Both groups, just as much.   And they measured the blood fats response to the standard breakfast and dinner and found no difference in the two exercise groups.  Both were 16% lower than the couch potato group.  That means the effect of the exercise is to lower your blood pressure up to 24 hours afterwards…

This study was designed to be doable for anyone.  It wasn’t getting sweaty.  It wasn’t running until you are out of breath.  It was just brisk walking, and the participants got to define just what brisk was.  That part was self-directed.

Did you get that?  Three minutes at a time, ten times a day is just as good as going to the gym for control of blood fats and blood pressure.  Now, that isn’t cardiovascular training.   You can measure even more good stuff happening to you if you exercise to the point of being sweaty.  But Dr. Miyashita’s study builds on our NEAT (Non Exercise Activity Thermogenesis) reporting.  We know that NEAT activities (housekeeping, talking on the phone standing instead of sitting, weeding the garden, putting away laundry standing instead of sitting) burns half the calories of rigorous gym activity.

WWW: What Will Work for me.  Well, well.  I am good at working on a list of easy stuff.  I can do 3 minutes at a time.  I can tuck it into a day’s activity.  No sweat.  Then, all I have to do is build up 3 minutes at a time until I’m at 30.  It doesn’t have to be one block all at once.  It’s good for my brain, it’s good for my waist, and for my heart.  “Honey, I’ll walk the dog….”

What’s a Healthy Eating Pattern?

What’s a Healthy Eating Pattern?

Competency # 5 The Way to Eat

Reference:   Am J Clin Nutr: Nov 2008 Fargnoli et al 1213

If you stick with a “healthy diet” you can lower your risk of heart disease.  We know that.  What’s a healthy diet?  The Harvard Nurses’ Study followed 1922 women starting in 1980.  Every four years these nurses were given questionnaires about their eating habits.   62% of these women were overweight, just like average Americans.  They were randomly selected from the 122,000 women in the study, but in part because they had no active disease at the time they started.   Their blood was collected in 1990.  Now, in 2008, we have the laboratory sophistication to go back to those blood samples and measure the changes in inflammatory markers against their dietary habits.

Nine measures were known to be associated independently with mortality risk.  They called these measures AHEI or Alternate Healthy Eating Index.  The nine measures are as follows: 1) number of fruit servings per day  2) number of  veggie servings per day  3) ratio of white meat to red meat  4) trans fat intake 5) ratio of polyunsaturated fat to saturated fat  6) fiber    7) nuts and soy  8) moderate alcohol and 9) multivitamin use.  On a 1-9 scale, each of these was given a value.   Some folks were as low as 2.5 points.    Some were as high as 87 points.  Take the top 20% and measure their blood markers of inflammation.

Here’s the list of what got better.  The healthy diet folks had a 24% higher adiponectin level.  Adiponectin is secreted by fat tissue.  It makes you more insulin sensitive, is inversely related to weight and has a marked lowering of heart disease risk.  You want more in your blood.  Resistin was lower some 17%.    Resistin is thought to be another fat secreted hormone that is markedly associated with inflammation.  You want lower.  C-reactive protein was 41% lower.  sE-selectin was 19% lower, ferritin ws 24% lower.  The list goes on.  If you can spell them, much less pronounce them, you would see that there is a clustering of across-the-board beneficial effects on inflammation.  A good diet lowers inflammation.

We are getting closer to understanding how our diet messes up our arteries.  Inflammation is the key and the sophistication of your body’s internal chemistry is awesome.  There are many regulatory mechanisms that all work together in a beautiful ballet.  Your fat tissue is the source of those hormones.  It is not a simple, silent calorie storage device.  It is active, secreting hormones that direct much of your metabolism and your inflammation.  The inflammation doesn’t get you in the near term.  But when a heart attack strikes at age 48, you wonder just what went wrong.  “Why didn’t somebody tell me sooner?”  Well, consider yourself informed.

WWW: What Will Work for me?  This is the dilemma of an illness with no symptoms.  Inflammation is the furnace burning within.  The good news is that you can change your diet today.  The choice I make right now works within hours.   I suspect being overweight isn’t the problem.  It’s being inflamed.  Brings a whole new meaning to the term “having the hots”.  Remember, Eve had an apple.  What a loving spouse!

Lack of Sunshine Associated with Autism!

Lack of Sunshine Associated with Autism!

Competency # 17 Vit D

Reference:   Waldman et al Arch Pediatr Adolesc Med. 2008;162(11):1026-1034.

Autism.  We all have heard about autism being caused by the mercury in vaccinations.  Well, that turned out to be just about the most studied fallacy in history.  It isn’t.  Period.  Your vaccinations are safe.  Yes, we have had a huge increase in autism in the last 50 years.  Autism now strikes over 1 in every 150 children in America.  It results in heartbreak for families with unbelievable stress and disruption in the family.  Was there something else that’s changed in our environment?  Was it toxins from plastics, air quality, sugar?  The frustration and anger from families with autism has been so intense that Montel and Don Imus have both weighed in on it, suggesting that the scientific community was hiding essential facts.

This article suggests we now have a clue!  Dr. Walman studied the amount of rainfall in Oregon, Washington and California over a seven-year period.  What they found was a correlation between rainfall and autism.  The more rain over any given three-year period, the more autism appeared subsequently.  The more rain, the more you stay indoors.  The more you stay in-doors, the less Vitamin D your body can make.  Over the last 100 years, we have all moved indoors.  Instead of playing outside, we watch TV.  Instead of going to the park, we hear about kidnappings and keep our kids closer to us.  And that means staying indoors.

There have been hints about this.  Rat studies have shown that if you deprive a pregnant rat of Vit D completely, its babies are born with the same brain defects that humans with autism have.  But that’s about it.  It’s just a hint, a glimmer.  Good science requires that we now take our population and raise the vitamin D level and see if our autism rates go down.  You can’t possibly design a research trial in which you intentionally see if untreated kids get more autism.  That’s not ethical.  But you can make dead certain every little baby gets enough and see if the rate in the population goes down.

The American Academy of Pediatrics just raised their recommendation to have more Vit D in kids from 200 to 400.  We reported on Hypponen who showed that 2000 IU a day in kids reduces insulin dependant diabetes 80% (Lancet 2001).  If our developing pancreas becomes healthy with more Vit D, why not our babies brains too?

WWW:  What Will Work for me?  I couldn’t resist this story.  I see too much heartbreak in the families with autism that I see as patients in the ER.  Please, please, please, tell everyone you know.  The American Academy of Pediatrics urges you to DOUBLE your dose of vitamin D.  It’s the beginning of winter in Wisconsin.  We get no Vit D for the next 6 months.  Talk to every mother of young children you know and make sure they see their pediatrician to get on a supplement.

Coconut Oil: A Saturated Fat from Eden

Coconut Oil: A Saturated Fat from Eden                                            Number 241

Competency #13 Fats

Reference: Soc Sci Med 16, 1539-1549, 1982 Report of the Tokelau Study

My head is spinning.  I have to figure this out.  Help!  As late as last week I cheerfully stated at a conference that you basically shouldn’t eat any oil grown south of Atlanta.  That was a way of poking a jab at palm oil and coconut oil.  These oils have been rapidly replacing many fats in our diet as food producers try to come up with alternatives to trans fats.  Indonesia is being deforested and will be replaced with huge plantations of palm oil producing palms.  All so that McDonald’s can say, “No trans fats in our fries”.  Both are more or less solid at room temperature and are considered saturated fats.  We have been on a bandwagon against saturated fats because they have been implicated with causing increases in inflammatory markers and mucking up our cholesterols.  But are vegetable source saturated fats any different than animal source saturated fats?

Here are the results of the Tokelau and Pukapuka Studies.  These two Pacific atolls are part of New Zealand.  They are quite remote and have had little infiltration of “western food”.  In fact, their diets are basically coconuts and fish.  “What’s for dinner, honey?” is easily answered, “Whaddya want, coconut or fish?”  That makes their diet very high in saturated coconut fat.  No sugar.  No white flour.  They have a rare pig or chicken.  And they had virtually no coronary artery disease. Then a typhoon devastated the island and half of the population was moved to New Zealand because of overpopulation and water supply stress.  In New Zealand, they got access to “Western food”, and rapidly started gaining weight, developing diabetes and heart disease.  Now, the Tokelaus were getting 63% of their calories from coconut oil back on the island. And their cholesterol was high by 30-40 points, but they had no high blood pressure, diabetes or heart disease until they moved to New Zealand.

Once on New Zealand, they started to develop high blood pressure, to gain weight, to become diabetic, to develop gout and to have heart attacks.  The group left behind on the island didn’t.  This is like a controlled experiment.  One gene pool moving to a new world where they had access to westernized processed foods.   New Zealand is also farther away from the equator, so change in sunshine amount also creates a Vitamin D change.

We’ve always assumed that your blood pressure going up was part of aging.  This longitudinal study has demonstrated that this is just not so.  It also suggests that coconut oil and the saturated fats in it aren’t so bad.  This population study is only one of about 10 similar ones that all show the same effect. (Maasai in Africa is another similar story).  Or could it be the effect of living in abundant sunshine, getting huge amounts of Vit D and abundant fish every day are the differentiating qualities?  Exercise? Stress?

WWW: What Will Work for me?  I’m having major cognitive dissonance.  I am rethinking my core anxiety about the saturated fat coconut oil.    My suspicion regarding sugars and white processed flour products grows.  I spent my childhood greasing my hair back with coconut oil.  Was that good for me?  Can’t go back to that.  No hair.  But I am eating sugar and processed carbohydrates.  Maybe I shouldn’t!