Friday, June 30, 2017

Healthy Dietary Fats Help Beat High Cholesterol

Replacing saturated fats with healthier ones found in some vegetable oils can reduce cholesterol levels and heart disease risk as much as statins, a new American Heart Association (AHA) advisory says.

Those healthier fats are poly-unsaturated fats and mono-unsaturated fats. Poly-unsaturated fats are found in corn, soybean and peanut oils. Mono-unsaturated fats are found in oils such as olive, canola, safflower and avocado.
Saturated fats are found in meat, full-fat dairy products and tropical oils such as coconut and palm.

Recently, questions have been raised about recommendations to limit foods high in saturated fats, so the AHA ordered a review of current evidence.

“We want to set the record straight on why well-conducted scientific research overwhelming supports limiting saturated fat in the diet to prevent diseases of the heart and blood vessels,” lead advisory author Dr. Frank Sacks said in an AHA news release. Sacks is a professor of cardiovascular disease prevention at the Harvard T.H Chan School of Public Health.

“Saturated fat increases LDL – bad cholesterol – which is a major cause of artery-clogging plaque and cardiovascular disease,” he said.

In clinical trials, reducing the use of saturated fat in favor of poly-unsaturated vegetable oil reduced heart disease by about 30%, similar to statin drugs, according to the advisory.

Lower intake of saturated fat combined with higher intake of poly-unsaturated and mono-unsaturated fat is linked to lower rates of heart disease, other studies show.

Several studies found that coconut oil – which is widely promoted as healthy – increased LDL cholesterol levels in the same way as other saturated fats do.

Wednesday, June 28, 2017

Wisdom Wednesday: Corn

Very little research into corn allergy has been published. Some allergists have questioned whether corn allergy exists at all. However, a 2012 study conducted in Italy suggests that some corn proteins, specifically the prolamins (zeins) in corn, contain amino acid sequences that resemble the gluten proteins in wheat so closely that eating corn could have a similarly damaging effect on some people with celiac disease as eating wheat. Some individuals with celiac disease may have to reevaluate the use of gluten-free foods that use corn in the formulation and preparation.

During the past 15 years some investigators have found that corn allergy, especially in children, may be more prevalent than previously thought. Most reactions tend to be mild, and not all people who have been sensitized to corn will develop obvious symptoms when they eat it. In one reported study, only 6 out of 16 children who were skin-test positive to corn and who had corn-specific IgE antibodies in their blood actually developed symptoms when they ate corn.

I believe that much like soy, it is the processed corn that creates symptoms for so many people. I often counsel patients to eat corn on the cob, but avoid corn in processed foods. Additionally, it is the repeated exposure in processed foods, sometimes multiple times per day, that sensitizes the gut to mount an immune response to corn.

Symptoms associated with corn allergy or sensitivity include erythema (reddening or flushing of the skin), pruritus (itching), urticarial (hives), itching and blistering of the oral cavity, throat tightening, eczema, abdominal pain, asthma, angioedema and hay fever-like symptoms.

Monday, June 26, 2017

Many Americans May Be Taking Too Much Vitamin D

When it comes to vitamin D supplements, it’s possible that Americans may be getting too much of a good thing, new research suggests.

In 2014, just over 3% of U.S. adults took more than 4,000 IU of the vitamin daily, exceeding the upper limits of what is considered safe, the researchers said. In 2007-2008, only 0.2% did that.

For perspective, the recommended daily amount of vitamin D is only 600 IU for adults aged 70 and younger. For those over 70, the recommendation is 800 IU a day.

“More may not always be better with vitamin D,” said study author Mary Rooney, a doctoral student at the University of Minnesota in Minneapolis.

“There’s not much research on longer-term health outcomes on high-dose supplements,” she said. But studies have hinted at potential harm, such as excess calcium in the blood, which can cause deposits in blood vessels, Rooney and her colleagues said.

One reason people may be taking so much extra vitamin D is concern about getting too little of the vitamin. The vitamin is crucial for good bone health, according to the researchers.

Vitamin D is known as the sunshine vitamin because the body makes it naturally when exposed to sun. It’s also found in fortified foods such as milk, and naturally in fatty fish such as salmon, Rooney said.

Heller said that appropriate vitamin D levels have been liked to lower risks of certain cancers, early death, depression in adolescents, type 2 diabetes, and improved heart health and immune system regulations.

But she noted that vitamin D deficiencies are common worldwide, and said many people may need to take vitamin D supplements to get sufficient amounts.

Friday, June 23, 2017

The Whole Truth About Whole Fruits

Fresh fruits are loaded with fiber, antioxidants and other great nutrients. And studies show that eating fruit whole gives you the most of this food group’s potential benefits, like helping to prevent heart disease, stroke and some types of cancer.

While drinking smoothies can be convenient and healthy if they’re not loaded with added sugar, you lose some the fruits’ fiber during blending. It’s also easy to drink a lot more calories than you’d get in one or even two pieces of whole fruit.

Research published in the British journal BMJ suggests that eating certain whole fruits in particular may significantly lower your risk of type 2 diabetes. Since type 2 diabetes is epidemic in the United States, finding ways to prevent it is critical to continued good health.

For the study, researchers looked at decades of diet and health records for thousands of people. They saw – but did not prove – that those who ate 2 or more servings each week of fruits like blueberries, grapes, raisins, prunes, apples and pears reduced their likelihood of getting type 2 diabetes by 23%.

Conversely, drinking fruit juice every day had the opposite effect, increasing the chances of diabetes by 21%. One possible reason: the spikes in blood sugar that the concentrated sugars in juice can cause.

It’s not yet clear which nutrients in those good-for-you fruits may offer diabetes protection. But one thing seems certain: An apple a day might keep the blood sugar disease away.

Wednesday, June 21, 2017

Wisdom Wednesday: Soy

Opinions on the health benefits and health hazards of soy are as sharply divided as the current political atmosphere in the United States.

Advocates of soy point to studies showing it reduces serum cholesterol significantly when used as an animal protein replacement. Soy is a complete protein, containing all the essential amino acids needed by the human body. It really does help vegetarians obtain adequate protein intake. That’s often difficult to achieve without animal products.

Early studies on soy suggested that the phytoestrogens in soy can help women through menopause, alleviating hot flashes, mood swings and potentially help prevent breast cancer. However, more recent studies have shown the potential to disrupt estrogen metabolism and possibly even stimulate reproductive cancers.

I believe this dichotomy stems from two very different foods that we call “soy”.

The Japanese having been consuming a fermented, organic soy for well over 1,000 years. One of those products, Natto, I use to reduce the high sensitivity C-reactive protein associated with heart disease. Fermentation breaks down some of the large chain proteins in soy making it more digestible. It also denatures the phytic acid and other anti-metabolites in soy that disrupt the digestive process.

However, the soy used by the food industry contains these anti-nutrients (including the estrogen disruptors). Most processed soy products contain additional additives like coloring agents, favors, preservatives, sweeteners, emulsifiers and synthetic nutrients. This processed food-like substance bears little resemblance to the fermented soy enjoyed in Japan.

Monday, June 19, 2017

Obese Women May Have More Intense Hot Flashes

There’s another downside for women who carry a lot of excess weight: more intense hot flashes and night sweats during menopause, new research suggests.

“This study supports earlier studies that found that women who are heavier tend to have more hot flashes, particularly close to menopause,” said Dr. JoAnn Pinkerton, executive director of the North American Menopause Society.
The study involved nearly 750 Brazilian women between 45 and 60 years old.

The study authors said their findings support an idea that’s known as the thermoregulatory theory. This theory suggests that excess weight is linked to “vasomotor symptoms” – such as hot flashes and night sweats – because body fat acts as insulation, trapping heat in the body.

Obese women were also more likely to experience other symptoms more often, including joint pain, muscle pain and urinary issues, the study authors said.

The study was published online May 31 in the journal Menopause.

The researchers said their findings highlight the importance of a comprehensive approach to weight control among menopausal women.

Friday, June 16, 2017

Does a Low-Fat Dairy Habit Boost Parkinson’s Risk?

Though you might think eating low-fat dairy foods is a healthy move, new research suggests the habit is tied to a slight rise in the risk of developing Parkinson’s disease.

In the study, researchers analyzed data on about 130,000 men and women, tracking their dietary habits every four years and the number of people diagnosed with Parkinson’s. After 25 years, more than 1,000 people developed Parkinson’s, a progressive neurodegenerative illness affecting coordination and movement.

Those who consumed at least three servings of low-fat dairy a day had a 34% higher risk of getting the disorder than those who only consumed one serving a day. Looking specifically at milk consumption, the researchers found that drinking more than one serving of low-fat or skim milk daily was also linked with a 39% higher chance of developing Parkinson’s.

No such association was seen with the consumption of full-fat dairy products, such as whole milk.

“It is important to note that the risk of Parkinson’s disease is still low, even among people in our study who consumed higher amounts of low-fat dairy or milk,” said study author Katherine Hughes, a researcher at the Harvard T.H. Chan School of Public Health in Boston.

The study was funded by the U.S. National Institutes of Health and the U.S. Department of Defense. It was published online June 7 in the journal Neurology.

Wednesday, June 14, 2017

Wisdom Wednesday: Dairy

Dairy intolerance is usually due to incomplete digestion of lactose. Lactose, a disaccharide, is cleaved into one molecule of glucose and one of galactose by the enzyme lactase. Lactase is produced by the cells that line the brush border of the small intestine.

Lactase deficiency is often genetic but can also occur from any illness that damages the brush border of the small intestine. As noted in previous blogs, this single cell lining is replaced every 24-36 hours and requires significant amounts of bioavailable folic acid (5-MTHF). A third of the population has at least one genetic mutation that impairs the conversion of folic acid to 5-MTHF. Because this conversion also takes place in the brush border, a loop often occurs in which cell production is diminished so less folic acid is converted further diminishing cell production. The result is leaky gut.

Mayo Clinic states that lactose intolerance is “usually harmless but the symptoms may be uncomfortable.” The symptoms are diarrhea, nausea, sometimes vomiting, abdominal cramps, bloating, and gas. These are also the symptoms of IBS (irritable bowel syndrome). While lactose intolerance is “harmless”, the medical profession believes that new drug development is vital to treating IBS. (See my blog “New Bowel Disorder Treatments Needed, FDA Says” posted on May 5, 2017)

Like any food sensitivity, tolerance for lactose varies from person to person. It is estimated that 75% of the world’s population has some degree of lactose intolerance.

Monday, June 12, 2017

Antidepressants During Pregnancy Safe for Baby

Expectant mothers, if you’re taking an antidepressant it won’t make your newborn cranky or at higher risk for other problems, researchers report.

Northwestern University researchers divided 214 new moms into three groups: those with a mood disorder who were not using an antidepressant; those who were taking a serotonin reuptake inhibitor (SRI) antidepressant; and those without a mood disorder who were not on an antidepressant.

At two to four weeks after birth, babies in all three groups had similar rates of irritability, difficulty feeding, sleep disturbances and respiratory problems, the study found. The issues affected 3 out of 10 babies in each group.

Instead, preterm birth was the major risk factor for what is known as Neonatal Discontinuation Syndrome (NDS). Babies with NDS get agitated, restless, cry excessively and may be rigid or have tremors.

Many women fear that taking antidepressants during pregnancy will harm their fetus.

“Most pregnant women are naturally going to worry more about their baby’s health than their own, and might forego taking an antidepressant to avoid these neonatal signs,” study first author Amy Yang said in a university news release.

“But with the information form this study, they can be reassured that the baby’s behavior at two to four weeks after birth is not likely due to exposure to medication or depression,” she added. Yang is a biostatistician in Northwestern’s Center for the Study and Treatment of Depressive Disorders.

Friday, June 9, 2017

Seasonal Allergies: Which Medication is Right for You?

An allergy is your body’s reaction to a substance that it has identified as an invader. If you have allergies and encounter a trigger – called an “allergen”- your immune system fights it by releasing chemicals called histamines (hence the term “antihistamines”). Histamines cause symptoms such as repetitive sneezing and itchy, watery eyes.

Seasonal allergies are usually caused by plant pollen, which can come from trees, weeds and grasses in the spring, and by ragweed and other weeds in late summer and early fall.

Since you can’t always stay indoors when pollen counts are high, your health care provider may recommend prescription or over-the-counter (OTC) medications to relieve symptoms. The U.S. Food and Drug Administration (FDA) regulates a number of medications that offer allergy relief.

Antihistamines reduce or block symptom-causing histamines and are available in many forms, including tablets and liquids. Many oral antihistamines are available OTC and in generic form.

When choosing an OTC antihistamine, patients should read the Drug Facts label closely and follow dosing instructions, says Jenny Kelty, M.D., a pediatric pulmonologist and the FDA. Some antihistamines can cause drowsiness and interfere with the ability to drive or operate heavy machinery, like a car. There are other antihistamines that do not have this side effect; they are non-sedating. Some non-sedating antihistamines are available by prescription.

Nasal corticosteroids are typically sprayed into the nose once or twice a day to treat inflammation. Side effects may include stinging in the nose.

Decongestants are drugs available both by prescription and OTC and come in oral and nasal spray forms. They are sometimes recommended in combination with antihistamines, which used alone do not have an effect on nasal congestion.

Wednesday, June 7, 2017

Wisdom Wednesday: Wheat

Wheat is the most common food sensitivity in the world today. As noted in last week’s Wisdom Wednesday, you might react to any of the proteins or carbohydrates in wheat.

Wild wheat was a staple in the diet of most hunter-gatherer populations that pre-date farming.

The Egyptians are credited with being the world’s first farmers. This may have begun as early at 10,000 BC but was well documented by 5,200 BC. They grew barley and wheat in plowed fields then ground the seeds between stones to make flour. This “stone ground” wheat was a much healthier grain than the wheat produced today.

Despite the quality of their grains, archeologists are able to differentiate the hunter-gatherer from the farmer when examining mummified remains from ancient Egyptian tombs. Examination of those who ate farm raised grains shows evidence of cardiovascular disease, arthritis, osteoporosis and other chronic degenerative diseases. The hunter-gatherer will be free of all of these ailments. It is interesting to note that the Egyptians perfected the art of mummification long before they became interested in farming.

The wheat that was grown remained relatively unchanged until the 1960’s. Long before GMO (genetically modified) wheat, hybridization altered the very nature of wheat. By cross-breeding various strains, scientists were able to create wheat with a shorter, heavier stalk, which was insect resistant.

By the time genetic testing became available, they had created strains of wheat that were genetically a whole new species from the original wheat strains. One of those changes was a 400% increase in the gluten content.

Monday, June 5, 2017

Studies Spotlight Diet, Supplements for Knee Pain

Fiber helps lower cholesterol, stabilize blood sugar levels and keep the bowels running smoothly, but a new study suggests it can also reduce knee pain from arthritis.

Researchers found that people who ate the most fiber reported reduced osteoarthritis knee pain by up to 60%. However, X-rays did not show any difference in their knees compared to those who consume less fiber.

A second study looked at the effects of the dietary supplement chondroitin on knee pain. That study – sponsored by a maker of the supplements – found that taking chondroitin daily was linked to less knee pain and improved function.

Both studies were published online May 23 in the Annals of the Rheumatic Diseases.

“With both of these studies, the danger is that people are thinking they’re making a change in their arthritis, but they may only be masking the pain. Neither study has proven a change in the natural history of osteoarthritis,” explained Dr. Victor Khabie, who was not involved with the studies. He is co-director of the Orthopedic and Spine Institute at Northern Westchester Hospital, in Mount Kisco, N.Y.

Lead researchers Zhaoli Dai, a postdoctoral researcher at Boston University, said, “There is a strong link among obesity, inflammation and painful knee osteoarthritis. We speculate that eating more fiber increases satiety and therefore reduces total caloric intake and reduces body weight.”

The second study looked at chondroitin sulfate. It’s a chemical found naturally in the cartilage of the knee, according to the U.S. National Library of Medicine. Reductions in pain and improvements in joint function were greater in people treated with chondroitin or celecoxib at three and six months. The researchers said that chondroitin provided similar relief to celecoxib.

Khabie said, “It looks like there’s an anti-inflammatory or pain-relieving effect when chondroitin is taken in a very purified, very well-controlled state, but that’s probably not what’s available off-the-shelf [in the United States].” He noted that chondroitin is a supplement, and in the United States supplements aren’t regulated in the same way that drugs are.

Friday, June 2, 2017

Dying Patients Often Given Medicines That Won’t Help Them

As older people approach the end of life, many are being prescribed drugs of questionable benefit, a new study shows.

“People with life-limiting illness often receive medications whose benefit is unlikely to be achieved within their remaining life span,” said study author Lucas Morin. He is from the Aging Research Center at Karolinska Institute in Stockholm.

The study included more than a half a million people, aged 65 and older, in Sweden. All died between 2007 and 2013. The proportion of patients getting at least 10 different drugs rose from 30 to 47% during the year before death, the findings showed.

People who died from cancer had the largest increase in the number of drugs. Those living in institutions were given more medications than people living in the community. But the number of drugs increased more slowly for those living in an institution, the investigators found.

Many patients were given a high number of drugs near the end of life to control symptoms. But for some, long-term preventive mediations or disease-specific drugs were also continued until the end of life, according to the report.

For example, during the last month of life, almost half of patients used drugs to keep blood platelets from sticking together and forming blood clots. Another 41% were taking heart medications called beta-blockers. Fifteen percent were taking another type of heart medication called a calcium channel blocker.

Blood pressure medications, such as ACE inhibitors (21%), vasodilators (17%), or potassium-sparing medications (12%) also were given during the last month of life. About 16% of people in the study were taking cholesterol-lowering medications, known as statins.

The report was published online May 15 in The American Journal of Medicine.