Wisdom Wednesday: 2015-2020 Dietary Guidelines for Americans

These guidelines were released in January, 2016 and have significant updates for the consumer based on good science. However, there are some areas where the good science didn’t translate to the updates. I’ve read the guidelines and a couple of reviews, including one by the Harvard T.H. Chan School of Public Health in collaboration with Metagenics and the Joslin Diabetes Center.

Here is a summary of some of the areas that fell short:

• Healthy Fats – The Dietary Guidelines recommend reducing fat consumption by consuming fat-free and low-fat dairy products and limiting saturated and trans fats. They also indicated that healthy diets include oils. Including healthy vegetable oils, like olive oil and flax seed oil, is a step in the right direction. These are rich sources of essential fatty acids that are lacking in the American diet. Other oils like sesame seed oil have anti-inflammatory properties and coconut oil is well tolerated by most of the public. Although they do not contain any of the omega fatty acids, they are easily digested and utilized by the body. Trans fats have no redeeming value but research has demonstrated that saturated fat is not necessarily unhealthy. The recommendations should provide information on the proper use of healthy fats, like in cooking. The guidelines should differentiate between a diet that is low in total fat intake versus taking a whole food and reducing its fat content. It is no longer a whole food and should be avoided. Besides, low-fat diets are no more effective for weight loss or maintaining health than any other diet.
• Added sugar – The Dietary Guidelines recommend limiting added sugar to no more than 10% of total calories. Even if a person is not overweight, obese, or suffering from chronic diseases like diabetes, long-term intake of added sugars, like high fructose corn syrup, lead to the development of metabolic syndrome, cardiovascular disease and type 2 diabetes I am pleased that sugar has been identified as a major factor in chronic disease and that the USDA recommends reducing added sugar. However, in future guidelines they need to go further and recommend diets with no added sugar, limiting sugar consumption to 5% of total caloric intake.
• Grains and Carbohydrates – The Dietary Guidelines recommend that 50% of grains consumed be whole grains. While whole grains can be an important component of a healthy diet, these recommendations remain too supportive of grains and carbohydrates. The nutritional valve of grains beyond empty calories is very limited. It is further reduced by refining these starchy products. Wheat, rice and potatoes have a high glycemic index and should represent less than 25% of caloric intake, even in their whole state.

The Bottom Line - Maintain a healthy weight
Almost 70% of American adults are overweight or obese. The 2015 Dietary Guidelines represent progress toward healthier eating in America. Many nutritionists, myself included, believe that the epidemic status of obesity in the United States warrants increased attention to achieving and maintaining healthy weight.

Sleepless Nights Might Raise Women’s Type 2 Diabetes Risk

Women who have chronic sleep problems may have an increased risk of developing type 2 diabetes, Harvard researchers report.

Problems such as trouble falling or staying asleep, getting less than six hours of sleep, frequent snoring, sleep apnea or rotating shift work appear to increase the risk of type 2 diabetes, the researchers said. They found that women who reported trouble falling asleep all or most of the time had 45% greater odds of developing type 2 diabetes.

“Women with sleeping difficulty, especially when also having other conditions, should be aware of potential higher risk of diabetes,” said lead researcher Dr. Yanping Li, a research scientist at Harvard T.H. Chan School of Public Health in Boston. “Doctors should pay more attention to the potential diabetes risk of women who have difficulty falling asleep or staying asleep,” she said.

“Not sleeping well affects the circadian rhythm regulated by hormones that are so important for metabolism and involved in control of blood sugar. Thus, it is not surprising that sleep disorders are associated with obesity and diabetes,” said Dr. Joel Zonszein, director of the Clinical Diabetes Center at Monteflore Medical Center in New York City. He was not associated with the study.

The report was published Jan. 28 in the journal Diabetologia.

Eating More Healthy Fats May Extend Life

For years, experts have preached the gospel of eating “healthy” fats and limiting “unhealthy” fats. Now, a new study contends that if people worldwide began to eat healthier fats, there might be more than a million fewer deaths from heart disease every year.

Although a great deal of attention has been focused on reducing saturated fats from the diet, the researchers said the focus should be two-fold: reducing unhealthy fats such as saturated fat and trans fats, and replacing them with healthy fats, such as polyunsaturated fats.

“Our findings highlight the importance of ending American fear of all fat. We estimate that nearly 50,000 Americans die of heart disease each year due to low intake of vegetable oils,” said Dr. Dariush Mozaffarian, senior author and dean of the Tufts Friedman School of Nutrition Science and Policy in Boston.
The study was published online Jan. 20 in the Journal of the American Heart Association.

Polyunsaturated fats are found in fatty fish (such as salmon, herring mackerel and trout), tofu, soybean oil, corn oil, sunflower oils and seeds, and walnuts. These fats help lower bad cholesterol, and have been linked to a lower risk of heart disease and stroke, according to the American Heart Association (AHA).

Saturated fats are found in meat and dairy products. Trans fats are found in processed, baked and fried foods, according the AHA.

Wisdom Wednesday: Annual Laboratory Testing

I highly recommend that you have annual lab work to access your current state of health, predict future health issues and hopefully avert them in the process.

My practice uses functional neurology as a framework. This requires physical testing of patients in the office. I then compare my findings against the patient history and laboratory testing. Laboratory testing is standardized and repeatable giving absolute benchmarks above and beyond the patient’s symptoms and their ability to convey them to the physician.

Here is a list of some of the more common tests I recommend and a brief explanation of why they are of value:

• Comprehensive Metabolic Panel (CMP) – these fasting tests include the glucose, kidney indicators (uric acid, BUN, creatinine, & eGFR), electrolytes (sodium, potassium, chloride, carbon dioxide, calcium, phosphorus & magnesium), protein (albumin & globulin), bilirubin, alkaline phosphatase, LDL, liver enzymes, and iron indicators (iron binding capacity, UIBC, serum iron, iron saturation & ferritin). Abnormalities of any of these tests are related to metabolic issues like hepatitis, impaired kidney function or anemias.
• Glycohemoglobin A1c – measures the glycosylation of the hemoglobin molecule on red blood cells. This test effectively measures your average blood glucose levels over the past two months. It is now considered the gold standard for diagnosing pre-diabetes and type 2 diabetes.
• Serum Lipids – total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol and VLDL cholesterol. Traditionally, these tests are used as a basis to prescribe statin drugs. I use them as a measure of cholesterol metabolism as it relates to thyroid, liver, digestive, and endocrine function.
• Thyroid Panel – the TSH (thyroid stimulating hormone) is the minimum test. I also like to run the T3 and T4. If I am concerned about autoimmune disease (Hashimoto’s thyroiditis), I also include the TPO (thyroid peroxidase) and thyroid autoantibodies.
• Vitamin D – measures the serum level of 25-hydroxy vitamin D, the inactive form of vitamin D after conversion from either D2 or D3. Vitamin D is really a hormone and deficiency is very common. Adequate levels are vital to proper function of the immune system in addition to calcium and bone metabolism.
• CBC (compete blood count) – includes white blood cells (WBCs), red blood cells (RBCs), hemoglobin, hematocrit, volume indices, and white blood cell types. This test shows anemias, infection fighting, and even vitamin B12 and/or folic acid deficiency.
• C - reactive protein (CRP) – this is an inflammatory marker that is fairly specific for vascular inflammation. It is an important indicator of cardiac risk.
• Homocysteine – an intermediate metabolite of sulfur amino acid metabolism. It is very dependent on vitamin B12, folic acid, and vitamin B6 status. It is also an important indicator of cardiac risk.
• Urine Analysis – reveals signs of infection fighting (UTI), acid demand from the diet, and possible kidney stone formation.

Obviously, there are many more tests that can or should be run, depending on your history. I still believe the PSA (prostatic specific antigen) is a good test for men over the age of 40. If you have been advised to take or are taking a statin, then an L(p)a is highly recommended.

The Bottom Line:
Please have routine laboratory testing run annually.

Can Berries, Citrus Fruits, Boost Male Sexual Health?

Biochemicals found in berries, citrus fruit and red wine might help men maintain healthy erections, a new nutrition study suggests.

Foods rich in these flavonoids are associated with reduced risk of erectile dysfunction, researchers reported Jan. 13 in the American Journal of Clinical Nutrition.

Eating a flavonoid-rich diet may be as good for erectile function as briskly walking for two to five hours a week, researchers from Harvard University’s T.H. Chan School of Public Health and the University of East Anglia in England reported.

Flavonoids give fruits and vegetables their vibrant colors. The study found that three specific flavonoids – anthocyanins, flavanones and flavones – offered the greatest benefit in preventing erective dysfunction.
Anthocyanins are generally found in blueberries, cherries, blackberries, radishes and red wine. Flavanones and flavones are found in citrus fruits.

“Men who regularly consumed foods high in these flavonoids were 10% less likely to suffer erectile dysfunction,” lead researcher Aedin Cassidy, a professor of nutrition at the University of East Anglia, said in a university media release. “In terms of quantities, we’re talking just a few portions a week.”

High Uric-Acid Levels, Lower Risk of Parkinson’s?

Men with high levels of uric acid in their blood may be less likely to develop Parkinson’s disease, a new study suggests.

Researchers compared about 400 people in ongoing studies who developed Parkinson’s disease and more than 1,200 people in the same studies who did not develop the movement disorder.

Men with the highest levels of uric acid (urates) were nearly 40% less likely to develop Parkinson’s disease than those with the lowest levels, according to the study published online Jan. 13 in the journal Neurology.

“These results suggest that urate could protect against Parkinson’s or slow the progression of the disease in its very early stages before symptoms are seen,” study author Dr. Xiang Gao, of Pennsylvania State University, said in a news release from the American Academy of Neurology.

“The findings support more research on whether raising the level of urate in people with early Parkinson’s may slow the disease down,” Gao added.

There was no association between urate levels and Parkinson’s disease risk in women, the study found.

Urate is formed when chemical called purines – found in food – are broken down in the body. Previous research has suggested that urate may help protect brain cells.

It’s easy and inexpensive to boost people’s urate levels, but it must be done with care because extremely high levels can cause kidney stones and gout, Gao said.

Wisdom Wednesday: Schisandra

Schisandra chinensis is a deciduous woody climbing vine that bears flowers and small fruit of a deep red color. The plant is sometimes referred to as Chinese Magnolia Vine. The fruit is used in Traditional Chinese Medicine (TCM) and Russian medicine for treatment of asthma or as an expectorant, urinary and genital disorders, feminine health, sedative astringent, and as a general wellness tonic to counter fatigue.

The active compounds in Schisandra are thought to by the lignans but they are structurally unique, and quite different from other lignans such as Sesamin (from sesame seed oil). However, Schisandra fruit also contains unique triterpenoids but their exact role in supplementation is not currently known. Standardized extracts are based on the various lignans, specifically the schisandrins.

Quality Schisandra chinensis grows in Northern China and Western Russia. However, an inferior product from Southern China, Schisandra spenanthera is frequently substituted in herbal preparations resulting in a product that is ineffective.

Russian traditional medicine air dries the fruit then extracts the organic compounds with ethanol to create a tincture. The product I obtain from Australia is prepared by this method.

Schisandra lignans act as hormetic anti-oxidants. Hormesis is a phenomena similar to exercise where damage is induced only to subsequently protect and repair to a greater extent. The result of hormesis tends to be elevation of Heat Shock Proteins and increased expression of anti-oxidative enzymes in mitochondria such as Glutathione Reductase.

The therapeutic, preventative, and (theoretically, not yet demonstrated) life enhancing properties of Schisandra chinensis extends to most organ systems of the body. Schisandra has been demonstrated to reach the brain, liver, lungs, kidneys, spleen, heart, and adrenals.