Author: Sally Feltner MS, PhD

Diet and Doctors?

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Medical schools are notorious for not teaching future physicians much if anything about diet and nutrition. This problem has been a frequent topic for decades and change comes slowly if at all.  It has long been known that patients will listen to their doctor’s advice more than conventional nutritionists (registered dietitians, for example) and insurance coverage for their services has been limited. In my opinion and experience, many doctors would feel more comfortable referring their patients to qualified diet programs if they were covered by insurance.

If we are ever to curb the effects of poor nutrition in our food  environment that includes obesity, doctors and other health care practitioners (with legitimate nutrition education) must become more involved in helping to solve the problem. More innovative ideas and diet programs that are medically supervised are greatly needed.

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For an interesting idea:

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Intermittent Fasting and Protein – Not for Body Builders?

 

Intermittent fasting is becoming a hot topic for weight loss and/or practicing calorie restriction that is limited to a certain amount of time every day, e.g. 16 hours of fasting with an 8 hour time frame of eating your daily calories..

The problem does arise as to whether people can obtain their protein requirement with that eating pattern. This pattern usually results in eating only two meals a day. The following article explains the issues. The bottom line: This  type of diet may not be practical for those who want to build muscle; however, weight training does appear to help to preserve lean body mass when eaten with sufficient amounts of protein.

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Fast Food Addiction?

FAST FOOD ADDICTION: A MAJOR PUBLIC HEALTH ISSUE

ARC Journal of Addiction, Vol. 4, Issue 2, 2019, pp. 1-11

HIGHLIGHTS

“Unprocessed or minimally processed foods are whole foods in which the vitamins and nutrients are still intact. The food is in its natural (or nearly natural) state. Unprocessed or minimally processed foods would include carrots, apples, raw chicken, melon, and raw, unsalted nuts.

Processing changes a food from its natural state. Processed foods are essentially made by adding salt, oil, sugar, or other substances. Examples include canned fish or canned vegetables, fruits in syrup, and freshly made breads.

Some foods are highly processed or ultra-processed. They most likely have many added ingredients such as sugar, salt, fat, and artificial colors or preservatives. They may also contain additives like emulsifiers or stabilizers. Examples of these foods are frozen meals, soft drinks, hot dogs and cold cuts, fast food, packaged cookies, cakes, and salty snacks.” Source: Harvard Health Letter

The growing widespread use of fast food among Americans is of concern due to the high fat and energy intake, which may cause obesity and subsequently obesity related chronic diseases. Added fat sugar and salt create a taste that makes people crave these foods, a sensation that many described as an addiction. US fast food sales increased exponentially between 1970 and 2000, from $6 billion to $10 billion. During this time, obesity rates among US adults doubled and it is expected that 85% of US citizens will be affected by obesity by 2030.

Fast foods in particular are known to cause many of the chronic diseases that have become the leading causes of death in the United States. What are some of the effects of fast food on the body? Most of the fast foods contain a large amount of sugar, fats and carbs and less minerals and vitamins. This means that people are taking in large amounts of unhealthy calories in the shape of fast food which leads to weight gain and ultimately obesity. Obesity is linked to several long-term health conditions that include premature death, diabetes, heart disease, stroke, gall bladder disease, fatty liver, arthritis and joint disorders and some cancers. One study showed that consumption of fast foods greater than two times a week increased the risk of insulin resistance and type 2 diabetes. Frequent consumption of fast foods was accompanied with overweight and abdominal fat, impaired insulin and glucose homeostasis, lipid and lipoprotein disorders, induction of systemic inflammation and oxidative stress.

Supersize Me was a 2004 American documentary film directed by and starring Morgan Spurlock, an American independent filmmaker. Spurlock’s film follows a 30-day period from February 1 to March 2, 2003, during which he ate only McDonald’s food. The results showed that his physician became concerned when his liver enzymes became alarmingly high and he had gained considerable weight in that short period of time.

 A new study in PLOS Medicine finds eating unhealthy food is associated with a higher risk of developing cancer. People who ate the most junk food showed a higher risk of stomach, colorectal, and surprisingly lung cancers. Separately, men showed a higher risk of lung cancer and women showed a higher risk of liver and post-menopausal breast cancers. Nitrate and nitrite, which are abundant in processed meats are potential carcinogens found in breast, prostate, pancreas, and colorectal cancers along with non alcoholic fatty liver disease and insulin resistance.

Sugar overload – what happens in your body?

“20 minutes after drinking a soda, your blood sugar spikes, causing an insulin burst. Your liver responds to this by turning any sugar into fat. 40 minutes later, caffeine absorption from the soda is complete. Your pupils dilate; your blood pressure rises, and as a response your liver dumps more sugar into your bloodstream. 45 minutes later,  your body ups your dopamine (a neurotransmitter)  production stimulating the pleasure centers of your brain; this is physically the same way heroin works by the way.“

Fast food in particular was first popularized in the 1970s in the United States, which is today the largest fast food industry in the world. Fast food restaurants serve as popular sites for their meals eaten outside the home. Current approaches suggest that fast food restaurants should be required to clarify nutrition information such as calorie and fat content on their menu boards and on product packaging. Studies have shown mixed results as to whether consumers’ choices are affected by this information on packaged and fast foods.

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COVID-19: Immune Boosters or Snake Oil?

Are We Just Talking Snake Oil?

In these days of the pandemic, there are promises and claims made that can cure or prevent the COVID-19 virus from occurring. Should you believe these claims or are they just snake oil? Sadly, most are not proven, and no safety or efficacy has been established. Some have stood the test of time as folklore, others, not so much.   I am not a promotor of taking diet supplements unless a doctor says you are deficient in certain vitamins or minerals.  But here is what is known about a few that can possibly end up on Dr. OZ.

Vitamins and Minerals

Vitamins C, D, A and the minerals zinc and selenium can be grouped together as they may help by shortening the duration of primarily respiratory diseases (colds, flu and Coronovirus).  Vitamin C and D both can act as a natural antihistamine and anti-inflammatory compound. You can get required amounts as a multi-vitamin-mineral compound – there is no need to take them individually or use mega-doses.

Garlic

Fresh, aged extract and garlic supplements may reduce the severity of respiratory infections. It has been described as: lipid-lowering, antithrombotic, antimicrobial, antiviral, and antiparastitic. Garlic has also been shown to fight the common cold (often caused by Coronoviruses.)  It also should be mentioned that in the world’s oldest medical text, the Egyptian Ebers Papyrus, garlic is mentioned repeatedly. It was also reported that it was fed to slaves and soldiers in the ancient world to keep them healthy. And of course we all know that it has warded off vampires in almost any Dracula movie in history.

But back to research – Seventy patients were given a high-quality standardized garlic supplement for 12 weeks while another group were given a placebo. The garlic group had only 24 colds during the study, compared to 65 for the placebo group. The average duration of symptoms was less than half for those taking the garlic.

Of course, this is only one study, however, the active garlic ingredient called allicin was written about way back in 1944 in a paper published in the Journal of the American Chemistry Society.

Beta-glucans – What are They?

Beta-glucans are large molecules made up of multiple sugar units—beta-glucan may offer a number of health benefits, including lowering cholesterol, improving blood sugar management, and boosting the immune system. As a soluble fiber, beta-glucan itself is not digested, however, it slows food transit in the intestines. Studies report when beta-glucans bind to immune cells like natural killer cells (NK cells), T-cells and macrophages, the activity of these cells is increased.

Many studies have supported the idea beta-glucans have a wide range of protective effects, including improved resistance to infections, liver protection, and cardiovascular benefits. It also appears to help inhibit tumor growth in mice. Americans need more fiber in their diets – so this compound can help provide the amount we need daily.

Sulforaphane

“Sulforaphane has also been shown to have antiviral properties. Studies have shown that sulforaphane reduces viral load in the nose, increases NK (natural killer)  cell production, displays antiviral activity against H1N1 Influenza virus, and can suppress replication of Hepatitis C Virus and inhibit HIV infection of macrophages through Nrf2. Interestingly, heat shock proteins which are produced upon sulforaphane consumption are also known to have antiviral properties. This is a quote from the web page, Orthomolecular.org. This site promotes using megadoses of nutrients and claims are made that have not been investigated (to my knowledge).

NOTE: Since sulforaphane can be easily obtained by consuming cruciferous vegetables that include broccoli, Brussels’ sprouts, cabbage, cauliflower, and kale. No need to take ultra-processed supplements that may not contain any or all of the  beneficial nutrients found in “real” foods. Sulforaphane is also purported to be a potent cancer fighter and there is some evidence to support these claims.

Elderberry

Elderberries are the dark purple fruit of the elderberry shrub. A rich source of antioxidants known as anthocyanins, elderberry is reputed by some to be effective in treating the common cold, flu, constipation, hay fever, and sinus infections. Others contend that it may be useful in treating toothache, sciatica, and burns, among other things, but some of these claims are less supported by research than others.

The European elder (black elderberry, Sambucus nigra) is the species most often used in supplements, although other elder species also produce anthocyanin-rich berries. There are several elderberry supplement options and preparations, such as gummies, lozenges, syrups, teas, and more.

Many of elderberry’s health benefits can be attributed to anthocyanin. As an antioxidant, anthocyanin works by clearing the body of free radicals that damage cells at the DNA level.1 It also has antiviral properties that may prevent or reduce the severity of certain common infections.

Elderberry also exerts anti-inflammatory effects, reducing swelling and pain by tempering the body’s immune response.

Elderberry juice syrup has been used for centuries as a home remedy to treat the cold and flu, both of which are caused by a virus. The syrup is believed to reduce the severity and duration of the infection if taken within 48 hours of the first symptoms. Some preliminary evidence from small studies supports this claim.

A 2016 study from Australia reported that, among 312 long-haul airline passengers, those who used elderberry extract 10 days before and five days after their flight had 50 percent fewer sick days resulting from a cold than those who didn’t.  In addition, passengers who used elderberry had less severe colds based on a scoring of upper respiratory tract symptoms.

What elderberry did not appear to do was reduce the risk of getting a cold; both the elderberry group and placebo group had more or less the same number of infections.

However, a 2012 study suggested that elderberry could help prevent influenza infection by stimulating an immune response. Choose a low-sugar capsule or tablet, not as a sugary syrup.

Source: Elderberry: Benefits and Dangers.  https://www.healthline.com/nutrition/elderberry

 Buyer Beware

If you choose a supplement, take them in moderation and inform your doctor as some could be antagonistic toward other prescription drugs you have been prescribed. Keep in mind the following found on dietary supplement labels: “These statements have not been evaluated by the Food and Drug Administration. This product is not inteneded to diagnose, treat, cure, or prevent any dieaase.”

Sources:

University of Maryland Medical System: Immunity Support Boosters

For a comprehensive list (it’s very long), search COVID-19 Schemes, Scams and Misinformation,

Stephen Barrett, M.D., William M. London, Ed.D, MPH July 18, 2020

COVID-19 and Vitamin D?

Can Vitamin D Prevent or Ameliorate Covid-19 Infections?

Previous research has reported that vitamin D can increase the incidence and severity of infectious diseases like influenzas or the common cold. The question remains as to whether this applies to Covid-19 infections.

The primary role of vitamin D is to aid the absorption of calcium and phosphorus for bone formation and muscle function.  A deficiency can also increase the risk of chronic inflammation, a common cause of several major chronic diseases.

Vitamin D is produced to its most active form from cholesterol in skin cells upon exposure to ultraviolet rays from the sun.

Inadequate vitamin D status is common. It is reported that vitamin D deficiency can be common in the elderly, homebound or darker skinned individuals. Obesity is another risk factor for severe COVID-19 and low levels of vitamin D are commonly found in these patients.

Another primary function of Vitamin D is known to reduce inflammation and can stimulate the release of anti-microbial proteins that kill viruses and bacteria. A study at Northwestern University suggests that vitamin D could suppress what is known as the “cytokine storm” that has been reported be fatal in some coronavirus patients.

People are scrambling to the supplement stores for vitamin D, but there are certain caveats to supplementation at high doses of any supplement on the market, including vitamin D.  Here is what you should know about its efficacy and/or safety.

It can become very easy to be deficient in vitamin D since it is found in very few foods like fatty fish, egg yolks and fortified milk (not commonly found in the highly processed Standard American Diet).

It is recommended that people ask their doctors for a blood test to determine their vitamin D status.  Deficiency is defined as a blood level below 10 nanograms per milliliter. Blood levels of 20-50 nanograms per milliliter are generally considered normal.

The Institute of Medicine recommend that most adults get 600 International Units (IU) of vitamin D from food and supplements daily or 800 IU if they are 70 years or older. Most experts agree that D is safe at doses up to 2000 IU and that 4000 IU a day is established as the Tolerable Upper Intake. The dose you take should be established by your physician and your blood levels. Toxicity is possible with long-term use of 10,000 IU daily.

The consequences of overdose include:

  • Mental retardation in young children
  • Abnormal bone growth and formation.
  • Nausea, diarrhea, irritability, weight loss.
  • Deposition of calcium and organs such as the kidneys, liver and heart.

What the Research Shows

A recent study at the University of Chicago reviewed the medical records of about 4300 patients who had been tested for COVID-19 early last spring. After controlling for factors like age, race, and chronic medical illness, they found that people with a vitamin D deficiency before the pandemic began were 77% more likely to test positive for COVID-19 compared to people who had normal levels of vitamin D.

 Other studies have mixed results, however some researchers feel that there is enough compelling evidence to suggest that a randomized trial is needed to specifically test to see whether assigning people to take vitamin D every day will reduce the severity of their illness, if infected. People are bombarded recently with supplement companies promoting high doses of vitamin D – trials are also needed for consumers to make intelligent and safe choices regarding their health.

Source:

Judith E. Brown, Nutrition Now. 7th Edition

Anahad O’Connor, Exploring the Links Between Coronovirus and Vitamin D. The New York Times, June 10, 2020.

Is Aging Affected by How We Live?

In order to understand how aging or longevity  can be influenced by our lifestyles one has to have a basic understanding of epigenetics  – still considered a controversial factor in disease and our overall health (morbidity and morality). Even though it is still to be determined, epigenetics is an interesting topic and thought-provoking hypothesis. Simply it is how we treat our bodies and how the resultant “wear and tear” on our health can lead to chronic diseases as well as how long we may live as determined by its affects on our genes. Here is how it works:

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“Op-Ed: Why Diet Matters in Covid-19”

The following article by Arnold R. Eiser, MD, presents some interesting points about diet as a lifestyle. Nutrition is just one lifestyle factor that may play a role in the prevention and treatment of other inflammatory diseases as such as rheumatoid arthritic, inflammatory bowel disease, and cancer. Obesity itself is a proposed risk factor for Covid-19. Could lifestyle factors such as diet, exercise, smoking, among others, play a part in the susceptibility of contracting and dealing with severity of the infection? If so, prevention along with vaccines could be a key intervention in the disease process.

“At present, the most effective measure in halting the transmission of COVID-19 and preventing associated chronic complications is unarguably the avoidance of exposure to the virus through physical distancing, face masks and eye protection. In addition, changes in lifestyle factors, including nutrition, exercise, smoking, alcohol consumption, screen time and sleep, may be able to contribute to shifting the risk distribution for COVID-19.These factors also appear to play a role in the management of mental disorders,which are commonly observed in pandemics such as the current one. The present overview will discuss the potential role of lifestyle factors in regard to immune functioning and prevention of severe outcomes of COVID-19.” Eiser, MD, MEDPAGE Today, January 30, 2021

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Working for an extension of a Healthy Lifespan

The Power of Phytochemicals

Phytochemicals in addition to vitamins, minerals, and fibers are thought to be the bioactive compounds responsible for contributing to the health benefits of a plant based diet.

How to Choose Phytochemicals

  • Choose three different colors of fruits and vegetables each day.
  • Try a new fruit or vegetable each week.
  • Use new spices – not just salt and pepper.
  • Add vegetables to sauces and casseroles.
  • Double your typical serving of vegetables.
  • Add asparagus, pesto, artichokes to pizza.
  • Buy jars of chopped garlic and basil.
  • Snack on whole grain crackers.
  • Switch to whole wheat bread, brown rice and whole wheat pasta.
  • Add fruit to cereals or vegetables to eggs.
  • Try High Fiber V-8 juice instead of sugary orange juice.
  • Include nuts in stir frys and baked goods.
  • Sprinkle flaxseed on your oatmeal.

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Breast Cancer, Obesity and Time-restricted Eating

There is a great need for research on the effects of diet and cancer. Cancer is the second leading cause of death in United States. As with cardiovascular disease, there is evidence that the risk of cancer can be reduced with changes in diet and activity patterns. Breast cancer is the leading form of cancer in women worldwide as there are new cases of invasive breast cancer that occur among women annually; a percentage of them will die from the disease. Obesity has been estimated to be associated with 13 different types of cancer.

Time restricted eating or intermittent fasting has been shown to have health benefits in addition to weight loss. This study attempts to measure the effects of intermittent fasting without calorie restriction on aspects of breast tumor formation in mice.

Note: Since this was an animal study, different metabolic effects can be found in humans. While most people can practice many fasting styles safely, extreme types of any type of fasting, can lead to inadequate intake of nutrients such as fiber, vitamins, and minerals. Therefore, people should approach any style of fasting with caution. If you have diabetes, you should consult with your physician before attempting any type of fasting program. (SJF).

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