2012 YEAR IN REVIEW – 18 Top News Stories:
Where’s the Beef: A study published in the December 2011 American Journal of Clinical Nutrition done at Penn State asserts “By including lean beef daily, study participants in this randomized controlled clinical study experienced a 10% decrease in LDL-cholesterol from baseline.” But what our researcher, Dr. Kenney, discovered was that, what this study clearly does not show is if replacing omega-3 rich seafood with even the leanest red meat is heart-healthy. Nor does it show that replacing beans, whole grains, fruits, and vegetables with even the leanest beef would not raise LDL-cholesterol levels and promote coronary artery disease (CAD). Clearly it would, as substituting beef for whole plant foods would result in a reduction in fiber intake and an increased intake of saturated fat (SFA) and cholesterol. What this Penn State study does show is that if one is willing to consume only the very leanest of beef while still cutting SFA and cholesterol intake just as much as on a DASH diet then short-term impact on blood lipids and other CAD risk factors will not be much different. The authors do state that: “Adhering to the BOLD and BOLD+ diets that we prepared might be challenging for consumers, at least initially, and, therefore, decreases in LDL-cholesterol concentrations would be less than expected.” True, but more importantly, this study tells does not negate the growing evidence linking increased red meat intake with an increased risk of CAD, type 2 diabetes, several types of cancer, and other possible ills. Eating more beef and less plant foods would also have clear adverse effects on the environment as well. For more, see the October 2011 Nutrition Action Health Letter.
Eggs: Dietary cholesterol has been shown to elevate LDL-cholesterol levels and has been associated with an increased risk of developing atherosclerosis and coronary heart disease (CHD). This has led the American Heart Association, the National Cholesterol Education Program, and the Dietary Guidelines for Americans to all recommend that Americans should limit their intake of dietary cholesterol and eggs. Eggs are the single greatest source of dietary cholesterol in the American diet. A study of vegetarian college students in a double-blind controlled clinical trial showed that increasing their dietary cholesterol with more eggs from 97mg to 418mg per day raised LDL-cholesterol levels by an average of 12% in 3 weeks. In addition to elevated fasting cholesterol levels, there is growing data showing that eating more eggs and cholesterol damages arteries by altering postprandial blood lipids, increasing inflammation, and impairing endothelial function.
Perfect Storm: Two recent large, long-term epidemiological studies add to the growing data linking diet to increased risk of cardiovascular disease (CVD) morbidity and mortality. Excessive dietary intake of salt, saturated fat, and cholesterol, coupled with a low intake of foods high in potassium and fiber, lead most people to develop high blood pressure and high blood levels of LDL cholesterol. The same healthful diet and lifestyle factors that could dramatically cut heart disease in women and men would also significantly reduce the risk of many types of cancer, stroke, Alzheimer’s disease, osteoporotic fractures, and numerous other ills.
Salt Consumption and Stroke: Growing scientific data is linking the consumption of more salt with an increased risk of memory loss, stroke, and senility. For example, the November 8, 2011 issue of Neurology reported the results of a study, which followed 23,752 older (mean age 64) people for 4 years. At baseline all the subjects had tested normal for cognitive function. They also were assessed for stroke risk using the Framingham Stroke Risk Profile, which predicts the risk of stroke based on the person’s age, blood pressure (BP), education level, history of heart disease including atrial fibrillation and other heart rhythm problems, evidence of left ventricular hypertrophy (LVH), smoking, and diabetes status. During the next 4 years 1,907 of them developed loss of memory function and/or thinking problems. Of the 25% who scored the highest on the stroke risk profile (12 or more pts) 15% developed signs of senility compared to only 3% of the 25% whose initial stroke risk score was the lowest. The study found that older age, increased systolic BP and LVH were the only stroke risk factors independently predictive of future major loss of cognitive function.
High Insulin Levels May Promote Pancreatic Cancer: Obesity, insulin resistance, type 2 diabetes, and a diet high in fatty meats and dairy products have all been associated with an increased risk of developing pancreatic cancer. A study in Sweden, which followed over 75,000 people for 7.2 years, found that consuming more sugar significantly increased the risk of developing pancreatic cancer. People who added sugar to their foods and drinks at least 5 times per day had a 69% increased risk of pancreatic cancer compared to those who did not add sugar to their food. Consuming dietary sugar in beverages has been linked to weight gain and the development of type 2 diabetes in several studies. A recent case-controlled study done in Italy examined the diets of 326 pancreatic cancer patients and that of 652 healthy control patients and found that those consuming the most soluble fiber were 60% less likely to get pancreatic cancer. Those consuming more insoluble fiber were 50% less likely to get pancreatic cancer.
Fiber and Diverticulosis: A recent study by researchers at the University of North Carolina (UNC) made headlines after being published in the February issue of Gastroenterology. The study consisted of data collected on the reported activity level and diet of 2,104 patients (30 to 80 years old) who had undergone an outpatient colonoscopy between 1998 and 2010. They reported no significant association between activity level, or the intake of meat or fat, and the presence of diverticulosis. However, they did find that those who reported the lowest fiber intake were actually 30% less likely to have had diverticulosis. Given the overwhelming data indicating bowel problems and numerous other ills result in large part from a typical modern Western diet, the recent apparent contradictory data from the UNC study should not alter clinical practice. Indeed, given the clinical improvement often seen with increased fiber intake in those with bowel disease, it may well be the correlation between higher fiber and more diverticulosis is an example of reverse causation. Simply put, those with symptoms of diverticular disease may well have been more likely to have increased their fiber intake to help reduce their symptoms.
Statins and Soda: The FDA recently required statin drugs to carry a warning stating that they may increase the risk of type 2 diabetes and developing impaired memory. A study that followed more than 2,500 adults found that drinking diet sodas daily may increase the risks for heart attack and stroke and other vascular events by 43 percent, but no such threat exists with regular soft drinks or with less frequent consumption of diet soda. The results were published online in the Journal of General Internal Medicine on January 30, 2012. Media reports may lead some to switch to regular sodas and stop their statins, even though these data were not from well-designed studies. There is no known plausible mechanism by which diet sodas or non-caloric sweeteners might cause more heart attacks or strokes nor is there any reason to believe statins might lead to diabetes or dementia.
Successful Weight Loss is a Reality: A recent study US adults by Harvard research examined data from the 2001-2006 National Health and Nutrition Examination Survey (NHANES). This secondary analysis of the NHANES data looked at sub-sample of 4021 obese adults age 20 and older and found that 63% reported that they had tried to lose weight in the past year. The 2523 who reported they attempted to lose weight the previous year were asked what method(s) they had utilized to try to shed excess pounds. Dr. Nicklas and associates then performed a multi-variant analysis on the 2523 adults to determine which factors appeared to increase the odds of successful weight loss. Of those who attempted to lose weight, 40% (1026) were successful at losing at least 5% of their weight and 20% (510) reported losing at least 10% of their weight. Clearly this data shows that a tad more than 60% of obese Americans who attempt to lose weight are in fact successful at dropping enough weight to have a meaningful improvement in their health – especially if that excess weight is kept off long-term.
Autism Tied to Mother’s Health: A study by Paula Krakowiak at UC Davis and published in the May issue of Pediatrics examined over 1000 children 2-5 years of age. She found that obese mothers were about 60% more likely to have a child who developed autism and more than twice as likely to have a child born with some other type of developmental problems. In this study, having an obese mother, especially one who had diabetes and/or elevated blood pressure, were the variables most closely correlated with an increased risk of a child developing ASD. Some researchers have suggested that insulin resistance and the accompanying metabolic abnormalities may be impacting brain development.
Is it Hunger or Pleasure? Research is now finding that when people eat for pleasure instead of for physiologically normal hunger, the endogenous reward center in the brain is primarily what is motivating them to eat those extra calories. A study conducted by Dr. Monteleone at the University of Naples SUN in Italy sought to better understand the differences between eating for pleasure compared to eating in response to true hunger. Dr Monteleone says “hedonic hunger refers to the desire to eat for pleasure, rather than to restore the body’s energy needs.” He gives an example I often use, and that is eating a high calorie dessert like a piece of cake after a very satiating meal has nothing to do with real hunger driven by energy needs.
Sugar in Beverages Causes Weight Gain, but Candy Does Not: A study comparing the impact of consuming sugar as either soda or jelly beans over several weeks found that subjects compensated for the extra calories coming from the jelly beans and spontaneously reduced their intake of other sources of energy. However, this compensatory reduction in other sources of calories failed when the same amount of sugar was added to the diet as a soda. Not surprisingly, after 4 weeks, weight was stable in those consuming the extra sugar as jelly beans whereas average weight increased significantly when the same amount of sugar was consumed as a soda. A more recent analysis of data from three different prospective studies with over thirty thousand subjects followed concluded: “The genetic association with adiposity appeared to be more pronounced with greater intake of sugar sweetened beverages.”
Cuckoo for Coconuts: The June 2012 issue of the Nutrition Action Health Letter skewered two of America’s more infamous MDs with long histories of promoting nutrition quackery. Both Drs. Mehmet Oz and Joseph Mercola have apparently gone cuckoo for coconuts. They both claim it is a healthy fat that can help slim you down. However, their claim that coconuts and their oils aid weight loss are based on studies using MCT oil. While the Nutrition Action article was fairly reasonable, it also confused the issue by erroneously implying that research using MCT oil might also apply to whole coconut oil because Nutrition Action claimed coconut oil is 60% MCT. There is no precise definition of which fatty acids are medium-chained. Some say those with 6-12 carbons are medium-chained whereas others include just those with 8 and 10 carbons. However, the more important issue is that only 10 to 15% of the fatty acids are in whole coconut oil. MCT oil is only 99.9% caprylic acid and capric acid. These two unequivocally medium-chain fatty acids have 8 and 10 carbons, respectively. Coconut oil is 45 to 50% lauric acid, which has 12 carbon atoms. Metabolically, lauric acid appears to have more in common with myristic acid (14 carbons), and palmitic acid (16 carbons) than it does with the shorter, medium-chain fatty acids that make MCT oil. Indeed, lauric, myristic, and palmitic acid all markedly raise LDL-cholesterol levels compared to longer chain saturated fatty acids like stearic and behemic acid (with 18 and 20 carbons, respectively). And they raise LDL-cholesterol more than the shorter medium-chain fatty acids as well.
Coconut Oil is Not Slimming: Those who claim that coconut or coconut oil stimulates metabolism and aids weight loss base this claim not on studies done with either coconuts or coconut oil but rather MCT oil, which is distilled from coconut oil and palm kernel oils. The claim that coconut or coconut oil speeds up the metabolic rate and promotes weight loss appears to be based solely on research done with MCT oil. Coconut oil appears to have very different effects on body weight than the MCT oil extracted from it. Despite all the claims about coconut oil or coconuts being slimming, there still are no credible clinical trials to support such claims. Making unsubstantiated health claims is the essence.
Waterlogged: Dr. Tim Noakes has written an excellent book on the dangers of consuming excess fluid — Waterlogged: The Serious Problem of Overhydration in Endurance Sports, published by Human Kinetics. In this book, Dr. Noakes presents a thorough review of the scientific data on the thirst mechanism, dehydration, electrolyte balance, and body temperature regulation. He also offers compelling evidence of the dangers of drinking too much fluid before, during, and after exercise.
Can Chocolate Prevent Strokes? Research that suggests chocolate and cocoa powder may lower blood pressure (BP) has been accumulating for many years. This research began with observations of the Kuna Indians of Panama, who see little or no rise in BP with age. The Kuna living on their island homes drink 5 or more cups of a cocoa drink daily. The Kuna who live in Panama City, on the other hand, do not, and they see their BP rise with age, just like others in Panama. Cocoa beans, like many other plant foods, contain phytochemicals that appear to improve the functioning of the endothelial cells that line the lumen of arteries. These and similar phytochemicals called flavanols are also found in tea, the skin of grapes, and numerous other plant foods. Chocolate flavanols have been shown to help dilate blood vessels, improve blood flow to the brain and heart, and help lower blood pressure. There is also limited evidence that chocolate flavanols may help reduce platelet adhesion and improve insulin sensitivity. Much of this research has been short-term and used specially processed cocoa powder processed in ways that do not drastically reduce flavanol content. Most of the chocolate consumed in the USA is alkali processed and much of it has a lot of butterfat and refined sugar added to it. For now, the best bet for getting more healthful flavanols in the diet is eating more minimally processed plant foods. Cocoa not processed with alkali (warning, it has a bitter taste) is far better for your health than a milk chocolate candy bar.
Fish, Not Supplements: Omega-3 fatty acids are certainly essential fatty acids, but most data suggests that people who consume at least 1 or 2 servings of fish a week get enough. Indeed, even modest fish eaters are less likely to have a heart attack and die than people who eat no seafood at all. A new meta-analysis looking at the effects of omega-3 fatty acids in patients at high risk for cardiovascular events has shown that the supplements have no beneficial effects on hard clinical outcomes, including all-cause mortality, cardiac death, sudden death, heart attack, or stroke. The meta-analysis included 20 clinical trials of 68,680 patients.
Low Levels of Vitamin D Linked With Heart Disease: A study published on August 30th in the online issue of Arteriosclerosis, Thrombosis, and Vascular Biology Journal has found that low levels of vitamin D are associated with a much higher risk of heart attack and an increased risk of dying from all causes combined. The results of this study and accompanying meta-analysis strongly suggest that people who are deficient in vitamin D are at a significantly greater risk of dying sooner. Much of that increased risk comes for coronary heart disease.
Sports Drinks May Promote Obesity: A study presented at the annual scientific meeting of the Obesity Society this past September suggests that the public perception of sports drinks being a healthier option than sodas may be incorrect. Data on nearly 11,000 children (9-11 years old initially) of participants in the ongoing Nurses’ Health Study II were tracked over time by Dr. Alison Field and her colleagues at Harvard’s Medical School. After 2 years of follow-up, the kids gained almost 2 lbs on average for each can of soda they drank daily. With both obesity and hypertension on the rise in children in the United States, it seems likely that the increasing consumption of sports drinks in kids is at least partially responsible. Both children and adults should be encouraged to consume water rather than sports drinks.
Judy’s passion for cooking began with helping her grandmother make raisin oatmeal for breakfast. From there she earned her first food service job at 15, was accepted to the world famous Culinary Institute of America at 18 (where she graduated second in her class), and went on to the Fachschule Richemont in Switzerland where she focused on pastry arts and baking. But after learning that the quality of a croissant directly varies with how much butter it has, Judy sought to challenge herself by coming up with recipes that were as healthy as they were tasty.
Judy received The Culinary Institute of America’s Pro Chef II certification, the American Culinary Federation Bronze Medal, Gold Medal, and ACF Chef of the Year. Her enthusiasm for eating nutritiously and deliciously leads her to constantly innovate and use the latest in nutritional science to guide her creativity, from putting new twists on fajitas to adapting Italian brownies to include ingredients like toasted nuts and cooked honey. Judy’s publishing company, Food and Health Communications, is dedicated to her vision that everyone can make food that tastes as good as it is for you.