Achy joints? It may be your diet.

One in four adults experience regular joint pain, and for those over 65, more than 50% have had their physician make a diagnosis of arthritis.  


Arthritis is the common vernacular for joint pain, a symptom found in hundreds of diseases.  But there are really two main groupings.


Traumatic arthritis results from a direct injury to the joint ligaments and cartilage. Healing of this injury then alters normal joint biomechanics leading to chronic discomfort.


Inflammatory arthritis is often just one aspect of a body-wide inflammatory process, rheumatoid arthritis and lupus, an autoimmune disease being two examples. Inflammation begins in the joint lining, or synovium, which then slowly destroys the joint cartilage.


Osteoarthritis, the “arthritis of aging”, has been assumed to be in the traumatic arthritis group, the result of years of  “wear and tear” on the joint cartilage. This presumption was supported by the observation that osteoarthritis was seven times more frequent in obese than in normal weight individuals. And was found more commonly in those who participated in soccer, competitive weight lifting, and elite level running, activities that increase joint stress .


However recent studies have identified low level synovial inflammation in what otherwise appeared to be classic osteoarthritis, suggesting a new possibility - our diet.


Studies of diseases as varied as cancer, diabetes, and heart disease had previously identified higher than expected blood levels of C-reactive protein, a specific finding in low level, chronic inflammation.  Many researchers have speculated that this inflammation is one of the factors involved in the development of these diseases. And now we have the same finding in many patients with osteoarthritis.


It turns out that diet can affect the level of C-reactive protein, and adopting a diet low in animal products and high in fruits and vegetables can lower this blood marker of inflammation.  Which suggests another addition to treating this common ailment.


We already know that a regular exercise routine decreases joint symptoms. A study following 6500 women for 12 years found that those who exercised regularly had far fewer complaints of joint pain than those who did not. Although it seems counter intuitive that a treatment for joint pain might be using them more, all the signs are pointing in that direction.


Adding a dedicated period of exercise into your daily routine is an easy first step. A non impact sport such as cycling, swimming, or water aerobics is preferable, but if that is more than you have the time for, a brisk daily walk will do.


You might consider losing weight. Even of you don’t think of yourself as obese, any weight you lose will lessen the stress on your hips and knees.


And now you have a third option. It makes sense to consider adopting a more anti inflammatory diet.  This would include eliminating all sugar. Substituting fish, whole grains, and vegetables for the red meat main course several times a week. And using healthy oils such as olive oil, avocado oil, canola oil in your food prep. You can find additional ideas in one of the many articles or books on the  Mediterranean diet.


It is possible your joint aches are just the tip of the iceberg, a symptom warning of a body wide inflammatory process, in which case this lifestyle change will continue to deliver additional health benefits as the years roll by.

https://www.arthritis.org/Documents/Sections/About-Arthritis/arthritis-facts-stats-figures.pdf

http://www.drmirkin.com/joints/inactivity-linked-to-arthritis.html

https://www.ncbi.nlm.nih.gov/pubmed/27103057

https://www.ncbi.nlm.nih.gov/pubmed/25574790

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3372675/

https://adoctorsrx.blogspot.com/2017/07/anti-inflammatory-diets.html

The Fountain of Youth

Exercise regularly and you will maintain a stronger immune system, lower your risk of a heart attack, and have less chance of developing diabetes. And over time maintain a better memory and lower your odds of developing dementia.


But even with those positives, the aging process moves inexorably onward. It has been estimated that after our peak at age 30, we lose between 5 and 10% of our physical stamina every decade, and as the years pass, that is reflected in the fatigue we feel at the end of the day.


Loss of stamina is a combination of less muscle bulk (strength) combined with a decrease in the effectiveness of our cardiovascular system (aerobic capacity) in providing the oxygen our muscles need to function.


Regularly pushing the cardiovascular system (High Intensity Interval training - HIIT) and stressing the musculoskeletal system (weight or resistance training) can blunt the rate of decline. Just 30 minutes a day of either HIIT or working out at the gym can have a significant impact on your energy levels.


There is little question as to the mental lift you experience from taking charge of your health. But how much physiologic return do you get for that 30 minutes a day? And could you do better?


Investigators in Indiana (Ball State) located 28 men and women who had exercised regularly for 50 years. Most took up running in the health conscious 1970’s and then just stuck with it. They enjoyed it and made it part of their life. Most were recreational athletes (running, biking, swimming) and only a few actually exercised to be able to compete. On average, group members exercised 5 days (or 7 hours) a week.


Investigators also identified a healthy peer group (also average age of 70 years) who were not regular exercisers, and a 3rd group of active, but not athletic, 30 year olds. They then tested all subjects to determine their aerobic (cardiovascular) capacity as well as taking a small sample of leg muscle tissue (a minor procedure).


The findings were even more impressive than had been expected.


First, the analysis of number of capillaries (need to deliver oxygen to the muscle fibers) and concentration of muscle cell enzymes (needed to process oxygen and glucose to provide energy for physical activity) in the muscles of the athletic seniors were identical to those of the 30 year old comparison group.


Even more astounding was the finding that the aerobic capacity (the measure of how much work a subject could do per minute), although slightly less than that of the 30 year old comparison group, was 40% better than their sedentary peers.  And using information in the medical literature, equivalent to the aerobic capacity of active adults 30 years their junior.


This study shows how effective regular aerobic exercise can be as a tool to blunting the effects of aging.  Instead of the inexorable 5 to 10% decrease per decade described in many articles on aging and human physiology, this group of regular exercisers slowed the rate of decline significantly. If you believe the data, to perhaps 3 or 4% per decade.


It may not be as easy as drinking the water of the fountain of youth, and not all of us have the inclination or time to take on this level of exercise commitment, but  if you did, it would appear that for an average of an hour of aerobic exercise a day (17,500 hours over 50 years) you gain an additional 30 years of robust exercise capacity. Or about 1 day for each hour invested. In my book, that’s a pretty good ROI (return on Investment).


References:

https://www.nytimes.com/2018/11/21/well/move/regular-exercise-may-keep-your-body-30-years-younger.html


https://www.physiology.org/doi/abs/10.1152/japplphysiol.00174.2018

New Year's Resolutions - Aging well

It’s the holiday season. Which means confronting that annual task of making your New Year’s resolutions.

We are all another year older, so it’s not unusual for aging to work its way into our deliberations.  How are we feeling? Are we doing all that we can to stay healthy and be ready for those trips and projects that we put off?

This year’s columns focused on strategies to decrease our odds of falling victim to the four major diseases of modern life  - heart disease, cancer, diabetes, and dementia. It seemed the ideal time for a summary in case you needed help jump starting the resolution planning.

And just like your IRA, making changes early, investing some energy in your 30s and 40s, leverages the benefits with greater rewards than you’ll get putting things off until that AARP invitation arrives in the mail. So for your first resolution - “No more procrastination”.

Smoking remains the number one cause of morbidity (illness) and mortality (death) in the US. If you are still taking an occasional puff, stopping smoking is an easy number two for the list.

Recent work suggests there is no completely risk free level of alcohol intake, and previous suggestions of a small health benefit from a drink a day were most likely wishful thinking. Health risks go up more quickly after that first drink, so moderation should be the goal.

Loss of your muscles accelerates with aging, but resistance exercise (lifting heavy objects) decreases the rate of loss.  

Stress your heart and you will not only decrease the risks of developing coronary artery disease, but you will be able to do more with those disappearing muscles.

Diet is a much more complex issue. Here are several common components in all healthy eating plans.

   - Get rid of sugar. More and more evidence indicates sugar is more harmful to your health than either salt or fats.

   - Replace red meat with fish, whole grains, and vegetable side dishes. Your microbiome will love the extra  fiber.

   -  Don’t skimp on protein. As we get older we need more, not less, protein. The inadequate daily protein intake of the elderly on limited incomes is a significant factor in their muscle loss.

   - Use more healthy oils -  olive oil, avocado oil, canola oil, walnut oil, flaxseed oil, or chia seed oil. Oily fish such as Salmon provide the especially healthy omega-3 fatty acids.

Social interaction is the final piece. Keep in touch with close friends. Go to church. Volunteer. Play bridge. These connections are important to keep your mind healthy and your spirits up.

So there you have it,  the secrets to not only living longer, but living better - aging well.  A healthy diet, regular exercise, no smoking, and alcohol in moderation.

Need a few more specific resolutions?   

Eliminate sugar from your diet. I’d make this number three on your must do list. It will be a challenge.  Sugar is addicting and the first 2 weeks will be hard. But the health rewards are huge.

Cut your red meat portions in half, or better yet consider two meatless meals a week (fish can count as “meatless”)

Fifteen or twenty minutes of dedicated exercise a day. For the week, three days of resistance exercise and four days of vigorous walking or biking to the point you feel short of breath.

Happy New Year.

References (more references in topic specific blog posts - right column):

https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.117.032047

https://www.nytimes.com/2018/09/03/well/live/preventing-muscle-loss-among-the-elderly.html

https://well.blogs.nytimes.com/2015/04/15/the-right-dose-of-exercise-for-a-longer-life/

Saving your brain

Over 5 million people in the United States currently suffer with dementia.  And if you are fortunate enough to live to age 85, it’s estimated your chances of exhibiting signs of dementia are at least one in four, and perhaps as high as one in two (50%).

These are alarming statistics but there is hope.  In a moment we’ll look at options that are estimated to cut your risk by a third.

Dementia refers to a set of symptoms (impaired decision making, misuse of language, and memory lapses) which can be found in a number of diseases.

Alzheimer’s is the most common cause, responsible for 60 to 70% of all  cases of dementia.

“Vascular dementia”, the result of diminished blood flow to the brain, comes in second with another third of the cases.

Prevention is the key to beating dementia as once symptoms develop, indicating the presence of ongoing damage, they are generally irreversible.

As you will see, options include many of the lifestyle changes that are common to other vascular or blood flow related diseases such as heart attacks and strokes. But to be effective they will need to be adopted in midlife.  

Diabetes and Blood Pressure Management

Diabetes, high blood pressure and obesity all contribute to premature aging of blood vessels. Whether it is preventing heart attacks, stroke (the major vessels to the brain), or vascular dementia (the small blood vessels), control of blood pressure and blood sugar levels are of unquestionable benefit.

Diet

Diet can have a powerful effect. And it is about both the negative effects of foods you should avoid as well as the positives of those you should add to your diet.

One study showed that those following a Mediterranean diet had less brain atrophy — an effect similar to 5 years of aging — than those who did not. And another that those who consumed two servings of green leafy vegetables a day had a rate of cognitive decline equivalent to someone 11 years younger.

And the foods to be avoided?  Red meat, butter, margarine, cheese, sweets, fried and processed foods, and empty sugar calories such as sodas.

Although it is not traditionally considered a “food”, alcohol in large amounts has been firmly linked to dementia, and even small amounts on a regular basis produce brain damage on neuroimaging studies.  This finding implies there is no “safe” level of intake for alcohol.

Social Engagement/Marriage

Having strong social networks as well as marriage are dementia protective.

Being a loner is associated with a number of poor health outcomes including cancer survival.  Why? Those in a relationship or with strong social networks tend to live healthier lifestyles.

Or perhaps being able to share worries moderates life’s stresses which are know to correlate with an increased risk of subsequent dementia.

Exercise

Last but not least is exercise. Of all the prevention options, this is the most powerful.

A group of 191 Swedish women, 38-60 years of age in 1968, were given an ergometer cycling test. When their mental status was valuated in 2010 (fourty years later), it was found that the women with high physical fitness at middle age were nearly 90% less likely to have developed dementia compared with the women who were only moderately fit.

Medications

Are there any medications of preventive value?

Vitamin E and Selenium, commonly suggested anti oxidants, have no protective benefit.

There is limited information on metformin, an insulin “sensitizer” and effective anti-aging medication in a mouse model.  Although it does diminish the incidence of dementia in diabetics (presumably via treatment of the diabetes itself) there is no solid evidence that it has a protective benefit for those with normal blood sugar metabolism.

But there is a glimmer of hope on the medication horizon. Smoking dope. The long term administration of THC, the main psychoactive ingredient in marijuana, ameliorates age related learning and memory deficits in elderly mice even though, paradoxically,  it impairs learning and memory in young mice.

How can that be? One of our many neurochemical pathways is the cannabinoid system.  As we age, this pathway, along with the others, becomes less active. In old animals, THC treatment restores the failing cannabinoid system activity, whereas it overactivated the normally functioning cannabinoid system of young animals.

So we once again see a theme that is common to many of the diseases of aging - an active lifestyle paired with a vegetarian leaning diet. But for the brain, we will add the importance of avoiding social isolation. Three lifestyle changes that you can add in small amounts to daily routines and will add years of benefit down the road.

References:

https://www.amjmed.com/article/S0002-9343(18)30643-0/fulltext

https://tandfonline.com/doi/abs/10.1080/1028415X.2017.1324357

http://www.aginganddisease.org/EN/10.14336/AD.2017.0501

https://www.ncbi.nlm.nih.gov/pubmed/26491085

https://www.frontiersin.org/articles/10.3389/fnagi.2017.00183/full

https://www.nature.com/articles/nm.4311.epdf

https://www.ncb i.nlm.nih.gov/pubmed/29263222

https://www.bmj.com/content/361/bmj.k1675

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5894933/

https://jnnp.bmj.com/content/early/2017/10/30/jnnp-2017-316274

https://www.thelancet.com/commissions/dementia2017

http://www.drmirkin.com/fitness/exercise-preserves-brain-function.html 

http://www.health.harvard.edu/press_releases/regular-exercise-releases-brain-chemicals-key-for-memory-concentration-and-mental-sharpness

http://www.health.harvard.edu/press_releases/regular-exercise-releases-brain-chemicals-key-for-memory-concentration-and-mental-sharpness

https://www.nytimes.com/2018/03/28/well/mind/fitness-in-midlife-may-help-fend-off-dementia.html

https://www.nytimes.com/2017/10/04/well/move/for-your-brains-sake-keep-moving.html

https://www.bmj.com/content/361/bmj.k1675 Exercise no help once you have it.


http://www.drmirkin.com/morehealth/risk-for-dementia-goes-down-with-steps-to-prevent-heart-attacks.html

https://www.drmirkin.com/health/morehealth/dementia-risk-increased-by-harmful-bacteria-in-your-colon.html  Dementia risk is influenced by the microbiome (and your diet).

Use it or lose it….perhaps forever!

Regular exercise is essential to staying healthy. It maintains our muscle tone, keeps the arteries healthy (preventing strokes  and heart attacks), and minimizes the memory loss of aging. One of its less obvious, but no less important, effects is on insulin metabolism, reducing the risk of developing type 2 diabetes.

Most of us assume we can take a break (often for vacation) from our regular exercise routine with no downside risk beyond a little extra effort to get back up to speed on our return to the gym.  But new work suggests the deconditioning effects of that break may not be completely reversible, especially as we get older.

One study of middle aged adults (average age 35) confirmed this decrease in the body’s insulin sensitivity after just 2 weeks of slacking off on their daily exercise. This younger group returned to their baseline a few weeks after returning to their normal routine.

A second study evaluated an older, pre diabetic population (average age 69). It again documented a decrease in insulin sensitivity that correlated with the reduction in activity, but then, surprisingly, went on to document an incomplete recovery.

These two studies give new credence to the adage "use it or lose it" in that the loss of exercise related conditioning may not be completely reversible.

But you do have several alternatives. Although you may not be able to stick with your full exercise routine, you should be able to maintain your conditioning with a more limited workout regimen.

First, you can cut back on the level of exertion. It has documented that participants can actually improve strength and endurance exerting at only 55% to 85% of their personal maximum, a level that is just uncomfortable on a “perceived exertion” scale.

But more importantly you can cut back on the duration of your sessions.

For aerobic conditioning (heart and lungs) you may have to push your level of discomfort as the trade off for time spent by using HIIT (high intensity interval training).  This will prevent deconditioning, and can in some instances actually improve aerobic fitness 10 times more quickly than moderate endurance training.

HIIT requires an all out effort for 30 to 60 seconds followed by a minute of recovery. Repeat five sets - three times a week. Although it may sound like more than you might want to take on, numerous studies have shown HIIT to be more acceptable to participants than slower (and longer) aerobic routines. And best of all,  you can maintain your aerobic fitness with just 3 ten minute sessions a week.

Then we have muscle tone/strength.

Here the “aha” studies have shown that you can decrease the weights you are using, pushing just 70% of a personal one-time maximum for 30 repetitions, the point at which your muscles begin to fatigue).

And more recently “slow lifting” with each rep performed in a slow and more deliberate way rather provides equal benefit to fast repetitions. So a slow set of 30 repetitions will get you almost the same benefit as the dreaded “set of 3” that make up the traditional gym routine.

So there you have it. Take that vacation. Commit to 3 HIIT sessions a week (you can do them anywhere). And if you have access to a weight machine, add in several sets using modest weight to the point of muscle fatigue.

Then you will be ready to settle right back into your regular gym routine when you get home.

https://www.nytimes.com/2018/08/01/well/exercise-break-vacation-metabolic-diabetes-health.html

https://www.ncbi.nlm.nih.gov/pubmed/29671031

https://www.ncbi.nlm.nih.gov/pubmed/29095970

https://www.ncbi.nlm.nih.gov/pubmed/29771824

https://well.blogs.nytimes.com/2014/02/26/how-to-get-fit-in-a-few-minutes-a-week/

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0166299

http://www.cptips.com/FSarticle.pdf

Don't forget your morning flax.

More than a hundred studies have shown that eating more fruits and vegetables decreases your odds of a heart attack, stroke, cancer, and early death. And the more vegetables you eat, the more pronounced the benefit.


What is the mysterious health factor associated with vegetables? It could be the simple fact that as we fill up with low fat vegetables we eat less red meat. Or maybe it is the plant antioxidants protecting us from the pesticides and other harmful chemicals in our environment.  The answer, it appears, is much less glamorous - it is the extra fiber.


Fiber is the structural skeleton of all fruits, vegetables, nuts, and beans. Fiber is a carbohydrate (a starch) but unlike flour and other dietary carbohydrates, it is impervious to our digestive enzymes. And as a result this fiber passes unchanged into our colon where it is digested as a source of energy by our microbiome (the millions of resident bacteria).


There are 2 kinds of fiber.


Insoluble fiber absorbs water but won’t dissolve in it. Put a teaspoon of bran in a glass of water and you can see for yourself.  The “bulk” of the indigestible fiber in our diet resistants digestion by the microbiome, passing through the colon unchanged. Its benefit is in keeping our stool bulky, helping maintain regular elimination.


Soluble fiber, on the other hand, will dissolve in water and is a “food” used by the microbiome.  Various fatty acids formed as a byproduct of this bacterial metabolism are absorbed into the bloodstream and are thought to be the real reason dietary fiber is so beneficial to our health.


These fatty acids appear to affect various metabolic processes.  For example, aiding in the control of blood sugar levels (diabetes) and helping to lower blood cholesterol and fat levels. Other fatty acids make it only as far as the colon lining cells where they are used by the cells themselves and thus keep the lining of our colon healthy.


Put mice on a low fiber diet and their colon lining cells shrink in size and produce less mucus. A thinning of the mucus barrier lining the colon in turn allows bacteria closer contact with the lining cells themselves. This triggers an inflammatory response as our immune system works to  “protect” us from an invasion of foreign bacteria.


It has been speculated that this ongoing inflammation may play a role in the development of colon cancer. And may be the explanation of the association of a high fiber diet with a decrease in colon cancer risk.


Chronic colon inflammation may also play a role in other inflammatory conditions such as arthritis and asthma, as well as interfering with normal sugar metabolism (diabetes) and also how we store excess dietary calories. It appears to shunt these extra calories directly into fat cell storage contributing to obesity.


By providing energy to the colon bacteria, soluble fiber keeps our microbiome (those millions of bacterial factories in the colon) healthy and productive.


When mice are put on a low fiber diet, the total bacterial population quickly drops to a tenth of its pre-diet size along with experiencing a significant decrease in bacterial diversity. The result? Fewer and possibly less efficient factories to produce those helpful fatty acids.


Thus soluble fiber has two benefits. It provides the raw materials for fatty acid production and is a source of energy to keep the bacterial production facilities open and available.


What are your options to tap into fibers’ benefits?  Increasing the amount of fruit and vegetables in your daily diet is the easiest start. This will not only add additional fiber but indirectly decrease the amount of red meat.  


While you are working to diversify your diet, consider adding a tablespoon of flax meal (in applesauce) to your morning vitamin routine, or to your breakfast smoothie. We know this simple step works as diabetics taking a tablespoon of flax meal a day dropped their fasting blood sugars and a subgroup with high blood pressure also experienced a drop in their average readings.


A single change as you take action to improve your health. A small step, but in an important direction. Then in the late afternoon you can add a snack on a couple raw carrots or broccoli as you make dinner.

https://www.ncbi.nlm.nih.gov/pubmed/12875900

http://www.drmirkin.com/nutrition/n233.html

http://www.drmirkin.com/nutrition/how-soluble-fiber-promotes-good-gut-bacteria.html

https://www.nytimes.com/2018/01/01/science/food-fiber-microbiome-inflammation.html

Added after publication:

https://nutritionfacts.org/video/benefits-of-flax-seeds-for-inflammation/

Eat your way to a healthier, longer life.

The expression “you are what you eat” was coined in the late 1800s and  implied that one’s state of mind was influenced by their diet . An advertisement in 1923 upped the ante when it suggested that “"ninety percent of the diseases known to man are caused by cheap foodstuffs.”

Last year a more rigorous scientific approach published in the Journal of the American Medical Association (https://jamanetwork.com/journals/jama/fullarticle/2608221) concluded that fully half of the 700,000 annual deaths from heart disease, stroke (which along with cancer are 2 of the 3 leading causes of death), and diabetes are a direct result of poor dietary habits.

The analysis found that a deficiency of healthy foods contributed as much to a poor health outcome as did an excess of unhealthy foods. Let’s take a look at the 10 diet changes they suggest would have the biggest impact.

Salt was at the top of the list of things to avoid. If you are looking for one single dietary change to improve your health, take the salt shaker off the dinner table along with cutting recipe recommendations for salt in half. It will take a couple weeks to adapt to this change, but you will soon realize how much unneeded salt is added to restaurant meals and those processed foods you are buying at the grocery store.

Sugar, especially in sodas, was number two.  Along with salt, sugar is the one additive that takes a 2 week commitment to break what is a real taste addiction for many.

Processed meats, which are high in both salt and fat, were high on the “to be avoided” list.

And finally, as you might have suspected, red meat rounded out the 4 items to be avoided.

Now let’s switch to the foods that are often in short supply in our diets and, if increased, would have a positive impact on our health.

Fish, with its omega-3 fatty acids provides a great alternative to red meat. A win-win diet change, decreasing red meat while adding the omega-3s.

Also expected we tend to scrimp on our daily intake of fruits, vegetables, and whole grains. When you cut down on red meat, these offer great alternatives to assure you don’t leave the table hungry.
Fats, of course, made the list.  A separate study published last month, re-emphasized the cardiovascular disease (CVD) risks of “trans” as well as saturated fats. The study quoted from prior papers indicating that merely replacing dietary saturated fats with polyunsaturated vegetable oil reduced CVD by 30%.

Nuts, loaded with unsaturated (good) fats, were the final “must add” with a strong association with good outcomes. When you get that urge for a few chips and doritos between meals, a hand-full of nuts is a healthy alternative to get you to your next meal.

Another study indicated  that adding just five tablespoons of olive oil or 30 g  (a handful) of unsalted nuts to a conventional Mediterranean diet provided a 30% reduction in the risk of CVD mortality compared with simply lowering saturated fat intake alone.

So that rounds out ten changes to consider in your daily diet.

If you have been reading my columns the past year, this study confirms the  major themes of prior articles.

- Less sugar. More and more the evidence indicates it is more harmful to your health than either salt or fats.

- Less red meat.  And replace it with an increase in whole grain and vegetable side dishes. Both changes support a healthier microbiome with all its benefits.

- Less saturated and more poly-unsaturated fats. Cook with unsaturated vegetable oil (or olive oil).  Get a jar of unsalted nuts for snacks. They are the answer to killing that urge to snack.

- And finally, the more you can do cook a meal yourself, avoiding restaurant and processed foods from the store, the more successful you will be in limiting your weekly intake of salt, sugar, and harmful saturated fats.

https://www.ncbi.nlm.nih.gov/pubmed/28267855

https://www.phrases.org.uk/meanings/you-are-what-you-eat.html

https://academic.oup.com/eurheartj/article/39/17/1503/4987029

Eggs TMAO and cancer/heart disease: https://nutritionfacts.org/2020/08/13/what-explains-the-egg-cancer-connection/

Give your baby's genes a boost.

A full 50 years before Darwin published his theory of natural selection, Lamarck theorized that an organism would pass on environmental adaptations to its offspring. If you cut the tails off three or four generations of mice, you’d soon see a few tail-less babies.

Darwin, on the other hand, felt that our genes were hardwired and inherited unchanged from our parents. And then passed unchanged to our kids. Life experiences did not affect future generations. You could cut off as many mouse tails as you’d like, but would never see tail-less mice in future litters.

This assumption of a hard-wired inheritance ruled the science of genetics for over a hundred years. However, the last few decades have seen a shift in this absolutist view. Why are two identical twins (exactly the same genetic makeup or genotype) often slightly different in appearance (phenotype)?

The study of differences in genetic expression, that is how identical genes are turned on, off, or are somewhere in between, is called epigenetics. A specific cell protein, miRNA, seems to be the switch that impacts how our hardwired genetic code is interpreted.  And lifestyle has been shown to directly impact cell miRNA levels.

A recently published study on brain physiology shows the link between the increase in miRNA levels in the brains of regularly exercised mice and a corresponding increase in brain nerve cell connections.  This was not unexpected as we knew from prior investigations that the level of our exercise directly correlates with brain health.

Surprisingly the researchers also found the same increase in miRNA levels in the sperm of the exercising group as well as improved brain development in their offspring. (It is fair to assume that the same miRNA changes occurred in the eggs of exercising female mice, but it was a lot easier for the experimenters to collect sperm from male mice than harvest eggs from the females).

These elevated miRNA changes in the babies soon returned to normal levels if the baby mice did not exercise as they grew. And the grandkids of the original study mice returned to a normal pattern of mouse brain development as would be expected with a similar, unaltered genetic makeup.

Even though this study focused on exercise, we know that other daily activities and exposures can impact miRNA levels, and that miRNA levels can in turn impact other aspects of genetic expression including, for example, cancer development.

It has been speculated that exposure to toxins in our environment (pesticides for example), medications and illicit drug use, and even diet can impact on our miRNA.

Thus, our development (and, in turn, our kids) is not just limited to the genes we inherit from our parents (and their parents).

This means that you can have direct, but limited, control to maximize the benefits of your genes and in turn your genetic contribution to your kids. But for that extra bit of benefit to be passed on to another generation, your kids would also have to adopt a similar “healthy” lifestyle.

And while you are helping give your kids a healthy boost to their genes, you will benefit from this healthy lifestyle. The exercising mice all benefited from a more connected network of nerve cells in their brains which it can be speculated what translates into a decreased tendency to develop Alzheimer’s. And we also have that suspected link between miRNA levels and cancer development.

So, when you are vacillating on that decision to buy the slightly more expensive pesticide free produce at the local QFC, or get out for that all too easy to skip afternoon walk, remember that the decision you make will impact a lot more people than just you.

https://www.nytimes.com/2018/05/09/well/move/do-fathers-who-exercise-have-smarter-babies.html

https://www.cell.com/cell-reports/fulltext/S2211-1247(18)30404-2

https://www.ncbi.nlm.nih.gov/pubmed/17413852

The Daily Dozen

Every day there seems to be a new research study on healthy eating or lifestyle habits, along with a new diet or exercise recommendation. How can you sort out what’s proven from the “fad” of the week, and then make the necessary changes in your family’s routine.

Dr. Greger (nutritionfacts.org) is a well-known guru of healthy eating who writes an interesting column. He has pulled together a Daily Dozen nutrition and lifestyle tips which he tries to follow. They are all well proven and might give you a place to start if you are interested in changing your own health routine.

It is important to stress that these tips are just a guide, suggestions, and not a list of absolute “must dos”. The Daily Dozen is just a tool to get you started.

It’s interesting to note that Dr. Greger encouraged his family engaged by using an erasable white board on the refrigerator with check boxes for each item. But reaching their daily goal soon became just another piece of the family’s routine and the white board was moved to the garage.


The recommendations are generally food focused with two lifestyle goals as well.


Foods

1. Beans (legumes).  Legumes are a key to keeping your colon bacteria (the microbiome) happy. You should have three ½ cup servings a day. Split peas, chickpeas, lentils, and tofu count as legumes, as does pea soup and hummus.

2. Flax Meal. One tablespoon a day. Flax contains lignans, a potentially anti cancer compound, at a concentration one hundred times higher than other foods.  And the other poorly absorbed plant fibers in the flax also help keep that microbiome in balance. Mix the flax meal with applesauce and you can take credit for a fruit serving along with your fiber.

3. Berries. One halfalf cup every day. Fresh or frozen. These along with other colored vegetables are loaded with micronutrients and antioxidants.

4. Fruit. One medium apple or other piece of fruit (orange, banana, pear) a day. Or substitute one cup of cut up fresh fruit or a half cup of dried fruit.

5. Cruciferous vegetables. One half cup a day. Broccoli, cabbage, collards or kale. Cruciferous vegetables contain sulforaphane, which is not found in other green leafy vegetables.

6. Greens. Two servings. One serving is a cup of leafy vegetables or half cup cooked such as kale or spinach. And if you had an extra half-cup of broccoli, you can count that as well.

7. Other vegetables. Two one-half cup servings. Carrots, asparagus, anything that is not leafy.

8. Whole grains. This one is easy in a western diet. One half cup of oatmeal. One half cup of cooked pasta. One tortillas or one slice of bread. Or popcorn (three cups) for an evening snack.

9. Nuts. One-quarter cup.  A great snack mid morning when you are tempted to open the refrigerator. Peanut butter counts as well!

10. Tumeric.  One-quarter teaspoon. I don’t think its alleged anti cancer properties are as proven as Dr. Greger’s other recommendations, but I’m including it as it is his Daily Dozen.
    

Lifestyle

11. Ninety minutes (total per day) of brisk walking or 40 minutes of more intense exercise such as jogging, swimming, or biking. It does not need to be consecutive. You can break it up over the day.

12. Water.  Five glasses. As with the Tumeric, I’ve seen articles questioning the benefit of five glasses of water.
    

At first glance, this list looks overwhelming. But when you think about it, a peanut butter sandwich with a banana covers the nuts, fruit and whole grains for the day. And a big salad with a few nuts, tomatoes, and other vegetables covers a lot of ground.

The advantage of starting with a list is that it helps keep things balanced and on track. It reminds you what you may need to buy at the store, and helps with meal planning, especially if you are making dinner and want to add categories you’ve missed during the day. And before long, your choices second nature and the list can go back in the drawer.

If you want to give it a try, there is even a smart phone app called Dr. Greger’s Daily Dozen  (in the Apple App Store for sure) that will take the place of that white board or sticky notes on the refrigerator.


References:
https://nutritionfacts.org/video/dr-gregers-daily-dozen-checklist-2/

First the fat, then it was the salt and now it’s our sugar.

Cut back on your sugar and carbohydrates? Increase the fat in your diet? Ten years ago fat was the killer in our diet and carbohydrates the answer to preventing heart disease, the bane of our fast food society.

Dr. Atkins (of Atkins Diet fame) was one of the first to suggest that sugar, not fat was the reason for our epidemic of obesity. A recent review of 23 studies in 2017 supported this claim with the observation that study participants on a low carbohydrate diet often lost 2-3 times as much weight as the low fat groups. 

And even more interesting, many of the low carbohydrate group lost weight without any calorie restriction. 

The appetite suppressing effects of dietary fat were associated with an unexpected reduction in participants’ total daily calories. This “fat effect” is why we often take a trip to the refrigerator within a few hours of a chinese meal (generally low fat) and can find ourselves skipping that early lunch after a breakfast of bacon and eggs (high fat).

Then there were the studies showing that excess sugar increased the risk for heart attacks and strokes. In 2014 the Journal of the American Medical Association published a study showing that that North Americans who ate 25 percent of their calories as sugar had a fatal heart attack rate 2.75 times that of those who ate less than ten percent as sugar calories.

A meal high in sugar--or a sugared drink--leads to a rapid rise in blood sugar. Unless that extra sugar is used by exercising muscles (one of the reasons a good walk after dinner is a healthy habit), it is converted almost immediately to a type of fat called triglycerides.

These in turn cause fatty deposits in the lining of blood vessels and are the reason for the increased risk for a stroke or heart attack.

Even cancer has been linked to a high sugar diet. Rapidly growing cancer cells get almost all of their energy from sugar in a process that is oxygen-independent, while normal cells get their energy from fats, protein, and sugar in a process that is dependent on oxygen.

This observation led to speculation that the occasional cancerous cell (resulting from a spontaneous mutation) would have a better chance of survival in the presence of a high blood sugar. The theory is supported by a recent study showing an increased risk of colon cancer recurrence in patients with higher total daily carbohydrate diets.

Why has it taken so long for this to be sorted out? That is a story in itself and a great example of why industry funded research should always be suspect.

In the 1940s there was an ongoing argument in the medical literature on the role of fats versus sugar as the major risk factor for heart disease. To quote from an online blog by Dr. Mirkin, “... in 1965, John Hickson of the Sugar Research Foundation (now the Sugar Association) wrote to Harvard researchers asking them to write an article showing that sugar was safe and healthful. He paid them $6,500 and asked them to review only the research papers favorable to the sugar industry.”

This was the first step in a cascade of events that demonized fat and promoted sugar as heart healthy. And it has taken 50 years for the real facts to come to light.

But the wheel turns and we are now coming back around to our grandmother’s advice to eat a balanced diet. The healthiest approach is not an artificially low fat versus low sugar diet, but instead about eating a balanced diet—a bit of meat, occasional fish, a side of pasta, and several portions of fruit and vegetables. And getting rid of that sugar bowl in the kitchen and on the table.

It won’t be easy. Evidence from PET scans shows the same brain activity changes with the over consumption of sugar that we see in drug or tobacco addiction. And when you talk to someone who has tried to limit the sugar in their diet, their story reminds you of the withdrawal symptoms described by smokers and alcoholics. That is several weeks of withdrawal symptoms with a long term residual urge to have that piece of candy or sugared cereal. 

But in their next breath the successful will just as quickly tell you how much better they feel. So to keep you and your family healthy, it is time to think about taking that sugar bowl off the table….and then out of the kitchen.

References

https://www.ncbi.nlm.nih.gov/pubmed/23136358   
Dietary glycemic load and cancer recurrence and survival in patients
with stage III colon cancer: findings from CALGB 89803.

http://www.drmirkin.com/nutrition/honey-is-not-better-than-hfcs.html

http://www.drmirkin.com/nutrition/big-sugar-paid-harvard-to-say-that-sugar-is-healthful.html

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32252-3/abstract

http://www.drmirkin.com/nutrition/sugar-added-to-foods-linked-to-heart-attack-risk.html

https:// www.healthline.com/nutrition/23-studies-on-low-carb-and-low-fat-diets

https://www.healthline.com/nutrition/6-graphs-the-war-on-fat-was-a-mistake#section6

https://nutritionfacts.org/video/are-sugary-foods-addictive/

http://www.drmirkin.com/heart/added-sugars-linked-to-high-blood-pressure.html

Diabetes and dementia - its the pp blodd sugar. https://www.drmirkin.com/health/diabetes/how-pre-diabetes-increases-risk-for-dementia.html

Three tips to jump start that weight loss resolution.

The last few cold days of Winter are here. That can only mean that the longer days of Spring are just around the corner. This is ideal time to see how you’re doing with your New Year’s resolutions, especially that plan to lose a few pounds after the holiday food blitz. If you have been having trouble moving your numbers the right way, these three tips may help you re-energize your program.

Quality over quantity

The traditional approach to weight control (dieting) is based on rigorous portion control and counting calories. Eat fewer calories than you expend each day and watch the dial on the scale plummet. But a recent study suggests that it is the quality of your diet, not quantity is more important.

One study was done to see if there were any advantages of recommending a low fat versus a low carbohydrate diet. Both groups were instructed on cooking and eating nutrient-dense, minimally processed whole foods whenever possible. One group was instructed on low carbohydrate foods and the other on low fat alternatives. Both were asked to try to cut down on portion size, but neither was asked to count calories. At the end of a year both groups lost an equal amount of weight. And participants were most surprised that they did not have to restrict or even think about calories to do so.

The conclusion? Losing weight is not as much about limiting fats or carbohydrates as it is about changing your eating habits to focus on whole foods (those you prepare at home and are not pre-processed and packaged ready to eat).  

This may require changes to your lifestyle - more cooking at home, no more quick lunches in the car after a drive-thru lunches at McDonalds - but using whole foods (more vegetables, less added sugar, fewer refined grains) will be healthier as it helps you control your weight.

And after you have shed those unwanted pounds, the same whole food approach, once you have changed your eating habits, is easy to maintain.

No white at night

When you eat the balance of your daily calories is as important to any diet plan as your total daily calories

Calories, especially carbohydrate calories (the “white” foods - bread, pasta, rice) eaten early in the day are metabolized preferentially by active muscles over the following three or four hours. And any carbohydrates not used for immediate energy needs are processed into into fat and stored for future use.

Thus, it makes sense to eat the bulk of your calories early in the day (before 2 PM) when it is most likely you will be up and about at work or doing chores and errands. If you make dinner the big meal of the day, a larger percentage of the meals calories will go directly to fat. If you want to minimize that happening, take a walk (it doesn’t have to be a long one) right after dinner.

A good goal might be a 25-50-25 caloric split for breakfast-lunch-dinner.

Consider fasting

There is solid science behind fasting. An English study compared a traditional calorie restricted diet with one that kept total weekly calories the same but added fasting two days a week (they did allow 700 calories on those two days). Over the three-month study, the average weight loss of the fasting group was twice that of the traditional diet group.  And sixty-five percent of those who fasted intermittently lost weight, compared to only 40 percent of those on calorie-restricted diets.

One fasting approach is to adopt a weekly meal plan that includes five days of a normal diet and two “fasting” days.

A second idea would be to modify your daily routine to extended the fasting period to 16 hours (you already have seven or eight while you are sleeping) and then plan your meals for the remaining eight hours. This has been called a 16:8 plan. This is not an absolute and a few bloggers with work shift challenges have suggested that 14:10 works as well.

For an extended daily fasting period, the meal to skip is the late evening meal. When a morning fast was compared to an equivalent evening fast, equal weight was lost, but blood markers of inflammation increased in the morning fast group.

With the daily fast scenario, dieters that move towards two meals a day with just a snack or salad for dinner. One small study compared two groups of women on similar low-calorie diets. One group ate 700 calories for breakfast, 500 for lunch and 200 for dinner, while the other group reversed that with 200 - 500 - 700. Over three months, the large breakfast group lost twice as much weight as the large dinner group.

The message seems clear, eating fewer calories in the evening appears to prove the adage: Eat breakfast like a king, lunch like a prince and dinner like a pauper.