Obesity and Prenatal Omega-3s

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Scientists continue to research the causes of obesity. For many, as we’ll see, it’s not as simple as eating less and moving more; in the study I’m going to review this week, the researchers are going prenatal.

The Copenhagen Prospective Studies on Asthma in Childhood 2010 (COPSAC) is an ongoing longitudinal study to examine the effects of omega-3 supplementation in the third trimester of pregnancy on a number of factors. The primary objective was to see if allergies and asthma were reduced in the offspring of women who took the omega-3s versus those who took a placebo. Asthma or persistent wheeze showed a 31% reduction in risk in the group receiving fish oil compared to 23% the placebo group.

The researchers also collected a variety of anthropometric data, plus blood samples for metabolic and blood lipid analysis, and assessed body composition. In a prior paper when the children were age six, the omega group were about one pound heavier but with a proportional increase in lean and fat mass.

In the current analysis at age ten, the omega group were determined to have an increased BMI, increased risk of being overweight, a tendency for increased fat percentage, and higher metabolic syndrome score when compared to the placebo group. That doesn’t sound good. Does this mean women should avoid omega-3 fish oil during pregnancy, especially the third trimester? I’ll let you know on Saturday.

Tomorrow is the monthly Insider Conference Call. I’m going to cover starvation but not the Minnesota Starvation Study—you’ll come away stunned. I’ll also answer your questions. If you’re not an Insider, become one by 8 p.m. tomorrow and you can join in.

What are you prepared to do today?

        Dr. Chet

References:
1. BMJ 2018. doi: https://doi.org/10.1136/bmj.k3312
2. AJCN. 2024. doi.org/10.1016/j.ajcnut.2023.12.015

The Ridiculous: Obesity and Weight Loss Scams

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As I planned this series of Memos, I wrestled with using the word “obesity” because everyone appears to hate that term—especially when directed at themselves. I decided to stick with it because it afflicts close to 40% of us in the United States. Before I get to ridiculous weight loss plans people are hawking, how did we get here?

Obesity is the product of success. We’ve been successful in creating so many labor-saving devices, we can’t burn enough calories in everyday activity anymore. We’ve successfully produced so much food, available just about everywhere, and made to appeal to all our tastes—sweet, salty, fatty, and umami. They’re hard to resist. The U.S. and Canada have worked hard to produce so much food. But with that success comes overconsumption. Pure and simple.

I question whether obesity is a disease. The dieticians and nutritionists have tried health education without success. Now the medical community has taken over with surgery and pharmaceuticals. And we’re still getting fatter, not because we’re failures but because we’re reaping the rewards of success. We have to change our approach to how we treat food if we’re going to be successful in changing the outcome.

In this series, I’m going to cover recent ads, commentaries, and research on obesity and weight loss. Let’s begin with a Facebook ad my daughter-in-law sent Paula the other day.

The Ridiculous

Paula got a text from Kerri that showed the benefits of MagnaGermanium earrings; these magnetic earrings will activate your lymphatic system, drain away toxins, detox your body, and allow you to lose weight naturally. I had to check it out—after all, it was FDA approved!

It was just a bunch of testimonials. No science, even though the ad referred to it. Claimed to be made in an FDA-approved facility, but there’s no such classification. It’s a pure scam but reasonably priced: just $22.97 a pair in the ad I reviewed. Look around a little, and you can find them for one cent; that tells you all you need to know about the quality.

I don’t think I have to say anything else. By the way, those Kelly Clarkson “ads” for Keto-ACV Gummies? Worst artificial intelligence effort I’ve seen so far. They’re also in the ridiculous category.

We’re just getting started. Next week, a look at fish oil and the potential for overweight children. You don’t want to miss it.

What are you prepared to do today?

        Dr. Chet

Nature in Motion

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There are just some events in nature you don’t want to miss: Niagara Falls, glaciers in Alaska, the Grand Canyon. Those are relatively stable.

A total eclipse of the sun is something fleeting that you have to see on its timetable. That’s why, with his mom’s blessing, Paula and I took Riley out of school his first day back after spring break and headed for the border: we drove to Northeast Indiana to view the eclipse. (We wore Purdue shirts in honor of Paula’s alma mater and their trip to the NCAA Finals.)

As we approached the area, Riley used his eclipse glasses to give us a running account of how much the sun was blocked. Where we chose to stop resulted in about 99% of totality—better than if we had stayed in Grand Rapids. It was amazing to experience in real time. Was it worth the time to drive that far? Yes. As I said, some things you just have to see in motion.

The rest of this month is going to be about obesity and weight loss. There have been several studies and commentaries published in the last few weeks, and I have to comment on them. I’d like to think of it as a trip from the ridiculous to the sublime; I think you’ll enjoy the journey.

Insiders: our next conference call is Wednesday, April 17, at 9 p.m. Eastern Time.

What are you prepared to do today?

        Dr. Chet

The Look of Success

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With this being a holiday weekend, the Memo comes a day early. We hope that your holiday weekend is filled with safe travels and good times with family and friends, plus at least one chocolate bunny, whatever your beliefs.

As motivation to get up every time you stumble and fall, here’s the look you make when you fail at something a couple hundred times and finally nail it, courtesy of our grandson Riley who just turned nine; here’s a link to the whole 11-second video of Riley’s first successful frontflip.

See you after Spring Break.

What are you prepared to do today?

        Dr. Chet

Your Last Resort

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Did you ever have one of those days where you just didn’t have it?

  • Maybe you wake up just a little later than expected.
  • Maybe your energy got up and went before you had a chance to get up and go.
  • Maybe everyone in the world seemed to want a piece of you today—and they succeeded.
  • Maybe nothing you wanted to do got done.

What do you do? Here are some ideas:

  • Put on some weather-appropriate clothes and go for a walk.
  • Get on the exercise bike and move those legs.
  • Grab the dumbbells and work those biceps and triceps.
  • Or just get up and sit down 25 times to work those quads.

It doesn’t matter what type of exercise you do, but get that one thing done and you’ve done something positive you can feel good about. It may do wonders for you mentally and make the day a success, or at least not a total loss. Use exercise as the last resort to rescue your day.

What are you prepared to do today?

        Dr. Chet

Flavonols: Eat, Drink, and Maybe Live Longer

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The analyses of the NHANES study on flavonols and mortality did more than just look at a class of phytonutrients; researchers also looked at the individual flavonols and how they impacted mortality. A little background first.

Flavonoids

Flavonoids are a group of phytonutrients made up of six classes of nutrients. They are flavan-3-ols, flavones, flavanones, anthocyanidins, and the previously mentioned flavonols. Each of those classes are made up of individual phytonutrients. Flavonols have four primary phytonutrients in its class: quercetin, kaempferol, myricetin, and isorhamnetin. We’ll skip the rest of the individual phytonutrients in the other classes because they weren’t part of the study.

The researchers examined the reduction in mortality for each flavonol phytonutrient. When comparing the first quartile (lowest) with the fourth quartile (highest) intake, not every phytonutrient reduced the mortality from all conditions. In other words, the overall reduction in mortality was greatest when looking at total flavonol intake, not in any single phytonutrient. Too often research focuses on single phytonutrients as potential treatments of conditions and diseases, so it’s great to see a study that looks at total intake of a class of nutrients.

Absorption

As mentioned, flavonols are one part of the flavonoids. One characteristic is that they seem to be poorly absorbed. Or are they? It could be that there are unknown genetic factors that impact absorption and/or utilization of those nutrients. It may be that when isolated from a plant, the absorption is interfered with in some way that’s not apparent. It may be that the microbiome has a role to play in absorption.

What is most likely is that when eaten or drunk in its natural or prepared state, it is the interaction of all the flavonols that help absorption. Or it may be the combinations of flavonoids found in specific foods that work together for absorption.

What foods have the highest flavonol content? When looking at mg/100 grams, raw onions, cooked onions, apples with the peel, brewed black decaf tea, and brewed black tea top the list. When looking at the top three consumed? Onions, black tea, and apples top the list, but beer comes in fourth place. While the amount per 100 grams is low, we consume a lot of it.

The Bottom Line

At the end of the day, the most important thing to know is that we have to consume flavonols to get the benefits. In reality, your mama was right: eat your fruits and vegetables. They’re good for you. And if you chase them down with a beer, that’s probably okay as well.

What are you prepared to do today?

        Dr. Chet

Reference: Nature Reports. 2024. https://doi.org/10.1038/s41598-024-55145-y2. Arch

How Flavonols Affect Mortality

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Observational studies are just what the title indicates: observing something over time. In the case of the National Health and Nutrition Examination Survey (NHANES), one of the objectives is to observe the relationship between diet and whether it impacts how long we live. I recently came across a paper that examined the relationship between flavonol intake and mortality. Observational studies cannot give cause and effect; they can only suggest a relationship, which would then be followed up with randomized controlled trials. That doesn’t happen often enough in nutrition studies; how do you blind subjects to the foods they’re eating? Therefore, we take what we can get.

Researchers wanted to find out the relationship between one class of flavonoids called flavonols and mortality. They used data from the volunteers in three different NHANES data collection periods who completed a 24-hour dietary recall with an in-person interview and telephone follow-up. This is about as good as it gets when collecting dietary data in such large studies—over 11,000 subjects.

After accounting for age, gender, and other factors, there was a clear relationship between flavonol intake and mortality. Total flavonol intake was associated with an overall decrease in all-cause, cancer-specific, and CVD-specific mortality risks. The decrease in hazard ratio was as much as cutting the risk in half (cancer-specific) and by one-third from CVD and all-cause mortality; results were not as clear for diabetes and Alzheimer’s disease. There’s more to this study, and I’ll cover it on Saturday including the foods with the highest flavonol levels.

What are you prepared to do today?

        Dr. Chet

Reference: Nature Reports. 2024. https://doi.org/10.1038/s41598-024-55145-y2. Arch

Stretch Your Body, Stretch Your Lifespan

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“Stretching reduces your risk of dying from all causes” was the message from Tuesday’s Memo. How does that work? Why would stretching decrease mortality? There are no definitive answers, but here are a few possibilities.

It may be that stretching strengthens the blood vessels as well as the connective tissue; that may decrease the potential for blockages or building up plaque in the arteries. Or it may be that the deep breathing that’s associated with most forms of stretching also contributes to the health of the heart and lungs.

One of the other benefits of stretching is a resultant increase in strength, which could help keep the muscles more pliable, and that’s important at any age. I’ve already mentioned that there may be an improvement in arterial function when undertaking stretching, but associated with stretching is a reduction in resting heart rate and an increase in vasodilation. Their possible net impact could lower blood pressure, which would reduce mortality.

I think that one of the most important benefits is going to be related to mobility and balance. We often only think of the flexibility of the muscles of our hips and our knees, but something as simple as raising your hands above your head can benefit stretching those lower joints as well. And all that contributes to your ability to move in space as you get older; maybe you move more if you stretch regularly. By regularly, that means five days a week, the criterion in one of the studies I mentioned.

Finding out the why stretching helps may take a while, but the fact is that there are benefits to what we would consider the easiest forms of exercise. As you move forward through this year, when you have a few minutes in every day, whether it’s waiting for the microwave to finish heating a cup of coffee, washing your hands after using the bathroom, or standing alone on an elevator, taking the time to do purposeful stretching may provide a benefit that you don’t envision. To take it one step further, put together a short routine of three to ten minutes that you do every day; if you have old injuries or joint issues, an appointment with a physical therapist can help you devise a routine you can do safely. And now that spring has sprung and you can get out of the house a little easier, try a class in yoga, tai chi, or qigong. Be sure to look for one that’s within your abilities; Paula and I tried a class a few years ago and were embarrassed that we couldn’t get up and down as easily as the 20-somethings.

The net effect should be that your muscles and your connective tissue will be more pliable. Who knows, you just may end up living a little while longer as well! Sounds like a good investment of time to me.

What are you prepared to do today?

        Dr. Chet

References:
1. Med Sci Sports Exerc. 2020 Dec;52(12):2554-2562

2. BMC Public Health. 2023; 23:1148.

Reducing Your Risk of Dying the Easy Way

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Quick! If I were to ask you which form of exercise would decrease your chance of dying, and especially your chance of dying from cardiovascular disease (CVD), what would your answer be? You’d probably pick some form of aerobic exercise such as running, elliptical training, walking, and cycling—any type of exercise that works the heart and the entire body to improve your cardiovascular fitness. That’s on the list for sure, but it’s not the form of exercise that seems to decrease your risk of dying the most. Data from two large observational studies show this form of exercise decreases your risk of dying the most: stretching.

Stretching? Stretching is that toe-touching and heel-to-butt type of stretching we were all taught in high school or some other fitness class. But that’s not all. What also counts as stretching would be activities such as yoga, tai chi, and qigong. They feature slow, elaborate movements that control the body in ways that result in stretching the muscles and other connective tissue. That all counts as stretching.

How much does it reduce mortality? In two large studies, 10% and 12% respectively over the course of several years, the highest reductions in both studies. You get more benefit if you combine it with other forms of exercise such as aerobic training and weight training. But stretching? How or why? I’ll cover that on Saturday.

The Insider Conference Call is tomorrow night at 9 p.m. Eastern Time. Get your questions answered about anything related to health including exercise if you become an Insider by 8 p.m. tomorrow.

What are you prepared to do today?

        Dr. Chet

References:
1. Med Sci Sports Exerc. 2020 Dec;52(12):2554-2562
2. BMC Public Health. 2023; 23:1148.

Reality Check: Vitamin D

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Let me be clear. You should know how much of every dietary supplement you take and why you take it. If you exceed the amounts recommended on the label, you should also know why. But the case of the 89-year-old man who died because of an assumed excess vitamin D intake shouldn’t change a reasonable intake of vitamin D for anybody. Let’s take a look at what we don’t know.

Unanswered Questions

How much vitamin D was he taking? There is no indication that he took more than the upper limit. The assumption was that he was taking a very high amount, but wouldn’t there be receipts from pharmacies or groceries where he bought the supplements to deduce an estimate of how much he took?

Why did he decide to take more? Was he not feeling well? Someone with chronic heart disease and kidney disease might not feel all that great.

What medications was he taking? Was he taking those at the right time in the proper quantities?

One more: How do we know how he processed vitamin D? The assumption was that he mega-dosed on vitamin D, but what if he simply couldn’t process it well at 89?

About Exceeding That Upper Limit

For adults, the Tolerable Upper Limit (TUL) is listed at 4,000 IU (100 mcg), but that includes a safety factor of 6,000 IU per day. There were no observable events in the literature even at 10,000 IU per day, but to be safe, it was set at 4,000 IU.

Also, I’ve never seen a vitamin D supplement without a recommended amount to take. On the other hand, I’ve never seen a warning about consuming excess pharmaceuticals on the prescription bottles either. Buried in the flyer that comes with the prescription, yes, but not on the label.

The Bottom Line

Whether you’re 19 or 89, you should base your vitamin D intake on a vitamin D blood test. Vitamin D is not innocuous; take too much and it can be harmful. But there is nothing to fear in taking it in reasonable amounts to benefit your bones and your immune system. Physicians have prescribed 50,000 IU once a week for months to help people who need to raise their serum 25-hydroxyvitamin D (25OHD) levels. If it were not safe, it wouldn’t be used in that fashion. It also means you shouldn’t take it at a high level without guidance.

Again, base your vitamin D intake on the blood test and know why you take the amount of vitamin D you take. No reason to get extreme; just be reasonable.

The special pricing on the Real-Life Detox ebook ends tomorrow. The clocks change tonight, so it’s a good time to change your body with some spring cleaning.

What are you prepared to do today?

        Dr. Chet

Reference: Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium; Washington (DC): National Academies Press (US); 2011.