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.

Vitamin D: Cautionary News

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Every once in a while, news on the suspected abuse of a dietary supplement makes headlines; such was the case when I read my news feed this past weekend. An assistant coroner in Surrey, U.K., declared the cause of death for an 89-year-old man was excessive calcium build-up due to high levels of vitamin D supplements. He was hospitalized in May 2023 and died 10 days later. The coroner’s report just released cited his vitamin D intake as a contributor to his death.

When more vitamin D is taken in than the body can process, the possibility exists that it can release calcium from the bones, which can then settle in the coronary arteries and kidneys. Heart and kidney failure were the actual causes of death. The coroner criticized the labeling on the supplement bottles because it contained no warnings. When queried, representatives of several U.S. medical schools talked about the “dangers” of exceeding the 4,000 IU (100 mcg) upper limit for vitamin D.

I think the man’s death was tragic, but I think everyone needs to take a deep breath. There are several issues related to this situation that weren’t talked about, and I’ll cover those in the Saturday Memo.

Remember, the Real-Life Detox ebook is on sale through Sunday evening. Laptop, tablet, or smart phone, you can spring clean your liver to get ready for the summer.

What are you prepared to do today?

        Dr. Chet

References:
1. https://www.express.co.uk/life-style/health/1872500/supplements-vitamin-d-warning-man-dies-overdose
2. https://www.ncbi.nlm.nih.gov/books/NBK56058/

Spring Cleaning

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Earlier this week I was an election worker for the Michigan primary. It wasn’t particularly busy at times so, as often happens, people asked me what I do and then checked out my website. The conversation came around to my thoughts on detoxing. I said I thought it was really good; after all, I wrote Real-Life Detox to help people clean out their liver to get a head start on eating better.

A woman asked me about the basics of the program. After I talked about the cruciferous and allicin-containing vegetables, she said she likes to cook a lot of greens such as collard and mustard greens. I said, “Great. Just no bacon.” She laughed because I knew exactly where she was going with the comment. I gave her some ideas on how to make it healthier while maintaining the flavors.

I decided to do two things. First, reduce the price of the e-book to $7.95 for a week; the price goes back up Sunday, March 10. Second, I added the recipe for collard or any type of greens to the Recipes section of the website. My opinion is that it rivals the Cabbage Soup as the foundation of the foods you can eat that have all the detox veggies. And when you’re cooking supper and you need a green vegetable, these greens are a good option instead of nuking some peas or adding one more salad. Try them and let me know what you think.

It’s time to spring clean the most important thing in your life: you.

What are you prepared to do today?

        Dr. Chet

P.S. Apologies to all of you waiting for the Managing Pain Super Bowl Webinar replay. We’re having technical problems (the file won’t upload), but Paula and our IT guy are working on it. If you bought the webinar, you’ll get an email with a link as soon as we’ve got it.

The Step-by-Step Approach to Pain

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As I wrap up preparations for tomorrow’s Managing Pain Super Bowl Webinar, I wanted to provide you with a little more information—specifically, how I’m going to use a step-by-step approach to deal with pain.

The typical approach used by the medical profession is to try a treatment and if that doesn’t work, try the next step in the recommended treatment plan.

What I’m going to teach you is how to use several modalities or approaches simultaneously to manage your pain. For example, let’s say you have a painful joint. In order to build muscle in that joint, you may begin with using light weights; you may use a dietary supplement to decrease inflammation at the same time. It would also be a good idea to do some fascia stretching to stimulate the breakup of adhesions that contribute to the pain. I could go on, but that’s the idea.

You can still participate in the live webinar if you sign up by Sunday at noon Eastern Time. If you can’t make it, I’ll automatically send you a link for the replay when it’s ready. This is an important webinar because it addresses the one question I get all the time. Join me for an hour Sunday afternoon; it just might make a big difference in your ability to live your life.

What are you prepared to do today?

        Dr. Chet

Help for Long-Haulers

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Many people suffer from a myriad of symptoms after contracting a COVID infection. Muscle and mental fatigue seem to be common among these “long-haulers”—more technically called post-viral fatigue syndrome. Based on prior research by the investigators, they randomly selected twelve subjects with long-haul COVID symptoms. Half the subjects took four grams of creatine monohydrate for six months; the control subjects took inulin fiber.

Every measure of energy production in muscle and brain demonstrated improvement. Questionnaires on fatigue and muscular pain matched the improvement in energy production in the tissues that were tested. Did increased energy account for the benefit? While the study was small, mostly due to the complexity of the research methods, it appears that’s a reasonable conclusion, although larger studies should be done.

Creatine is just one of the modalities I’m going to cover in this weekend’s Managing Pain webinar. Pain can be the result of several body systems that are not working properly; the objective is to use a step-by-step approach considering many systems to manage pain. Sign-up today for the live webinar Sunday at 3 p.m. Eastern.

What are you prepared to do today?

        Dr. Chet

Reference: Food Science & Nutrition. 2023. 11(11):6899-6908

Gas Station Heroin

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I have to admit that I’d never heard the headline’s words strung together like that until I read about the banning of several products that contained an anti-depressant called tianeptine, which is approved in some countries (not the U.S.) as a prescription drug for the treatment of depression. It is a tricyclic antidepressant; in some cases, it has a mood elevator effect. I can’t confirm that it is a high similar to fentanyl as claimed in some articles. While the products have been pitched as dietary supplements, they most definitely are not.

Here are three rules to follow when considering a dietary supplement:

  • Know the active ingredient you’re looking for, whether it’s a vitamin, mineral, herb, or other supplement like glucosamine. If you’re not sure, don’t make an impulsive purchase because a friend recommended it.
  • Check the label for a certification from a legitimate testing company like NSF or the USP, the two most prominent certification companies.
  • Most important, don’t buy dietary supplements from convenience stores or gas stations. What are you thinking? That area around the cash register can be a minefield of promises from energy to libido. Don’t fall for it!

The Managing Pain webinar is a week from tomorrow. Reserve your spot for the live webinar; spaces are limited and going fast. I hope to see you live. I’m ready to teach!

What are you prepared to do today?

        Dr. Chet

Managing Pain

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Quick: what’s the location of pain that’s experienced by most adults in the United States, regardless of age?

Pain afflicts everyone at one time or another, but the older we get, research shows that we’re more likely to experience chronic pain. That time you twisted your knee when you played a pick-up game of basketball? When you rolled your ankle playing tennis? That time you were rear-ended in a car? How about when you slipped and fell on the ice? You may have had pain then and recovered, but all of those things could have caused micro-tears in connective tissue and now the bill has become due.

In this webinar, I’m going to cover the most common forms of pain experienced by people of all ages. By the way, the most common type? It’s lower back pain. While the focus is going to be joints and extremities, the approach can be used with other forms of pain such as migraines and fibromyalgia.

The objective of this webinar is to give you a step-by-step approach on how to deal with chronic pain. The goal is that you can use it to help yourself in the future. Every known modality will be discussed.

The Managing Pain webinar will be held Sunday, February 25, at 3 p.m. Eastern Time. If you’re not available at that time, no worries. The replay will be available later that day and for the next six months. The cost of the webinar is $13.95; Member and Insider discounts apply.

There are many places you can be on a Sunday afternoon, but this is an opportunity to help yourself for years to come. Spend a little while with me and learn to change your life. Sign up today.

What are you prepared to do today?

        Dr. Chet