Supplementing Your Diet: Supplement Info Now on MP3

/in /by

More than ever, we live in a digital age. Those of you who are in the supplement business have had to adapt your business to use more electronic tools to survive and thrive.

I did Supplementing Your Diet as a CD with the idea that anyone could use it to help people understand why they need to supplement their diet, where they should begin, and how to select a quality manufacturer. You could lend it to someone, make an appointment to get it back, and maybe get an order. Because of the current state of social distancing, hose days are gone or at least on hiatus for a while. On top of that, CD players are becoming scarce. It’s time to enter the digital age with this product

Today we’re introducing Supplementing Your Diet as an MP3 download. How does that help your business? You can gift an audio to others so they can listen to it. All you have to do is put in their email address on the billing page when you buy it, and they will be notified and can download it (be sure to let them know it’s coming so they don’t mistake it for spam or malware). And you can send it anywhere in the world without a thought for postage.

The price of each download is $4.95, less your Member or Insider discount (remember to log in first). If you gift them to potential clients and customers, you’re taking a calculated risk but the information really helps people understand why supplementing is critical in this day and age. I can’t sell products for you, but I can explain the benefits. Then it’s up to you.

The Bottom Line

I created Supplementing Your Diet to help people understand the benefits of supplementation and to help business owners market their product with the best of scientific research. Add it to your repertoire of digital tools to increase your bottom line today.

What are you prepared to do today?

        Dr. Chet

Cost vs. Benefit for Saturated Fat

/in /by

In Tuesday’s Memo, I suggested that I don’t like speaking in absolutes when it comes to health recommendations; I’ve seen too many exceptions. What about our Michigan cardiologist? Was he correct? Yes and no, but mostly no.

He implied in the interview that the source of saturated fat is animal products. That isn’t true. In fact, someone could be a vegan and still over-consume saturated fats from using vegetable oils. Palm oil, vegetable oil, even almonds and other nuts that contain monounsaturated and polyunsaturated oils also contain saturated fats. My point is that even without any animal products such as cheese or milk, you can still get a lot of saturated fat in a vegan diet.

He was also overstating the positive effects of lowering saturated fat intake. I read the abstract; it said that it would take 56 people lowering their saturated fat intake for two years to prevent a single cardiac event. Further, the review did not show any reduction in mortality. To me, it raised a lot of questions that may have been answered but not reported.

Should we lower our saturated fat intake? Probably, but it’s going to take a lot more answers to swing the cost to benefit ratio in favor of giving up animal products for the potential benefits we may get.

What are you prepared to do today?

        Dr. Chet

Reference: Cochrane Library. https://doi.org/10.1002/14651858.CD011737.pub2

“Give Up Meat or Else!”

/in /by

“Animal Foods Conclusively Cause Heart Disease!” was the title in my news feed that attracted my attention. I had to check it out, because I’m not a fan of absolute statements in the health field; too often, some facts have to be ignored to make definitive statements such as that true. Was this any different?

A cardiologist from Michigan was interviewed in response to a recently published paper in the Cochrane Review. The review updated the information related to saturated fat intake and the rate of cardiovascular disease and mortality. After reading the paper, that’s the response the doctor gave to an interviewer from the Plant Based News. He suggested that the review conclusively shows that reducing saturated fat intake will result in a 21% decrease in CVD events. The implication is that most saturated fat comes from animal products: if we really buckle down and reduce our saturated fat consumption more, we can reduce events even further.

He makes the connection between animal products and saturated fat. But is that correct? It would mean that vegans, who consume no animal products, are protected from cardiovascular disease. Is that true? I’ll let you know on Thursday

What are you prepared to do today?

        Dr. Chet

Can Wearable Health Monitors Predict COVID-19?

/in /by

As of this writing, there are a minimum of five studies in the U.S. to determine whether wearable health-and-fitness monitors can predict the COVID-19 infection before noticeable symptoms actually occur. They’re looking at masses of data, rather than individual data points. Some are trying to predict how severe the infection will become using the data, which would allow a city, county, region, or even a state to move the necessary resources to the locations where outbreaks will occur. It would be a real step forward in the use of digital monitoring for tracking the potential outbreaks of disease.

While I hope they’re successful, there are two problems. The devices are expensive and only about 20% of the U.S. population actually owns them; how many use them is another whole question. Fitbits and Apple Watches are purchased by the type of people who are already interested in their health. This would limit the applicability to the general population.

The second problem is that it doesn’t do an individual any good at this point. Because the data are collected anonymously, no one could be informed if they’re at risk. As more treatments are discovered, early treatment may limit the severity of any long-term effects, but that doesn’t really help if you don’t know your data.

The issue is the right to privacy and especially health information privacy. I understand that and agree with it, but there should be some way an individual could be notified. Maybe this is the point where artificial intelligence could be used to keep human eyes out of it. And when we get to that point, odds are good that insurance will cover such devices because it always cost less to treat disease in its initial stages.

If you own such a device, such as a Fitbit, Apple Watch, Oura, Garmin, or other device, there’s a list of research studies at the end of this Memo along with the contact information I could find. Check them out. The more we know, the better prepared we can be for this or any other potential epidemic in the future.

What are you prepared to do today?

        Dr. Chet

Wearable Device Study Information:
Duke Covidentify: https://bit.ly/2XXTAp6
Scripps Detect Study: https://bit.ly/3gWkMNy
Stanford Covid-19 Detection Study: https://stanford.io/2XuTGWa
RNI Wearable Devices for Covid Monitoring: https://bit.ly/37022IB

Heart Rate and Viral Infections

/in /by

What might we gain by collecting and analyzing data from fitness and health devices? In a recently published study, researchers collected data from over 200,000 different Fitbit users. They selected users from the top five states of Fitbit users and collected data on height, weight, and age as well as heart rate and sleep data. It’s important to note that the data were collected anonymously so there was no invasion of privacy.

They ended up with data sets on over 47,000 people. That’s where this study became mathematical in nature. They correlated heart rate and sleep data with the rate of flu-like cases reported in each state by the Centers for Disease Control. They found changes in heart rate and sleep time correlated with the increase in reported cases of the flu. It helped improve the prediction model between 6.3% and 32.9%.

This is important for a couple of reasons. First, they were able to handle billions of data points; that seems so easy to say, but think about what that involves in terms of data storage. Second, they were able to show some predictive use for the data.

Although they were improving the ability of the CDC to predict the number of cases in general, it requires a lot more to actually predict who has a viral infection. More about that on Saturday.

What are you prepared to do today?

        Dr. Chet

Reference: DOI:https://doi.org/10.1016/S2589-7500(19)30222-5.

Health Monitors and COVID-19

/in /by

Do you have a Fitbit that you use regularly? Does it track your heart rate? How about an Apple Watch? Can it track your temperature? Blood pressure? Millions of people use those types of devices. Think of the potential for collecting data. It could be millions of data points per second.

I recently wrote about a study that integrated data collected from smartphones with health reminders and recommendations to see whether texts and emails could impact behavior. I didn’t believe they could, based on the limited data used by the computer to send recommendations. That was really an issue of total numbers of subjects; they had 300 and they needed 300,000 or better yet, 3,000,000.

These new studies overcome the problem of limited subjects. Several research groups are collecting data anonymously from fitness devices to find out if they can predict when someone has the COVID-19 virus. What could those devices track that might predict a viral infection? Heart rate, for one. I’ll talk about that study on Thursday.

What are you prepared to do today?

        Dr. Chet

Researching GOLO’s Claims

/in /by

Before I get into the rest of the research on the claims made by GOLO, I want to be clear that I have nothing against any products or programs in the market. I’m not assessing the entire program for any company. But having worked for a couple of decades with companies that follow the FDA and FTC Guidelines for dietary supplements very closely, it’s more than frustrating when companies play loose with the research. If they make a structure-function claim, they should be able to substantiate those claims according to the guidelines.

Published Studies

The GOLO website refers to two studies that were published in journals. In the first study, a researcher assessed the effectiveness of the GOLO program on measures of weight and glycemic control. The study lasted 13 weeks; 16 out of 26 subjects completed the trial. There were significant reductions in body weight and insulin levels.

In a second study, the same researcher compared the subjects who used the GOLO weight loss program. The control group was given a placebo and the experimental group was given the program’s dietary supplement. The treatment group lost more body weight than the controls; there were also positive changes in serum insulin and a score of insulin resistance.

The implication is that in all studies, published or not, the dietary supplement made the difference in the results. There’s no way to tell. While every study talked about caloric intake, they did not report comparative data, either within subjects when there was no control group, or between groups when there was. This is simply poor research methodology and statistical analysis.

Does the Research Prove the Claim?

As I said on Thursday, while the company makes many claims on the website, I stuck to the one that said the product was “clinically proven to reduce insulin resistance.” They did not prove that the dietary supplement helped reduce insulin levels, blood glucose levels, or HOMA-IR, a measure of insulin resistance. There were just too many confounding variables they did not examine. I already made mention of the caloric intake. The program evolved over time from one where they planned a 500-calorie deficient diet for the subjects to one where they were advised on how to construct a diet from certain food selections. That’s why caloric intake is so important; we need to know that to find out how well the subjects met the dietary guidelines. The best they could claim is that the supplement may have assisted some subjects to lose weight.

In each study, the changes in HbA1c were relatively meaningless in the real world; reducing HbA1c by 0.18% and 0.61% is within the error of the method. As for the use of HOMA-IR, the researcher who developed the algorithm has said that it was not suitable for these types of clinical trials, just for large epidemiologic studies. Finally, the reduction in blood sugar in every trial where it was measured could be explained by exercise, which they also did not account for in the analysis; many people don’t realize exercise can modify insulin resistance by the third workout.

The Bottom Line

There were many more issues with the selection of data used in the multiple analyses and in the choice of statistics themselves. Most importantly, the significant loss of subjects—all four lost up to 40% of all subjects—was acknowledged by the authors, but they didn’t explain its impact. I could go on with errors, but it’s unnecessary. For the claims made, the level of substantiation is simply not sufficient to exhibit the dietary supplement’s benefit for insulin resistance. The weight loss program may be beneficial, but it can’t be verified by any of the studies they completed or by the materials provided on their website.

Eat less. Eat better. Move more. Do those long enough and you will be able to lose weight, get fit, and improve your metabolism as well.

What are you prepared to do today?

        Dr. Chet

References:
1. Diabetes Updates, 2019 doi: 10.15761/DU.1000125.
2. Trends Diabetes Metab, 2019 doi: 10.15761/TDM.1000109.

Dental Cavities Are an Engineering Wonder

/in /by

Continuing our look at the process of dental decay, the methodology for this study was complex to say the least: preserving the plaque, analyzing the structure, obtaining samples of the bacteria, attempting and succeeding to grow the structures on enamel surfaces that mimic teeth, getting photographs of the electronic polymeric structure, and more.

This study demonstrated that the Streptococcus mutans bacterium doesn’t merely attach to the biofilm and multiply; it organizes itself and other bacteria into dome-like structures in order to protect the most inner part of the dome. They tested this by exposing the teeth to a commonly used anti-bacterial rinse and found only the most exterior part of the dome was destroyed. The bacteria then reorganized themselves and the other bacteria so they could continue the attack that causes tooth decay. As long as the medium is present, in spite of treatment, the bacteria will continue to organize its structure to promote decay. Amazing.

What was the conclusion? There was none at this point because this is new research. I have one for you that isn’t controversial nor does it require anything that you probably already don’t do intermittently: cut out a sugary diet for your children and yourself to stop the constant feeding of the bacteria. Then brush regularly after every meal; teach your kids to swish with water after every popsicle or gummy bear. And to break up the plaque, floss every day. That seems to be the only way to address this oral bacterium that’s an engineering marvel.

What are you prepared to do today?

        Dr. Chet

Reference: doi.org/10.1073/pnas.1919099117

Investigating the Architecture of Cavities

/in /by

Have you ever wondered how your kids get cavities or why you got them as a kid? As I was researching studies on the microbiome, I found a fascinating article on cavities.

Cavities, also called dental caries, are a disease caused by bacteria that attack the biofilm known as plaque and damage the enamel of the teeth by creating an acidic atmosphere. In addition to the bacteria, cavities are also dependent on diet. All that stuff about sugar causing tooth decay? Yes, it’s actually true—just maybe not in the way we thought. The primary bacterium associated with tooth decay is Streptococcus mutans, an aggressive plaque builder and acid-producer. But how?

Researchers from two universities wanted to examine any types of structures that might be built on teeth by S. mutans and other bacteria that might contribute to cavities. What kind of structures are we talking about? No one really knew for sure. But to find out, they needed to study the structures as close to the mouth as possible but not actually in the mouths of children; they used the extracted teeth of children who had so much decay the teeth couldn’t be saved and preserved them for analysis. As unbelievable as it may sound, up to 2.5 billion people, mostly children, are impacted by this type of decay.

We’ll continue this look at the topic on Saturday.

What are you prepared to do today?

        Dr. Chet

Reference: doi.org/10.1073/pnas.1919099117

Vitamin D and COVID-19: What Would a Reasonable Person Do?

/in /by

The Medscape article did not call for any conclusions or recommendations nor should it have. That’s not the purpose of that type of article. However, that didn’t stop healthcare professionals from voicing their opinions in the comments section of that article. We’ll take a look at what they said, discuss the potential benefit of vitamin D testing and supplementation for COVID-19, and determine what a reasonable person should do.

Comments Abound

I rarely read the Comments section on any posting. There’s no point, because people will disagree about almost everything, especially when interpreting scientific information. If you think people attack people only on social media, not true; academic arguments can get really vicious.

There were not just comments about the Medscape article, but about what people posted in response to the article: accusations of “junk science,” “pseudoscience,” or “snake oil salesman.” These are healthcare professionals at all levels going after one another. They may not use the same language, but the insults and accusations about being shills for pharmaceutical companies are still there. You see the condescending attitude of some physicians about research and the opinions of people who treat patients with supplements. The end result is the same as a Twitter fight; it accomplishes nothing beneficial.

Potential Benefit of Vitamin D

Within the Medscape article was a reference to an article that hasn’t been peer-reviewed yet. That paper attempts to quantify the relationship between vitamin D deficiency and extreme responses to COVID-19 infections. They looked at vitamin D and C-reactive protein (CRP), a marker that indicates inflammation. CRP is depressed in severe cases of COVID-19 infection but not as depressed in milder cases of infection.

They found that “the risk of severe COVID-19 cases among patients with severe vitamin D deficiency is 17.3% while the equivalent figure for patients with normal vitamin D levels is 14.6%; that’s a reduction of 15.6%.” Understand that this paper makes many assumptions about the relationship between vitamin D status and CRP that may or may not be correct. However, if the number of severe COVID-19 cases resulting in deaths in the U.S. were reduced by half that amount, that would mean thousands fewer deaths.

The Bottom Line

I began this by asking the question “What would a reasonable person do?” That’s a term often used in legal matters, but I think it applies here as well. Based on the Irish study, optimal vitamin D levels should be maintained between 50 to 60 nmol/L. You would need a blood test to find out if you’re there. If your physician is not amenable right now, use the last vitamin D test you had as the base level. I just had my blood work done in the past couple of months, and it was 30 nmol/L. If you’re in the optimal range, keep doing what you’re doing.

If you’re low, as I was, it’s time to increase your vitamin D intake. This is especially true if you have a comorbidity such as being obese, having type 2 diabetes, an autoimmune disease, asthma or another lung disease, or are over 60. Talk with your physician about increasing your vitamin D intake. By how much? You could safely increase your intake by 1,000 to 2,000 IU or 25 to 50 mcg, but get your doctor’s input on whether you should take a higher amount for a while to increase your vitamin D levels faster.

As I said a week ago, respect this virus. One of the ways you can do that is by treating your body as any reasonable person would, including getting your vitamin D to optimal levels.

What are you prepared to do today?

        Dr. Chet

References:
1. Irish Med J. 2020; 113 (5):81-88.
2. Vitamin D: A Low-Hanging Fruit in COVID-19? – Medscape – May 17, 2020.
3. doi: https://doi.org/10.1101/2020.04.08.20058578