Unusual Questions: Resistant Starch

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Recently an Insider asked what I knew about resistant starch and whether it can help control blood sugar in someone whose blood sugar was higher than normal. Here’s what I found.

Resistant starch (RS) is found in many vegetables and some fruits. It resists digestion and absorption, especially in the small intestine. One of the problems: RS is described on the Internet as not digested and absorbed, but that’s not accurate. It resists digestion and absorption in the small intestine but doesn’t block it completely. Because it doesn’t break down to sugar molecules, RS will not spike blood sugar the way non-resistant starch might.

RS is digested by gut bacteria in a fermentation process. Because the RS feeds healthy bacteria, it produces, among other substances, short-chained fatty acids—fats that can be used for energy without being processed by the liver. The highest amount of RS can be found in beans, grains, potatoes, bananas, and plantains.

However, it’s not quite as simple as that because food preparation happens to be important in this process. I’ll cover that as well as some other research on RS in Saturday’s Memo.

What are you prepared to do today?

        Dr. Chet

Unusual Questions: The Grit in Pears

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Let’s kick off the 2020 Memos a little differently. Every health website is focusing on weight loss and fitness resolutions. Of course they are—it’s that time of year. But let’s be non-conformist and start by answering questions that may seem a little unusual, such as: is there any truth that cooking rice or pasta and then refrigerating it increases the fiber content? I’ll start with one Paula asked: what are those little gritty things in pears? You know, like the fruit has little pieces of sand in it.

My first thought was that it was some type of fiber. Wrong. It turns out that there are different types of plant cell-wall components. Some are flexible, some are not. Sclereids are cell-wall components that are rigid; clusters of them cause the grittiness in pears. The seed coats of beans, peas, and most other seeds are also made up of sclereids. They’re indigestible and just pass through the digestive system. Are they fiber? The don’t seem to be, but because they’re not digested, they’ll add bulk to the stool. That explains why peas and corn seem to seem to look the same exiting as they do entering.

I can’t let you go without a little nutrition talk: pear and cheese is one of our most frequent evening snacks. You can’t go wrong pairing any kind of pear with our favorite Costco Tillamook Extra Sharp Cheddar in the black wrapper. Or try a green salad with pear, blue cheese, dried cranberries, glazed walnuts, and balsamic dressing; add leftover chicken, and you’ve got a meal.

The idea of refrigerating pasta and rice was interesting, so I’ll be writing about resistant starch the rest of the week. If you have any questions that seem to be a little out there, send them to me and I’ll answer them next week. If you want to know, I guarantee others do as well.

What are you prepared to do today?

        Dr. Chet

Reference: Chapter 3: Cells, Tissues, And Organs: The Microscopic Components Of Plant Structure. J&P Learning.

Happy New Year!

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Another year has begun, filled with our hopes and dreams of what is possible. It’s a time of setting goals, developing a plan, and then working on seeing those dreams become reality. Most of you probably have a revamped healthier and fitter body on your list.

The question is: what does that mean to you? How do you define health? How do you define fitness? The answers could be different for everyone. That means that you may need a specialized plan to reach those goals.

For 2020, I’m designing the information and programs you need to do just that. As the month and year proceed, I’ll tell you how I’m going to help you achieve those goals. One thing for sure is this: it will all come down to how you answer one question.

What are you prepared to do today?

        Dr. Chet

Merry Christmas!

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From Paula, myself, and our extended family, we wish you all a very merry Christmas and a happy holiday! And I guarantee our Elf on the Shelf gets into more mischief than yours.

What are you prepared to do today?

        Dr. Chet

MRSA at Home for the Holidays

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Meticillin-resistant Staphylococcus aureus (MRSA) is a threat to our health because the potential infections are severe and effective antibiotics to treat it are failing, yet it’s a strain of bacteria that exists just about everywhere, including in our homes. How can we limit exposure, and what can we do to prevent catching MRSA? That’s what a recent study attempted to discover.

A group of researchers recruited 150 healthy children who had been treated for a staph infection from 2012–2015 for a year-long study. All 692 people who lived in the house more than four nights per week were also recruited. That also included 154 dogs and cats. To establish a base line, cultures were collected from three anatomic sites of household members, two anatomic sites on dogs and cats, and 21 environmental surfaces to detect S. aureus. Interviews with household members were also done—no interviews with the dogs and cats. Data collection was repeated every quarter for 12 months.

The objective was to see how many new strains of S. aureus were introduced into the household and how many were transmitted between household members. Here’s what they found:

  • There were 510 introductions of novel strains into households.
  • There were 602 transmissions within households in a variety of ways.
  • Frequent hand washing reduced the likelihood that a new strain would be introduced.
  • Those who were exposed to S. aureus were mostly renters and those who shared bedrooms with strain-colonized housemates.
  • Transmission occurred more between household members who shared towels. I don’t think many people share bath towels, but hand towels are widely shared at home. Giving all family members their own hand towel could quickly become unwieldy in large families.
  • Finally, pets were most often the recipient of the transmission of bacteria, not the transmitters. (Who’s licking their dogs and cats?)

All kidding aside, this study illustrates how bacteria can be introduced into our environment and how it can be passed person to person or animal. It seems the best thing you can do to limit the spread of MRSA bacteria is to wash your hands regularly. With the holidays upon us, more people entering our homes, and more visits to family and friends, that seems to be the simplest solution to MRSA at home for the holidays.

Get yourself a gift of health this holiday season: the Optimal Performance program is on sale. Get prepared to have all the energy you need to achieve your goals in 2020. You can also shed that weight you’ve been wanting to lose. Order your copy today.

What are you prepared to do today?

        Dr. Chet

Reference: DOI:https://doi.org/10.1016/S1473-3099(19)30570-5.

How Much Sleep? It May Be in Your Genes

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I know a young woman who goes to work at four in the morning; she has a job with flex time and likes getting out by noon so she has time to spend with her young children. Here’s the thing: she generally goes to bed between 11 p.m. and midnight. She needs only four to five hours of sleep. Her dad is the same way. Not tired, not dragging—that’s all they need. It seems it may be their genes that are responsible.

In a recent study, researchers identified a mutation in a gene called grams protein-coupled neuropeptide S receptor one (NPSR1), a mutation that’s associated with a naturally short sleep phenotype in humans. This mutation is rare, but it does exist. One of the purposes of this type of research is to see if there’s a drug that could stimulate or inhibit the target gene to help others get by with less sleep. That’s decades away, if it can be done at all without raising more problems.

For all the rest of us, we need as much sleep as we need. We may not be able to get it every night, but it’s part of a healthy lifestyle. Getting enough sleep is something we all should try to do to be healthier.

What are you prepared to do today?

        Dr. Chet

Reference: Sci Trans Med. 2019: DOI: 10.1126/scitranslmed.aax2014.

It’s Official: Prescription Fish Oil

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The U.S. Food and Drug Administration approved the prescription fish oil Vascepa for expanded use on Friday, December 13. The approval for the medication is for the secondary prevention of cardiovascular disease in patients under the following conditions:

  • Triglycerides above 150 mg/dl for everyone with diagnosed CVD and taking a statin medication.
  • Diabetes and two or more additional risk factors for CVD along with taking a statin medication.

The modifiable risk factors for CVD include smoking, obesity, high cholesterol, hypertension, and sedentary living. Remember from our prior series, secondary prevention may help reduce the risk of CVD symptoms developing.

My concerns are the same as they were before. Triglycerides less than 250 mg/dl can be resolved by diet and exercise in most people. Because the mechanism of action is unknown as to how the prescription works, there’s no reason to think that reducing triglycerides by lifestyle change won’t work as well as the prescription; the clinical trial didn’t track this data.

Speaking of lifestyle change, keep in mind the website specials on the Optimal Performance program as we get ready for the New Year. The Basic Meal Plan will teach you how to change your diet to reduce triglyceride levels if your levels are too high.

What are you prepared to do today?

        Dr. Chet

References:
1. http://bit.ly/36EbsYK
2. N Engl J Med 2019;380:11-22. DOI: 10.1056/NEJMoa1812792.

Holiday Eating: The Best Solution So Far

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In our quest to find the best holiday eating strategy, we may have been looking at the wrong metric. Prior researchers have been looking at the subjects reporting of how well they stuck to their eating habits and exercise program. The final study looked at a hard metric: body weight. Here’s what they did.

Researchers recruited subjects who were overweight and obese but had been losing weight, plus a group of normal-weight subjects. They further divided the two groups into control groups and experimental groups. The control groups simply weighed in before the holiday season began at Thanksgiving, after the season ended on January 1st, and again a month later. The experimental groups also weighed in during those times but in addition, they were told to weigh in every day using a scale with Wi-Fi access. Their results were displayed graphically to chart progress.

What happened? The control groups, whether overweight, obese, or normal weight, gained an average of close to six pounds during the holiday season. The normal weight subjects who weighed themselves daily maintained their weight. Those who were overweight and obese continued to lose weight, losing on average 2.5 pounds. At the one month follow-up, the control group lost only half the weight they gained over the holidays. Researchers speculate that annual holiday weight gain contributes to weight gain over years.

The Bottom Line

What’s the best strategy for holiday eating? There are two things that are critical: maintain your exercise program and weigh yourself regularly, preferably every day. True, your daily weight will fluctuate but you won’t let it get away from you—that’s when you get into trouble. As for your eating habits, not every day is a holiday party with mass quantities of food to consume. Chill out a little during the parties and pitch-ins, but for the most part, stick to your regular eating habits; that applies whether you’re overweight or not. I think that’s the best strategy for the holiday season.

What are you prepared to do today?

        Dr. Chet

Reference: Obesity. 2019;27(6):908-916. doi: 10.1002/oby.22454

Is a Relaxed Holiday Eating Plan Better?

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The Portuguese Weight Control Registry is similar to the National Weight Control Registry. While the amount lost is different, 11 pounds, the members still have to have kept the weight off at least a year. Researchers asked what techniques participants used for weight maintenance, comparing weekdays versus weekends and holidays versus non-holidays. The criteria were different. Those researchers were looking at weight regain of 3% or less that was maintained for an additional year. What did they find?

Subjects who relaxed their eating plan on weekends maintained their weight loss better than those who strictly adhered to their diet and exercise regimen. The comparison with holiday and non-holiday habits didn’t show any differences in weight regain. There were a significant number of subjects who dropped out, and that probably impacted the results.

Neither of these studies on the Registries was perfect but it does give us some insight. Depending on your mental make-up, it may be better to stick to your regimen during the holidays or maybe you can relax a little. While not reported, it would depend on your mental willpower at the time. That might change year to year. Well, where does that leave you? One more study to review that might provide the solution.

What are you prepared to do today?

        Dr. Chet

Reference: https://doi.org/10.1186/s12937-019-0430-x

Should You Have a Strict Holiday Eating Strategy?

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Tis the season for gaining weight. It began on Thanksgiving, but we’re in it big time now. If you’ve lost weight and want to make sure you don’t see it again, what do you do? Let’s review some of the research on strategies that people who’ve lost weight and maintained it have used.

The first is a report from the National Weight Control Registry. In order to be a subject in that study, you have to lose 30 pounds and maintain it for at least a year. Researchers took a group of recent additions to the study and asked them specific question on their strategies during the upcoming holiday season at that time, and then tracked how they did. They also recruited a group of normal weight people and did the same thing.

Most of the experimental group said they were going to follow their typical routine as related to diet and exercise plan. In other words, they were going to try to strictly follow their weight loss routine. The normal weight individuals didn’t really have any special plans. Most successful losers did follow their plan although it was more difficult during the holiday season. About the same percentage of successful losers and normal weight subjects gained weight, maintained their weight, or lost weight during the holiday season. The difference was that the successful losers found it more challenging to do so based on their response to survey questions.

Is that the best strategy? Stay the course? Another study on Thursday.

What are you prepared to do today?

        Dr. Chet

Reference: J Consult Clin Psychol. 2008. 76(3): 442–448.