Potatoes and Your Microbiome

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A Cherokee legend talks of two wolves inside us, one good and one evil. Which one will win? The one you feed. It applies to our microbiome as well. We have good and bad microbes within us at all times. Which ones dominate? It depends on how we feed them.

In a recent study, researchers tested a prebiotic made up of a harder-to-metabolize starch extracted from potatoes. The subjects were a group of elderly and middle aged men and women. The objective was to compare the types of bacteria that responded positively to the prebiotic.

At baseline, the elderly subjects had higher amounts of the bad microbes, proteobacteria such as E. coli, compared to middle-aged subjects. After three months of using the prebiotic, there was a decrease in the bad microbes in the elderly subjects while both groups experienced in increase in bifidobacteria, the good microbes. The conclusion was that the prebiotic helped create a better microbiome balance.

While this was a small study that focused on one type of prebiotic, there’s a lesson. If you have a diet that includes vegetables, beans, and some starchy root vegetables such as potatoes, you will get a variety of prebiotics including the type used in this study. They will help you feed the good microbes to create the right balance in your digestive system. Which microbes will win? Your diet determines which ones dominate.

What are you prepared to do today?

Dr. Chet

 

Reference: DOI: http://dx.doi.org/10.1016/j.clnu.2017.03.025

 

Fiber and Your Microbiome

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Researchers used gnotobiotic mice in a recent study to test the importance of fiber; gnotobiotic mice are born with no bacteria of any type. Researchers used a synthetic human microbiome to introduce a bacteria colony into the mice. Once the colony was established, they withheld fiber from the diet of the mice. Then it gets scary: the mice’s microbiome used the naturally occurring mucus layer of the digestive system as food, which led to exposure of the underlying cells. The mice were exposed to a pathogen similar in effect to strains of E. coli in humans, and the mice that were deprived of fiber became ill as a result of the bacteria and died.

This mucus barrier is the same in our digestive system. The fiber we eat feeds our microbiome; if we don’t get adequate fiber in our diet, the possibility exists that a similar destruction of the mucus can take place.

The solution seems simple: eat vegetables, beans, and other fiber-containing foods to strengthen your microbiome and use a fiber supplement as insurance.

What are you prepared to do today?

Dr. Chet
Reference: http://dx.doi.org/10.1016/j.cell.2016.10.043

 

How to Limit Your Processed Food

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There are two strategies that you can use to control your intake of processed foods.

The first is the simplest yet the most difficult, especially if it’s something you really love to eat: Don’t buy it. If it’s not in the house, you can’t eat it. Whenever I tell that to someone, the next words out of their mouth are usually something like “That’s not going to happen!”

I understand completely, but for me, it’s the only way I can reduce my intake of chips and peanuts. If they’re in the house, I will eat them and I won’t stop. Some types of nuts such as almonds or walnuts are easier to control. I have yet to find something to substitute for any type of chip. You can put salt on carrots and celery, but it isn’t the same. You can dip broccoli or cauliflower in olive oil or balsamic vinegar and it doesn’t come close. It’s the combination of processing combined with the fat and salt that makes these foods difficult to resist for me.

Can you walk away from the pantry as you let one square of chocolate dissolve in your mouth? Can you eat two Oreos and put the package away? We all have our Achilles heel of foods; Paula almost finished a box of deluxe ice cream sandwiches the day we bought them, so we never bought them again. For you, it may be bread or donuts or chocolate or jelly beans. If you can’t walk away, just don’t buy it.

The second approach, and one that may be more reasonable for some, is to portion out a serving and don’t eat any more. In my opinion, there are no foods that you can never eat as long as you control the amount and the frequency. If you can control your portions, that works just fine. If you can’t, you have no alternative other than to not purchase them.

Here is a bonus third way: Eat your vegetables first. Research shows that vegetables contribute to satiety. If you eat them first, it may be easier to control the processed foods you desire. Drinking a glass of tomato juice instead of a milkshake may not be as rewarding emotionally, but it may satisfy you physically.

This is something to work on at home with your children. Based on recent changes to the guidelines for school lunches, the upper levels of sodium may be suspended for school districts that request it. It seems innocent enough but in effect, your kids probably will be exposed to high levels of salt, learning to become dependent on the same nutritionally deficient foods we have problems with today. Schools can also opt out of the whole-grain requirement, so expect to see cheaper white bread. Best bet is to fix healthy lunches for your children every day and teach the kids to fix them, too.

I hope this helps. For me, it’s a never-ending battle and I know it is for others as well. Find which strategy works best for you—abstinence or control—and stick to it.

What are you prepared to do today?

Dr. Chet

 

What’s Wrong with Processed Foods

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If you do an Internet search for processed foods, you’ll get a whole lot of opinions on why they’re a bad thing. There isn’t a substantial amount of research behind the opinions when you look closely. In fact, there isn’t a substantial amount of research on processed foods at all and why they’re difficult to resist. Keep in mind that I’m talking about extensive processing; fruits and vegetables that are frozen immediately have been shown to have more nutrients than fresh produce that’s been sitting in the grocery display case for a while, and canned fruits and vegetables are a close second.

What’s the problem with processed foods, other than the fat, sugar, and salt? Two things stick out in my mind. First, the act of processing alters the vitamin, mineral, and phytonutrient content of the foods. Whether we’re talking about grains such as wheat or corn, beans such as soy, or dairy such as milk, some if not most nutrients are lost in the processing.

Second, you lose the fiber, and given how little fiber adults get, that might be the most serious loss of a nutrient. Fiber acts as a prebiotic to feed the microbes in our gut and helps with satiety and digestion. Breads, pastas, rolls, bagels, and every other processed food that uses grains come up short.

I’ll add one more to the list: probiotics. Processing destroys the good bacteria and other microbes that are valuable to our health. It isn’t just what we are getting in processed foods that harmful; it’s what we’re not getting that compounds the problem.

What’s the solution? I’ll finish this up on Saturday.

What are you prepared to do today?

Dr. Chet

 

Why Can’t I Stop?

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If there’s one question that frustrates all of us, including myself at times, it’s “Why can’t I stop eating ____?” For me, it’s salty and crunchy such as nuts and chips. For others, it’s refined carbohydrates such as baked goods, or sweets such as chocolate or cookies. Why can’t we just stop eating them? Why are we not able to say “Enough!” once we’ve started eating?

The reasons appear to be simple. The common denominators in every processed food appear to be salt (sodium), sugar, or fat, or some combination of the three. You don’t really ever hear someone saying they went on a kale-eating binge, do you? It’s always some processed or refined food. I’ll add fast foods to that list because the foods are cooked and assembled in a way that makes us want more.

I’ll examine a couple of reasons why these foods are so problematic on Thursday. For some insight on the food industry and how the food industry manufactures foods we can’t resist, get a copy of Michael Moss’s book Salt Sugar Fat: How the Food Industry Hooked Us. It’s a revealing look at how companies spend a lot of money on research to put together the flavors we can’t resist.

Dr. Chet

 

How to Live to Your 90s

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Today’s message is based on my father-in-law, Don Jones, or Joner as most of us knew him. As I said Wednesday, he passed away last Sunday. He lived to 94 years and six months; Peggy, the sister he was closest to, died at the exact same age. How was he able to live that long? I’ll give you my observations based on his life.

  • Genetics: it pays to have the right genes and Dad certainly did. Several of his siblings lived into their 90s.
  • Quit smoking: he quit smoking before he turned 21 years old. That’s probably the single most important thing he did. His father and siblings who smoked all died much younger. He never drank alcohol after that either.
  • Love: he loved his wife of over 70 years deeply, and as I said Wednesday, he longed to be with Ruth again. That’s a love that transcends life itself.
  • Humor: he had a great sense of humor. He gave it and was able to take it as well. My big ears were a frequent target. Once after we came in from a run together on a cold day, he said, “I know why you wear that headband: reduce wind resistance.”
  • Demeanor: he was almost always calm and pleasant and rarely showed any anger. Paula said when she was a kid and acted up, he’d just hang his head and sigh, and that hurt worse than any spanking. Once when he was mad at me, he showed it by leaving the newspaper at the top of the steps instead of putting it on the counter. He never stayed mad long.
  • Faith: he believed in God and lived his faith.
  • Exercise: he worked physical jobs most of his life. Then he began running when he was 70 and continued until he was in his mid-80s, hitting 700 miles for 2002. No doubt that helped him live longer than he might have with a genetic tendency toward stroke. He was never very fast but once you’re over 70, there’s not a lot of competition and he enjoyed picking up trophies at many of his 5Ks. I’m sure that competitive spirit added zest to his life.
  • Body weight: he was never fat for his height. That reduced any additional stress on his joints.

Those are my observations on how Joner lived into his 90s. While you can’t change your genes, you can certainly make the most of what you’ve got; his lifestyle and approach to life certainly helped my father-in-law.

What are you prepared to do today?

Dr. Chet

 

I’m Alive V2.48

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When I opened my eyes this morning, I said the same thing I’ve said for the past 24 years: I’m alive! I’ve come to believe that if I wake up this morning, it means I have at least one more year. It makes no sense, but I can’t change the way I think about this one thing.

The question is why. My dad died 48 years ago today at the age of 41. Ever since I opened my eyes on May 10th when I was 41, I believed I would live another year. Again, it makes no sense but it’s what I believe. For the many new subscribers, now you have a little insight into how I think.

This year also has a similar message to the one from three years ago. My father-in-law, Don Jones (Joner to most of us), passed away on May 7 at the age of 94. It was three years to the day and almost the same time of day as my mother-in-law, Ruth Jones. While we most definitely will miss him and all his stories, we’re not sad. His body had let him down the past couple of years; I think he decided it was time to go be with his Ruthie again and he just quietly slipped away. How can you be sad about that? They were together on this earth for over 70 years and now they have eternity. That deserves a celebration.

Whether it’s a day, a month, a year, or until I’m 94, I’ve got a lot to do to help you get healthy and fit to be able to live life the way you want to live it. Stay tuned because we’re just getting warmed up.

What are you prepared to do today?

Dr. Chet

 

Why You Should Get “Cooked”

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While Paula and I were visiting our son and his wife last week, I suggested that all of us watch a series on Netflix called “Cooked”; it’s a series written by Michael Pollan from the book of the same name. I talked about him early last year and his movie “In Defense of Food.” I had read the book and watched the series earlier, and although Paula doesn’t generally like how-things-are-made programs, she watched a couple of minutes with me and ended up going to bed an hour late.

Each major chapter of the book has been made into a segment that lasts about an hour. The titles define the topic as it relates to cooking: fire, water, air, earth. Each one has been crafted to provide a little common-sense science along with interesting stories and background. I loved the book and now I love the series; the family did as well.


“Cooked” Insights

The series is full of revelations that seem obvious in hindsight, but that you’ve probably never thought about before. Like cookware: humans couldn’t effectively combine the flavors of various foods until a pot was invented that could withstand the heat of the cooking fire. No pot? No boiling. No soup, no stew, no sauces.

And did you know there’d be no chocolate without fermentation? Paula was surprised to learn that about one of her favorite foods.

A thread that ran throughout the series was this: the key role of sharing a meal in the process of human bonding. Mute the phones and leave them in your pockets; spend mealtime loving the ones you’re with. Unless you’re a doctor on call, all those messages will wait.


The Bottom Line

Watch this series on Netflix; you’ll learn more about meat and vegetables and how they’re transformed into food than any other place I can think of. You’ll have a great time learning, and I bet it will change your thinking about food. Paula insisted I warn you that a few scenes in “Fire” are tough to watch, but we’re grown-ups and we need to face the truth about where meat comes from. If you’re watching with your kids (which would be really great), you may want to pre-screen that segment.

My favorite story? The nun with a PhD in microbiology who makes cheese. You’ll begin to understand the microbiome more clearly after you see the “Earth” segment.

What are you prepared to do today?

Dr. Chet

 

Classic: Type III Error

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You know that eating fruits and vegetables is good for you, right? I tell you that all the time because that’s what the research indicates. But according to an editorial piece in the Journal of the American Medical Association (JAMA), maybe we’ve been wrong all this time (1)—at least as it relates to reducing our risk of cancer. Here’s a recap of the editorial and my take on it.


The Editorial

Mike Mitka is a well respected senior writer for JAMA; he’s published numerous articles that are well researched and contain interviews with the authors and other experts. In a 2010 JAMA article, he writes that an article from the European Prospective Investigation into Cancer and Nutrition (EPIC) clearly demonstrates that high intakes of fruits and vegetables do not reduce the risk of cancer, at least not very much.

Based on the study published in the Journal of the National Cancer Institute, increasing fruit and vegetable intake by six ounces per day reduced the risk of cancer only 3% (2). A couple of well-known researchers supported the notion that research does not support plant intake reducing the risk of cancer, including the director of nutrition for the American Cancer Society.

The problem is that it’s just not true, at least not in that study. The way it’s written, the study suggests that when subjects increased their intake of vegetables and fruits by six ounces, the reduction of cancer risk was a paltry 3%. This was an observational study, not an interventional study. No one kept track of who increased or decreased their plant material intake, and there’s no way to know that from the data collected.

The way I read the article, the EPIC study is central to this new belief about plant consumption not being related to decreased cancer risk. The first articles from the study were published in 2003, and that’s when scientists suggest the evidence grew weaker supporting reducing cancer by plant consumption.

I’ve written about EPIC before; it’s one of the largest observational studies ever conducted with over 520,000 subjects from 23 different centers in 10 European countries. While I suggested that there was strength in numbers when you want to try to tease out subtle effects, I mentioned that the researchers gathered nutritional information at the beginning of the study with a Food Frequency Questionnaire; subjects were asked as many as 256 questions about what they had eaten in the past year. There are two problems with that when you’re looking at the rate of cancer.

First, you have to assume that this one-time questionnaire on diet applies to the patterns of the way the subjects ate and will continue to eat. By the validation studies that were done for the EPIC study itself, that certainly was not true (3). Correlations between what people ate one year apart were as low as 36% in a sub-sample of the subjects. Researchers chose to adjust levels statistically, but that just isn’t the same as actually collecting the data. But when you’re dealing with a half million subjects, you just can’t collect dietary histories on every subject.

Second, the assumption is that the levels that the subjects ate were actually adequate to reduce the rate of cancer. In the study, the average fruits and vegetable intake for men was 17 ounces per day and about 19 ounces per day for women (4). Using an example from the editorial, a medium apple is 10 ounces and a serving of broccoli is about 3.5 ounces. That’s just two servings and that’s close to what the subjects actually ate.

The fact is that most subjects in the study did not eat very many vegetables and fruits and it got worse the further north the country was located. That should have been the overwhelming conclusion of the study to begin with before any other analysis was conducted.


My Take

Trying to explain statistics is not my strong suit, but I adapted this from a blog by Satoshi Kanazawa, an evolutionary psychologist in London and a contributor to Psychology Today (5).

There are two types of errors in statistics. There’s the error of a false positive: you think that the data reflect your hypothesis when it doesn’t. Then there’s the error of false negative: you think the results do not support your hypothesis when it does. Statisticians call the former type of errors “type I errors” and the latter type of errors “type II errors.”

My feeling is that Mitka and researchers who are using the EPIC study to make suggestions about the relationship between plant intake and cancer risk are committing a “type III error.” What’s that? An unwavering belief in statistics: you don’t look at anything but the numbers, and that rules what you believe. Maybe a better way of describing a type III error is hubris, an overbearing pride in statistics. These researchers are very smart people. Did no one consider that the way the data were collected didn’t make sense when tracking diet’s effect on cancer risk? That’s hard to believe unless pride gets in your way.

But when you get right down to it, if you eat an apple and some broccoli on a typical day and someone told you that adding a banana or a tomato would reduce your risk of cancer by 3%, doesn’t it seem like a great idea to add that banana or tomato? Imagine what you could do if you actually ate the recommended eight to ten servings!


The Bottom Line

This will not be the last time I write about EPIC because there are over 500 articles published to date. I still think that eating more vegetables and fruit reduces the risk of all disease including cancer based on the thousands of other studies that say that it does. It seems like the larger the study, the less beneficial effects anything seems to have whether it’s diet, exercise, or supplementation. Maybe someone should start considering whether the effects are being washed out by regressing to the mean. But that’s a message for another day. Time for some berries!

What are you prepared to do today?

Dr. Chet

 

References:
1. JAMA. 2010; 303 (21): 2127-9.
2. J Natl Cancer Inst. 2010 Apr 21;102(8):529-37.
3. International Journal of Epidemiology 1997; 26 (Suppl. 1): S26–S36.
4. Public Health Nutrition: 5(6B), 1179–1196.
5. www.psychologytoday.com/blog/bloggers/satoshi-kanazawa

 

Classic: Vitamin Dumb

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As Paula and I visit our son and his wife this week, I’m choosing what I call Dr. Chet’s Classics. This one from 2010 illustrates two points. First, mega-dosing vitamins and minerals can have consequences that someone might not expect, and “if some is good, more has to be better” is not a good idea unless there’s a genetic or other reason. Second, even with the best intentions, researchers sometimes don’t use their heads when designing research studies.

Researchers reported in JAMA on the effects of vitamin D on fractures and falls in a group of over 1,500 women over 70. The results were surprising in that the vitamin D group had more falls and more fractures than the placebo group. Well, maybe not so surprising.

Remembering to take medications as well as supplements is a problem. So how did the researchers choose to address that issue? Give the women a year’s worth of vitamin D once a year.

That’s right. They gave these subjects 500,000 IU vitamin D once a year. I was almost rendered speechless—500,000 IU? What in nature would give them a model to follow? If you spend all day in the sun without sunblock, your body shuts down the production of vitamin D automatically; that’s why you can’t overdose on D from the sun. But this was oral intake; in what universe did these researchers think this was a good idea? Would they give someone a year’s supply of cholesterol-lowering medication or pain medication in one dose per year just because the subjects might not remember to take their meds every day? And what earthly good would that do?

In an editorial in the same issue, the authors suggested that medical professionals examine how vitamin D is administered, and that maybe administering 50,000–100,000 IU doses isn’t such a good idea.

Do ya think?

Taking up to 10,000 IU vitamin D3 is safe and 2,000-6,000 IU per day is a good goal. But this study illustrates that there’s no need to megadose. Doing that is like taking vitamin Dumb.

What are you prepared to do today?

Dr. Chet

 

Reference: JAMA. 2010;303(18):1815-1822.