Tag Archive for: diet

Can Fasting Reduce Inflammation?

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In this Memo, I’ll review the third paper from the recent journal Cell on fasting and summarize what this all may mean for the use of intermittent fasting.

Researchers used both mice and humans as subjects in a series of studies. The objective was to examine how the immune system responded to a fasting protocol. For the study in humans, the subjects fasted for 19 hours after eating, with blood samples taken before and after the fast. In the mice, a variety of protocols were used. The most common was mice were fed for a short time before food was withheld for the remainder of 24 hours.

In mice and humans, circulating monocytes were reduced. This was important because they were pro-inflammatory in nature; thus inflammation decreased in response to the fasting protocol. In some of the studies, this reduction was maintained even with exposure to pathogens. That means the immune response was not compromised even in animals with induced autoimmune diseases.

Fasting Protocols

Three different studies used at least three different approaches to fasting. In the first study, food was withheld completely for 36 hours. In some phases of the second study, calories were reduced by 50% although the vitamins, minerals, and protein were maintained at normal levels. The final study used a fasting protocol we’re most familiar with: eat within a few hours and liquids only the remainder of the day.

The results were similar in sustaining and perhaps improving the immune system of the animals when placed under pathogenic stress. The only issue is what form of dietary restriction worked best? You can’t ask mice how they felt; you can only check immune system markers. In one of the approaches, the skin of the mice was injured at different times of continued fasting. The healing ability continued until the fast went beyond 48 hours; after that wound-healing was impaired.

The Bottom Line

These studies haven’t changed my approach to fasting. If you’re going to fast to rejuvenate your immune system, don’t play games. Reduce caloric intake to 500 to 800 calories per day for two to three days; those studies show the best benefit. Be sure to select small quantities of the healthiest foods.

Fasting is not abstinence. The current approaches to intermittent fasting are really intermittent abstinence. The idea is to abstain from food completely for 12 to 18 hours while still drinking liquids. That may not be possible for everyone. Some medications have to be taken in relation to food intake. Pre-diabetics and type 2 diabetics should still monitor blood sugar, especially if exercising during the fasting times. The current intermittent fasting approach is more about controlling when you eat than anything else, and that’s something you should do anyway.

I believe in fasting. That’s why I wrote Real-Life Detox—so you could do it right and gain the most benefit. The critical thing is to find a way to eat that you can sustain for the rest of your life, and that includes occasional fasts.

Eat less. Eat better. Move more. That’s always the goal.

What are you prepared to do today?

        Dr. Chet

References:
1. Cell. 2019. DOI:https://doi.org/10.1016/j.cell.2019.07.047.
2. Cell. 2019. DOI:https://doi.org/10.1016/j.cell.2019.07.049.
3. Cell. 2019. DOI:https://doi.org/10.1016/j.cell.2019.07.050

Fasting and Immune Function

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Intermittent fasting is the latest health fad. When I say fad, I mean there are as many definitions of what it means as there are experts. In a recent edition of the journal Cell, three papers were published that provided some insight into the effects of three different types of intermittent fasting on three different systems involved in immune function. That’s our topic of the week. I’ll present each study and comment on the implications on Saturday.

In the first paper, researchers used juvenile mice to examine changes in immune function in sections of the intestine called Peyer’s patches (PP). These patches form an important part of the immune system by monitoring intestinal bacteria populations and preventing the growth of pathogenic bacteria in the intestines. The mice were fasted for 36 hours. Results were compared with normally fed mice that served as controls.

During fasting, immune cells were disrupted and thus compromised the typical immune response; specifically, B cells were sent to bone marrow. It’s difficult to say whether this is a protective mechanism or not. The B cells were returned to the PP during re-feeding. There were many more parts of the study, but the bottom line was that the immune system was compromised during fasting and remained impaired for a time after re-feeding.

We’ll take a look at the second study on Thursday.

What are you prepared to do today?

        Dr. Chet

References:
1. Cell. 2019. DOI:https://doi.org/10.1016/j.cell.2019.07.047.
2. http://bit.ly/2lxYIRa.

How Methionine Affects Cancer Treatment

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If you’ve ever been diagnosed with cancer and you start searching the Internet, one of the things that you’ll come across is using a vegetarian diet to help treat the cancer. I’ve recommended it myself combined with conventional treatment. The question is why? Yes, the phytonutrients from plants are healthier, but is there something in animal products that’s detrimental?

A research group examined the impact of the amino acid methionine on a pathway of one-carbon metabolism; this pathway is the target of a variety of cancer interventions that involve chemotherapy and radiation. They demonstrated that removal of methionine from the diet of mice and humans resulted in more effective treatment in two types of cancer. Chemotherapy and radiation were more effective in both types of cancer once the diet was changed.

There are a couple of important points. First, this was tested on only two types of cancer. There’s no reason to think it would benefit every type of cancer treatment because this one-carbon pathway is not a target for every treatment. Second, because methionine is found in all meat and seafood, it would mean giving up all meat for the duration of treatment.

For myself, I’d give up meat and seafood during treatment whether we have the research or not. It wouldn’t have to be forever and combined with giving up refined carbs to reduce the risk of C diff, it could lead to a better chance for treatments to work. And that’s the key. It’s not in place of treatment; it’s combined with treatment. The goal is to put the odds in your favor. This seems like a simple way to do that.

What are you prepared to do today?

        Dr. Chet

Reference: Nature Vol 572: 397–401 (2019).

Fearsome Twosome: C. Diff and Clade A

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Clostridioides difficile, C. diff for short, is a serious bacterial infection typically acquired after antibiotic treatment in a hospital. Antibiotics disturb the microbiome balance, and as a result, a bacterium that typically may not be a threat becomes one. But C. diff is not just a single bacterium.

In a recent paper, researchers from London sequenced and compared the DNA of 906 strains of C. diff—906! They reported that 761 strains came from humans living in 33 countries. They found that C. diff is still evolving. In fact, one species has adapted to living in hospitals; the type of C. diff that seems to dominate has been termed Clade A. It didn’t develop overnight; it took many years, but it developed specifically for the hospital environment.

Clade A has two characteristics that are a problem for us. It’s resistant to anti-bacterial cleaning products and therefore survives after cleaning. Even more critical is that this form of C. diff has developed the ability to use sugar as a fuel. The researchers actually tested modifying the diets of mice exposed to Clade A and found that it thrived with a sugary diet.

Where does that leave us? I think that further research should explore changing the typical hospital diet including elimination of sugars and simple carbohydrates. The cleaning part is more complicated. Heat will kill it, but that applies to only hospital instruments; for instance, you can’t heat a door handle or a bed’s handrail or to a high enough temperature to kill bacteria. A different solution must be discovered.

For now, in addition to the normal antibacterial precautions, I think it’s smart to greatly limit simple carbs post-surgery or when you’re spending a lot of time in a hospital.

What are you prepared to do today?

        Dr. Chet

Reference: www.nature.com/articles/s41588-019-0478-8.

Should Your DNA Guide Your Diet?

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In an opinion piece, a college professor in the U.K. who had written about personalized nutrition wanted to find out whether she should change her diet based on her genetic profile. She decided to send her DNA to Norway for analysis.

Her genetic profile indicated that she was at risk for having high cholesterol and an increased risk for cardiovascular disease. To deal with that, she became a vegetarian. She also takes high levels of B vitamins because she doesn’t process one of the B vitamins very well. Her point was that knowing her genetics gave her the motivation to take control of her diet and lifestyle. She now advocates that all of us should take control of our health through personalized nutrition based on our DNA analysis.

I’m not so sure. I think genetics are one piece of a complex puzzle. What causes the genes to express themselves? What turns them off? More than anything, what role does the microbiome play when combined with the genes? We still don’t know the answers to any of those questions.

Someday we may be at a point where we can be very specific about nutrition, but we’re not there yet because we not only don’t know the answers—we don’t know the correct questions to ask. For reliable results, it still comes down to what I always tell you: Eat better. Eat less. Move more.

What are you prepared to do today?

        Dr. Chet

Reference: http://bit.ly/2ZclpII

Looking for Single-Nutrient Solutions

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As you might expect, I get asked a lot of questions about health, especially diet and exercise. One of the similarities between questions is whether a specific nutrient is special or unique. When I do the research to learn about the nutrient, I’ve never found one that’s the be-all and end-all—not turmeric or echinacea or omega-3 fatty acids or anything else. Can they be beneficial? Absolutely. But they’re a finishing touch, not a foundation.

The foundation of health begins with vegetables, fruits, whole grains, quality protein, and the best oils. The foundation also includes basic supplementation such as a multivitamin-multimineral and probiotics, among others. If you don’t begin with the best diet, then specific nutritional gaps, whether due to food preferences or genetic issues, can’t be bridged effectively because the body isn’t built on a strong foundation. Once you build your foundation, some of the specific nutrients can fill in gaps and act as insurance for the days you can’t eat as well as you know you should.

Eat better. Eat less. Move more. Build a foundation and you might find miracle nutrients aren’t really necessary.

What are you prepared to do today?

        Dr. Chet

P.S. Paula and I wish all of you a happy Memorial Day weekend! Travel and celebrate safely, and we’ll see you back here on Tuesday.

Nothing Else Matters

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“Where health is at stake, nothing else should be considered.”

            Jane Austen’s Emma

Health today is a serious matter. My observation is that we spend a lot of time worrying, maybe even obsessing, about our health; this is not to be confused with disease. If we have a serious medical condition that requires treatment, we’re right to be concerned. But even our treatment and recovery can be impacted by excessive worrying. It’s our attitude toward health that can be improved. For that, we’re going to visit Jane Austen’s novels.

I recently read an article by the author of “The Jane Austen Diet.” He talked about the health nuggets in Austen novels that are often overlooked. Three things caught my attention: the Austen approach to food, exercise, and self image.

The characters and heroines in Austen’s novels seemed to enjoy their food. While the diet was heavy in meats and vegetables, the focus was to enjoy the company of others while eating and not allow one’s feelings to dictate how much one ate. Can we say that today? We worry about the carb count or the fat grams. Stress causes many people to eat more, sometimes a lot more, than they otherwise might. Enjoy a meal with others can be a rare event. How many of our meals happen in our cars as we hustle from one place to another?

The message seems to be to slow down and enjoy food. Food is not just to nourish our body; it should nourish our souls as well.

What are you prepared to do today?

        Dr. Chet

Reference: https://wapo.st/2UeaSiZ

The Science Behind the Weight Loss Cycle

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One of the tenacious problems with weight loss is that people don’t lose all the weight they want to lose and then don’t keep it off. In trying to find out why that happens, I narrowed it to two studies that pointed the way to a solution.

The first was a study that attempted to develop an app for people to provide help exactly when they needed it. In reviewing studies to create the app, they used data from four studies on weight loss and weight gain. While they couldn’t identify the precise point for every individual, they could identify a time frame in general where people start to hit a plateau: about week 11 of any diet. That’s the point where people begin to stop paying attention to their meal plan as closely as they did when they began, and their weight gets stuck.

Another study used was the Minnesota Starvation Experiment from World War II in which lead investigator Ancel Keys severely limited calories for a group of conscientious objectors who volunteered to be starved; much of what we know about calorie restriction and helping famine victims comes from that study. It’s the only study ever in which every subject lost weight in a linear fashion. How? Researchers adjusted the subjects’ calories the following week to keep weight loss on track.

Using those two studies, I developed the Weight Loss Cycle, a way to responsibly get to your ultimate weight loss goal and then maintain it, and as far as I know, this approach is unique. What makes the Weight Loss Cycle different is that it’s not a diet with good foods and bad foods, no meal plans or recipes. You can use whatever eating plan you want; the Weight Loss Cycle shows you how to use it to achieve your goals and stay there.

If you’ve hit plateaus in the past or gained back the weight you’ve lost, the Weight Loss Cycle in the Optimal Performance program could be your key to success.

What are you prepared to do today?

        Dr. Chet

References:

1. Am J Clin Nutr 2014;100:787–95.

2. Keys A. The biology of human starvation. University of Minnesota Press, 1950.

Life Expectancy Is More Than Living Longer

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What’s more important to you: living longer or living better with the years you have? Think about it as you read this Memo and I’ll come back to that later.

The Upside of the Study

There were three important lifestyle variables that clearly stood out (1). The more exercise you get, the better off you are. Of those who got perfect 5s, they averaged over an hour per day of exercise. Second, the lower the BMI, the better; researchers didn’t track who might have lost weight over the years to get in the lowest BMI category, but it’s clear that carrying fewer pounds helps.

Finally, the Alternate Healthy Eating Index (AHEI) is a score of the quality of the diet, not the quantity. The highest quintile was below 60 out of 100 possible points. That means you don’t have to eat perfectly; just eat your vegetables and fruit and fewer refined carbohydrates and sugars, and you’ll see benefits.

The Downside of the Study

The subjects were overwhelmingly white and they were nurses and doctors for the most part. Whether that translates to other races and professions, we just don’t know.

The biggest issue for me is the Food Frequency Questionnaire used in the original studies as well as the AHEI scores. Trying to remember what you’ve eaten in so many categories over a year never made sense to me; there’s just too much potential for error. There were also differences in AHEI scores between the Nurses Study (all women) and the Health Professionals Follow-Up Study (all men). The men had an AHEI of 59 while the women in the nurses study had an AHEI of 37.5 in the groups assigned a 5. That makes no sense to me. I know the FFQ were slightly different, but the way the data are extracted to arrive at the AHEI score should have accounted for that. Are men so much better with the quality of their diet? Not buying it.

Supplements

Here’s something I found interesting. The use of a baby aspirin went up as the overall scores went up. In contrast, multivitamin use went up as the overall scores went down. To me, that means that healthcare professionals in all professions know that taking a baby aspirin is good for you. It also means that the poorer the diet, the more people try to compensate with supplements. The goal should be to complement a good diet with a multi, not try to make up for a poor one.

Amount of Time Living with Disease

I asked you a question at the beginning of this memo: what’s more important to you: living longer or living better? Right now, the average number of years spent living with some form of disease is almost 12 years (2). Not every condition is as debilitating as others, but would you rather live longer no matter what your health is or would you rather live well right up to the day you check out? Only you can answer that one. The study didn’t examine quality of life so we don’t know how the subjects did.

Here’s my guess: I would wager that the more healthy lifestyle variables you can add to your life, the longer and better you will live. Eat less. Eat better. Move more. It all starts with those six words.

What are you prepared to do today?

Dr. Chet

 

References:
1. https://doi.org/10.1161/CIRCULATIONAHA.117.032047.
2. https://ourworldindata.org/life-expectancy.

 

Energy Thieves: Medications

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Another class of energy thieves is medications. This may not apply to everyone but based on the latest CDC stats, close to 50% of all American adults take at least one prescription drug and almost one-quarter take three medications or more. There are three ways medications can steal your energy when you need it to perform your best.

  • Some medications can directly affect energy levels. Beta-blockers used for hypertension are an example; they’re supposed to slow down heart rate. They can also affect beta-receptors in other areas of your body. The net effect saps energy.
  • Other medications indirectly steal energy. An extreme example would be chemotherapy and radiation during cancer treatment, but some medications such as statins can cause muscle discomfort which can also steal energy levels.
  • Not taking the medications as directed can also steal energy. The simplest example is thyroid medication for hypothyroidism. It’s designed to be taken in the morning (unless otherwise specified by your doctor). If it’s not taken when it’s supposed to be taken, it can’t help with energy levels.

There are numerous medications that can impact energy. The first step is a discussion with your physician to address your concerns; schedule that today. I’ll be discussing strategies to minimize energy loss due to medications in the Super Bowl Webinar on Sunday, but it all begins with a discussion with your doctor.

What are you prepared to do today?

Dr. Chet

 

Reference: https://www.cdc.gov/nchs/fastats/drug-use-therapeutic.htm