Tag Archive for: inflammation

Protect Your Brain—Eat More Magnesium

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In the last Memo, we were left with the researchers’ question: if magnesium intake and BP were not related to a neuroprotective effect, what was? The researchers had some idea based on prior research: inflammation. Let’s take a look at what they found on the follow-up to their original study.

The methodology and subject pool of the study was essentially the same as the other study with the addition of several measures of inflammation, including hs-CRP. Researchers found that as magnesium intake increased, inflammation decreased. Subjects with higher levels of magnesium intake had increased brain volumes including grey matter and white matter, but not white matter lesions. This was an observational study, so cause and effect cannot be determined, but with close to 6,000 subjects, I think we can safely say there’s a definite relationship between magnesium intake and a neuroprotective effect.

How Much Do I Need?

The average intake of magnesium was 360 mg for men and 340 mg for women. A reader recently sent me a post in which a physician recommended that everyone should take 500 mg of magnesium every day. I’m not going to go that far because there’s still too much we don’t know. The biggest issue is we don’t know where the subjects got their magnesium; this study was done in the United Kingdom and they tend to eat more plant-based foods than Americans.

I’ve written to the lead author of the study to see if they plan to publish another study breaking down the contribution from foods and from supplements—I’ll let you know what he says. For now, I’m going to recommend that we increase our consumption of the top five sources of magnesium from foods. Those are:

         1 ounce pumpkin seeds
         3 ounces spinach
         1 ounce almonds
         3 ounces avocado
         1 ounce dark chocolate

If you’re interested in more information on magnesium and its benefits, become an Insider and you can listen to a replay of the last Insider conference call. Remember: Eat less. Eat better. Move more.

What are you prepared to do today?

        Dr. Chet

Reference: European Journal of Nutrition (2024) 63:1807–1818

How Can Vaccinations Reduce Alzheimer’s Disease?

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In reading possible explanations for the potential benefits of flu vaccinations for reducing the risk of Alzheimer’s disease (AD), it always comes back to reducing inflammation. Further, it isn’t just the flu vaccine that seems to have that effect. Pneumonia, DTAP booster, shingles, and others have also been studied with similar results: vaccinations seem to reduce the risk of AD. The question is still why? I’ll give you two possibilities.

Vaccines Stimulate the Immune System

Whenever you get a vaccination, the immune system is stimulated. It may be that the activated system addresses weaknesses in the immune system that should be protecting the nervous system. Some researchers speculate it may reduce the formation of amyloid bodies (sticky proteins that harm the brain) and prevent the progression of dementia.

One thing to remember is the population being studied. It might be that, in spite of lifestyle habits, inflammation increases as we age, specifically in the brain. Some people may have genetics that can help. However, it may not just be the nervous system in the brain that’s at risk from increased inflammation. There is an increase in cardiac arrythmias of all types, decreases in muscle function, and many other effects that we attribute to simple aging. It may not be as simple as working hard on a healthy lifestyle, and it may exceed our attempts at living healthier.

Viral Infections Cause Inflammation

“I never get sick!” I’ve heard that a time or two. My question is “How do you know?” Maybe you’re sick, but your immune system has fought off all the symptoms you expect. The assumption is that every virus you get exposed to will leave you with some form of physical manifestation: a cough or runny nose during a cold, vomiting or diarrhea with a food-borne pathogen, or a fever from the flu.

But how do you know that you’re not in a state of inflammation, wreaking havoc on your nervous system, your heart, or another organ? You think your immune system isn’t working even though you don’t “feel” it? It can be. If we’re not flat on our backs, we don’t think we are undergoing immune system challenges. That’s simply not reality, and the problem is that the challenges get worse as we get older.

The Bottom Line

I think this research causes a dilemma for some people: vaccinate or not? As we get older, our immune system doesn’t work as well. Let’s be honest: lots of things don’t work as well, but we’re still kicking, darn it! What we could ignore in our youth now demands our attention. Yes, we need a healthy lifestyle that includes a better diet, a little exercise, and some immune-boosting supplements such as vitamin D and C.

The challenge is the anti-science climate we now live in, and nothing is more controversial than talking about vaccinations. Opinions may be based on flawed science—or in some cases, no science, just opinion—and access to social media where people can say anything they want to say. For me, the science is pointing to benefits from vaccinations if you’re older than 65. Just spread them out over a few weeks or months to give your immune system a chance to adapt.

Whatever you decide to do, it’s your body. It’s your choice.

What are you prepared to do today?

        Dr. Chet

References:
1. J Alz Dis. 88 (2022). 1061–1074. DOI 10.3233/JAD-220361
2. Vaccine. 2021. https://doi.org/10.1016/j.vaccine.2021.08.046

Soreness and Specificity of Training

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The first Super Bowl Webinar I ever did was about specificity of training. A running buddy years ago summarized how to run faster this way: “If you want to run faster, you gotta run faster.” In other words, even short bursts of running very fast would eventually help build speed more than slow, long runs.

The key element of specificity of training is that you can’t run faster by swimming or cycling or weight training; you have to do that by running. The same concept applies to just about any physical endeavor. Chefs can’t improve their knife skills by running or weight training: they have to spend hours chopping and slicing.

If you use an elliptical trainer or recumbent bike or you ride a bicycle, you’re training specific muscles to fire in specific patterns. When you change to another mode of exercise such as walking or running, you’re going to use the same muscles but in different ways; some muscles maintain balance and others maintain posture in addition to those that are doing the bulk of the work moving your body. And they’re different in different modes of exercise; even with all my education and experience, I was surprised at how sore I was when I had to switch from running to walking. Until you’ve trained those muscles for the particular activity, you’re going to be sore. And the sad news is that it gets worse as you get older.

Dealing with Discomfort

The important thing to understand is that this discomfort is temporary; the exception is if you had an orthopedic issue that never has been resolved. For me it was my knee, and now that’s resolved. If you’ve avoided getting something repaired, it’s your call but the longer you wait, the more you risk not getting back the mobility you had.

If you’ve changed your mode of exercise, here are some ways to deal with it:

  1. Start with heat followed by easy stretching. We think that our muscles and connective tissue are like rubber bands while stretching. Not exactly accurate, but warm muscles are more pliable so doing some kind of warm up will help you avoid injury. Easy does it; stretching too far too fast is a recipe for even more pain.
  2. Increase fluid intake to “flush” out some of the breakdown products of muscle and other connective tissue.
  3. Use glucosamine and vitamin C to help the connective tissue repair process. The purpose of breakdown is to build back better, but to do that, you need the nutrients that repair the microtears in the connective tissue.
  4. Ice specific areas, especially the front of the shins; shin splints is the common name for pain in this area. The connective tissue compartment that holds the tibialis anterior muscle (the one that pulls up your toes) isn’t very pliable, so reducing inflammation in that muscle can really help.
  5. Most of the soreness you’re feeling is from inflammation. If you feel you need to, and have no medical reason you can’t, use a non-steroidal anti-inflammatory drug such as ibuprofen; it relieves pain, but reducing inflammation is key to your recovery and continued progress.

The Bottom Line

It can literally be a pain to start to exercise or change your mode of exercise. There’s a price to pay but in comparison to the benefits you’ll get, the cost is minimal. Be sure to start slow: if you push too far too fast, you’re going to set back your progress while you recover. In the long run, you’ll get farther by taking small steps so you can keep going without a pause for injuries.

We’re not done talking about walking yet, but if you have any stories about finding the right shoe for you, let me know. I’m doing background research on that, so I won’t write about it next week—you have time to send me your stories.

What are you prepared to do today?

        Dr. Chet

Knowing Your Health Patterns

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The reason it’s important to track health variables is to find any patterns in the results. Remember the study on hs-CRP and cancer? Paula immediately looked up her CRP levels and found two things. First, it had gone down consistently over several years. Second, she hadn’t had it tested every year, but she will from now on.

Remember my blood pressure? I tracked it from that point (five weeks post-surgery) through today. From 177/107, it has come down appreciably though not in a consistent way; it’s consistently around 130/80 before exercise and 110/70 after exercise. That’s two patterns.

There are some other patterns that may be more relevant. For example, perhaps you’ve had heartburn after eating. Tracking what you eat may show a pattern that the higher the fat content, the worse the heartburn seems to be; the same may be true with constipation.

In short, you may find that one thing leads to another, but only under certain conditions. It’s knowing which conditions that’s most important to finding an answer to your health issue.

Patterns for Disease States

Many conditions have patterns of events that can be predictive of disease. For example, as bone density declines, your risk of a bone fracture increases. As blood pressure goes up, so does the risk of stroke. For type 2 diabetes, as blood sugar and HbA1c rise, so does the risk of prediabetes, type 2 diabetes, and all the accompanying complications.

Those types of patterns can be predictive of disease. Or they may not. As we’ve learned in the Memos, risk factors set the odds but they’re not cause and effect. But there’s another reason.

Your Pattern

The reason tracking to establish patterns of response is important to you is that it may just be your unique pattern—because while we’re all the same in many ways, we all have our unique variations. You may not know what’s unique about you because you haven’t tested it or tracked it to find your pattern. But whether it’s your blood pressure, your blood sugar, your response to foods, or some other variable, it simply may be your individual pattern and may be indicative of nothing.

That doesn’t mean you don’t get the issue checked out by a healthcare professional, but it may mean you don’t have a disease or condition as a general response would indicate. And since you know your pattern, you can track the results of any medication or other intervention your doctor prescribes.

The Bottom Line

Tracking variables to detect patterns is useful to us all. While it won’t help everyone who tries it, the goal is to know yourself better. You won’t have to do it forever, but if you’re concerned about a specific condition, this is a way to help yourself.

And it won’t necessarily be bad news; Paula was relieved to find her hs-CRP had been going down, and you may find an encouraging pattern as well. Even if the results are not what you’d hoped, better to know than not know, right? Because now you can take action.

If you have no idea where to begin, become an Insider or Member at DrChet.com. You’ll have exclusive access to me by email or phone, and I can guide you in checking out whatever factors could be related to the health issue you’re concerned about.

What are you prepared to do today?

        Dr. Chet

Track Your Health Issue

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Over the past few months, I’ve written about my blood pressure increasing from being sedentary for five weeks after my knee replacement. I’ve also written about hs-CRP in the study on inflammation and cancer. In addition, I’ve gotten questions about the impact of foods on the digestive system and the variation in blood sugar readings throughout the day.

While the questions vary, my answer is always the same: track it for a while. Whether it’s on a fitness watch, on a spread sheet, an app, or a notebook, record it somewhere. Doesn’t matter how you do it—just record the numbers along with other pertinent information, such as:

  • Date and time of day.
  • What you ate, if it’s important to the issue such as gastroesophageal reflux, or if you’re restricting calories for weight loss or longevity.
  • When you took your meds and supplements.
  • How well and how long you slept.
  • If it’s your blood pressure, record your anxiety or stress level as well as reading in relation to exercise.

The combination of factors is endless, and not every factor will be as obvious. If you continue to track it, you’ll have an edge determining what is and isn’t related to what you’re tracking.

Could this be a lot of work? Yes. Will you find an answer? Maybe, maybe not. What it can do is allow you to discover something that’s useful and I’ll talk about that on Saturday.

What are you prepared to do today?

        Dr. Chet

How C-Reactive Protein Can Predict Cancer Risk

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High-sensitivity C-reactive protein (hs-CRP) is a measure of inflammation in the body. This blood test looks for inflammation that’s not apparent; with severe infection you have a fever, but other types of inflammation may go unnoticed. This is subtle because you don’t feel anything. On top of that, CRP hasn’t been shown to be diagnostic for any disease. It still may not be, but a recently published study demonstrated that there’s a chance that if CRP changes over time, that may be indicative of some forms of cancer.

The Study

The researchers examined the relationship between CRP trajectory patterns and new-onset cancers among 52,276 participants over eight years; CRP trajectories were developed from 2006 to 2010 to predict cancer risk from 2010 to 2019. The study was restricted to the population who participated in physical examinations in 2006, 2008, and 2010, and had their CRP measured each time.

If you can think of a variable, they tested for it, as well as collecting demographic information that allowed them to consider confounding variables in the statistical analysis. The subjects were tracked for the next eight years to find out who developed cancer and what type of cancer they developed.

The Results

During the extensive and complicated statistical analysis, four CRP trajectory patterns emerged:

A low-stable pattern (43,258 subjects)
A low-stable pattern was associated with a low risk of new cancers.

A moderate-increasing pattern (2,591 subjects)
Subjects in the moderate-increasing CRP trajectory pattern were associated with an elevated risk of any form of cancer, but especially lung, breast, leukemia, bladder, stomach, colorectal, liver, gallbladder, or extrahepatic bile duct cancer.

An increasing-decreasing pattern (2,068 subjects)
Subjects in the increasing-decreasing trajectory pattern were associated with an elevated risk of any form of cancer, but especially lung, breast, bladder, pancreatic, and liver cancer. This pattern was also associated with decreased risk of colorectal cancer.

An elevated-decreasing pattern (4,359 subjects)
Subjects with an elevated-decreasing trajectory pattern were associated with increased risk of leukemia and decreased risk of esophageal and colorectal cancer.

The Bottom Line

Here’s what we know now: inflammation is definitely one of the hallmarks of cancer. Regular assessment of CRP over many years may now be predictive as a risk factor for cancer but not diagnostic. There’s more research to go, but this study is a step in the right direction.

The good news is that it’s another risk factor that can be changed through lifestyle: Eat less. Eat better. Move more.

What are you prepared to do today?

        Dr. Chet

Reference: Int J Cancer. 2022. 10.1002/ijc.34012

How Periodontal Disease Makes COVID-19 Worse

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Aging with a Vengeance is more than gaining muscle mass and losing fat around your waist; it also means that your immune system is robust. I think we often over-emphasize supplementation; while I think it’s necessary, it really should serve as support for other actions that are equally or even more important. For example, taking care of your teeth. By that, I mean regular checkups, brushing after meals, and flossing every day. Does that affect the immune system? You bet it does, and a recent study illustrates how significant that can be.

Researchers in Qatar conducted a study to see if people with periodontal disease had an increased risk of being in the intensive care unit (ICU), being put on a ventilator, or dying from COVID-19. Qatar Is a country of 2.3 million people with an advanced electronic medical records system; because dental records are a part of the medical records system, they were able to identify people with periodontal disease, sometimes called gum disease. In addition to the medical records on COVID-19 and how the subjects fared, they were also able to get data such as BMI, HbA1c, and CRP, among other health indicators.

As an observational study, researchers were able to find 568 people who were diagnosed with COVID-19 between February 2020 and the end of July. That number included 40 people with severe cases of COVID-19 that required hospitalization. The characteristics of those who had severe cases are similar to what we find in the U.S.: more were overweight or obese, had higher HbA1c levels, and had higher CRP levels.

Of those who had periodontal disease, 33 had severe cases of COVID-19; only seven people who had no periodontal disease had a severe outcome. When looking at the odds ratios, a person with periodontal disease had six times the risk of being admitted to the ICU, almost eight times the risk of being put on an ventilator, and a 17 times greater risk of death from COVID-19.

Why would having periodontal disease, an infection that appears to be limited to the teeth and gums, have such an overall effect? The reason is that it creates a state of higher inflammation that compromises the immune system. When exposed to the virus, the immune system is already stressed and the body does not have all the resources it needs to fight the infection.

The Bottom Line

Here’s my advice: if you’re overdue for your dental checkup, call and make the appointment, especially if your gums bleed regularly when you floss, if your gums seem inflamed, or if you have a very bad mouth odor. No excuses; gum disease should not be ignored.

I see many comments in social media about “all the talk being about vaccinations, masks, and social distancing.” “No one ever talks about diet and exercise, etc.” The reason, at least in my humble opinion, is that the last 50 years have clearly demonstrated that most people in the U.S. don’t eat well, don’t move enough, and eat more than they should.

Instead of criticizing people for their poor dietary and exercise habits, the current medical approach seems to be to meet people where they are. My hope is that by addressing some of the other issues related to health, such as periodontal disease and overall healthcare in our quest to age with a vengeance, all readers will see ways to make their immune system much more robust so it can do a better job of protecting them.

And if it has the side benefit of shutting up the naysayers that talk about long-term solutions only at the exclusion of the things that we know are working right now—such as vaccinations, masks, etc.—I’m good with that. As I said in May, not fear; respect.

What are you prepared to do today?

        Dr. Chet

Reference: J Clin Periodontol. 2021. DOI: 10.1111/jcpe.13435.

Spice Up Your Life and Be Healthier

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Before I get into this memo any further, keep in mind there were only 12 subjects in this study, and we don’t change our recommendations for an entire society based on a limited numbers of subjects. We just have to recognize that this is a preliminary study. Second, because they examined a large number of variables, the probability of getting a false positive increases.

As long as we keep those in mind, the results were really surprising. Adding spices to a high-fat, high-carbohydrate meal reduced the inflammation caused by that meal. While coconut curry chicken might not be your preference, I’d wager you’ve eaten a bacon cheeseburger with fries and a soft drink at some point. That can easily add up to a similar profile of a high-fat, high-carbohydrate meal. So let’s take a look at the spices.

The Spices

The spice blend included the following spices, but not all dishes contained all the spices. For example, the turmeric was used in the chicken dish while the cinnamon was used in the biscuit:

Turmeric
Ginger
Cinnamon
Oregano
Parsley
Basil
Coriander
Cumin
Red pepper
Rosemary
Black pepper
Bay leaf
Thyme

This is not a magic blend by any means, but each of these spices and herbs have different phytonutrient blends. The magic comes from those phytonutrients. Recall the image of the various sizes of measuring spoons. A teaspoon is 5 grams, a half teaspoon is 2.5 grams, and an eighth of a teaspoon is 0.625 grams. That illustrates how little of a spice you need per serving. Keep that in mind if you decide to spice up your meals.

What we don’t know is whether there’s any interaction between those spices and herbs that would impact the inflammatory hormones. We know that turmeric and ginger have been studied extensively. The researchers recommended testing each spice individually.

Two Observations

There are probably dozens of factors that need to be examined, but two stand out in my mind. First, we’ll need to find out the impact of cooking on each of the different herbs and spices. Does heat destroy the phytonutrients or does it enhance them? We have a partial answer from this study because the spices were put into the dishes as they were being prepared and not added as a topping.

Second, if you take supplements with phytonutrient blends in them, it may be wise to take them either before or while you’re eating so the phytonutrients will be available to help during the digestive process. I’ve always recommended taking your supplements whenever you can remember to take them, and I still stand by that because consistency is more important than timing. But if you can increase the potential benefits by taking them with meals, that’s a good idea.

The Bottom Line

The reason that I loved this approach to research is because it was practical. By that I mean, instead of assessing only one food or a specific group of foods, this study looked at what we would consider “bad foods” together with herbs and spices that are full of phytonutrients to see how they work together.

If you think about it, if saturated fat and refined carbohydrate were as bad as they’re thought to be for the risk of CVD or type 2 diabetes, those diseases would take effect much faster. But perhaps, cake with dark chocolate frosting or French fries with ketchup work with their phytonutrients to somewhat neutralize the bad effect of the food by itself. It doesn’t mean that we don’t bear responsibility; we should still eat as healthy as we can. But perhaps if we choose wisely, we may be able to enjoy some of the food that are perceived as not as healthy if we can spice them just right.

What are you prepared to do today?

        Dr. Chet

Reference: J Nutr 2020;150:1600–1609.

The Health Benefits of Spices

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Continuing our look at the research study on the effect of spices on markers of inflammation, there were some interesting results. The high-fat, high-carbohydrate meal was coconut curry chicken, a cornbread muffin, and a biscuit; that strikes me as an odd meal, but you do what you must for research. The only difference was the spices added to allow for comparative results.

Examining the effect of the 1,000-calorie, high-fat, high-carbohydrate meal, the researchers found an increase in the release of inflammatory hormones above baseline in all subjects. So that’s the first result: inflammation was increased after eating the test meal with no spices added.

Compare that to consumption of the same meal with six grams of spice blend: it significantly reduced IL-1β secretion at four hours after the meal compared with the meal with none of the spice blend. Also, IL-6, IL-8, MCP-1, and TNF-α secretion after the meal containing six grams of the spice blend was below baseline values for each cytokine (inflammatory hormone). These results suggest that spice consumption may reduce inflammation after a high-fat, high-carbohydrate meal for hours after eating. The paper is Open Access, so you can read it yourself at the link in the references.

Those are interesting results, and I’m guessing you really would like to know which spices were used in the study. I’m going to give you that spice blend and put this research in context in Saturday’s memo. But if you haven’t done our little experiment with the teaspoon, half teaspoon, and eighth teaspoon, please do it before then.

What are you prepared to do today?

        Dr. Chet

Reference: J Nutr 2020;150:1600–1609.

Can Spices Make You Healthier?

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I’d like you to do something before you read the rest of this memo. Go to your drawer that contains measuring spoons, and pull out the teaspoon, half teaspoon, and eighth teaspoon. Then measure out salt or sugar for each different volume and put it on a plate. Notice how little there is by the time you get to the eighth teaspoon. Keep that image in your mind for the remainder of the week.

Too often, nutrition research lacks a practical approach; researchers try to drill down into the details before they look at the larger response to any intervention. In other words, examining what people actually eat and cook, then changing something and seeing what happens. I don’t mean exaggerated results such as weight loss, but more subtle effects such as changes in triglycerides, cholesterol, blood sugar, and in this case, markers of inflammation.

This week we’re going to take a look at a recently published paper that took exactly that approach. Researchers selected a group of 12 overweight male subjects with at least one additional risk factor for cardiovascular disease and fed them a high-fat, high-carbohydrate, 1,000-calorie meal. They fed them the same meal on three different days: once without any specific spice blend, second with two grams of a spice blend, and the third time with six grams of the same spice blend. They tested the subjects to see what markers of inflammation were changed after each feeding. I’ll give you the results in Thursday’s memo.

What are you prepared to do today?

        Dr. Chet

Reference: J Nutr 2020;150:1600–1609.