Monday, September 03, 2007
You Can Control Your Risk of Colon Cancer – Here’s How
The new study published in Journal of the American Medical Association (JAMA) 8/15/07, looked at patients with Stage III colon cancer treated with chemotherapy. They found that those eating a more “Western pattern diet” experienced a tripling in risk of recurrence or death in contrast to those following a more “prudent diet.”
The “Western pattern diet” is characterized in the study as higher intakes of red and processed meats, sweets and desserts, French fries, and refined grains. Whereas the “prudent diet” is characterized as higher in fruits and vegetables, poultry and fish, low-fat dairy products, legumes and whole grains.
This is not rocket science but basic intelligent nutrition advice for anyone interesting in enhancing health and vitality and lower their risk of all chronic disease. But it may be worthwhile to look further into the evidence and consider it in the context of previous studies on diet and colon cancer. There are at least four important themes that you can learn from:
1. It’s not just desserts and white bread: It is a known fact that high levels of insulin is associated with enhanced tumor growth. High levels of insulin and insulin resistance is associated not just with intake of sugars and refined grains but with other factors such as when you eat, how you balance carbohydrates with protein and healthy fat in each meal, and how much you exercise.
2. It’s not just French fries: Avoiding “unhealthy fats” and including a moderate amount of “healthy fat” is essential for controlling systemic inflammation, a marker of cancers and all chronic disease. Most people think all they need to do is select reduced fat or nonfat products. A most important consideration often overlooked is processed vegetable oils (any oil that is not expeller-pressed or cold pressed, partially hydrogenated fats). These are found not just in fried foods but in many products that most people consider basically healthy, including salad dressings and marinades, peanut butters, spreads, baked goods, crackers and breads, many restaurant foods.
3. Don’t forget Vitamin D: Less than optimal vitamin D levels are associated with a host of chronic health issues, including colon cancer. A simple blood test and subsequent supplementation with a vitamin D capsule can eliminate this risk factor.
4. It’s more than just fruit: We all know that increasing our intake of fruits and vegetables lowers cancer risk because it increases your intake of vitamins, minerals, and powerful plant compounds called antioxidants. Most people end up focusing on fruits and barely get in a serving of vegetables each day. Focusing on vegetables first, including dark green leafies and cruciferous, is most important. My advice is to aim for at least 6 servings a day. I admit this requires planning, but once you get in the habit of doing it, it is not so difficult. And, it’s one of the best protective measure you can take for yourself.
Not Surprising – Diet Soda Is Bad For You
Some older studies have suggested that articial sweeteners stimulate hunger. But, it now seems they cause bigger problems. A recent and very compelling study actually found a significant positive association between soda drinkers (both regular and diet) and metabolic syndrome – a precursor to adult onset diabetes and heart disease. The study was part of the famous Framingham Heart Study and looked at soft drink consumption of over 6000 middle-aged adults over a 4-year period. Even after adjusting for other dietary and lifestyle factors, they still found that a significantly higher percentage of those people who consumed one or more 12-ounce servings of soda per day developed metabolic syndrome factors over the 4-year period than those who had less than one drink per day. It did not matter much whether the soda was regular or diet.
Metabolic syndrome, also known as insulin resistance or syndrome X, is associated with lifestyle factors such as lack of physical activity, being overweight, and having high serum glucose and lipids and high blood pressure.
Not many people would question that regular consumption of soda sweetened with high fructose corn syrup might result in weight gain or any of the other factors listed above, but diet soda? The authors of the study, which appeared in Circulation, Journal of the American Heart Association, 7/23/07, offer several possible explanations to this phenomenon. The high sweetness of diet (or regular) soft drinks may lead to a greater preference for sweets. They also suggest that caramel content of both diet and regular drinks may be “a potential source of advanced glycation end products, which promote insulin resistance and can be proinflammatory,” (increasing risk of damage to the arteries.)
I have been watching the effects of artificially sweetened drinks and foods for some time in my practice and discussing this with colleagues. We have noticed that, for most people, especially those trying to lose weight, removing these products can have a powerful impact. Many of us suspect (but studies are yet to confirm) that artificial sweetenrs may actually be more harmful than natural sweeteners. Articial sweeteners fool the brain to stimulate hunger and insulin response – simply thinking about the taste of sweet can cause a spike in insulin by telling the brain that something sweet is coming. This tells you to eat more sugar or more food to balance out insulin.
So, my advice to all my clients is to read packages and become mindful of the amount of sweeteners – both articial and otherwise – in the food and drink products they consume. Most are totally unaware of how considerable their intake of these sweeteners is and are amazed of how many products contain them, including those foods marketed as “health foods” – nonfat yogurts, frozen desserts, low calorie snacks and drinks, salad dressings, cereals, energy bars – just to name a few.
The goal is to remove these products from the diet and wean away from the taste of sweet. Most soon find that they enjoy their food and drink more and the benefits to their weight and health issues are truly remarkable.
Wednesday, March 08, 2006
Women's Health: State of Confusion
I wrote a Letter to the Editor of the New York Times noting this, which was published 2/26 (after some abridgement), and is captioned below.
A more balanced article, In Study of Women's Health,Design Flaws Raise Questions, by Tara Parker-Pope, appeared in the Wall Street Journal on 2/28.
The question for women, of course, is what to do. Some answers relating to calcium and bones are in my recent post, How to Protect Your Bones -- Calcium is Not the Entire Solution. Tune in for my future comments on other aspects of the study.
New York Times
Published: February 26, 2006
To the Editor:
The editorial published with the calcium study notes that ''several aspects of the study may have reduced the chances of detecting a benefit.''
Many women in both treatment and control groups were already taking calcium and vitamin D supplements, and a hip-fracture benefit was found for those who had not been taking calcium and vitamin D.
Also, on average, both groups were clinically deficient in vitamin D at a level unlikely to be corrected by the amounts of vitamin D used in the study. Adequate magnesium, also vital for bone metabolism, was not addressed at all.
Dana Reed New York, Feb. 19, 2006
The writer is a nutritionist.
Sunday, February 19, 2006
How to Protect Your Bones -- Calcium is Not the Entire Solution
My last post on "Big Study Confirms Calcium Pills Alone Will Not Prevent Osteoporosis" cuts through the hype of recent news, to explain what the study really says about calcium. So what do you do with all of this information?
Here are some guidelines to help you protect your bones.
- Use supplements to supplement the diet, not replace it, and get your calcium from a variety of both plant and animal dietary sources. Food sources have the benefit of providing other synergistic, protective nutrients along with calcium.
- Choose your calcium supplement carefully – do not choose it based on price alone. Be aware that when it comes to pills, not all calcium supplements are created equal and many are not in a form that can be well absorbed. Look for a chelated form of calcium, such as calcium citrate and make sure your supplement also has magnesium and other trace minerals. Some people may also benefit from vitamin K. It is the synergistic effect of these other nutrients that allows calcium supplements to be of benefit.
- Be sure you are getting just the right amount of healthy fat and protein for your size and activity level. Either too little or too much is not good for your bones.
- Take steps to ensure your diet is not excessively acid-forming. If it is, this can rob your bones of calcium.
- Get your serum 25 (OH) vitamin D levels tested periodically and supplement accordingly. Insufficient levels of vitamin D are implicated in osteoporosis as well as a host of other chronic diseases.
- If you have digestive issues, get help to fix them. Even minor symptoms of poor digestion can be a sign that you are not effectively absorbing the essential nutrients from your food and supplements. Some dietary modifications and the use of some additional targeted digestive aids may be helpful.
- Get your serum homocysteine levels tested periodically. Increased blood levels of this harmful compound is detrimental to your bone health and can be remedied by a combination of nutritional supplements, including folic acid.
- Get enough, and the right type, of physical activity. Proper exercise – both weight bearing and muscle strengthening – is a major contributor to bone mineral density.
Big Study Confirms Calcium Pills Alone Will Not Prevent Osteoporosis
The recent news coverage of the results of the WHI study on calcium supplementation and bone health is highly misleading. This includes the 3/16/06 New York Times article entitled “Big Study Finds No Clear Benefit of Calcium Pills.”
The media’s sound-bite approach to nutrition is a shameful public disservice and perpetuates the simplistic view that foods and nutrients are either all good or all bad for all groups of people. In fact, since this story came out, many of my patients have asked if they should stop taking supplements altogether.
A more responsible summary of the study published in the 2/16/06 edition of the New England Journal of Medicine, is that it did find a significant hip fracture benefit for certain subgroups, namely – those who were not taking personal calcium supplements, those who adhered to the treatment (59% did not), and those over 60 years old.
But, the results were not as significant as they might have been since, as the editorial published with the study points out, “…several aspects…may have reduced the chances of detecting a benefit…”
- Many participants in both the treatment and control group were already taking calcium supplements, resulting in a mean calcium intake at baseline of 1150 mg, more than the intervention dose of 1000 mg.
- During the study, participants in both groups were allowed to continue to take these supplements and medications, which could seriously confound the study.
- 50% were on HRT, and some were also taking osteoporosis medications.
- 75% were overweight or obese, another factor thought to protect bones.
Thus, the total hip fracture rate among controls was about half of what was expected for a control group, making the difference in fracture rates between the two groups even less distinct.
Furthermore, on average, both groups were clinically deficient in vitamin D – at a level unlikely to be corrected by the amounts of vitamin D used in the study. Adequate magnesium was not addressed at all, and that is also vital for bone metabolism and calcium absorption. If all of that is not enough, the form of calcium used in the study was calcium carbonate, shown to be less well absorbed that some other forms of calcium. (These factors may help explain the increased risk of kidney stones found in the study. A well-designed calcium supplement that is better absorbed may actually reduce the risk of kidney stone.)
Perhaps the most important message to be gleaned from this study is that women need to do more than take calcium pills to prevent the development of osteoporosis. But, this is not news, so it was ignored by the media in favor of the more sensationalized message.
So what do you do with all of this information? See my next post, "How to Protect Your Bones -- Calcium is Not the Entire Solution."
Saturday, February 18, 2006
Welcome to Reed Nutrition
For information on my private nutrition therapy practice, and how I can work with you, see the sidebar, and the link to the Reed Nutrition Web site.