Flavored E-cigs Banned in Michigan

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If you’ve been paying attention to the health news at all, you know that there have been some serious respiratory issues and deaths related to vaping. Because the majority of patients were young and were using flavored juices in the vaping products, Michigan Governor Gretchen Whitmer placed a temporary ban on the sale of all flavored e-cigarette products in the state. I applaud the governor’s action. It gives the legislature six months to come up with reasonable legislation governing vaping and vaping products.

This is not a simple issue. Health is the primary concern, especially the health of teenagers and young adults. But because of the prior lack of regulation, the vaping industry has grown to be a multi-billion dollar industry. They’re firmly entrenched, much as the tobacco industry was. They’re not going to go quietly.

The products are being pitched as healthier alternatives to cigarettes. They contain nicotine but none of the other noxious chemicals in cigarettes. They may be useful in helping adults quit smoking, but I’m skeptical of that one. Why create a billion-dollar industry that’s sole purpose is to lose customers? But the operative word was adult.

The concerns are that vaping devices use flavored juices that make them appealing to teens. Even those sold to kids without nicotine set the stage for taking the next step to a nicotine product. But are juices or flavored liquids safe to vape? I’ll update what I wrote two years ago on Thursday.

What are you prepared to do today?

        Dr. Chet

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 Memory T Cells

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The second paper from the journal Cell on fasting examined the longer term effects of fasting on memory T cells. Several species of mice were used in a variety of studies; these were complex experiments to say the least. Before I go further, a little about memory T cells.

Memory T cells are a class of T cells that remain after responding to a prior infection; they’re also created in response to vaccinations. The benefit is that if someone is re-exposed to the same or similar pathogen or toxin, the memory T cells mount a more vigorous attack than after the first exposure.

The mice were monitored for two weeks to establish a baseline caloric intake, then they were maintained on 50% of their caloric intake for three weeks or longer. There were several experiments. In some, while the calories were reduced by 50%, protein, vitamins, minerals, and essential amino acids were maintained at 100%. Therefore, there were no micronutrient or protein deficiencies, just calorie deficits.

The researchers found that stress hormones increased in response to caloric reduction. The memory T cells were transported and stored in the bone marrow. When the diet was returned to normal, the memory T cells were returned to their typical locations in the immune system. Other experiments showed that the memory T cells had an enhanced ability to fight pathogens.

One more study to examine on Saturday.

What are you prepared to do today?

        Dr. Chet

References:
1. Cell 2019. DOI:https://doi.org/10.1016/j.cell.2019.07.049.
2. Translational Biology in Medicine, 2014.

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.

All Research Matters

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As we enter the final holiday of summer, I want to challenge you to listen to a podcast over this long weekend. Before I get to the details about the podcast, I want to tell you why research matters.

I spend a considerable amount of time examining nutrition research. If you read what I write, you know I’ve criticized who nutrition research is done by as well as how nutrition research is done. That doesn’t mean that the research is not worthwhile. The interpretation of what any given study means can be debated and methodologies can always be better. It doesn’t mean that the research isn’t important; if nothing else, it can show how not to do something.

Take a different topic such as climate change or vaccinations. These topics are a great way to start an argument because people have strong opinions on them. Pick either side and you can find research to support your position. Again, that’s due to the interpretation of research on highly complicated topics, but it doesn’t mean that the research shouldn’t have been done in the first place. It absolutely has to take place.

We seem to be entering an era where government-sponsored research is being attacked, and that will be harmful to us in ways we can’t imagine. Think about it. Do you want research funded only by the sugar industry to set dietary guidelines? How about climate research funded only by the gas and oil industry or energy research funded only by the windmill industry? That’s where basic science research is critical to bring balance to the equation. No research should be avoided because it offends one industry or another.

Now to the podcast: listen to Malcolm Gladwell’s podcast called Revisionist History on your favorite podcast platform. The episode is titled The Obscure Virus Club. It’s the story of a small number of scientists who persisted for decades in researching obscure viruses and whose findings were ignored for way too long; I’ll tell you that Paula was in tears as she figured out the life-or-death consequences of those delays. Think of the implications if even more research were unfunded and unpublished. Just because it’s a holiday weekend doesn’t mean our brains shouldn’t be engaged. Send me your thoughts after you listen to it.

What are you prepared to do today?

        Dr. Chet

Research: http://revisionisthistory.com/episodes/40-the-obscure-virus-club

What’s Next?

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Riley, our four-year-old grandson, recognizes patterns in daily life. Right now one of his favorite questions is, “What’s next?” Usually, it’s in relation to eating, because he knows after supper, for instance, there’s a gummy vitamin. So during a phone call, an Insider asked me what I’m working on and I immediately pictured Riley and thought, “What’s next?” The headlines usually dictate what I’ll be researching and writing about, and there have been a few topics that caught my attention.

The first is intermittent fasting. The journal Cell had a series of studies by different labs examining the benefits of the intermittent fasting for the immune system. With intermittent fasting being promoted in so many ways, there’s confusion as to which way is best. I have an idea that it will revolve on the amount of food restriction, but we’ll see.

The second is a new prescription omega-3 fish oil that’s supposed to reduce triglycerides. I’m waiting for a paper that examines the quantity of omega-3s in supplements; my concern is that there will be a push to eliminate omega-3s in supplement form at some point in the future now that there’s a prescription form.

The final topic is vaping. I’ve written about it before but with more recent research, including at least one case study about the death of someone vaping, it’s time to look at the research again.

That’s “what’s next” after I get all the research collected and read. We’ll be back for one more Memo on Friday before the Labor Day holiday weekend.

What are you prepared to do today?

        Dr. Chet

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

Does Exercise Intensity Affect Obesity?

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As I wrote on Thursday, exercise intensity did not seem to impact mortality, or death rate, in a large group of older women. Of course, living longer is important to many people. Could exercise intensity provide benefits as it relates to reducing the staggering 40% rate of obesity in the U.S.? Maybe. Let’s look at a recent study from Taiwan.

The Taiwan Biobank Study is a longitudinal study that recruits Han Chinese subjects 30 to 70 years old. Much like the All of Us study, researchers take anthropometric data such as height and weight as well as blood samples for multiple DNA analyses. They also collected data on physical activity; their objective for this part of the study was to see if exercise and the intensity of exercise impacted genetic manifestations of obesity.

Genes and Obesity 

What manifestations? Body mass index, percent body fat, and waist circumference among others. Researchers asked the subjects what type of exercise they did, how long they exercised, and how many times per month they exercised. Then they calculated a BMI Genetic Risk Score (BMIGRS) based on the genetic markers for five obesity-related gene combinations. This was complicated; you know I like to see raw data, but with over 16,000 subjects and all of the compounding variables, that’s not realistic.

When they divided the subjects into quartiles based on BMIGRS, they found that the exercise with the greatest impact on the obesity-related genes was jogging. That was followed closely by mountain climbing, walking, exercise walking, international standard dancing (the kind of ballroom dance you learn at a studio or see on Dancing With the Stars), and a longer practice of yoga. Those activities had an impact on the expression of the genes related to obesity. It means that it down-regulated those genes, which means that if you jog, your BMI is lower, you have a lower percent body fat, and your waist circumference will be smaller.

Do you have to jog? No. All the listed exercises had an impact on the obesity genes so if you can’t jog, that’s fine. Extended yoga and dance were also on that list, and they don’t have the impact on joints that jogging or even mountain walking would have.

There were also some other interesting findings. Joggers exercised less time, about 30 minutes, and fewer days per month, about every other day. Walkers walked nearly an hour at a time and walked two out of three days.

The Bottom Line      

One thing was clear: every type of exercise was better than no exercise. I’ve said many times before that exercise by itself is not a great way to lose weight because you have to invest so much time in it to have an impact, and no matter what exercise you choose, you still have to eat less. But if you want an advantage that will impact any obesity genes you have, higher intensity exercise is better. You have to adjust for orthopedic and any other issues, but the more intense the exercise, the better the results. If you’re going to walk 10,000 steps per day, walk them like you mean it.

What are you prepared to do today?

        Dr. Chet

 PLOS Genetics | https://doi.org/10.1371/journal.pgen.1008277.